Charge nurses can't change the number of hours on the unit, but they can manage how those hours are spent. Relationship to Applicant: ( RN Peer ( Supervisor/Manager Dates: from ________ to _______ ( Health Team Member (MD, PT, Social Worker, etc.) My teammates became an invaluable source of support for me as I processed my patients death and proceeded to care for the next patient. After I triaged through all the emergent, transfer and appoint today boxed, I felt it was time to negotiate and find a safe outcome that would balance the members operational needs. > u kJ bjbjUU o ?g?g5 2 ~ ~ / / / 0 0 0 8 >0 "2 t 0 W 4 ( 4 : 4 4 5 k V V V V V V V $ nZ $] W Q / i k W ~ ~ 4 5 [ bW _ _ _ ~ R 4 / 5 V _ V _ _ r J * " 'T 5 # The night ED team decided to admit him to the OBS unit instead of sending him home so late knowing that he lived alone. Teaching/Coaching Function I was very consistent in providing my patient and his wife the details of surgery to alleviate their doubts and worries. education you need could be more affordable than you think. An arterial blood quality efforts are ongoing and that quality can always be improved activities easily. I agreed with her that it was probably not a good idea. The administrator did not know anything about this patient. Even though her HA had decreased it was still continuing and she had a history of complications following delivery. All applicants who meet minimum qualifications are interviewed by the FSC. She had six, yes six, drains coming out of her abdomen. I directed my surgical technician the need to open and count the instruments trays necessary to do an open case thinking in mind the severity of my patients bleeding. The clerk told me that a patient had been dropped off in the ER waiting room. Work in the area of clinical specialty with the Employer an average of twenty-four (24) hours per week over the past year. mechanisms regulate acid-base levels to keep the pH within a normal ( Interpreting kinds of pain and selecting appropriate strategies for pain management and care. I was delighted for making the right decision and happy for Mrs. C. that she got there just on time. NAME (Last, First, Middle) 2. In an effort to calm her fears, I introduced Mrs. S. to the RN who would be taking over her care and also to the on-call physician. On August 6th T. climbed out of his bed during the night and pulled out his line. Joelle Jean, RN, FNP-BC has been a nurse for more than 10 years and family nurse practitioner for over three years. another for physical, emotional, or financial support (Taylor et al., ( Eliciting and understanding the patients interpretation of his or her illness. You can structure the narrative of your self-evaluation in whatever way is most meaningful to you. An incomplete portfolio may impede your advancement. Promotes a multi-disciplinary approach to patient care. I was not going to let this go. I was there to educate re: his current condition and prepare him for what would transpire at the ED. The charge nurse role may also include tracking team performance metrics and solving staffing shortages. Two letters of reference are needed from a Clinical Nurse with at least two years experience at BID Needham or an advanced practice nurse (NP or CNS). A disclaimer to call back if her symptom worsens or others develop would end up this call. WebA) The client is very old and has multiple health problems. Along the way identify new options, closing old options, channeling, teaching and mediating on behalf of the patient. ( Maintaining a caring attitude towards patients even in the absence of close and frequent contact. All Selection Committee meetings will be scheduled within thirty (30) days of the applicable deadlines. Therapeutic communication is an interpersonal interaction between Writing Exemplars word doc.doc I, therefore, have become very familiar with my patients, and have good rapport with them. This plan might address the next level of care, such as discharge to the home, transfer to another medical unit, or admission to a skilled nursing facility. She told me she had never seen this type of injury and thanked me for the help and instruction. Appeals Process Any applicant denied the Clinical Expert designation may appeal the decision of the Facility Selection Committee (FSC) as follows: A written appeal, clearly stating the basis for the appeal, must be submitted to the FSC that made the original decision no later than thirty (30) days after written notification of denial. NUR 347. The nurse is accountable for the care provided to clients and When the baby woke her up around 4am the HA was still there but was better so she didnt call. I also gave him a run-down of what would occur in the OR including the awake time out that we were doing to ensure that the whole team was on board about the surgical plan, correct procedure, and correct site and side. I assisted in maintaining the pts airway during and after the intubation. He did deny thoughts of want to hurt himself or others. Individuals in the charge nurse role must recognize and complete essential tasks first. populations that are closely associated with a social, economic, or The Role of Mentors As an applicant for Staff III/IV, HH/H III, you must select a mentor to assist you in the application process. It was my job to ensure my patients safety at all times. J. wanted to stay home and be with her 3 day old newborn, she did not want to leave her daughter. The patient trusts in this nurses expertise and ability to handle even critical situations that involve life and death. management, finances, and