C Ted was started on thirty mg/hr and was receiving tremendous relief. Be sure to proofread your exemplar for punctuation and spelling. I realized Mr. P was unable to express his concerns or fear about his discharge. Mrs. B would not remain home for long. 2. 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. Because the family brought the medication to the ED, the doctors could see the amount of pain made he was on from the pump settings and a peripheral IV was started. While awaiting a physicians assistance during a crisis, the Staff Nurse III confidently manages the patients care by making decisions and effectively directing others. Intuitive use of knowledge/fine discretionary judgment. I needed to be his voice. She takes 4 or 5 Tums, drinks plenty of water and she goes to sleep. Newly diagnosed atrial fibrillation, receiving blood thinners, waiting admit to a telemetry bed. I told her she could put me on speaker phone so she could effectively feed her daughter, which she agreed to do. By August, 6th T. required 230mg.hr to maintain comfort. She stated she didnt want to go through that again tonight and though maybe she should have her BP checked. NAME AND LOCATION OF FACILITY 4. Nursing exemplar.pdf. Her vitals were 7-/32, Heart rate 142, Temperature 103.8 and her respiratory rate was so fast they were hard to count. Successful applicants need to become familiar with requirements to maintain their new status including renewal requirements. Coagulation (DIC), Attention Deficit Hyperactivity License Number________________________________________________________ 8. This was a case requiring more time than most and yet proved to be one of the most rewarding. As I continued my triage, I asked why she hadnt called last night when the HA was 9/10. All applicants that meet minimum qualifications are interviewed unless the applicant withdraws their application Interview Date _____________ Application Form: All sections of application form are filled out completely and accurately. Professional Contributions Participation in two (2) of the following within the past twelve (12) months is required. 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. Change), You are commenting using your Twitter account. ACLS/PALS/NRP counts if it is applicable to the clinical area and NOT a job requirement. By initiating a plan to have her newborn watched it reassured her that she can get treatment and be less anxious about leaving her daughter. The applicant may contact a member of the Facility Selection Committee to verify completeness of the application prior to submission. You can take as much space as you feel is necessary to tell your story. The narrowing of an artery caused by building up of plague and its rupture leads to clot formation also. (Taylor et al., 2019), Lippincott List of Nursing Concepts and Exemplars, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, The Methodology of the Social Sciences (Max Weber), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Civilization and its Discontents (Sigmund Freud), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Give Me Liberty! ( Contingency planning. She wanted to get something stronger for her HA and maybe come in tomorrow for a BP check if the HA didnt get better. He was a quiet, giant of a man, months later I would realize that he when he stood up was 64 or taller. %%EOF He has been placed on a medical hold for his manic behavior and chasing cars. 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. Development is a dynamic and continuous process as one She could take up to 10 at once with no relief. The Staff Nurse III raises the level of practice by effectively using whatever resources exist and by functioning as a dependable expert readily available to other team members. In the beginning of this call I acted as a cultural mediator to make the patient comfortable by speaking her language and I have made many attempts to clarify her symptoms through the invaluable help of a translator. AJN, 87(1), 23-31. She also told me that the facility did not have the Morphine prn as ordered and that they would not be able to obtain any narcotic from the pharmacy until tomorrow The patient had been hospitalized for confusion and the discharge diagnosis was Urinary Tract Infection. 2010-12-08T15:15:14-05:00 I was completely comfortable handling this call and started the process of gaining the familys trust. In planning for the admission of in origin. As I continued to follow Mr. P, he had increased confusion, changes in vital signs and increasingly abnormal liver studies. Content experts may be called if the committee has limited knowledge in a specialty area Committee members may serve a maximum of 2 years in any single category. Later the patient went to CT, returned and was transferred to a trauma center. 0000000872 00000 n understand and empathize with the clients experience. This time, I got a BP that was indeed elevated but the pulse was 30. cardiac systems. This allowed him to be able to participate more in his care. ( Getting appropriate and timely responses from physician. hR8A{sL@ I got her post-operatively after surgery for the pancreatic abscess. I called for a Nursing Assistant to come in and help me with her vitals. Remember, youre nominating your chapter for an award, so you want your submission to be stellar! ( Combating the hazards of immobility: Preventing and intervening with skin breakdown, ambulating and exercising patients to maximize mobility and rehabilitation, preventing respiratory complications. What were your goals and did you achieve them? At that point I really understood the saying that there are two sides to nursing the art and the heart. Choose a mentor from the local FSC mentor list. Rather, it is the refinement of preconceived notions and theories through encounters with many actual practical situations that add nuances or shades of differences to theory. I knew this patient and his family would take a great deal of my time, so I enlisted my coworkers to assist with my other patients needs in case I was unavailable. 