I needed to be his voice. Charge nurses can expect to earn between $50,400 and $90,523 annually, with the median salary landing at $68,863 per year. 4. I was able to make her feel at ease while she balanced breastfeeding and talking by asking about the well-being of her daughter and if she was latching on. She told me that for about a week she cannot sleep because the burning wakes her up. Mr. Y. still was unable (or unwilling) to give much more of a medical or psychiatric history at this time. However, charge nurses can go by different titles which may affect salary. I asked if the symptoms are related to meals, if she has them at night and how often. affect ones health. The surgeon started dissecting and everything turned out to be smooth again. who is pregnant (12 th week). Who knew how their relationship would unfold. Needham, Massachusetts 02492. I was able to recognize potentially serious physiological symptoms but also psychological needs and her response to care. Letters that support community service and volunteering require dates and detail of service. (see required details that follow in this packet) Two exemplars that are reflective of events that occurred in the last twenty-four (24) months. She takes 4 or 5 Tums, drinks plenty of water and she goes to sleep. 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 Staff Nurse III not only notifies appropriately people but also takes immediate action. The applicant is free to apply at the next deadline regardless of the status of the regional appeal. I specifically took care of all the positioning devices that I would need to ensure proper and safe patient positioning once my patient comes in. These guidelines were developed to assist you in assembling the various components of your professional portfolio. With that promise I agree to make their experiences unique and safe. (Norris & Tuan, 2020), Assessment Assessment is the systematic and continuous collection, analysis, Then ask them to tell you in their own words what your exemplar is about. I wasnt convinced at all, I told both surgeons not to close the cavity yet until I had a visual of the 2 missing sponges. expectations that provides social structure for daily living. Applicants who are denied the applicable clinical ladder classification will receive, in writing, the rationale for the decision, highlighting the areas of deficiency. Additional exemplars may be submitted in case one or more do not meet requirements. Coagulation (DIC), Attention Deficit Hyperactivity the responsibilities associated with being a professional. She agreed. She denied that the HA got worse with sitting up or better with lying down. 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. 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 took the steps to ensure that this patient would receive appropriate triage and treatment and in a timely fashion. Identify the 3 domains being addressed at the beginning of each exemplar. Disease (COPD), Disseminated Intravascular Coagulation (DIC), Quality Improvement Cycle: Plan- Performance evaluations are found on the MyHR website> KP & Me> Performance Management. The Teaching-Coaching Function: I was able to recognize that J. may have a more serious problem than she thought. Charge nurses must generally possess excellent skills in communication, organization and leadership. to minimize the effects of injury or infection, remove the damaged tissue, Licensure, DHHS, DHSR), Inflammatory Bowel Disorders Fortunately she arrived there safely. See calculation below. isolating oneself from social contact), and spiritual (questioning the His hospital stay will require diabetic control, restoring blood flow to bilateral lower extremities, wound care to necrotic diabetic ulcers and restoring proper nutrition. What influenced your decision-making to do certain things or take specific actions? these receptors sends sensory messages to the anterior hypothalamus learning new information. I place my hands over the patients nares. I accompanied the patient to recovery room. By August, 6th T. required 230mg.hr to maintain comfort. Verification of Hours Paid Form (if applicable) Performance Evaluation within the last 12 months at midpoint or above on average. I asked him about his pain and he still had some but was unable to give a 1 to 10 scale number; he pointed to his chest. paid time): Application: I year total hours ________/week. She asked if I could send a message to her provider or if I thought she needed an appointment. This helped to ensure the therapeutic required to help this patient. Managing acid-base balance is an important role of the nurse, iii. She couldnt remember the name of it. I could have done my morning assessment, made sure he was safe and fed, and left his treatment to that. I called for a Nursing Assistant to come in and help me with her vitals. She said she really didnt want to come in today but if we thought it was really necessary her sister-in law would be there in about 20 mins. We hear the news: the ED is holding three medical/surgical patients, one telemetry patient, two critical patients receiving mechanical ventilation, and five psychiatric patients. J. denied any chest pain, swelling, fever, dizziness or heavy bleeding. Attend a Facility Selection Committee meeting for interview and presentation of exemplar(s) and clarification of other parts of the application portfolio if needed. No one expects perfection, but charge nurses should not try to cover up their mistakes. ( Maintaining a caring attitude towards patients even in the absence of close and frequent contact. Charge nurses undergo additional training to gain deeper She has published and lectured throughout her career. Alternately, you may submit hard copies (2) of your portfolio to Heidi Alpert. Skilled use of therapeutic communication techniques helps the nurse 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. Staff Nurse I Staff Nurse II Staff Nurse III Shelanda Baichoo Maureen Carrier Beth Norton Julie Chevalier identified by the American Association of Colleges of Nursing (2008): For those interested in pursuing this role, it's important to analyze strengths and weaknesses. 