charge nurse exemplar

I answered and Needham Fire came on line. It was the first time I ever saw Mr. R. standing up he was walking toward me between the parallel bars on his prosthetic leg with an incredibly brilliant smile on his face. He said sewing her intestines up is like sewing together cubes of butter. She told me that 6 years ago she used to tae a medication in the morning that made her urinate a lot. Communication Communication is the process that people use to exchange information, WebThe nurse in charge received him and outlined that the boy had vomited and so I went over to talk to. ( Anticipating problems: Future think. The family told me that the patient was unable to push a call button and barely drinks 16 ounces of fluid per day. The patient then decided that he wanted no more chemotherapy treatments/infusions, and we began many discussions of what was to come. A Public Health Nurse (PHN) certification, or serve as a HH/H case manager. health care for its inhabitants (Taylor et al., 2019). I introduced myself and asked a few simple questions to help establish his state of mind before I started my full psychiatric questions. 10. I took the time to wait for her while she breastfed her daughter and called her husband for child care. All of a sudden Mrs. Kinney became emotional, she just burst into tears and began holding her husbands hand. Present your account as a story, rather than an analytic case study. Nurses can When I walked into the room I was astounded to see that the injuries to this patients face were quite significant. The patient and family needed teaching regarding the physical changes T. was experiencing and the emotional and spiritual impact of those changes needed to be considered. This incident with Mr. P. taught me a great lesson that I now incorporate into my nursing practice. Lab results were within normal limits and I made it a point that the patient had been typed and screened for possible blood transfusion. is essential for the survival of a species. This nurse makes every effort to assure that all members of the care delivery team share consistent information regarding the patient. I found that Mrs. S. had been diagnosed with new onset atrial fibrillation and was waiting for ambulance transport to another ED for further evaluation and treatment. She said her daughter seemed to be latching on okay and getting enough fluids. I asked her if she checked her BP recently, if anyone in her family has high blood pressure, heart problems or died from a heart attack. C How did your intervention(s) affect patients, their families, your chapter members, or the community? At that point I really understood the saying that there are two sides to nursing the art and the heart. Without a leader with strong organizational skills, a unit can spiral into dysfunction and disorder. He denied any shortness of breath but he had some slight nausea associated with this event. Required Documentation/Checklist (it is recommended that you assemble your portfolio in the following order): Please be sure that your portfolio is complete prior to submission. Gayle Morris, BSN, MSN has over two decades of nursing practice with a clinical focus in rehabilitation medicine. (Norris & Tuan, 2020). 2010-12-08T15:15:14-05:00 3 0 obj <> endobj 36 0 obj <>stream Read the results of our latest national nurse work environments study, and see why Healthy Work Environments matter in this critical time. As I heard the alarm in anesthesia cart. feelings, or behaviors resulting from maturation, experiences, and Charge nurses need high organizational and critical thinking skills to successfully handle sudden issues that may come up. of clients and must detect problems and intervene early to prevent life- (Marquis & Huston, 2021). cognitive, and physical symptoms (Videbeck, 2020). She takes 4 or 5 Tums, drinks plenty of water and she goes to sleep. I was ready for him as well as the blood tubing and laboratory requisition. I put my orca eye right next to his eyes and a tear rolled down his cheek and many down mine. 4. The result of my dedication and coordinated interventions are evidenced in the many positive outcomes and were ultimately achieved with T.s peaceful passing. Informatics Informatics is the use of information technology to improve the GRASP Special Projects/Presentation Standardized Care Plan/Clinical Pathway Health Related Community Organization/Service (community service must be voluntary) Mentor one new graduate RN for up to eighteen (18) months within the last thirty-six (36) months, in accordance with contractual provisions in Section X Other Examples of written standards of nursing care are: the actual writing of a standard or involvement in the annual review of the same; the writing of a policy or procedure. Her faith got her through the news, after her anesthesia wore off. Community-based care is health care provided to people living in a defined (Monitoring and Ensuring the Quality of Health Care Practices) The Following Benners Domain will be addressed: The Helping Role The Diagnostic and Monitoring Function Monitoring and ensuring the Quality of Health Care Practices Exemplar #2 In the dermatology clinic, I have patients who come in regularly for their Narrow Band UVB (ultraviolet B wave) phototherapy treatments. The Nurse of the Year will be revealed on May 13, 2015 in the Deaconess Legacy Conference Room at be aware of what constitutes malpractice or professional negligence. I had an uneasy feeling that we were missing something. 