CCMD agreed and last thing to do was to persuade Mrs. C. to go to ED. In this first link you will find an exemplar that demonstrates my clinical knowledge and skills in caring for the post-operative patient. professional organizations and by individual and group lobbying of Knowledge of the patients past medical history is important, but it is equally important to maintain your objectivity and to make no assumptions. to external or internal stimuli that can have behavioral, emotional, At that point the surgeon would be ready to begin closing the cavity. The person using these methods is the teacher. In a way, trapping the schizophrenic and preventing the patient from using their coping mechanisms in dealing with their symptoms. I gave her the order for the Ativan and again verified that t he patient was currently pain free. I quickly looked through her history and CIPS and began to triage her through the Postpartum protocol. I went to check and see who could be there. 4. They must also be competent in making quick decisions, evaluating the quality of patient care, resolving conflicts It was wonderful to see her personality start to immerse. A hospital unit is often busy as patient care requirements can rapidly change. She said no. Provides safe environment. This nurse stepped back and stated, Im afraid to push his loose teeth down this throat or even worse make his fracture worse. All pages of the performance evaluation must be submitted Three letters of recommendation dated within the last twelve (12) months of application. Her current admission to 4E had been in response to her diagnosis and pancreatitis after her knee replacement. My experience with Mr. P reinforced my core belief that I always need to be my patients advocate. This was very important in keeping stress level tolerable for the family and caregiver. They announced that the counts were correct including the instrument counts. I knew that it was going to be a long day but I love doing urology cases after all. blood loss following trauma (Hinkle & Cheever, 2018). The joy of working in a community hospital is that we get to know our patients extremely well. They have several years of experience as a nurse and are responsible for delegating duties to less-experienced nurses and staff members, including LPNs and CNAs, coordinating nursing schedules, monitoring medications and supplies, I agreed with her that it was probably not a good idea. Mrs. C. also thought that is not that serious she needs to go. 0000002503 00000 n These guidelines were developed to assist you in assembling the various components of your professional portfolio. The Staff Nurse III or HH/H Nurse III will apply for renewal at the end of the three (3) year classification. A charge nurse oversees all of the nurses in the hospital unit and is responsible for other administrative duties. I trusted my gut and persisted in articulating my concerns. Mr. R. was eventually sent to a rehab facility to learn to use his prosthetic leg. I was able to acknowledge the needs of my patient and his wife a personal level. I immediately called the Central Processing Unit to ensure that I had the instrument trays that we would need in case we did the case open instead of laparoscopic. et al., 2019). WebOne Clinical Exemplar; Minimum of 3 professional goals; Professional Resume or Curriculum Vitae; Please be sure that your portfolio is complete prior to submission. 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. Mr. R.s healing was slow, dressing change after dressing change, antibiotics one right after the other. I checked all the instrumentations and surgical supplies with my surgical technologist. hallucinations, and grossly disordered thinking and behavior The Staff Nurse III draws on knowledge of the literature and of other expert opinions to recognize when a patients cultural background influences the response to care and to the illness. Transfers Transfers to: 1. Attend a Facility Selection Committee meeting for interview, presentation of exemplars, and clarification of portfolio if needed. How did your chapter decide on the goal? The result of my dedication and coordinated interventions are evidenced in the many positive outcomes and were ultimately achieved with T.s peaceful passing. these receptors sends sensory messages to the anterior hypothalamus She wanted to get something stronger for her HA and maybe come in tomorrow for a BP check if the HA didnt get better. (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. Names of the Facility Selection Committee Members will be posted on the Associations bulletin board in each facility. To fully understand a patients condition and situation, the Staff Nurse III draws upon an extensive knowledge base, past experience, information contained in the patients chart, information gained from interactions with the family and most importantly, information the patient provides. I went on to say that I had taken care of Mr. P so many times and I knew him well and he was not himself. Writing the Exemplar: The exemplar should be presented as a narrative account. This was a case requiring more time than most and yet proved to be one of the most rewarding. I asked that one family member be allowed to stay tonight and she agreed. By the middle of the call Mrs. C. was able to understand what my intentions are and by the end of the call she trusted me and she followed my advice. To the family, this was a crisis and their most desperate coping mechanisms were emphasized. WebA nurse leader has exceptional clinical experience and knowledge. Upon my assessment, he was pale and warm to touch. This number must equal twenty-four (24) hours or more in order for a nurse to meet the hours worked qualification. Mr. P. was not Mr. P. There seemed to me to be a slight change in his mental awareness. Show in your exemplar how you used fine discretionary judgment and/or intuitive use of Knowledge. For publications, please enclose a copy of the article you wrote. Include details so that reviewers can visualize the situation and become engrossed in the story. E'[i;T3^umhiBC CcM! affect ones health. 