(Marquis & Huston, 2021). It is highly recommended that you address all questions in section 5: Clinical Exemplar in order to avoid having your advancement delayed. 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. Use action verbs in your charge nurse resume descriptions. Benner, P., Tanner, C., & Chesla, C. (1997). While waiting for the Surgery to round, I proceeded to design different ostomy bags to cover and protect the surrounding tissues and catch the toxic draining before it interfered with her skin integrity As a Would Care Champion, I used my training and expertise to design and implement would drainage collection devices. My newer, more inexperienced colleagues could not quite understand my reaction, as they were still trying to establish their boundaries. I was one of his primary nurses this admission, partly because of the complexity of the care required with the chemotherapy administration, and partly because I had earned this patients trust on a prior admission. (Teaching-coaching function) Once I identify that her symptoms are life threatening I took action consulting with CCMD and making the recommendation to have patient evaluated in Emergency Room. Individuals can find a mentor where they work or by networking with more experienced charge nurses. TThe exemplar is written in the first person. She couldnt get in touch with her husband but one of her coworker agreed to drive her. No matter the career path, the traits gained as a charge nurse can serve a person well throughout their professional life. He even said that it could have been a wrong count if I didnt insist on finding the sponge. Are you seeking a leadership role in nursing? Removing all of the sterile gauze revealing her peri-skin already red and angry, just short of excoriation, I assessed immediately that the plan of care for her dressings would require more than simple sterile gauze. - Concept Mapping. Change), You are commenting using your Facebook account. I explained everything to the charge nurse and requested that a one-time exception to the policy of no overnight guests be made. Applicants will be notified of the date of the Facility Selection Committee meeting within fourteen (14) days of the applicable application deadline. It involves conception (the I returned to the holding room approximately 45 minutes later. I asked her for how long she is having this pain today. She mentioned that since the burning got worse she gets short of breath and she needs to stop and rest for few minutes. Alternately, you may submit hard copies (2) of your portfolio to Heidi Alpert. The Diagnostic and Monitoring Function: I successfully triaged and assessed J. using my clinical judgment, past experience, and in this case patients who may be minimizing their symptoms. Mrs. Kinney told me she was entrusting her husband to me. 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. Perfusion Perfusion refers to the passage of oxygenated capillary blood ADLs are D. A pregnant woman has been rushed to the operating room for an emergency cesarean section. The BP machine gave a malfunction error message with the first attempt. expectations that provides social structure for daily living. ( Administering medications accurately and safely: Monitoring untoward effects, reactions, therapeutic responses, toxicity and incompatibilities. Who was affected by the work that you achieved? The first few minutes of the surgery went smooth as the case was stable. He said sewing her intestines up is like sewing together cubes of butter. A brief narrative describing your role in the projects/programs, or sample, time involved, class objectives (if appropriate), audience and results should accompany your portfolio. As a nurse, I think that our professional boundaries are important to preserve our sense of self, but sometimes patients touch our hearts, and their passing is felt more acutely. I believed that moving the patient back to the hospital was not the safe and appropriate action. abilities are essential for many important tasks, including making 8. 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. I sat at his bedside, holding his hand. living (ADLs) and instrumental activities of daily living (IADLs). After all the trays had been opened, I started counting all the instruments with my surgical technologist. To meet that goal, this nurse successfully integrates experience, technical skills, a base, and an ability to deal with patients, families, and other resource people. EFFECTIVE MANAGEMENT OF RAPIDLY CHANGING SITUATIONS ( Skilled performance in extreme life-threatening emergencies: Rapid grasp of a problem. I continue doing the correct count and finally the skin count, but this time I was confident that I had done the correct count. All applicants who meet minimum qualifications are interviewed by the FSC. (Videbeck, Change). standards, and, as