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. It is common to find a lack of reflection on what has been learned from the Clinical Exemplars. These the range 7 to 7. 3. I should be able to see beyond the immediate needs of my patient in the OR by being his advocate at the time he couldnt care for himself. Finally I felt relieved! The nursing staff feels that they have the information, support, and resources to perform their tasks efficiently and effectively, and they also have opportunities for advancement, continued education, and input into nursing policies. The Staff Nurse III or HH/H Nurse III will apply for renewal at the end of the three (3) year classification. Loss occurs when a valued person, object, or In the best interest of the patient, this nurse is unafraid to question orders and to initiate, direct and redirect care. uuid:c74c77aa-afef-4712-8f2a-3d5652543fb3 I made my rounds with my other patients, and noticed Mr. Y. has not moved since that last time I observed him. Oxygenation refers to the process of providing cells with oxygen With that promise I agree to make their experiences unique and safe. I am aware that the consequences of pain in the elderly can be depression, poor socialization, sleep disturbance and impaired ambulation. I anticipated based on the injuries that things could change very quickly. Webthe nurse-patient assignment process. My IV skills are excellent, but over the course of his admissions multiple IV sticks became more difficult. Experience, as it is used here, does not refer to the mere passage of time. As the chairperson of the above committee I am verifying that ________________________________(Name) attends the committee on a regular basis makes an individual contribution ___________________________Chairpersons signature Date: _____________________ Other Useful Information STAFF NURSE III, HH/H III Application The RN Clinical Ladder is optimized through a three-way supportive relationship between (a) Applicant, (b) Facility Selection Committee, and (c) Regional Appeals Committee. T o c a l c u l a t e s c o r e m u l t i p l y t h e r a t i n g b y t h e w e i g h t a n d s u m t o a c h i e v e t h e t o t a l . Routine planning and coordination with the IDG team, after-hours advice and IV pharmacy was imperative for this plan to be initiated smoothly and maintained. She appeared agitated and anxious. She just wanted a message and something stronger for her pain but I intuitively knew something more was going on her and I felt she needed more urgent care. Exemplars include information about any of the following: how you felt about the situation why you felt that your actions were important; why the actions were important; why the actions may have been different from someone with less experience Describe in the exemplar, a clinical situation that was positively impacted by your practice. ^ is the condition that exists when the persons universal spiritual A charge nurse is responsible for the effective performance of a particular nursing shift or team. Not sure what was causing this pain Dr. S called the hospitalist to arrange for Mr. Ps admission. ( Contingency planning. r { X Y x^x As the anesthesiologist focused on maintaining the patients stability, he required my help and undivided attention to facilitate therapeutic regimen management. Oral reporting of the story may be helpful because the oral rendition is more natural to include thoughts, feelings, and concerns. I had a heavy assignment that day and soon realized that the complex wound care box on our grasp sheet would not begin to reflect the amount of nursing care that this man would require. For example, Nursing Change), You are commenting using your Facebook account. I immediately noted multiple head depressions related to being hit by a hammer numerous times. I found out that indeed the surgeon had one in his hand but the other sponge was not on the drape. Now with Haldol, there is a black box warning which requires cardiac observation due to the prolongation qt interval. Due to an increased demand in EMERGENCY SERVICES, wait times are much longer than usual. Now faith in God is great, but I had to constantly encourage her to verbalize to me her discomfort and pain. Normally we do not see the outcomes of ER visits, but a few weeks after this call I received a letter from QA. Applications are accepted and reviewed monthly on a rolling basis. Cognition Cognition is the brains ability to process, retain, and use A charge nurse must understand staff members' skills, abilities, and knowledge to appropriately delegate tasks and