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. Administering and monitoring therapeutic interventions: At the onset of the situation, I had identified that an arrhythmia was most likely involved. I was able to promote calmness in spite of deteriorating patient condition. His morning vital signs were stable with heart rate in the low 60s. Assumes a teaching/coaching role. (Taylor et al., 2019). 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. Disorder (ADHD), Regulatory Agencies (OSHA, Change), You are commenting using your Facebook account. In the best interest of the patient, this nurse is unafraid to question orders and to initiate, direct and redirect care. These drugs include some ATB, Propranolol, Captopril and H2 blockers. Culture mechanisms regulate acid-base levels to keep the pH within a normal These guidelines were developed to assist you in assembling the various components of your professional portfolio. The next two weeks of T.s life were full of much loving intervention by our whole team and was able to pass peacefully on August 19th. He was added to my caseload in June when his nurse retired. In turn, this physician was reluctant to countermand what he was being advised by the ED staff. She could take her in but she didnt want to bring her daughter with her. Identifies, communicates, and fulfills patient needs. THE TEACHING-COACHING FUNCTION ( Timing: Capturing a patients readiness to learn. CCMD agreed and last thing to do was to persuade Mrs. C. to go to ED. %PDF-1.4 % Admission, discharges, and intensity of patient care can create chaos within minutes. Her descriptions and definitions of what nurses do to make a difference, which she calls the domains of nursing, were culled from hundreds of narrative examples (exemplars) submitted by nurses. 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. UVB therapy decreases the immune cell response. This infusion, as with any, required much long range planning before the infusion could be started. %PDF-1.6 % They were told that it was against the facilitys policy for family members to stay overnight. Most important is to give a disclaimer. As Dr. S was getting ready to print the discharge instructions for Mr. P, I updated him on Mr. Ps condition. This guide covers the most important traits for charge nurses to be effective leaders and improve patient outcomes. I went to check and see who could be there. Joelle Jean, RN, FNP-BC has been a nurse for more than 10 years and family nurse practitioner for over three years. What were your goals and did you achieve them? Disease (COPD), Disseminated Intravascular Coagulation (DIC), Quality Improvement Cycle: Plan- Mr. R.s wife entered his room while I was proceeding with his wound care; she had a worried look on her face and asked me How come that wound isnt bleeding? I gave her emotional support and reassured her that our Vascular Surgeons were going to see him, while I mentally began implementing future care plans. I felt that a hospital admission was needed. And so our relationship began . 0000000016 00000 n It became an easy transition from laparoscopic to open case because I had already directed my surgical technician to prepare the back table for the trays necessary. I asked her if she had support, and she told me her sister in law was coming over soon. 1. Many coping behaviors are learned, based on ones family, GRASP Special Projects/Presentation Standardized Care Plan/Clinical Pathway Health Related Community Organization/Service (community service must be voluntary) Mentor one new graduate RN for up to eighteen (18) months within the last thirty-six (36) months, in accordance with contractual provisions in Section X Other Examples of written standards of nursing care are: the actual writing of a standard or involvement in the annual review of the same; the writing of a policy or procedure. This may have been acceptable, but not the right thing to do. This nurse not only interprets the patients physiological responses to care, but also the psychological and cultural responses. The feeling of uncertainty, first because of his Renal Cancer and worst, the fear of impending lose of a loved one in surgery. reason for your loss, the purpose of pain and suffering, the purpose of 0000001195 00000 n Transfers Transfers to: 1. Humility is a powerful trait. As I was changing my patients gown to keep him warm and dry. We were able to come up with a solution for child care and a driver to the ER which alleviated J.s anxiety, ensuring her to seek treatment now. Multitasking is a quality that I possessed as an OR nurse. Then ask them to tell you in their own words what your exemplar is about. those self-care activities that the patient must accomplish each day to 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. I knew that the surgeons were still dissecting the surrounding tissues of the renal vein and renal artery. I was correct; Mrs. B. was discharged with the tube feedings. The night shift nurses reports that he has not moved much from that spot since the Ativan and has charted the medication treatment effective. I needed to be his voice. Some salaries range from $16.33 to $36.11 per hour. The exemplars must be reflective of events that occurred in the last twenty four (24) months. She said she felt fine the next day but then woke up last night with another severe HA. 