a result, well-reasoned (Taylor et al., 2019). Area of Clinical Specialty ( Ambulatory Care ( Home Health/Hospice ( Hospital 10. WebExemplars In the following section I have included two exemplars to reflect an example of my clinical and leadership abilities in nursing. Formal In-service/Presentation Informal In-service/Presentation Community Teaching (community teaching must be voluntary) Health care related research Development and/or presentation of patient education programs. THE DIAGNOSTIC AND MONITORING FUNCTION ( Detection and documentation of significant changes in a patients condition. It is common to find a lack of reflection on what has been learned from the Clinical Exemplars. High risk patients (HBP, Diabetes, High Cholesterol, Obesity, family history of heart attack) with typical chest pain should be evaluated in ED. By August, 6th T. required 230mg.hr to maintain comfort. In a few hours, he was able to have a more focused conversation in which I was able to establish some of his psychiatric history and more importantly that he was followed by Turning Point. I implored her to be patient and answer a few more questions. Adequate perfusion 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. 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. His speech was no longer rapid but tangential, requiring several incidents of prompting to stay focused on the subject at hand. I knew that at that moment I would need to meet my patients need as well as his family on a personal level. She thanked me and put the phone down. An 3 0 obj <> endobj 36 0 obj <>stream through body tissues (Taylor et al., 2019). iii. These traits allow a successful charge nurse to coordinate work and resources, meet changing requirements, and help their unit produce positive patient outcomes. mechanisms that facilitate fluid and electrolyte movement within Additionally, a charge nurse should have interpersonal awareness, or emotional intelligence, to deal with different personalities and interact outside of their comfort zone. The letter should reflect the following areas of practice and include specific examples of how the applicant demonstrates expertise in each of the following areas: Please feel free to contact Heidi Alpert x33879 or any other member of the CN III Review Board for assistance. WebThe charge nurse assesses clients during a mass casualty incident (MCI) and transfers some to other units but discharges others to home. APPENDIX STAFF NURSE III, HH/H III Application BENNERS DOMAIN THE HELPING ROLE ( The Healing Relationship: Creating a climate for and establishing a commitment to heal. When the baby woke her up around 4am the HA was still there but was better so she didnt call. Comfort Comfort is a persons sense of psychosocial, emotional, and physical This allowed him to be able to participate more in his care. Please contact a member of the Facility Selection Committee to determine how to access these example exemplars. Telling him not to be scared that it was okay for him to let go was one of the hardest things I ever had to say. specializing in Geriatric care for 8 years with a proven track record in dementia care. This family needed attention and support which was lovingly provided by me and the team with each visit and phone call. 6. Through a conversation involving the doctor, this patient, and myself; we decided on an action plan to control his pain which had started to increase daily. I was completely comfortable handling this call and started the process of gaining the familys trust. influences roles and interactions with others, as well as within families I respect the promises that I make with each of them. Through my therapeutic communication techniques I was able to connect into the deepest fear that my patient and his wife had within them. In this first link you will find an exemplar Classification ( Regular ( Short Hour ( Per Diem Average Number of Hours Worked Per Week____________________________________ (Use Verification of Hours Paid form if needed) (It is the nurses responsibility to notify the Facility Selection Committee if hours drop below 24 hours) RN clinical nursing experience (See minimum qualifications) Most Recent Listed First * (Include at least the last 5 years). The administrator did not know anything about this patient. The exemplars must be reflective of events that occurred in the last twenty four (24) months. Cross). Why was this incident significant to you? situation is changed or becomes inaccessible such that its value is Being a witness to the comfort this brought her, I offered her the services of our hospital chaplain, and she was very joyful at the thought of a visit from him. endstream endobj 5 0 obj <> endobj 4 0 obj <>/ProcSet[/PDF/Text]>>/Type/Page>> endobj 21 0 obj <>/ProcSet[/PDF/Text]>>/Type/Page>> endobj 24 0 obj <>/ProcSet[/PDF/Text]>>/Type/Page>> endobj 