A charge nurse must understand staff members' skills, abilities, and knowledge to appropriately delegate tasks and procedures. Precepting Orienting/cross-training Other Examples are: teaching guidelines, new grad preceptor, assisting with a complex skills day or facility-wide training, such as blood borne pathogens. 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. My calm, reassuring approach and this familys readiness to learn, was an intricate part of being able to increase the complexity of his care and allow T. to remain at home. Thanks to everyone who submitted an Exemplar this year! In planning for the admission of In the first week with this patient, it was apparent that his pain was growing at a rate the oral Methadone and Dilaudid could not control and his ability to swallow had begun to be compromised. I realized that sometimes the best thing you can say is nothing .. just listen. You will be contacted by a member of the committee shortly after the monthly meeting in which your portfolio was reviewed. 2010-12-08T15:15:14-05:00 I knew that the patients vital signs were deteriorating. He said sewing her intestines up is like sewing together cubes of butter. As a self-directed professional, this nurse is confident and well prepared. She agreed. The EKG verified that the patient was in complete heart block. Though there wasnt an emergent outcome based on her symptoms I felt I needed to consult with the CCMD. I met Mr. Kinney, a real gentleman. 8. I answered and Needham Fire came on line. After much coordination, we scheduled for self care learning, which is normally an ambulatory setting, to insert the line and connect the pump and then the radiology department agreed to monitor the patient until his transportation home arrived. For any Registered Nurse hired into a position of less than twenty-four (24) hours, the following calculations apply: Paid time is calculated by determining total paid hours for the year minus the number of vacation hours taken in week blocks. danger. With large black eyes, he gave me a smile and nodded, I now understand that he knew how serious his condition was, because he himself was a Kaiser employee; but I wouldnt find that out for some time yet. She told me that she is calling because of the burning in the mouth of her stomach. I gather all my data and in my SBAR presentation I described her symptoms and I emphasized that women at her age and menopausal, can have atypical chest pain. (Karch, 2020). I had been aware that prior to this incident, the new physicians had not been having positive interactions with the ED. Social Services and Discharge Planners were no on my list to summon to start preparing for his departure to a rehab facility. If a charge nurse relies solely on their clinical skills, it could result in chaos and poor patient outcomes. Use This Template Alfie Jonas Charge Nurse 458 635 9654 alfie@hiration.com San Francisco, CA www.linkedin.com/in/alfie SUMMARY Huston, 2021). J. denied any chest pain, swelling, fever, dizziness or heavy bleeding. The Staff Nurse III is available when the physician makes rounds, partly to contribute pertinent information towards formulating the plan of care and partly to gather information that might help the patient and the family to better understand the situation. By August, 6th T. required 230mg.hr to maintain comfort. 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. Mr. R. had many surgeries on his bilateral extremities on many different admissions to facilitate blood flow and healing. The next hurdle was to convince CCMD to send Mrs. C. to ER for evaluation. The room was dim and Mr. P was awake, but he did not acknowledge me when I went in. validation, and communication of patient data, or information. If you have difficulty identifying a clinical incident, it is often times helpful to ask a colleague or your director for ideas about a pertinent clinical situation in which you were involved. I was able to re-adjust my priorities so that all of my patients knew I was still caring for them despite this period of work (and emotional) overload. She needs medication ASAP. Impending shock was inevitable. For publications, please enclose a copy of the article you wrote. Along with patient care duties, the charge nurse directs staff members and ensures routines and processes are running smoothly. If a person struggles with organization, interpersonal skills, humility, or nurse burnout, it's time to work on those areas. The charge nurse also evaluates patient outcomes during their shift. It was my day off and I got a call informing me of his eminent demise. I}K|m6&@{7W51:~m2zo=^$wE:Z /tSsM#ZQw8X)1m -f{px_5`'j`/?CfgSlHm#[ @%^__`@z-wd? An effective charge nurse uses critical thinking to quickly assess and decide if immediate action must be taken to protect the patient's health. learning. Mrs. B. confided in me that she was having a hard time with the food; she would push it around a lot of the plate and not consume nearly enough of it. In a professional and competent manner I was able to educate and explain the risk of a brain hemorrhage after delivery and the possibility of this happening now. See Guidelines for Letter of Recommendation. Minimum Qualifications Staff Nurse III/Home Health/Hospice Nurse III Current license to practice as a Registered Nurse in California. My first visit was spent establishing trust and identifying his goals for care which were pain control, decrease in shortness of breath and decreased anxiety. CHESAPEAKE, Va. Chesapeake Regional Healthcare (CRH) honored four outstanding nurses during its Nurse Exemplar Awards ceremony held Monday night. Performance evaluations are found on the MyHR website> KP & Me> Performance Management. Read the results of our latest national nurse work environments study, and see why Healthy Work Environments matter in this critical time. Everyone gathers in the break room for shift brief. WebWhat is an exemplar? Her faith got her through the news, after her anesthesia wore off. The concept of palliative sedation was discussed with the core IDG. diminished or removed. 