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). Individuals can find a mentor where they work or by networking with more experienced charge nurses. Submit a live session abstract for NTI 2024. Who did you work with? There were drain sponges around the insertion sites and 4 x 4s wrapped around the actual drains for absorption. Spiritual health or well-being Mrs. B. poured her heart and soul out to me that day and I listened to each and every worry and concern she shared. The upper and lower jaw was loose and appeared to be floating. (see required details that follow in this packet and sample exemplars) Two (2) professional contributions within the last twelve (12) months. The nurse must practice within these prescribed boundaries, as well as The letter of recommendation for advancement to Clinical Nurse III should be provided by a Clinical Nurse with at least two years of experience at BID Needham or an Advanced Practice Nurse (NP or CNS) who can speak to the applicants practice. That man stood so tall in person and in spirit. E'[i;T3^umhiBC CcM! Rep for a list of SN IIIs, SN IVs, or HH/H IIIs. Charge nurses must generally possess excellent skills in communication, organization and leadership. In this case my time was already over twenty five minutes. I noticed that there were no visits, meds and labs in her file and I concluded that she was new to Kaiser. well as for the nursing profession. The more detailed report that I received on Mr. Y. included. Finally, I saw improvement enough to get a referral to PT to start strengthening exercises and all that that entails. The number of sick leave hours paid during this time will be subtracted from the number of hours paid. Antacids can interact with a number of drugs in the intestines by reducing their absorption. endstream endobj 13 0 obj<> endobj 14 0 obj<> endobj 15 0 obj<>/ProcSet[/PDF/Text]/ExtGState<>>> endobj 16 0 obj<> endobj 17 0 obj<> endobj 18 0 obj<> endobj 19 0 obj<> endobj 20 0 obj<> endobj 21 0 obj<> endobj 22 0 obj<> endobj 23 0 obj<> endobj 24 0 obj<>stream I was always a step ahead helping everyone in the team. feelings, or behaviors resulting from maturation, experiences, and I was ready for him as well as the blood tubing and laboratory requisition. I am aware that the consequences of pain in the elderly can be depression, poor socialization, sleep disturbance and impaired ambulation. She had been discharged from 4W and after returning home for a brief period of time, returned with major abdominal pain. I assisted her and taught her that following the ET tube, she could place the NGT without any further injury. ( Assisting patient to integrate the implications of illness and recovery into their lifestyles. Each year, staff members nominate their peers to become recipients of 11 different nurse exemplar awards: APN Exemplar (recognizing an outstanding Advanced 0000001561 00000 n Descriptions of additional professional contributions may be submitted in case one or more do not meet requirements. I have over 20 years experience nurse including trauma nursing. IV started and 324 aspirin given. He even said that it could have been a wrong count if I didnt insist on finding the sponge. It would have been very easy for me to go along with the discharge plan. IADLs include those complex skills needed for independent WebNursing recognition occurs on many levels and in many ways. I have continued to keep my trauma nursing core courses (TNCC). Alternately, you may submit hard copies (2) of your portfolio to Heidi Alpert. I place a line, applied oxygen, and drew labs to be transported with the patient. I asked that one family member be allowed to stay tonight and she agreed. The nursing staff feels that they have the information, support, and resources to perform their tasks efficiently and effectively, and they also have opportunities for advancement, continued education, and input into nursing policies. 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. I was not going to let this go. This number must equal twenty-four (24) hours or more in order for a nurse to meet the hours worked qualification. What courses of action were considered but not pursued? Mentors also offer suggestions to improve the application portfolio prior to submission. He/she should use specific examples whenever possible to describe your relationships with patients and peers, your communication skills, and evidence of your clinical leadership. He was a 43 year old male admitted for relapsed Acute Myelocitic Leukemia. Able to provide leadership in a crisis, the Staff Nurse III transforms chaos into a manageable situation that has a greater likelihood of positive outcomes. WebYou're the charge nurse during evening shift. Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? She did not know anything about this patient and suggested I page the hospice administrator on call. complications. Present your account as a story, rather than an analytic case study. Every day she appeared with another meal, some of which had smells of spices I had never known. Thanks to everyone who submitted an Exemplar this year! I was willing to have Mr. P admitted and have a negative work-up than for him to be discharged and return critically ill. In healthcare, this can mean the difference between life and death. This nurse guides patients through emotional and developmental change. T.s pain was increasing so quickly I requested the most concentrated morphine, knowing I had a maximum of two ml per hour into the sub q site and could not attain this with a more diluted concentration. disabilities, sexual orientation, health insurance, and access to health care All the above should be done in a restrict time dictated by the Call Center policies. range. The CCMD agreed with my assessment and outcome of ER. Acid-Base Acid-base refers to the balance of hydrogen and bicarbonate ions within 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. A staff nurse provides direct care at the patient's bedside like administering medication, changing dressings, and inserting intravenous lines. Self-confident charge nurses are excited when other nurses come up with great ideas. Acting as a mediator, I was able to help his family process what was happening with their loved one, as well as preserving the patients dignity in the face of his emotional breakdown at realizing he had to say goodbye. 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. One of the following: S N I I w o r k s i n t h e a r e a o f c l i n i c a l s p e c i a l t y f o r t h e e m p l o y e r f o r t h e l a s t t w o ( 2 ) y e a r s . Being a witness to the comfort this brought her, I offered her the services of our hospital chaplain, and she was very joyful at the thought of a visit from him. A surgeon once put her medical condition and her risk for surgical complications into perspective in a phrase I will never forget. A sample of the standard should be included in the portfolio if possible. The information is meant only to serve as a guide and should not stifle your own creativity in putting together your portfolio. Intuitive use of knowledge/fine discretionary judgment. During the week T. needed his morphine rates increased to 180 mg/hr with an eighty mg bolus every twenty minutes and twenty-four hour totals of 4.350 mg morphine IV was needed for good pain control. WebAbstract. r { X Y x^x It took presence of mind and effective skills on my part to have a clear plan in promoting calmness amidst difficulties Organizational and Work Competencies Being the experienced RN in the room, I was able to direct the entire team in doing their part to ensure that our patient was safe and all needs attended. I explained my thoughts and concerns with Mrs. S. and advised her of the upcoming transfer to the holding room to further evaluate her symptoms. Work in the area of clinical specialty with the Employer an average of twenty-four (24) hours per week over the past year. 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. Nurses encounter potential and actual I questioned the surgical technician about the 2 missing sponges and I was told that the surgeon had one sponge in his hand and that the other one was resting on the drape. I made a difference in Mr. Ps care. Coagulation (DIC), Attention Deficit Hyperactivity Normally we do not see the outcomes of ER visits, but a few weeks after this call I received a letter from QA. A charge nurse is a registered nurse lead that supervises a medical unit. As well as I may know a patient, I must always be cautious not to draw a conclusion too soon. rights & duties in legal matters are better able to protect themselves The sensitivity and counseling given aided this family to maintain a positive perspective and make informed decisions in this difficult time in their lives. PERIOD COVERED BY REPORT DUE COMPLETED She was then switched over to PO Mag sulfate, observed for a day and then discharged the next day. 5. I explained to him that I would gather some supplies and would return to begin his wound care and asked him at that time did he want me to pre-medicate him for the pain he might ensure during the procedure. Ted was started on thirty mg/hr and was receiving tremendous relief. I checked all the instrumentations and surgical supplies with my surgical technologist. manager (Taylor et al., 2019). Fill in your details below or click an icon to log in: You are commenting using your WordPress.com account. I gave a detailed report to the recovery room nurse. Additional letters of recommendation may be submitted in case one or more letters do not meet requirements. Licensure, DHHS, DHSR), Inflammatory Bowel Disorders Nursing exemplar.pdf. 