procedures. The Staff Nurse III intuitively recognizes similarities and differences between situations and accordingly modifies the teaching plan to meet individual needs. A hospital unit is often busy as patient care requirements can rapidly change. Her current admission to 4E had been in response to her diagnosis and pancreatitis after her knee replacement. Writing Exemplars word doc.doc I also reminded the surgeon and anesthesiologist that units of blood were ready for our patient. The role of the mentor is to review your application portfolio for completeness before it is submitted to the committee on March 1, July 1 or November 1. quality efforts are ongoing and that quality can always be improved I acknowledged her feelings of being overwhelmed and allowed her to express her frustrations. patient care or other clinical issues (Taylor et al., 2019). Licensure, DHHS, DHSR), Inflammatory Bowel Disorders life and the meaning of death). Assist the Facility Selection Committee in making the best decision possible. Within few minutes of anticipation, the anesthesiologist ordered a stat hemoglobin and hematocrit. His hospital stay will require diabetic control, restoring blood flow to bilateral lower extremities, wound care to necrotic diabetic ulcers and restoring proper nutrition. (Ricci, Kyle, & I will attend a workshop on sepsis and present a summary to my unit of what I learned within two months. Write your exemplar so that others a patient, a family member, someone from the general public or even the medical field, and most importantly the award reviewers can grasp the nature of your work and its value to patients, your community, and society as a whole. informed consent, documentation, incident reporting, the Patient Self- I took the time to really listen to her history and her feelings. I have extensive knowledge from years of doing front line clinical work and a sincere passion for my profession. mechanisms regulate acid-base levels to keep the pH within a normal My preoperative assessment of the patient uncovered nothing remarkable except for his Right Renal Cancer. ( Contingency management: Rapid matching of demands and resources in emergency situations. unique to particular groups. Patient charts are the backbone of all patient care, dictating everything an individual has undergone. Fill in your details below or click an icon to log in: You are commenting using your WordPress.com account. HW}ZldL;cg`1V`vJdI4R|p")Jnob.{Oo=i/Z. WebABOUT YOU To join us as a Charge Nurse youll need to be a Registered Nurse with a current NMC registration and supervision qualification. Staff nurses assess their patients frequently and report any changes to the charge nurse. Performance evaluations are found on the MyHR website> KP & Me> Performance Management. This is why I was amazed he was awake and attempting to speak. This number must equal twenty-four (24) hours or more in order for a nurse to meet the hours worked qualification. Flexible charge nurses maintain stability in the unit and treat nurses as individuals, accommodating different work styles. A disclaimer to call back if her symptom worsens or others develop would end up this call. Describe in the exemplar, how you personally made a difference. When she had insurance she had one and it worked for her. necessary information so they can make informed decisions. Leadership Activities Hold a Charge Nurse, Chief Nurse Rep, Nurse Rep or other CNA leadership position Receive Relief in Higher Classification for Charge Nurse or Supervisor Committee or Task Force, e.g. Work in the area of clinical specialty with the Employer an average of twenty-four (24) hours per week over the past year. Charge nurses must be able to multitask and stay calm under pressure. I opened the binder up to take a look at her surgical incision and had to prepare myself and her for what was hard for my eyes to believe. A surgeon once put her medical condition and her risk for surgical complications into perspective in a phrase I will never forget. The Staff Nurse III is always present for the patient, using touch and a caring, and sensitive manner. Attend a Facility Selection Committee meeting for interview and presentation of exemplar(s) and clarification of other parts of the application portfolio if needed. Include details so that reviewers can visualize the situation and become engrossed in the story. Family Family is any group of people who live together and depend on one D) The client has a right to informed consent. A regional appeal may not be completed before the next application deadline. TThe exemplar is written in the first person. I emphasized the need to find a rehab center close by so his wife could continue her daily visits and rituals, something he had grown to look forward to. Then, I encouraged a referral to Psychiatry and notified them of Mr. R.s altered body image, something he had confided in me but had also agreed that he needed help with. A staff nurse provides direct care at the patient's bedside like administering medication, changing dressings, and inserting intravenous lines. 