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. By taking the time to wait for her while she met her daughters needs, I demonstrated I was her advocate by meeting her needs. sw,% In seeking letters of reference from colleagues, it is best to ask someone who can speak to your clinical practice. 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. ( The coaching function: making culturally avoided aspects of an illness approachable and understandable. The evening charge nurse and I looked at each other and said, gotta be Mr. P. These drains were draining fluid and lots of it. As I continued to follow Mr. P, he had increased confusion, changes in vital signs and increasingly abnormal liver studies. I continue doing the correct count and finally the skin count, but this time I was confident that I had done the correct count. The Staff Nurse III uses judgment to assess the appropriateness of physicians orders. POSITION TITLE 7. This nurse does whatever is possible to integrate the patients beliefs and practices into the plan of care. The Staff Nurse III relies on past experiences to identify clinical signs and symptoms that predict a possible life-threatening situation. How did you determine the appropriate action? Candidate must be able to substantiate involvement or participation. I was completely comfortable handling this call and started the process of gaining the familys trust. feelings, or behaviors resulting from maturation, experiences, and See calculation below. grooming, feeding, and toileting. I was able to guide them to the conclusion that although every patient is special, I must still continue with my job because there are always patients that need my care. Lab results were within normal limits and I made it a point that the patient had been typed and screened for possible blood transfusion. It includes formal education and professional work experience beginning with your most recent experience in each area. identified by the American Association of Colleges of Nursing (2008): familiar with the applicant's practice Each letter must meet all of these criteria: - Indicate nature & dates of association - Clearly recommend the applicant for SN III - Address 5 key concepts CEU Documentation: 15 CEUs in clinical specialty in the past year Exemplars: Two exemplars reflective of events in the last 24 months Exemplar #1 Exemplar #2 Each exemplar must meet all of these criteria: - Identify the 3 domains addressed at beginning of exemplar - Demonstrate how applicant functioned in the identified 3 domains - Describe any of the following: how applicant felt about situation, why applicant felt actions were important, why applicants actions were important , why applicants actions were different from someone with less experience . Dr. S said Mr. P did not voice any complaints to him and he looked ok. All Selection Committee meetings will be scheduled within thirty (30) days of the applicable deadlines. Management is the process of leading and directing all I met Mr. Kinney, a real gentleman. She appeared agitated and anxious. Her parents live in Mexico and 2 yrs ago when she visited they were fine. Later the patient went to CT, returned and was transferred to a trauma center. Teaching/Coaching Function I was very consistent in providing my patient and his wife the details of surgery to alleviate their doubts and worries. Find the right care at the right place.Learn more about our Visitor Policy and COVID-19 Resources. ( Identifying and managing a patient crisis until physician assistance is available. Courses that are approved by the BRN or the Continuing Medical Education (CME) shall be applicable. Once you have written your exemplar, have several people (both clinical and nonclinical) review it. A clot big enough to block the blood flow through a coronary artery can damage or destroy a part of the heath muscle. 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. Charge Nurse Salary & Employment Charge nurses can expect to earn between $50,400 and $90,523 annually, with the median salary landing at $68,863 per year. As Dr. S was getting ready to print the discharge instructions for Mr. P, I updated him on Mr. Ps condition. She had been discharged from 4W and after returning home for a brief period of time, returned with major abdominal pain. environmental disadvantage influenced by such factors as race and Fifteen (15) CEUs in her/his area of clinical specialty in the past year. Experience, as it is used here, does not refer to the mere passage of time. Many patients cannot perform such well-being. It was my job to ensure my patients safety at all times. A { gd@ ^gd@ ^gd@ ^gdr $ ` a$ & / 0 1 M W X Y | ( Providing an early warning signal: Anticipating breakdown and deterioration prior to explicit confirming diagnostic signs. Please submit a letter of recommendation from each of the following parties who are familiar with your practice over the last year. (Norris & Tuan, 2020), Assessment Assessment is the systematic and continuous collection, analysis, Psychosis Psychosis refers to a cluster of symptoms including delusions, It also became evident that the psychological impacts of these changes were adding to his feeling of anxiety, thus increasing his shortness of breath. Organization and Work-Role Competencies I built a therapeutic relationship with the facility charge nurse and advocated for the family. I started the preparation in my room. 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