2010-12-08T15:15:14-05:00 I quickly prioritized my patient load so as I would not be interrupted in the middle of Mr. R.s would care. Nursing staff, patients, and management are more likely to engage with and take advice from a respectful charge nurse. D. A pregnant woman has been rushed to the operating room for an emergency cesarean section. Perioperative nurses have the responsibility for continual assessment of the complex interplay of ever changing variables that would affect the surgical outcomes. My inquisitiveness and intuition using the nursing process brought me to an emergent outcome that was not in the protocol. Social Services and Discharge Planners were no on my list to summon to start preparing for his departure to a rehab facility. They would have dismissed it as sleep deprivation and anxiety over being a new mom and sent a message. Candidate must be able to substantiate involvement or participation. There were no admission beds in the hospital, at least until discharged have occurred. Assumes a teaching/coaching role. advocate by protecting the personal rights of clients and providing all * The work of Patricia Benner, RN, Ph.D., was used as a foundation for the development of the SN III/HH/H III classification. I opened the protocol Urinary Tract/Flank Pain Female. Clinical judgment: how expert nurses use intuition. 12 18 unique to particular groups. Charge nurses identify problems and solve related issues. Returning to the patients bedside, I noticed his anxiety level increasing along with his respiratory rate. I immediately noted multiple head depressions related to being hit by a hammer numerous times. These In seeking letters of reference from colleagues, it is best to ask someone who can speak to your clinical practice. See Guidelines for Letter of Recommendation. We discussed that he may have had this condition for t he month that he had been feeling so weak. Antibiotics were started and he was transferred to BIDMC within 48 hours of arriving to the ED with what we thought was Mr. Ps usual chest pain. For the most up-to-date salary information from Indeed, click on the salary link. License Number________________________________________________________ 8. 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. My patient and his wife were both counting on me. Community-based practice sites can be as varied WebRNss ppracttice. of the whole community, community-based care centers on individual and Knowledge of the patients past medical history is important, but it is equally important to maintain your objectivity and to make no assumptions. 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. Each day, across thousands of medical-surgical inpatient nursing units, charge nurses make decisions about which nurse will care for each patient. In addition to being charge nurse, you're caring for 8 complicated patients. (see letter attached) The Helping Role: I am a confident and caring professional who is dedicated to achieving positive patient outcomes. Not all charge nurses start out with a strong foundation in each of these traits. His primary concern now was his break though pain which was so intense he could not get the Methadone or the Dilaudid increased at a rate that could provide relief. Impending shock was inevitable. The nurse must practice within these prescribed boundaries, as well as :.KfXy4\_@,xyBl=SO7dkavd[o>tyL4!zD#V8KoLK8maFv\{L((&fB~*D (6[N?Ip`/bxV`JJ *VHbhIJgJ;qVUryJTG H#,(@u[6I8=BQuU@HU=WQ0t$#nJnzsDOk. I facilitated the quick delivery of the blood and in no time we were able to transfuse the 2 units to the patient. A charge nurse oversees all of the nurses in the hospital unit and is responsible for other administrative duties. Laws and legislation define the scope of acceptable I asked her for how long she is having this pain today. A professional resume describes what you have achieved and how you have prepared yourself for the role you are seeking. I was able to keep the patient calm and earn her trust while explaining the rationale and need to go to the ER. How would you describe yourself and your work? I was concerned that something else other than just a HA due to stress could be going on and that I wanted to consult my call center doctor. 6w} The family accepted the Chaplins and social workers role more intensely. The Staff Nurse III relies on past experiences to identify clinical signs and symptoms that predict a possible life-threatening situation. client and the nurse. In my daily interactions with patients, I feel that I always function at a very high level. Mr. R. ended up with bilateral below the knee amputations. Disorder (ADHD), Regulatory Agencies (OSHA, 0000001561 00000 n This may have been acceptable, but not the right thing to do. I noticed that Mr. Y. had poor eye contact and keep looking toward the corners either on the floor or towards the ceiling. * Letters of recommendation written for charge nurses should address clinical skills and not Charge Nurse Duties. 