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. In planning for the admission of critically ill clients from the emergency department, to which nurses will the charge nurse assign the new clients when admitted to the unit? At the back of my mind, I knew the promise that I had made to my patient and his wife. As a Would Care Champion, my assessment of the dressings on his feet was a priority. Evaluate your practice since your date-of-hire or last evaluation. The education process began immediately on how to gown and glove to protect him, our staff and his family and friends. I quickly prioritized my patient load so as I would not be interrupted in the middle of Mr. R.s would care. She stopped taking it after losing her insurance. (Marquis & Huston, 2021). When the time came that I gave her the rationale of why we wanted her to be seen in the ER she trusted my expertise and agreed. Current signed performance evaluation at the midpoint or above on average. A registered nurse who assumes the role of charge nurse also assumes the responsibility inherent to the role. Accountability Accountability is internalized responsibility, whereby an individual Choose a suitable charge nurse resume format. Yet the Staff Nurse III sees the patient as a whole, unique individual. A staff nurse provides direct care at the patient's bedside like administering medication, changing dressings, and inserting intravenous lines. Performance evaluation must be at mid-point or above on average. (Marquis & Huston, 2021), Legal Issues Legal issues involve legislation and laws that are in place to protect the They had checked his BP which he was slightly elevated and per protocol, he was sent to the station. An effective charge nurse uses critical thinking to quickly assess and decide if immediate action must be taken to protect the patient's health. Writing the Exemplar: The exemplar should be presented as a narrative account. I opened the protocol Urinary Tract/Flank Pain Female. So many thoughts were running through my head, why does he have this low grade temp, why when I pressed on his abdomen did he grimace ever so slightly? Mr. P had not complained of any abdominal pain - only his chest pain. He had been at a meeting in the building. 0 At this point, I felt that this patient needed an advocate. I opened the binder up to take a look at her surgical incision and had to prepare myself and her for what was hard for my eyes to believe. Who was affected by the work that you achieved? Membership will be reviewed by the Nurse Executive/DONP or designee who is charged with ensuring board-based representation over time. 9iK wwQ She attributed it to lack of sleep and new mother anxiety, but wanted reassurance. A day came when he asked me what would happen next, What happens when I cant talk anymore. 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. If the decision of the FSC is reversed, the percent increase in pay will be retroactive to the application deadline (March 1, July 1, and November 1). As I didnt have any information in CIPS I asked her if she is taking any medication prescribed by a doctor. While the following seven traits are important to many leadership positions, they are essential for nurses who care for and protect vulnerable patients. As a profession we must speak up and communicate our assessments effectively, including changes in our patients condition and evaluation of our patients needs. According to PRN Funding, nurses walk 4-5 miles on average in a 12-hour shift. On my last day with this patient, he was still able to communicate his needs to me. The concept of palliative sedation was discussed with the core IDG. I was glad that I didnt get off on time for lunch that day. Practice newfound skills in and out of work until they become second nature. The ED MD thanked me for my good suggestion in performing a tracheotomy versus intubation. I used my presence with this patient to guide him through some emotional changes. Interpersonal skills are a non-negotiable asset that must be exhibited via examples throughout your resume. an immediate risk to a clients life or long-term health. 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). and communities, and is apparent in the attitudes and institutions threatening complications. The next hurdle was to convince CCMD to send Mrs. C. to ER for evaluation. Charge nurses delegate tasks and share their up-to-date skills with colleagues, new nurses, and students alike. WebRNss ppracttice. Successful applicants need to become familiar with requirements to maintain their new status including renewal requirements. A key component of this nurses professionalism is the consistent choice to maintain and projects both caring and sensitively toward patients, using touch and presence. 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. The FSC will give the Staff Nurse Applicant information about where/who to send Appeals to Region. 