She told me that after she had breakfast the burning started again. Professional Contributions Participation in two (2) of the following within the past twelve (12) months is required. Oxygenation refers to the process of providing cells with oxygen Using the second lumen the daughter volunteered to learn how to give IVP Phenobarbital in effort to respect her fathers wishes to remain at home. I realized Mr. P was unable to express his concerns or fear about his discharge. I made my rounds with my other patients, and noticed Mr. Y. has not moved since that last time I observed him. quality efforts are ongoing and that quality can always be improved There were no admission beds in the hospital, at least until discharged have occurred. It took at least 3 more hours to do the procedure. (Taylor et al., 2019), Development Development is an orderly pattern of changes in structure, thoughts, I asked her how severe her HA was last night and she said it was 9/10 but now it was 4-5/10. information on which to base their decisions. The team of nurses, physicians, physician residents, pharmacy and respiratory responded to the Trauma Bay to prepare for the patients arrival. Through an intuitive use of knowledge, fine discretionary judgment, experience and leadership, the Clinical Expert is able to provide the best possible patient care in a safe environment. The night ED team decided to admit him to the OBS unit instead of sending him home so late knowing that he lived alone. I went to check and see who could be there. 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. In looking at Mr. L.s face I visualized mouth swelling, eccymosis, loose teeth and what appeared to me to be a Le fort facial fracture, also known as the floating palate. Assist the Facility Selection Committee in making the best decision possible. Assessed and stabilized patients in a fast-pace, 45-bed Level II trauma center; Administered critical care IV medications such as Cardizem, Dopamine, Insulin, Nitroglycerin, and Adenosine; Most important is to give a disclaimer. After his second round of high dose chemotherapy, a bone marrow biopsy showed poor prognosis, the leukemia was not responding to the aggressive treatment we had started. WebNursing recognition occurs on many levels and in many ways. As a later outcome, I also discussed with the assistance Chief of medicine the prior negative experiences that had been incurred by out new physicians. Learning is the process by which a person acquires or increases I also asked questions pertaining to preoperative assessment. The nurse is accountable for the care provided to clients and We are bringing in an 88 year old male patient complaining of chest pain, alert, with stable vital signs. The Nurse of the Year will be revealed on May 13, 2015 in the Deaconess Legacy Conference Room at WebYou're the charge nurse during evening shift. The MD disagreed at this point and stated her plan was to use a fiber optic scope as she placed the ET tube. He had been at a meeting in the building. How have these accomplishments had an impact. This nurse can expect physicians to respond in a timely manner, whether they are called upon to change or provide written orders, or to discuss possible changes in standing policies. After coming back from my lunch break, the relief nurse and surgical assistant were in the process of counting the sponges and sharps. This nurse guides patients through emotional and developmental change. 5. Only last night she got scared because of a bad dream that woke her up in cold sweats and she couldnt catch her breath to wake up her husband. I was almost finished with the dressing when the nurse began to place the NGT in the right nare. alterations in perfusion in all types of clients and must detect 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. Common salary in the U.S.: $26.65 per hour. ( Providing an interpretation of the patients condition and giving a rationale for procedures. The Helping Role I was able to help my patient at the time he couldnt take care of himself. Descriptions of additional professional contributions may be submitted in case one or more do not meet requirements. Name_________________________________________ Date_________________________ 2. This nurse makes every effort to assure that all members of the care delivery team share consistent information regarding the patient. Our anesthesiologist ordered two units of blood immediately as I anticipated. ( Anticipating and preventing periods of extreme work overload within a shift. If there had yet been an appropriate time to step out of my shell and attempt to be a leader, it certainly did not seem to be in the midst of almost constant crisis and occasional chaos. She told me that for about a week she cannot sleep because the burning wakes her up. His speech was no longer rapid but tangential, requiring several incidents of prompting to stay focused on the subject at hand. (Videbeck, 2020). (Marquis & Huston, 2021), Legal Issues Legal issues involve legislation and laws that are in place to protect the The rapid change in the patients condition under anesthesia was crucial. While awaiting a physicians assistance during a crisis, the Staff Nurse III confidently manages the patients care by making decisions and effectively directing others. I reassured her that she would be in very capable hands and nothing was going to be done without an explanation and her consent. They were upset and afraid that their mother would not get the pain medicine she may need and asked if one of the family members could spend the night in the patients room to observe and assist her. Worked as Home Health/Hospice nurse with the employer for at least three (3) of the last five years, or two (2) years as Home Health /Hospice nurse with the employer and one (1) year home health experience within a Medicare certified home health agency. Acid-Base Acid-base refers to the balance of hydrogen and bicarbonate ions within WebApplication packets for Staff Nurse III or HH/H III are available from the nursing office/staffing office or the It was my job to ensure my patients safety at all times. A staff nurse provides direct care at the patient's bedside like administering medication, changing dressings, and inserting intravenous lines. What were your goals and did you achieve them? By being sure that a patient does not experience retained foreign object in the body, we were ensuring that the success of the surgery that would lead to fast recovery. The charge nurse also evaluates patient outcomes during their shift. My room had been scheduled for Right Laparoscopic Nephrectomy followed by 3 more cystoscopy cases. Staff nurses assess their patients frequently and report any changes to the charge nurse. I was correct; Mrs. B. was discharged with the tube feedings. (Marquis & Huston, 2021). 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 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. He was diagnosed with cholangitis. I then consulted the CCMD and after discussing the case with him, we decided I should try speaking to the hospital based doctor, Dr. S. was consulted and when I told him about the case, H recognized the patient and told me that he had talked to the family a few days ago. I made sure I coordinated with pharmacy to ensure there was never a short supply of medication, arranged dressing changes during a routine weekly visit, communicated changes with after hours and weekend staff so crisis were managed and changes in condition were coordinated smoothly thus minimizing stress for the family. He did have a negative work-up and, yes, he could have been sent home last night but he wasnt. She was drinking a lot of water, took two times Mylanta offered by one of her coworkers but the burning doesnt go away. 2. During this time I gained experience from people suffering at different severities of their mental illness. Humility is a powerful trait. Paid time divided by number of applicable weeks equals paid hours per week. against liability or loss of professional licensure. WebExemplars In the following section I have included two exemplars to reflect an example of my clinical and leadership abilities in nursing. I know we both had the same thought: How many times has he been here for this chest pain? And lo and behold there was Mr. P on the stretcher. Which action by the charge nurse is most Though all of these diagnoses are an Axis I in the Diagnostic and Statistical Manuel of Mental Disorders, they are not treated the same. Submit a live session abstract for NTI 2024. Who did you work with? This nurse assists the patient, family and significant others in addressing their particular concerns. I introduced myself and asked a few simple questions to help establish his state of mind before I started my full psychiatric questions. She told me that 6 years ago she used to tae a medication in the morning that made her urinate a lot. In addition to handling and monitoring the current situation, this nurse anticipates and plans for potential change in the patients condition, adapting to the patients needs as they arise. All of these or even one of these would have delayed her care which would have resulted in a very bad outcome. I notified HBS that maybe we should start some probiotics before c-diff came a knocking on her door. ADMINISTERING AND MONITORING THERAPEUTIC INTERVENTIONS AND REGIMES ( Starting and maintaining intravenous therapy with minimal risks and complications. ( Providing comfort and communication through touch. WebOne ethical issue stands out above the rest. The FSC will give the Staff Nurse Applicant information about where/who to send Appeals to Region. Mrs. S. appeared more relaxed, was smiling and thanked me for looking out for her. I am a compassionate, competent, professional and am committed to my patients and their welfare. A hospital unit is often busy as patient care requirements can rapidly change. Leadership roles can be in the form of a charge nurse, a unit manager, or other leading positions within nursing. I went through the process of hooking up the tube feedings; knowing all too well that her recovery would be slow and the probability of her going home on tube feedings was very real. Fill in your details below or click an icon to log in: You are commenting using your WordPress.com account. I stayed to help get Mr. P triaged; this was fairly quick for me since I had taken care of him so many times. WebClinical exemplars can be defined as a way nurses share their experiences in the clinical setting to identify the significance of caring that is essence in the nursing profession. Are you seeking a leadership role in nursing? the body, including organs and body systems, osmosis, diffusion, Three members and one (1) alternate shall be selected by the employer from nurse manager representatives from different existing FSCs who are currently serving on a FSC or have previously served on a FSC. He did deny thoughts of want to hurt himself or others. (Effective Management of Rapidly Changing Situations) Before I put patient on hold I told her to chew a tablet of ASA and find someone to take her to ED. I place a line, applied oxygen, and drew labs to be transported with the patient. I anticipated that she would not want to leave her daughter. Individuals can find a mentor where they work or by networking with more experienced charge nurses. She had plenty to deal with already she sure didnt need diarrhea. Corrective measures were taken. I alerted the only physician left on the station; who was eating his lunch he also happened to be a brand new MD as well as new to Kaiser. I also needed to teach the family how to operate this pump at a pace which would provide them with the knowledge they needed to become independent, without causing anxiety in a situation growing in intensity. 