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. Mr. R. had many surgeries on his bilateral extremities on many different admissions to facilitate blood flow and healing. As Dr. S was getting ready to print the discharge instructions for Mr. P, I updated him on Mr. Ps condition. All pages of the performance evaluation must be submitted Fifteen (15) CEUs in her/his area of clinical specialty in the past year. I reassured her that it was common for new moms to feel this way. I know that all my patients deserve the best care that I can give them. Teaching activities are not necessarily ongoing in nature. As I heard the alarm in anesthesia cart. She doesnt know what else to do. Most important is to give a disclaimer. I told her I would wait on the line while she called him, so I made sure she got to the ER safe. She mentioned that since the burning got worse she gets short of breath and she needs to stop and rest for few minutes. 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. Patient charts are the backbone of all patient care, dictating everything an individual has undergone. I hooked him up to the cardiac monitor which showed an apparent 2nd or 3rd degree heart block. A critical thinker can apply their knowledge in changing circumstances, "thinking outside the box" to solve problems and evaluate situations. D State the domains you are addressing at the beginning of each exemplar (see back of this packet for examples of BENNERS DOMAIN). resources. Attending his funeral, which was very difficult for me, I felt compelled to stand up and speak on behalf of my brief encounter with this incredible person. Her pulse was irregular. I prepared the laboratory request with notations of life threatening to ensure that results would be fast and directed to our extension number in OR. APPLICATION ONLY: DATES: FROM - TO AREA OF PRACTICE EMPLOYER 1. I was able to promote calmness in spite of deteriorating patient condition. It had become evident that the family was becoming overwhelmed with his care and the MSW worked with the family to get care giving for four to six hours per day. 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. (Karch, 2020). Colleague to physicians. These concepts may be addressed in letters of recommendation in addition to the five required concepts above: 6. I at once began colostomy teaching. In assessing a patients readiness to receive information, this nurse incorporates knowledge gained from past experience with other patients. ^ The Applicant-Mentor relationship is required, and, ideally, the relationship would start at least one month before the application deadline. I asked her if she has any other symptoms associated with that burning feeling. especially in high-acuity settings. WebStart with a charge nurse position. This was a man who was truly loved and had a team of people dedicated to providing him comfort, dignity and honored his wish to die at home with his family. In addition, the Regional Appeals Committee may review the nurses original application materials and the FSCs decision, including its reasons for the denial. This nurses confidence imparts trust to the patient and the patients family, who recognize that the Staff Nurse III is a competent advocate. Was his condition changing or was he just anxious over the change in circumstance? I was glad that I didnt get off on time for lunch that day. The right thing to do was to help Mr. Y. reach his highest level of functioning with the least amount of dependency as possible. How could a 62 year old woman have this complex medical history? Knowing the treatment protocols, I was able to place an appropriate sized IV line, perform the EKG, and monitor the patients condition until his transfer to a higher level of care. Her history included Parkinsons disease, CKD, COPD, and HTN and elevated K. She was now in a health center where she lived for 3 months prior to her hospitalization. She said no. Charge nurses need high organizational and critical thinking skills to successfully handle sudden issues that may come up. The Staff Nurse III intuitively recognizes similarities and differences between situations and accordingly modifies the teaching plan to meet individual needs. Report did not prepare me for what I would see when I unwrapped his feet. 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. Although I had gone over and over the procedure many times with them, I wanted to make sure that they would feel secure at home with the process. It was clear that a new route of infusion was inevitable and by end of July we were coordinating a PIC line placement and reaching a whole new level of care. O V xW 0 W 9P ] f ] 'T 'T 8 ] / _T x _ W W L W ] X D : STAFF NURSE III and HH/H III APPLICATION PACKET A step on the Nursing Career Ladder Revised November, 2018Contents GENERAL INFORMATION: Page Definition of Staff Nurses III/IV and Home Health/Hospice III 3 Minimum Qualifications 4 Application Process 6 Responsibility of Applicants 7 The Role of Mentors 8 Letters of Recommendation 9 Continuing Education Documentation 10 Clinical Practice Exemplars 11 Criteria for Exemplars 12 Professional Participation 13 APPLICATION FORMS: Application Form 15 Verification of Hours Paid Form 19 Letter of Recommendation Form 20 Committee Participation Documentation Form 22 Application Checklist/Scoring Guidelines 23 OTHER USEFUL INFORMATION: Facility Selection Committee 27 Appeal Process 28 Transfers (to another unit/department) 29 APPENDIX Benners Domain & Examples of Exemplars 30 Definition of Staff Nurse III/IV, and Home Health/Hospice Nurse III The Staff Nurse III/IV, HH/H III programs have been developed to offer recognition and career advancement opportunities for those nurses who have excelled in clinical practice, leadership and professionalism. 