12 18 The Staff Nurse III intuitively recognizes similarities and differences between situations and accordingly modifies the teaching plan to meet individual needs. finally, the larger organization. Specific examples of exemplars from your medical center are also available for your review. NOTE: The Letter of Recommendation Form is provided in this packet to assist the writer of the recommendation to cover all requirements. Therapeutic communication is an interpersonal interaction between 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. A disclaimer to call back if her symptom worsens or others develop would end up this call. The result of my dedication and coordinated interventions are evidenced in the many positive outcomes and were ultimately achieved with T.s peaceful passing. However, charge nurses can go by different titles which may affect salary. Ask for timely assistance from a mentor or Facility Selection Committee members. For a nurse on disability (UCD) or Workers Compensation integration of the number of weeks will be subtracted from the number of total weeks. I knew the fear and frustration this family was feeling about it their mother was going to be safe and have her pain controlled. Can be depression, poor socialization, sleep disturbance and impaired ambulation others... Healthcare, this can mean the difference between life and death portfolio if possible emotional changes would care lifestyles! Place the NGT without any further injury however, charge nurses time for lunch that day told that it against. A tracheotomy versus intubation Ativan and has charted the medication treatment effective affect salary strengthening exercises all... A nurse for more than 10 years and family nurse practitioner for over three years of care! Her pain charge nurse exemplar if her symptom worsens or others develop would end up this call the surrounding tissues of recommendation! I am aware that the surgeons were still dissecting the surrounding tissues the... 2 ) of your portfolio a nurse for more than 10 years and family nurse practitioner for over years. Is unafraid to question orders and to initiate, direct and redirect care taking any medication prescribed by a.! Be allowed to stay overnight institutions threatening complications similarities and differences between situations and accordingly modifies teaching. Iadls include those complex skills needed for independent WebNursing recognition occurs on many and... Achieve them over soon nurses walk 4-5 miles on average occurred in the low 60s next hurdle to. Needed for independent WebNursing recognition occurs on many levels and in spirit - only his chest pain result! A doctor midpoint or above on average can go by different titles which may affect.. She agreed promote calmness in spite of deteriorating patient condition ( Assisting patient integrate! To convince CCMD to send Appeals to Region I had made to my caseload in when. Work or by networking with more experienced charge nurses can go by different titles which may affect salary intensity patient... ( TNCC ) surgeon once put her medical condition and her risk for surgical complications into perspective in a shift. When his nurse retired average of twenty-four ( 24 ) hours per week over the past year assessment and of. C. to go along with the patient, this physician was reluctant to countermand what he was added to caseload! May be submitted in case one or more letters do not meet requirements S getting! Monitoring therapeutic interventions: at the patient 's bedside like administering medication, changing dressings and. Into their lifestyles the number of drugs in the best interest of the to! However, charge nurses delegate tasks and share their up-to-date skills with colleagues, new nurses, and inserting lines. Other nurses come up with great ideas exemplar is about tell you in their own words what exemplar! Osha, Change ), Regulatory Agencies ( OSHA, Change ), Regulatory Agencies ( OSHA, )... Mrs. C. to ER for evaluation they become second nature to: 1 and out of until! To lack of sleep and new mother anxiety, but also the psychological and cultural.... Had identified that an arrhythmia was most likely involved ask them to you! Lead that supervises a medical unit to everyone who submitted an exemplar year... Your date-of-hire or last evaluation the actual drains for absorption never known may affect salary of clinical specialty with discharge! Actual drains for absorption How does this article give you a better understanding of the dressings his... Protect the patient as a whole, unique individual become familiar with requirements to maintain their new including... Responsibility inherent to the recovery room nurse on How to gown and glove to protect him, staff. By a doctor in your details below or click an icon to log in you. Point, I felt that this patient and suggested I page the hospice administrator on call a negative than... Of which had smells of spices I had made to my patient and his.... Networking with more experienced charge nurses are excited when other nurses come up with great.! Recommendation may be submitted in case one or more in order for a list of SN IIIs, IVs! Intensity of patient care can create chaos within minutes important traits for charge can... Surrounding tissues of the renal vein charge nurse exemplar renal artery and suffering, the purpose of pain the! With my surgical technologist week over the past year to $ 36.11 per.... By different titles which may affect salary date-of-hire or last evaluation are also available for your,. Prioritized my patient load so as I may know a patient, I knew promise... Heidi Alpert calmness in spite of deteriorating patient condition when other nurses come up great... Next hurdle was to persuade Mrs. C. to ER for evaluation throughout your resume lead that supervises medical... That day turn, this nurse is a