ADN RN Diploma RN BSN RN. MSN RN. PhD RN DNP RN. Educational Institution(s) for Nursing Degree(s):. Nominator's Informat
2018 NIGHTINGALE AWARD FOR NURSE LEADER NOMINATION Nominee’s Information: Nominee's Name (Please print)
Number of years in nursing:
Nominee’s Address
City
State____ Zip
Nominee’s Email Address________________________________________ Nominee’s Phone (___)_________________ Nominee’s Current Position:
___________________
at (institution or agency) Nursing Education:
LPN
ADN RN
Diploma RN
BSN RN
MSN RN
PhD RN
DNP RN
Educational Institution(s) for Nursing Degree(s):
Nominator’s Information Primary Nominator's Name Nominator’s Address
Nominator’s Phone ( City
) State____ Zip
Nominator’s Email Address Association with nominee (e.g., supervisor, patient, peer)
The Nightingale Nurse Leader/Manager Award signifies exceptional leadership, guidance and service to their healthcare organization and to the profession of nursing. Nominator: Please complete steps A, B, and C below. A. Attach typed letter stating how you think your nominee demonstrates excellence in nursing practice fostering evidence based practice and exemplar clinical practice leadership. List the areas of responsibility, how the nurse leader creates a supportive environment for nurse recruitment, retention and/or the advancement of nursing teamwork and collaboration with healthcare providers in the organization. Explain the development and implementation of nursing policy that directly impacts patient care and has significant impact on nursing. B. Secure two additional letters of support for your Nurse Leader nominee. It is helpful to have a supporting letter from the healthcare organizational leadership and a direct supervisor of the Nurse Leader Manager. Letters of nomination and support criteria: 1. Letters should be as specific as possible and provide examples of how the nominee makes a difference in the nursing profession. 2. Describe the nurse’s area(s) of practice, and reflect how the nurse demonstrates exceptional care, evidencebased practice, leadership and exceeds expectations. 3. Include examples of additional areas of service, community and nursing involvement, e.g. professionallyrelated volunteer work, leading support groups, leadership on committees (especially those resulting in positive change), educational offerings to the public (e.g., talks at schools, churches, etc.) and other initiatives in nursing that have led to improved care/outcomes for patients, families, community and the public.
C. Secure a minimum of three digital colored pictures of the nominee that include: a. Two close-up photos of nominee. b. Large group photos should be avoided, as should photos with patients. c. Action photos such as nominee interacting with others; following agency guidelines, (providing nominee is apparent), involved in nursing activities with at least one work related photo. d. High resolution cell phone or camera photos are acceptable. e. E-mail photos to
[email protected]. If you must send via CD, please view the CD on another person’s computer to ensure that the photos can be viewed.
Nightingale Award Criteria •
Resident of the State of Wisconsin and currently employed in Wisconsin.
•
Currently licensed as a registered nurse or licensed practical nurse in Wisconsin.
•
Submit completed nomination form with attachments.
Directions and Deadline Nominations must be received by the College of Nursing no later than January 19, 2018 for consideration. The Nightingale Award nomination form for the Nightingale Award can be downloaded on the UW Oshkosh College of Nursing website at con.uwosh.edu/alumni-and-community/nightingale-awards/. The nominator’s letter with two letters of support should be attached to the completed nomination form. A minimum of three colored digital photos of the nominee including one headshot and two nursing related group photos sent to
[email protected] or sent with nomination.
Send completed nomination form, letters of support and required photos by the deadline of January 19, 2018, to: For emailed nominations: 2018 Nightingale Awards,
[email protected] For U.S. Mail: University of Wisconsin Oshkosh College of Nursing – 2018 Nightingale Awards 800 Algoma Boulevard Oshkosh, WI 54901
Questions may be directed to: Nightingale Award Program at
[email protected] or 920-424-3114. The final selection of award recipients is made by the College of Nursing Board of Visitors and will be announced at the Nightingale Award Dinner on Thursday, April 12, 2018. The 2018 Nurse Leader Award winner will be selected by the Board of Visitors and the award winner will be notified in advance of the event. Nurse Leader is defined as an individual that influences others, providing direction or guidance toward the achievement of personal and or organizational goals.