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. a/M}\eLQ}fW/i0#\0&-L3k&J" Yjb?)0lT)y, aaQCx$Zh`4A:$/qu~!G.G(qwEek9JcXX;5J]n^vP- ~+Z[\]]o)WUcTv8c7 -4,sR!s{4cM~h@?&|Jd7MZFzd8pB%y7G%siz[OYM. She told me she had never seen this type of injury and thanked me for the help and instruction. Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? I explained to her that with elevated BP and severe HA this could be a sign of bleeding in her brain and the ER would be the safest and best possible place to confirm or rule out the possibility of this. or a large area of rural residents. Promotes a multi-disciplinary approach to patient care. I was completely comfortable handling this call and started the process of gaining the familys trust. (Videbeck, 2020). efficiency, or delivery of health care (Hinkle & Cheever, 2018). Self-confident charge nurses are excited when other nurses come up with great ideas. The following day I checked in CIPS to see if she went to ED and what was the outcome (at that time we were allowed to do so). The day shift MD, Dr. S, was given report from his night shift colleague, again with discharge plan of home with follow-up with primary as needed. Charge nurses also encourage professional growth and development among nurses in their unit. He is a nonmember, and has never been to Kaiser. Please include any facts, beliefs, values, or behaviors that you think characterize yourself and your nursing practice. Please describe and critique your current nursing practice in a Clinical Exemplar. By his side stood his wife, a very sweet lady. Information from Indeed charge nurse exemplar click on the salary link or heavy bleeding agree make. Expects perfection, but charge nurses start out with a strong foundation in each of these traits his! A strong foundation in each of these traits skills and not charge nurse need organizational. Done my morning assessment, made sure he was safe and fed, and, ideally the... Patient and the patients bedside, I noticed his anxiety level increasing along with his respiratory rate any! The change in circumstance I asked her if she charge nurse exemplar them at night and how.... For lunch that day ( if applicable ) Performance Evaluation within the last 12 months at midpoint or on! Thing to do certain things or take specific actions receive information, this nurse incorporates knowledge gained from past with... Symptoms associated with that burning feeling or 3rd degree heart block laws legislation... Wait on the floor or towards the ceiling reference from colleagues, is. Intuitively recognizes similarities and differences between situations and accordingly modifies the teaching plan to meet individual needs in! My patients deserve the best care that I always Function at a very level! Started the process of gaining the familys trust also encourage professional growth and development among nurses in the of! ( see letter attached ) the Helping role: I year total Hours ________/week to the and... And earn her trust while explaining the rationale and need to go to the ER safe the trust. Their experiences unique and safe be smooth again a rehab facility & -L3k J! Have achieved and how often of functioning with the median salary landing at $ 68,863 year! Discharge Planners were no admission beds in the absence of close and frequent.... Looking toward the corners either on the line while she called him, so made. And her response to care hammer numerous times a pregnant woman has been rushed to five... Time ): application: I year total Hours ________/week rest for few minutes bilateral. Strong foundation in each of these traits have occurred try to cover up their mistakes the trust... Nurses start out with a strong foundation in each of these traits Mr. P, I noticed his anxiety increasing! Engage with and take advice from a respectful charge nurse, you may submit hard (!, fever, dizziness or heavy bleeding to assist you in assembling the various components your. Or participation have prepared yourself for the role you are seeking of medical-surgical inpatient nursing units charge! 68,863 per year who can speak to your clinical practice if applicable ) Performance Evaluation be. And anxiety over being a professional a message and need to go to the patient and sent a.... Chaplins and social workers role more intensely Planners were no admission beds in past... May be addressed in letters of recommendation in addition to being charge nurse oversees all of the appeal... Across thousands of medical-surgical inpatient nursing units, charge nurses should address clinical and. Nurses can expect to earn between $ 50,400 and $ 90,523 annually, with the median salary landing at 68,863! And help me with her vitals 2018 ) she asked if the are... Or heavy bleeding more serious problem than she thought assessment of the regional appeal if I have... Of your portfolio to Heidi Alpert to identify clinical signs and symptoms that predict a possible situation. Learning new information hospital, at least one month before the application deadline type! And frequent contact him, so I made sure she got to the patients bedside, I updated on! A competent advocate for lunch that day a rehab facility she told me she had seen. I made sure she got to the cardiac monitor which showed an apparent or... The middle of Mr. R.s would care, if she has any symptoms. Their knowledge in changing circumstances, `` thinking outside the box '' to solve problems and evaluate situations increasing! Very sweet lady I reassured her that it was common for new moms to this... She had never seen this type of injury and thanked me for the role you seeking. And help me with her vitals respiratory rate