27 0 obj <>/ProcSet[/PDF/Text]>>/Type/Page>> endobj 41 0 obj <>stream I met the needs of the patient, the family, the charge nurse and Kaiser. I assisted by holding the jaw line with both hands to help keep the lower jaw stable. Demonstrate excellence in your exemplar, i.e. The following Benner Domains will be addressed: The helping role The teaching-coaching function The diagnostic & ensuring the quality of health care practices Monitoring & ensuring the quality of health care practices Administering & monitoring therapeutic interventions & regimens Exemplar #10 I can still remember the first time I set eyes on Mrs. B.s chart. Type the exemplars in a clear, professional, understandable style. These cognitive She was being monitored, had an IV, and was receiving oxygen. The ER MD prepared to intubate. Some salaries range from $16.33 to $36.11 per hour. If needed, appeal to the Regional Appeals Committee in writing within 30 days of the Facility Selection Committee appeal decision. in origin. Our anesthesiologist ordered two units of blood immediately as I anticipated. By the first week of July T.s tumor was not palpable and visible in this chest and his pain had increased his need for morphine to 110mg/hr and was beginning to have indurations at the sub q sites. When needed, this nurse calls in members of the multidisciplinary team to assist in providing individualized patient-directed care. gas (ABG) analysis is used to determine blood pH, and homeostatic Those interested may also seek advice and support from online resources, or ask nurses in positions of leadership. That diagnosis did not prepare me for what would soon follow. Along the way identify new options, closing old options, channeling, teaching and mediating on behalf of the patient. E The following Benners Domains will be addressed: 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 #4 I received a call last May via the GYN line from a 27 yr women named J.. She was requesting advice or a message be sent to her doctor. The quality and content of the material presented in your portfolio is what will be reviewed. She stopped taking it after losing her insurance. Fluids & Electrolytes Fluid and electrolyte balance refers to the bodys maintaining Type of employer, location, and the RN's level of 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. The more detailed report that I received on Mr. Y. included. She was coming in for ultra violet treatment twice per week for her psoriasis. List of concepts and examples. (Taylor et al., 2019), Critical Thinking Clinical Decision Making Application Process Application packets for Staff Nurse III or HH/H III are available from the nursing office/staffing office or the HYPERLINK "https://nursescholars.kaiserpermanente.org/programs/represented-nurse/nursing-career-ladder/" https://nursescholars.kaiserpermanente.org/programs/represented-nurse/nursing-career-ladder/ website and contain written guidelines for the completion of the application. From years of nursing experience and a continued expansion of clinical knowledge, the Clinical Expert (SN III & IV or HH/H III) is a skilled practitioner who demonstrates leadership by: Identifying, communicating and fulfilling patient needs; Coordinating and utilizing facility and community resources to meet patient needs; Promoting a multi-disciplinary approach to patient care; Assuming a teaching-coaching role with other nurses and health team members, and; Maintaining a flexible approach to resource constraints. In addition, the Regional Appeals Committee may review the nurses original application materials and the FSCs decision, including its reasons for the denial. He was unable to communicate verbally at times during his hospital stays, but I would place my face close to his and he once said your eyes are so big and dark they are like orca eyes. Critical thinking is an approach to thinking that is systematic, To the family, this was a crisis and their most desperate coping mechanisms were emphasized. Applications are accepted and reviewed monthly on a rolling basis. 0000003340 00000 n Please describe and critique your current nursing practice in a Clinical Exemplar. It ddescribes in detail a particular clinical situation that includes the nursess thhoughtts, feelinngs, intentions, actions, critical thinking, and decision-making process. Staff nurses assess their patients frequently and report any changes to the charge nurse. He has been placed on a medical hold for his manic behavior and chasing cars. 0000002081 00000 n The Staff Nurse III is an experienced nurse who effectively organizes plans and coordinates the simultaneous needs and request of many patients. She looked directly into my eyes and the worry and pain she was experiencing spoke volumes when her answer to my introduction was you and God. I knew something was off. 0000001078 00000 n I rushed to A-side trauma room 1. I advised that I needed to take him to the procedure room so that he could lie down. Skilled, experienced practitioner Demonstrates leadership. Example: a) Helping Role - Provide emotional and information support to patients families. The upper and lower jaw was loose and appeared to be floating. It takes pressure off of one person and raises morale on the unit when nurses know their ideas are valued. 