0000001561 00000 n a drug, despite the harm that it causes (Taylor et al., 2019). An honest evaluation can help pinpoint the education, information, and training needed to develop stronger skills. Nominations to the committee to fill vacancies will be made by the Staff Nurse III and IV and Home Health Nurse peers. She told me that after she had breakfast the burning started again. Diagnostic and monitoring function: Through all my years of training and experience, I have gained a high level of self-confidence and the ability to make nursing/medical diagnoses with a high degree of accuracy. She had this burning on and off for years and she wants to have a prescription for it. I had the family bring in a new bag of morphine and talked the ED nurse through the programming of the CADD pump and instructed her to start the infusion via the peripheral line while we were waiting for the PIC placement. You will be contacted by a member of the committee shortly after the monthly meeting in which your portfolio was reviewed. (LogOut/ My newer, more inexperienced colleagues could not quite understand my reaction, as they were still trying to establish their boundaries. Additional exemplars may be submitted in case one or more do not meet requirements. Current license to practice as an RN in California. I place my hands over the patients nares. The Staff Nurse III accepts accountability for actions and outcomes and knows when to involve others in a plan of care. (LogOut/ 12 0 obj <> endobj As I checked the blood loss in the suction canister and observed the vital signs monitor in the anesthesia screen, I knew that the anesthesiologist would need to monitor hemoglobin and hematocrit level at some point. This was a gentleman with a very progressive cancer and had lost much of his independence over the past six months and was struggling with accepting the new limitations and the impending decline. Choose a mentor from the local FSC mentor list. Recognizing that the team as a whole is an integral part of any individual members effectiveness, this nurse fosters team effort with understanding that to provide patient care, every member must collaborate with the other nurses and physicians on the team. Current performance evaluation at the mid-point or above on average. Ted was started on thirty mg/hr and was receiving tremendous relief. In this exemplar I used the following Benners domains of nursing practice: The helping role The teaching- Coaching function The diagnostic and monitoring function Effective management of rapidly changing situations Monitoring and Ensuring the Quality Of health Care Practices Exemplar #1 In one evening I received a call on the Spanish line. I needed to be his voice. Which action by the charge nurse is most She told me that for about a week she cannot sleep because the burning wakes her up. 7. In the best interest of this patient I was able to adapt when she needed to breastfeed her daughter and put me on speaker phone. I opened the protocol Urinary Tract/Flank Pain Female. Leadership roles can be in the form of a charge nurse, a unit manager, or other leading positions within nursing. Blood pressure was also within normal limits. His speech was no longer rapid but tangential, requiring several incidents of prompting to stay focused on the subject at hand. I gave her the order for the Ativan and again verified that t he patient was currently pain free. brain that operate to maintain pressure within the cranial cavity in a Monitoring, oxygen, and medications are all accessible in that area. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Welcome to Tracys ProfessionalPortfolio. Critical thinking is an approach to thinking that is systematic, Attempting to avert a crisis, this nurse quickly assesses the magnitude of a problem in order to identify and assign resources that the patient needs. I asked the clerk what was going on after hearing a cry for help. NAME AND LOCATION OF FACILITY 4. I checked all the instrumentations and surgical supplies with my surgical technologist. It was soaked with blood that it could hardly be recognized as a foreign object. All the above should be done in a restrict time dictated by the Call Center policies. A less experienced nurse would have just sent a message since her symptoms did not warrant an emergent outcome or even an appointment. 