transportation. Guidelines for Clinical Nurse III Portfolios, 2023 Beth Israel Deaconess HospitalNeedham |, CardioVascular Institute at BIDNeedham, Center for Wound Care and Hyperbaric Medicine, Joslin Diabetes Center Affiliate at Beth Israel DeaconessNeedham, Core Curriculum in Adult Primary Care Medicine, Pulmonary Medicine, Critical Care, and Sleep, Clinical Nurse Advancement Program Application , Develops solid nurse/patient relationships, Demonstrates the ability to care proficiently for patient populations within their unit setting, Works with patients, their significant others and health care team to identify goals and plans of care including transition of care, Makes sound decisions by analyzing and integrating all patient data and nursing principles, Evaluates patient care outcomes and revises plan of care as needed, Prioritizes needs of individual patients in relation to other unit activities, Uses current literature in daily clinical practice, Makes clinical decisions based on documented findings, Takes initiative for professional development beyond standard requirements, Attends in-services/presentations beyond the unit specific requirements, Utilizes appropriate patient teaching methods and teaching materials to address patient learning needs, Consistently models high standards of nursing practice, Demonstrates accountability in ones practice, Offers and accepts assistance to/from colleagues, Demonstrates the ability to reflect on ones own practice, Demonstrates effective and professional communication, Identifies issues and problem solves issues to ensure resolution, Supports colleagues, shares expertise, and serves as a role model, preceptor, and/or mentor, Promotes teamwork and a positive work environment, Promotes the development of collaborative relationships with peers and other health professionals through open, clear, and concise communication, Develops positive relationships with interdisciplinary colleagues, Application for Clinical Nurse Advancement, Two letters of reference written by peer colleagues (see Guidelines for Letter of Recommendation), Director endorsement via a narrative summary of most recent performance evaluation, Self-evaluation of professional performance. She stated she wanted to try an Ibuprofen first and was going to call afterwards if the HA did not get better. She said her daughter seemed to be latching on okay and getting enough fluids. The following days required intensive teaching regarding cassette bags, medicating for agitation and adjusting to the increased acuity of his care. As I heard the alarm in anesthesia cart. An anxiety. Her pulse was irregular. The Staff Nurse III intuitively recognizes similarities and differences between situations and accordingly modifies the teaching plan to meet individual needs. The urgency in her voice, the last night bad dream that gave her cold sweats and shortness of breath, an achy arm since morning, all could be very well signs of cardiac ischemia. She stated that she would have tried to perform a tracheotomy if the intubation was not successful after one attempt. A newer nurse would have been less effective in this role simply from discomfort with death, and the inexperience would leave this patient with a sense of loneliness and isolation. The Exemplar is written in the first person and describes in detail a particular clinical situation that includes the nurses thoughts, feelings, intentions, actions, critical thinking, and decision-making process. I assisted by holding the jaw line with both hands to help keep the lower jaw stable. Nurses brain that operate to maintain pressure within the cranial cavity in a Staff Nurse I Staff Nurse II Staff Nurse III Shelanda Baichoo Maureen Carrier Beth Norton Julie Chevalier Was his condition changing or was he just anxious over the change in circumstance? WebWriting Exemplars Page 1 of 3 Adapted from: Presentation Notes: Nurse Action Days (2006) Christine M. Pacini, PhD, RN Director, Center for Professional Development, Research and Innovation University of Michigan Health Systems Introduction - Definitions An exemplar is a story of a real patient that is told in order to illustrate an RNs Community-based care is health care provided to people living in a defined It had been a long but good day in the ED. Fevers began and she was readmitted, requesting 4E. Criteria for Exemplars To assist you in writing exemplars, the following information pertinent to evaluation of exemplars is offered: Two written exemplars must be submitted for review. I then aged the Team Lead physician. See Guidelines for Letter of Recommendation. F What new knowledge or insights were gained from this experience and describe how this has impacted your current practice, Realistic and reflect aspirations for the future that stretch your capabilities, Feasible within the framework of your professional role. I escorted him to our injection room and had him take a seat. Accordingly, I began to assist in the intubation process and manual stabilization of the jaw. Upon entering his room his breathing was labored and from report, he was unresponsive. Who was affected by the work that you achieved? I went into the trauma room to see if I could help in any way. WebCharge Nurse Resume Examples. I place my hands over the patients nares. (Videbeck, 2020). In planning for the admission of WebThe median annual salary of a charge nurse is $68,911, according to PayScale. I explained to him that I could give him more medication, though it may make him sleepy and even slow his breathing to an extremely low rate, one where he would most likely lose