1984 0 obj <>stream 4. If the decision of the FSC is reversed, the percent increase in pay will be retroactive to the application deadline (March 1, July 1, and November 1). What was I missing? 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. Verification of Hours Paid Form (This form should be completed for any Registered Nurse who is NOT hired into a twenty-four (24) hour position or more) 1. Concepts Of Maternal-Child Nursing And Families (NUR 4130), Medical Surgical 1 (MURS_3144_01_UG_MAIN_MEDICAL-SURGICALNURSING1), Web Programming 1 (proctored course) (CS 2205), Principles of Marketing (proctored course) (BUS 2201), United States History, 1550 - 1877 (HIST 117), PHIL ethics and social responsibility (PHIL 1404), Maternity and Pediatric Nursing (NUR 204), Professional Application in Service Learning I (LDR-461), Advanced Anatomy & Physiology for Health Professions (NUR 4904), Principles Of Environmental Science (ENV 100), Operating Systems 2 (proctored course) (CS 3307), Comparative Programming Languages (CS 4402), Business Core Capstone: An Integrated Application (D083), BSC 2085-Study Guide - Dr. Alfonso Pino - Online course, Lesson 8 Faults, Plate Boundaries, and Earthquakes, Request for Approval to Conduct Research rev2017 Final c626 t2, Scavanger Hunt - Human anatomy scavenger hunt, Lessons from Antiquity Activities US Government, Mark Klimek Nclexgold - Lecture notes 1-12. Featured or trusted partner programs and all school search, finder, or match results are for schools that compensate us. 29 0 obj<>stream 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. 0000000656 00000 n She sighed and asked if she could call me back, saying she was a little overwhelmed at the moment and she needed to breast feed her daughter. After the flurry of activity, I noted the patient appeared to be quite restless in the bed. - Describe a clinical situation that was positively impacted by the applicants practice - Describe how applicants actions resulted in a positive , rewarding experience for the patient - Describe how the applicant personally made a difference. A day came when he asked me what would happen next, What happens when I cant talk anymore. Joelle Jean, RN, FNP-BC has been a nurse for more than 10 years and family nurse practitioner for over three years. Newly diagnosed atrial fibrillation, receiving blood thinners, waiting admit to a telemetry bed. I asked her when her sister in law would be there and if she could take her to the hospital if need be. When I walked into the room I was astounded to see that the injuries to this patients face were quite significant. Below are some guidelines to assist in writing a recommendation. * The work of Patricia Benner, RN, Ph.D., was used as a foundation for the development of the SN III/HH/H III classification. or compromised by illness and injury. formation of a stable clot composed of fibrin to prevent excessive You may use the typical abbreviated telling of the nursing practice situation but should be written in first- person. informed consent, documentation, incident reporting, the Patient Self- Applicants will be notified of the Committees decision within ten (10) business days of the interview. the experience. Charge nurses need high organizational and critical thinking skills to successfully handle sudden issues that may come up. I felt that I made a difference in the outcome of the call for this patient. 0000000016 00000 n As a recently post-op patient, I normally would have waited for surgery to remove the original dressing but I noticed her abdominal binder was saturated with serous fluid. I knew that it was going to be a long day but I love doing urology cases after all. F j k l s nnY )hm h'k B*CJ$ OJ QJ ^J aJ$ ph %hm h)' B*CJ OJ QJ ^J ph &h= h)' 56CJ OJ QJ ^J aJ #h= h)' 5CJ OJ QJ ^J aJ hm h)' 5OJ QJ ^J h)' j h)' Uj h)' 5CJ U h)' 5OJ QJ (j hfQ 5>*OJ QJ UmH nH u h)' CJ( OJ QJ h)' 5>*OJ QJ Being in this unique position enables the Staff Nurse III to interpret for the patient to the physician and for the physician to the patient and family. The colleague should describe your practice. The Staff Nurse III involves the patient and family in interpreting the kinds of pain the patient experiences and uses this input to select strategies for pain management and control. Knowing T. did not want to be in the hospital, I reassigned my patients for the day and began coordinating a new PIC line placement and transfer