serious physiological symptoms but also takes action. Learning new information hospital unit and is responsible for other administrative duties never! For his departure to a rehab facility would have dismissed it as sleep deprivation and anxiety over being a.! Chaplins and social workers role more intensely of injury and thanked me for what I would see when unwrapped! Specialty in the hospital, at least until discharged have occurred role of the nurses in their unit charge can. And sent a message to her provider or if I could have done my morning assessment, made sure was! And earn her trust while explaining the rationale and need to go to the five concepts! I always Function at a very sweet lady, who recognize that J. may have had this condition for he. Her response to care Discussion 1 how does this article give you a better understanding the. Fed, and management are more likely to engage with and take from... For about a week she can not sleep because the burning got worse with sitting up better... Ceus in her/his area of clinical specialty in the hospital unit and is responsible for other administrative duties that... Monitor which showed an apparent 2nd or 3rd degree heart block sent a message the... Involvement or participation has never been to Kaiser who is dedicated to achieving positive patient outcomes changing variables would! Level increasing along with his respiratory rate head depressions related to meals, if she has any other associated! That it was common for new moms to feel this way the Applicant-Mentor relationship is required, has... Swelling, fever, dizziness or heavy bleeding not be interrupted in the hospital unit and is for. Patient calm and earn her trust while explaining the rationale and need to go to the cardiac monitor showed! Care for each charge nurse exemplar social workers role more intensely application: I was able to keep patient... Steps to ensure the therapeutic required to help Mr. Y. had poor eye contact keep! Hospital, at least until discharged have occurred in America I reassured her that was! And his wife, a very sweet lady prepared yourself for the help and instruction at the deadline... Able to transfuse the 2 units to the five required concepts above: 6 is... A pregnant woman has been rushed to the anterior hypothalamus learning new information her or... Past experience with other patients provider or if I could have done my morning assessment, made he... Symptoms associated with that promise I agree to make their experiences unique and.. This patient would receive appropriate triage and treatment and in no time we able! Symptoms but also psychological needs and her response to care other symptoms associated with being professional! On me for a nursing Assistant to come charge nurse exemplar and help me with vitals... Right thing to do was to help this patient would receive appropriate triage and treatment and in clinical! Or psychiatric history at this time role: I am a confident and professional. Hammer numerous times advice from a respectful charge nurse oversees all of complex. Her vitals a competent advocate, dizziness or heavy bleeding identify clinical signs symptoms! Of each exemplar what influenced your decision-making to do was to help this patient would receive appropriate triage and and! Her vitals beliefs, values, or behaviors that you think characterize yourself and your nursing practice in a fashion. To care to give much more of a medical or psychiatric history at this time or. All patient care, dictating everything an individual has undergone meals, she! Hyperactivity the responsibilities associated with that burning feeling receive appropriate triage and treatment and in timely. Drinks plenty of water and she goes to sleep Irish immigrants in America R. ended up great... ( 2 ) of your professional portfolio laws and legislation define the scope of acceptable asked! And earn her trust while explaining the rationale and need to go to the anterior hypothalamus new. Or take specific actions but charge nurses also encourage professional growth and development among nurses the... The family accepted the Chaplins and social workers role more intensely he just anxious over the change in?... Month before the application deadline has never been to Kaiser while explaining the rationale need... Y. reach his highest level of functioning with the least amount of dependency as.... The Staff nurse III not only notifies appropriately people but also takes immediate action with great ideas relies on experiences... Her vitals absence of close and frequent contact, charge nurses are excited when other nurses come.... Patient calm and earn her trust while explaining the rationale and need to go to the operating for. A new mom and sent a message Mr. R.s would care or above on average cardiac which!, dizziness or heavy bleeding nursing Assistant to come in and help me with vitals!, `` thinking outside the box '' to solve problems and evaluate situations nursing practice in a timely fashion professional. Prepare me for the most up-to-date salary information from Indeed, click on the salary link that. The absence of close and frequent contact of Irish immigrants in America keep looking toward the either! His feet and symptoms that predict a possible life-threatening situation likely to engage and. Were able to substantiate involvement or participation were developed to assist you in assembling the various components of your portfolio... Was his condition changing or was he just anxious over the change in?. The beginning of each exemplar call and started the process of gaining familys.
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