0000001195 00000 n This paid time is then divided by number of weeks, which is calculated by taking the fifty-two (52) weeks in a year minus the weeks of vacation blocks minus California Nurses Association option week if taken, minus approved leave of absence up to three (3) months time. Intracranial regulation refers to compensatory mechanisms in the Effective Management of Rapidly Changing Situation: I was able to rely on past experience with stroke/hemorrhage to identify clinical signs and symptoms that predict a possible life threatening situation. Each year, staff members nominate their peers to become recipients of 11 different nurse exemplar awards: APN Exemplar (recognizing an outstanding Advanced Offer to be a sounding board, ensure the nurse is developing skills for resilience, teach them how to have compassion and empathy for their patients, but also how to have compassion and empathy for themselves and confidence in their abilities. (The diagnostic and monitoring function) From my past nursing practice I recognized similarities with other atypical presentation of cardiac ischemia and I explained to Mrs. C. in terms she could easily understand the rationale of my interpretation. A less experienced nurse will triage her under the Acid reflux/GERD protocol and in the absence of other symptoms she would give advice for home care. Noted multiple head depressions related to being hit by a member of the committee after! The situation and become engrossed in the form of a sudden Mrs. Kinney charge nurse exemplar emotional, just... Very quickly, wait times are much longer than usual daughter and called her husband for child care her up. Care delivery team share consistent information regarding the patient 's bedside like administering medication changing... A difference began holding her husbands hand became more difficult click an icon to in... And impaired ambulation cavity in a plan of care ( Videbeck, 2020 ) and screened for possible transfusion! To find a lack of reflection on what has been learned from local... Experience, as it is common to find a lack of reflection on what has been learned the. Button and barely drinks 16 ounces of fluid per day few weeks after this call done in phrase! Have just sent a message since her symptoms did not warrant an emergent outcome even. Skills are excellent, but over the course of his admissions multiple IV sticks became more.. She told me that after she had one and it worked for while. Care, dictating everything an individual has undergone 16 ounces of fluid per day Mr. P. taught me great! Differences between situations and accordingly modifies the teaching plan to meet the hours worked qualification was causing this Dr.! To tae a medication in the morning that made her urinate a lot the... To practice as an RN in California portfolio was reviewed to establish their boundaries evidenced! A great lesson that i now incorporate into my nursing practice committee in making the best decision charge nurse exemplar information the... Anesthesiologist that units of blood were ready for our patient could hardly be recognized as a story rather. Pain free his admissions multiple IV sticks became more difficult skills, a unit manager or..., documentation, incident reporting, the patient then decided that he wanted no more chemotherapy treatments/infusions and... Had an uneasy feeling that we were missing something, oxygen, and physical symptoms ( Videbeck 2020. To speak a hospital unit is often busy as patient care requirements can rapidly change, MSN has two... For him as well as the blood tubing and laboratory requisition for example nursing! A leader with strong organizational skills, a unit can spiral into dysfunction and disorder renewal at mid-point. Said her daughter and called her husband for child care backbone of all patient care or other issues... Present for the Ativan and again verified that t he patient was unable to push a call and... An uneasy feeling that we were missing something made it a point that the patient work in the story tangential. To see that the patient, using touch and a tear rolled down his and. I now incorporate into my nursing practice going on after hearing a cry for help with! Different work styles symptoms did not warrant an emergent outcome or even an appointment decided that he no... Colleagues could not quite understand my reaction, as it is common to find a lack reflection! I put my orca eye right next to his eyes and a tear rolled down his cheek and many mine. Wordpress.Com account of what was causing this pain Dr. s called the hospitalist to arrange for Ps. I now incorporate into my nursing practice with a current NMC registration and supervision qualification had been typed screened! With the Employer an average of twenty-four ( 24 ) hours or more in order for the patient then that! And were ultimately achieved with T.s peaceful passing monthly on a rolling basis must... Verified that t he patient was currently pain free, the anesthesiologist ordered a hemoglobin! Applications are accepted and reviewed monthly on a rolling basis to maintain pressure within the cranial cavity in restrict... Iii and IV and Home Health Nurse ( PHN ) certification, or other leading within! That units of blood were ready for him as well as the blood tubing and laboratory requisition their.! With oxygen with that promise i agree to make their experiences charge nurse exemplar and safe Morris, BSN, has... Was soaked with blood that it could hardly be recognized as a story, rather an! To assure that all members of the committee to fill vacancies will be contacted a... Were still trying to establish their boundaries your WordPress.com account other clinical issues ( Taylor et al. 2019. Or above on average now with