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. You can structure the narrative of your self-evaluation in whatever way is most meaningful to you. I started by reviewing my patients record in Health Connect and found out that my patient was a 72 year old male. The night shift nurses reports that he has not moved much from that spot since the Ativan and has charted the medication treatment effective. Management is the process of leading and directing all 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 . Type of employer, location, and the Some specialty units require even more time. (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 family was calling to ask that the patient be readmitted to the hospital immediately. A nurse's workday is unpredictable. Lying on his back in our hospital bed he remained soft spoken and only spoke when he had something to say, there was no idle chatter with this patient. 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. This guide covers the top traits charge nurses need to be effective leaders. I then worked to integrate the familys beliefs and practices by understanding their desire to stay with the patient that night. 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. She developed a severe HA and elevated BP and was put on IV Mag sulfate which alleviated her HA and brought down her BP. (see required details that follow in this packet) Documentation of at least fifteen (15) continuing education units in area of specialty (either CEU or CME) that was completed within the last twelve (12) months. I directed my surgical technician the need to open and count the instruments trays necessary to do an open case thinking in mind the severity of my patients bleeding. These imbalances can be respiratory or metabolic 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. (Norris & Tuan, 2020), Assessment Assessment is the systematic and continuous collection, analysis, AJN, 97(6). 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. WebRNss ppracttice. Brief description of relationship to applicant: 4. The first few minutes of the surgery went smooth as the case was stable. ( Anticipating problems: Future think. I then called that physician to let her know my assessment and concerns. I knew that it was going to be a long day but I love doing urology cases after all. Method Tool Design. Report did not prepare me for what I would see when I unwrapped his feet. Charge nurses need high organizational and critical thinking skills to successfully handle sudden issues that may come up. (see letter attached) The Helping Role: I am a confident and caring professional who is dedicated to achieving positive patient outcomes. First, to ask if I may enter out of common courtesy and build trust, and second to do that doorway assessment in which I as a nurse, look for condition of the room- is it a mess from him or compulsively neat, the patients physical appearance of being clean, disheveled, clothing on incorrectly, etc, the physical appearance of skin diaphoretic, dry, redness, lacerations, bandages, etc, the patients breathing, fast, slow, rhythmic, deep, shallow, tripoding, etc, eye contact, good, poor, focused on one item, etc, and a variety of other clues to help with the overall assessment. Every new charge nurse has moments of self-doubt, but they must have the confidence to step out and learn new skills. PERIOD COVERED BY REPORT DUE COMPLETED Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? Signed Performance evaluation based on the applicable performance standards for each year at the midpoint or above on average Electronic and hand signatures are accepted; however, AACC requires hand signatures of RN managers on the evaluation. I knew I was taking a risk that I could have been wrong but it was well worth the risk when I had such a strong conviction we were missing something. 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. Mrs. B. poured her heart and soul out to me that day and I listened to each and every worry and concern she shared. Now Mr. Y., did not receive the Magic Bullet pills or treatment, but was clearer with his speech and thinking. If needed, appeal to the Regional Appeals Committee in writing within 30 days of the Facility Selection Committee appeal decision. WebNurses who excel in managing client care and possess strong interpersonal skills often assume additional management duties when assigned the role of charge nurse or nurse The nurse must practice within these prescribed boundaries, as well as "hL3 h)' 5>*CJ OJ QJ aJ hL3 h[Q} >*CJ OJ QJ aJ h)' CJ OJ QJ aJ h[Q} CJ OJ QJ aJ hY CJ OJ QJ aJ hL3 CJ OJ QJ aJ h@ CJ OJ QJ aJ hL3 h)' CJ OJ QJ aJ hL3 h)' >*CJ OJ QJ aJ 3 Applications are accepted and reviewed monthly on a rolling basis. To meet this goal I first needed to realize this was a first time mother of a 3 day old newborn who was sleep deprived, overwhelmed and in pain. The Ativan was not going to do that, just imprison him with his hallucinations. R.N. If needed, appeal to the Regional Appeals Committee in writing within 30 days of the rewarding... 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