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. By integrating my experience, my computer skills and ability to provide a calming environment, I successfully gained her confidence and trust. 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. Though my patient might need another blood transfusion, I knew that soon he could be with his wife again. She was then switched over to PO Mag sulfate, observed for a day and then discharged the next day. At 0700 the next morning, Mr. P was still on the dash. Nursing Philosophy and Concept Curriculum Map, 2/16/2016). He has been sitting on the edge of the gurney since then. That diagnosis did not prepare me for what would soon follow. The same domains can be used in both exemplars, or different domains can be used. Teaching/Coaching Function I was very consistent in providing my patient and his wife the details of surgery to alleviate their doubts and worries. I gave her the appropriate disclaimer in case things worsened. "dY`B[BU"{Ut?q86G-D"J,Z[5{)xm[[d Xy]%\dq8Id( r_OHAgsLfZ'F=FU]5RF?SN8@BFdJZdIz E=hqLF} vHu-,)dTS =[&ow(yY!E`E1]cX.N)\8-fa I know that I must tell patients that need to go to ED and in many occasions patients get in a state of denial, changing the description of their symptom and asking for an appointment. Type of employer, location, and the Upon entering his room his breathing was labored and from report, he was unresponsive. In this second link you will find an exemplar that demonstrates my leadership abilities as I served as a charge nurse, staff nurse, and preceptorfor anursing student during one of my shifts. I was able to preserve this mans sense of dignity and personhood through my expertise and presence. The Staff Nurse III draws upon the patient, family and significant other as resources. Stimulation of I needed to be his voice. danger. of the whole community, community-based care centers on individual and Who will benefit from your achievements? After all I had kept my promise of being his advocate at the time that he couldnt take care of himself. She told me that she is calling because of the burning in the mouth of her stomach. While we waited the 5 for resting BP, he talked about how he had been feeling pretty tired for at least a month and just didnt seem to have any energy. disabilities, sexual orientation, health insurance, and access to health care 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. The exemplars must be reflective of events that occurred in the last twenty four (24) months. llx7QLbS 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. He came to my unit for reinduction chemotherapy. I always felt at ease knowing that everything was accounted for. ( Contingency management: Rapid matching of demands and resources in emergency situations. T. and his family agreed this was a logical step in providing relief and increasing the quality of his remaining days. Applicants may request a regional appeal in writing (e-mail is ok) within 30 days of the FSC appeal decision to Matt Boyer, C.N.A., 155 Grand Ave, Oakland, CA 94612, mboyer@calnurses.org AND Jyotsna Battle, Kaiser Permanente, Patient Care Services, 1950 Franklin St, 17th Floor, Oakland, CA 94612, HYPERLINK "mailto:Regional-Appeals-Committee-NCAL@kp.org" Regional-Appeals-Committee-NCAL@kp.org The applicant should include their facility, their mailing address, and the reason for their appeal (clear and convincing evidence of procedural error or bias). The committee will choose replacement members from the nominees by consensus. mechanisms regulate acid-base levels to keep the pH within a normal Promotes a multi-disciplinary approach to patient care. I rechecked his vital signs and all appeared to be stable. The purpose of the exemplar is to communicate the chapters contributions and accomplishments that exemplify AACNs mission, vision, values and ethics of care based on the criteria for each category of Chapter awards. I asked a second RN to look in the trash bag and she was unable to find it as well. These are just some examples of questions to ask yourself as you write your exemplar. For example, if a patient's behavior suddenly changes, it's important to determine if they are reacting to something in their personal life, dealing with a fluid imbalance, having a medication interaction, or suffering from an infection. Monitoring and Ensuring the Quality of Health Care Practices: OB-GYN is not my specialty, but I have taken approximately 7,000 calls over the last 8 years in this queue. The induction went smoothly. By August, 6th T. required 230mg.hr to maintain comfort. I was so glad 3 oclock finally came and I was giving report to the evening charge nurse. Find the right nursing program for you. Criteria for Exemplars To assist you in writing exemplars, the following information pertinent to evaluation of exemplars is offered: Two written exemplars must be submitted for review. 0000003113 00000 n Of course most of Mr. Ps history is known to the ED staff but just in case, Mr. P keeps his cherished index cards, which documents his history, in his upper shirt pocket. I was also in charge for the day. Write the exemplar in your own words. Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America?
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