consciousness. Organization and Work-Role Competencies I built a therapeutic relationship with the facility charge nurse and advocated for the family. She agreed. CCMD agreed and last thing to do was to persuade Mrs. C. to go to ED. I trust my skills and instincts and am an advocate for my patients. My experience helped me teach and assist a novice nurse, which in turn helped the patient. Soon enough I was helping anesthesia with more stat book work orders, circulating and communicating with the blood bank and laboratory at the same time. Nurses encounter potential and actual I will join a hospital committee this year and bring information back to the staff within one week after each monthly meeting. WebCharge Nurse Operating Room-spine & Joint Center Resume Examples & Samples. Finally I felt relieved! These Since I function at this level on a daily basis, my opinions are well respected by all the physicians with whom I work. WebRNss ppracttice. Not all charge nurses start out with a strong foundation in each of these traits. Show what you learned from this experience by answering the following questions within the description of your Clinical Exemplar or in summary at the end: The Clinical Exemplar does not have to be lengthy: 3-4 typed pages (double-spaced) is usually sufficient. Oxygenation refers to the process of providing cells with oxygen It is vital to have patient evaluated as soon as possible. I asked the ED MD if it wouldnt be better to trach this patient to protect the airway. The purpose of the exemplar is to communicate the chapters contributions and accomplishments that I rechecked the pulse manually - it truly was 3040 and the pt was slightly clammy. Current license to practice as an RN in California. The job of an advice nurse in a Call Center is similar to a detective job. F j k l $ ` a$gdL $ ` a$ gdm :]:^ $a$ I entered her room one day to see her in rigors; her abdomen was distended and very tender to the touch. You may use the typical abbreviated telling of the nursing practice situation but should be written in first- person. You've got a message from ER about ad mission of patient suspected to measles within the next 30 minutes My calm, reassuring approach and this familys readiness to learn, was an intricate part of being able to increase the complexity of his care and allow T. to remain at home. Your Name __________________________________ Date of Recommendation _________________ 2. I asked her when her sister in law would be there and if she could take her to the hospital if need be. efficiency, or delivery of health care (Hinkle & Cheever, 2018). He was a quiet, giant of a man, months later I would realize that he when he stood up was 64 or taller. With break relief coming and going and with such long procedures, I always made it a point to visually count the sponges and sharps in the back table. in which they simultaneously send and receive messages both verbally Clotting Clotting is the process whereby platelets circulating in the She waited 30 mins and ended up falling back to sleep. I asked her how long that would be and she wasnt sure if he could. It was wonderful to see her personality start to immerse. Health care disparities are differences in health outcomes between Mr. P stated that he awoke this a.m. with chest pain and it just had not gone away. I started the preparation in my room. activate coagulation factors in the blood plasma, and initiate the I also reminded the surgeon and anesthesiologist that units of blood were ready for our patient. I felt that I can connect her last night symptoms to cardiac ischemia but I needed more information to confirm it. I was able to acknowledge the needs of my patient and his wife a personal level. Your self-evaluation represents an opportunity for you to review and reflect on your past accomplishments, current activities, future interests, strengths, and areas for improvement. I knew how to negotiate with my intuitive use of knowledge, I contributed mightily to this patients and Kaisers best interest. I informed him of my assessment and that I thought something was going on. This nurse takes responsibility for the team itself by building and nurturing it. Give concrete illustrations of how you met your outcomes. The Charge Nurse is an exemplar for compassion, acceptance, respect and empathy honoring nursing as a distinct discipline and supporting an environment focused on healing and wellness. Monitoring and ensuring quality: In this situation, the knowledge that complete heart block is not a stable arrhythmia guided my decisions. Informatics Informatics is the use of information technology to improve the This nurse knows when to work with and through another person to achieve positive outcomes, when negotiating solutions with other, the Staff Nurse III is able to provide a rationale for recommendations and past actions. She takes 4 or 5 Tums, drinks plenty of water and she goes to sleep. No one expects perfection, but charge nurses should not try to cover up their mistakes. I knew this patient and his family would take a great deal of my time, so I enlisted my coworkers to assist with my other patients needs in case I was unavailable. Analgesics including opiods, can be used safely and effectively in the elderly. %PDF-1.6 % iii. 8. Specific examples of exemplars from your medical center are also available for your review. I then called that physician to let her know my assessment and concerns. Later she wakes up again with the same burning, drinks more water and goes to the bathroom to urinate. 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