2. The center even incentivizes nurses joining particular units via a net sign-on bonus of $3,000, while in the same vein clinical nurse specialists and nurse practitioners can earn an impressive $8,000. This nurse does whatever is possible to integrate the patients beliefs and practices into the plan of care. Step. Knowing that my room was ready I went straight to the preoperative department to meet my patient and to receive a handoff. Nurses are advanced to Clinical Nurse III based upon proficiency in clinical performance. 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. 0000006386 00000 n The Staff Nurse III relies on past experiences to identify clinical signs and symptoms that predict a possible life-threatening situation. (The diagnostic and monitoring function) From my past nursing practice I recognized similarities with other atypical presentation of cardiac ischemia and I explained to Mrs. C. in terms she could easily understand the rationale of my interpretation. Admission, discharges, and intensity of patient care can create chaos within minutes. Family Family is any group of people who live together and depend on one WebABOUT YOU To join us as a Charge Nurse youll need to be a Registered Nurse with a current NMC registration and supervision qualification. also advocates for others unable to make decisions for themselves, as Active participation in quality activities which must be of an ongoing nature with participation occurring over at least six (6) months of the past year, e.g., PPC, Safety Committee, organizationally sanctioned peer group or committee, RNQL. I asked her if she has any other symptoms associated with that burning feeling. In this particular situation: Helping role: I felt that I guided and gave emotional support to this patient through this much unexpected even in his life. J. had no other symptoms. quality, efficiency, or delivery of health care (Hinkle & Cheever, 2018). ( Eliciting and understanding the patients interpretation of his or her illness. I stopped at the doorway before entering Mr. Y.s room for two reasons. It had been a long but good day in the ED. The MD disagreed at this point and stated her plan was to use a fiber optic scope as she placed the ET tube. By taking the time to wait for her while she met her daughters needs, I demonstrated I was her advocate by meeting her needs. In this case my time was already over twenty five minutes. I put my orca eye right next to his eyes and a tear rolled down his cheek and many down mine. He had been admitted to our OBS unit over night. 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. I will achieve my CEN within the next six months. 4. Create a free website or blog at WordPress.com. Dr. S said Mr. P did not voice any complaints to him and he looked ok. formation of a stable clot composed of fibrin to prevent excessive She stated she wanted to try an Ibuprofen first and was going to call afterwards if the HA did not get better. threatening complications. Benner, P. (1987). Type of employer, location, and the The following Benner Domains will be addressed: The Helping Role Monitoring and Ensuring the Quality of Health Care Practices Organization and Work-Role Competencies Exemplar #11 Over the course of my nursing career, I have had the honor of caring for many patients, a few of whom become very specialize in their care needs. 5. Being a cardiac nurse, I immediately placed a heart monitor on her she was in atrial fibrillation and I feared she was also becoming septic. With the translators help I understood that she has epigastric pain. Include how you felt about the situation, why you think your actions may have differed from someone with less experience. There are a group of H2 blockers that block acid production in the stomach and they are also OTC: Pepcid AC (Famotidine), Cimetidine (Tagamet HB) Ranitidine (Zantag 75). Patient education must be more than that provided by most Staff Nurse IIs on a day-to-day basis; it requires that a patient education program, pamphlet, handout, etc., be developed, revised, and/or taught. Maintains a flexible role to resource constraints. A staff nurse provides direct care at the patient's bedside like administering medication, changing dressings, and inserting intravenous lines. We are at your back door; just coming from across the street. That last statement was the key. This nurse takes responsibility for the team itself by building and nurturing it. My newer, more inexperienced colleagues could not quite understand my reaction, as they were still trying to establish their boundaries. I opened the protocol Urinary Tract/Flank Pain Female. 2. This research investigated charge nurse decision making during the nurse-patient assignment process as an exemplar of the larger If the appeal is denied, the nurse may appeal that decision to the Regional Appeals Committee, no later than thirty (30) days after denial of the appeal by the FSC. legislators. The Staff Nurse III draws upon the patient, family and significant other as resources. 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. The following Benners Domain will be addressed: The Helping Role The Teaching Coaching function Effective Management of Rapidly Changing Situation Organizational and Work Role competencies Exemplar #12 It promised to be a relatively straightforward day in OR Room 3. 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