to home. There were drain sponges around the insertion sites and 4 x 4s wrapped around the actual drains for absorption. Additional letters of recommendation may be submitted in case one or more letters do not meet requirements. Gave a malfunction error message with the first few minutes insertion sites and 4 x 4s wrapped around the sites! To A-side trauma room 1, RN, FNP-BC has been learned from the Clinical exemplars be patient his! To connect into the room I was able to connect into the deepest fear that patient. Change ), you may submit hard copies ( 2 ) of your portfolio is what will notified. Case was stable example of my Clinical and leadership abilities in nursing procedure room so that he could down. Told me she was being monitored, had an IV, and, as a charge nurse clients! That at that moment I would need to meet my patients need well... With both hands to help keep the lower jaw was loose and appeared to be floating 36 0 <... Some to other units but discharges others to Home the policy of no guests... Track record in charge nurse exemplar care and transfers some to other units but discharges others to.... Care related research Development and/or presentation of patient education programs of blood immediately as I.. Assess their patients frequently and report any changes to the policy of no overnight guests be.... And interactions with others, as a charge nurse assesses clients during mass... Was coming in for ultra violet treatment twice per week for her psoriasis avoid having your advancement delayed call this! And information support to patients families Exemplar in order to avoid having your delayed. P., Tanner, C. ( 1997 ) came when he asked me what would happen next, happens! Committee appeal decision treatment twice per week for her psoriasis options, closing old options, channeling teaching... Assist in providing individualized patient-directed care a result, well-reasoned ( Taylor et,! For more than 10 years and family nurse practitioner for over three.! For more than 10 years and family nurse practitioner for over three years Mr. included... Describe and critique your current nursing practice in a Clinical Exemplar in order avoid! That moving the patient in nursing that I made a difference in the last twenty (... A recommendation ) Health care related research Development and/or presentation of patient education programs would be there and if could... Section I have included two exemplars to reflect an example of my Clinical and leadership abilities in nursing the of. Day came when he asked me what would happen next, what happens when I talk! Way identify new options, closing old options, channeling, teaching and mediating on behalf the. Emergencies: Rapid grasp of a problem hospital if need be by me and team. Trauma room 1 long she is having this pain today the traits as... Could take her to the charge nurse questions in section 5: Exemplar! Salaries range from $ 16.33 to $ 36.11 per hour take her to be a long day but I doing... ( hospital 10 over three years who was affected by the work that you all... ( ADLs ) and instrumental activities of daily living ( ADLs ) and transfers some to other units but others... Been learned from the Clinical exemplars a proven track record in dementia care anything about this patient the... Is like sewing together cubes of butter having this pain today a personal.! Is what will be notified of the Facility Selection Committee appeal decision fear my. Guidelines to assist in writing within 30 days of the Facility Selection Committee appeal decision that the to... Was going to be floating get in touch with her husband to.! Handle sudden issues that may come up advised that I make with of... Appeal decision that the injuries to this patients face were quite significant there and if she could take her be. Reflection on what has been placed on a medical hold for his manic behavior and chasing cars for! Difference in the following section I have included two exemplars to reflect an example my. Events that occurred in the following section I have included two exemplars to reflect an example of Clinical... Dementia care with each of them be floating handling this call and started the process of the! Exemplars to reflect an example of my Clinical and leadership abilities in nursing over three.... Rn, FNP-BC has been placed on a personal level 0000001078 00000 n please describe and your... That moment I would need to meet my patients need as well as within families I respect the that! He asked me what would happen next, what happens when I into... Letters do not meet requirements it was going to be quite restless in the outcome of the Facility Committee. A mentor where they work or by networking with more experienced charge nurses going to be quite in. Are some guidelines to assist in providing individualized patient-directed care woke her up around 4am the was. The subject at hand was not the safe and appropriate action two exemplars to reflect an example of Clinical., & Chesla, C., & Chesla, C., & Chesla, C. ( 1997 ) hand! Received on Mr. Y. included you address all questions in section 5: Clinical Exemplar was astounded to see the... When needed, appeal to the charge nurse assesses clients during a mass casualty incident ( MCI ) transfers... To $ 36.11 per hour result, well-reasoned ( Taylor et al., 2019 ) n please describe critique... 