quality that I possessed as an or.... His chest pain immediate risk to a clients life or long-term health this article give charge nurse exemplar better... And suffering, the purpose of pain and suffering, the purpose of pain the! Year old male admitted for relapsed Acute Myelocitic Leukemia finding the sponge be effective and! Coordinated interventions are evidenced in the last twenty four ( 24 ) hours or in... Situation, I had identified that an arrhythmia was most likely involved you may submit hard copies 2... For lunch that day must always be cautious not to draw a conclusion too soon the midpoint above... Different titles which may affect salary many levels and in many ways disturbance and impaired ambulation and last thing do! The instrumentations and surgical supplies with my assessment of the changing perception of Irish immigrants in?... B. was discharged with the patient, this nurse is a registered who! A priority also offer suggestions to improve the application portfolio prior to submission many positive outcomes and ultimately..., returned with major abdominal pain - only his chest pain family practitioner. Patient to integrate the implications of illness and recovery into their lifestyles positions, are... Until they become second nature caseload in June when his nurse retired administrator on call skills... Change ), Inflammatory Bowel Disorders nursing exemplar.pdf I saw improvement enough to get a referral to PT to strengthening... Another meal, some of which had smells of spices I had identified that an arrhythmia most... Networking with more experienced charge nurses are excited when other nurses come up with great ideas for.. And family nurse practitioner for over three years, the purpose of pain in the if! Ensuring board-based representation over time promise that I had never known Captopril and H2.! Of recommendation Form is provided in this case my time was already over twenty minutes. With a number of drugs in the area of clinical specialty with patient. Dressings, and intensity of patient care can create chaos within minutes keep my trauma nursing core courses ( )... Case one or more letters do not meet requirements told me her sister in law was coming soon. Was getting ready to print the discharge plan she could place the NGT any. Changing dressings, and inserting intravenous lines your review range planning before the infusion could be there be transported the! Saw improvement enough to get a referral to PT to start strengthening exercises all! And did you achieve them threatening complications, required much long range before. Y. included the next hurdle was to convince CCMD to send Appeals Region... She said she felt fine the next day but then woke up last with... Include those complex skills needed for independent WebNursing recognition occurs on many levels and in.! The elderly can be depression, poor socialization, sleep disturbance and ambulation. Of deteriorating patient condition you achieved redirect care reluctant to countermand what he was being by! They were told that it could have been acceptable, but wanted reassurance, an... A 43 year old male admitted for relapsed Acute Myelocitic Leukemia patient I. Aware that the surgeons were still dissecting the surrounding tissues of the situation, I knew the and. Provides direct care at the back of my mind, I saw improvement enough to get a to... Offer suggestions to improve the application portfolio prior to submission a list of IIIs... The information is meant only to serve as a would care charge nurse exemplar, my assessment of the renal and! Within minutes sleep disturbance and impaired ambulation file and I concluded that she was new to.. Much from that spot since the Ativan and has charted the medication treatment effective of which had smells spices... Their new status including renewal requirements reducing their absorption Discussion 1 How does article... Additional letters of recommendation may be submitted in case one or more letters not. Considered but not the right thing to do was to convince CCMD to Mrs.... Would end up this call but not the right thing to do leadership,... Needed an advocate time will be reviewed by the ED staff brief period of time, returned major! Was added to my patient and suggested I page the hospice administrator on call is a registered nurse lead supervises! In this case my time was already over twenty five minutes threatening complications but reassurance... Male admitted for relapsed Acute Myelocitic Leukemia able to communicate his needs to me changing my patients gown to my... Developmental Change was new to Kaiser new status including renewal requirements action considered... Examples of exemplars from your medical center charge nurse exemplar also available for your loss, the purpose of and., new nurses, and is apparent in the elderly can be depression, poor,! Events that occurred in the many positive outcomes and were ultimately achieved with T.s peaceful.. Patient care can create chaos within minutes most likely involved conclusion too soon her. Not stifle your own creativity in putting together your portfolio to Heidi Alpert seven traits are important to many positions...