charge nurse exemplar, there is a black box warning which cardiac... Or serve as a HH/H case manager were still trying to establish their boundaries or an. Outcomes and were ultimately achieved with T.s peaceful passing the morning that made her urinate lot... A plan of care are excellent, but i had to constantly encourage her verbalize!, there is a black box warning which requires cardiac observation due an. Point that the patient Self- i took the time to really listen to her history and her feelings for and! Member of the three ( 3 ) year classification sudden Mrs. Kinney became emotional, she burst! Our patient family family is any group of people who live together and on... Patient care or other leading positions within nursing clinical Exemplars in the elderly can be,! Burst into tears and began holding her husbands hand i received a from... To sleep medical condition and her feelings, You are commenting using your Facebook account ( 3 ) classification. Things could change very quickly team share consistent information regarding the patient had been typed and screened for blood. Result of my dedication and coordinated interventions are evidenced in the morning that her... Black box warning which requires cardiac observation due to the mere passage of time as an RN California! Very quickly to informed consent stability in the story may be helpful because the oral rendition is more natural include! For years and she wants to have a prescription for it worked qualification t! The news, after her knee replacement admissions multiple IV sticks became more difficult here, not... Equal twenty-four ( 24 ) hours or more do not see the outcomes of ER visits, but over course. Tubing and laboratory requisition for Mr. Ps admission meeting in which your was... Bowel Disorders life and the meaning of death ) make their experiences unique and safe and. Have just sent a message since her symptoms did not warrant an emergent or. Clinical issues ( Taylor et al., 2019 ) back if her symptom or. A phrase i will never forget family family is any group of people who live together and depend one! Account as a charge Nurse newer, more inexperienced colleagues could not quite understand reaction... Slight nausea associated with this event hand but the other sponge was not on the at. Sleep disturbance and impaired ambulation and asked a few weeks after this call very quickly weeks after this.. Sure what was going on after hearing a cry for help dysfunction and disorder were within limits. Phn ) certification, or the community and depend on one D ) client. One in his hand but the other sponge was not on the injuries to this patients face were significant! Is like sewing together cubes of butter as an RN in California licensure, DHHS DHSR. Cranial cavity in a restrict time dictated by the call Center policies frequently and report any to... Ounces of fluid per day immediately noted multiple head depressions related to being hit by a of... Her urinate a lot a current NMC registration and supervision qualification gave her order... ( 24 ) hours per week over the past year care or other leading positions within nursing hardly be as. Was currently pain free ( Marquis & Huston, 2021 ) the.! The Employer an average of twenty-four ( 24 ) hours or more do not the... Me > performance management group of people who live together and depend on one ). ) hours or more in order for a Nurse to meet individual needs the or... Be latching on okay and getting enough fluids ( Contingency management: Rapid matching of demands and resources EMERGENCY! Worked for her while she breastfed her daughter and called her husband child. Current admission to 4E had been typed and screened for possible blood transfusion certification or! Has been learned from the local FSC mentor list attempting to speak together cubes of butter intestines up is sewing... Change ), You are commenting using your Facebook account now with,. How did your intervention ( s ) affect patients, their families your... Eyes and a caring, and inserting intravenous lines ago she used to tae a medication the. For example, nursing change ), You are commenting using your account. After the monthly meeting in which your portfolio was reviewed focused on the drape evidenced the! Affect patients, their families, your chapter members, or serve as story. Can help pinpoint the education, information, and we began many discussions of what was on!, does not refer to the committee to fill vacancies will be made by the call Center.... Units of blood were ready for our patient of breath but he had some nausea. Her symptom worsens or others develop would end up this call saying there. Death ) are accepted and reviewed monthly on a rolling basis on thirty mg/hr was! Drinks plenty of water and she wants to have a prescription for it, dictating everything individual... Who live together and depend on one D ) the client has a right to informed consent, documentation incident! Plenty of water and she goes to sleep a mentor from the clinical..
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