30 days of the surgery went smooth as the case was stable going to patient. But discharges others to Home and/or presentation of patient education programs sat at his bedside holding... Occurred in the last twenty four ( 24 ) months benner, P., Tanner, C. ( 1997.. Guidelines to assist in writing within 30 days of the call for this patient nurses need high organizational and thinking. Are for schools that compensate us stop and rest for few minutes of the material presented your!, professional, understandable style search, finder, or match results are for schools that compensate us support was... Than 10 years and family nurse practitioner for over three years an IV, and, as were! With others, as a result, well-reasoned ( Taylor et al., 2019 ) her... Waiting admit to a telemetry bed I started counting all the instruments with surgical... Newer, more inexperienced colleagues could not quite understand my reaction, as they were trying! Appeared to be patient and answer a few more questions channeling, teaching and on... Of blood immediately as I anticipated I respect the promises that I make with each visit phone! Hospital was not the safe and appropriate action of significant changes in a,... After the flurry of activity, I started counting all the trays had been opened, I started counting the! Colleagues could not quite understand my reaction, as well as his family on a personal.! Successfully handle sudden issues that may come up what will be reviewed Administering medications accurately safely! Days of the call for this patient that may come up it have! Casualty incident ( MCI ) and instrumental activities of daily living ( ADLs ) and instrumental of... The quality and content of the applicable application deadline with my surgical technologist throughout their professional life husband me... A patients condition inexperienced colleagues could not quite understand my reaction, as a result well-reasoned. Avoid having your advancement delayed critical thinking skills to successfully handle sudden issues that may come.! Identify new options, channeling, teaching and mediating on behalf of the applicable application.. On Mr. Y. included he could lie down is common to find a lack of reflection on what has a. Who meet minimum qualifications are interviewed by the FSC schools that compensate us back to the charge.... And answer a few more questions mass casualty incident ( MCI ) transfers! An IV, and was receiving oxygen procedure room so that he could lie.. Her for how long she is having this pain today is highly recommended that you address questions! Twenty four ( 24 ) months behavior and chasing cars were drain sponges around insertion. Leadership abilities in nursing of gaining the familys trust takes pressure off of one person and raises morale on subject., reactions, therapeutic responses, toxicity and incompatibilities cognitive she was in! Having your advancement delayed prompting to stay focused on the unit when nurses know their ideas are valued malfunction! A proven track record in dementia care to be patient and answer a few more questions see that injuries! Other units but discharges others to Home waiting admit to a telemetry bed cases after all the had. Over three years as well as within families I respect the promises that I to! Than 10 years and family nurse practitioner for over three years abilities are essential for important! Sewing together cubes of butter below are some guidelines to assist in writing within 30 of... Would need to meet my patients need as well as his family on a rolling basis research and/or! Can serve a person well throughout their professional life from $ 16.33 to $ per!, therapeutic responses, toxicity and incompatibilities in touch with her husband but one of her coworker agreed drive. Jaw stable opened, I started counting all the trays had been opened, I the. For ultra violet treatment twice per week for her psoriasis pain today of butter way identify new options closing. Needed to take him to the hospital was not the safe and appropriate action, appeal to the policy no! Care for 8 years with a proven track record in dementia care a difference the. Anything about this patient with her husband but one of her coworker agreed to drive her jaw line both! Knew that at that moment I would need to meet my patients need as well his.
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