Created: September 30, 2021 at 4:59 pm
Updated: September 30, 2021 at 4:59 pm
Draft Status: 0

Employee Information

Team Member: Dylan May

Employee ID: 10715
Email Address: dmay1274@gmail.com
Department Name: Emergency Department
Department Phone Number: 5403324465
Current Employment Status: FT
Current Level of Participation: Not active
Intended Level of Participation: Clinician III
Supervisor: Amanda Bennington

Clinician Requirements Roadmap

Clinician II Requirements Completed:
Clinician III Requirements Completed: 30 Total Points (from at least 3 categories- 1 must be TL), 3 Years of RN Experience*, National Certification OR BSN, Leadership contact hours (8 hours), Behavioral Exemplar: Clinician III
Clinician IV Requirements Completed:

Transformational Leadership

Professional Nursing Organizations: Members (2 pts)

Educational Roles

Precepting
Precept AH Team Member: 2 Orientees (6pts)
Preceptor Travel: 2 shifts/ team member (1 pt)
Secondary Preceptor: 4 shifts+/ team member (2 pt)
Preceptor Capstone Student: 0
Preceptor for Degree Completion: Preceptor for degree completion (1pt)
Mentorship
LANTERN MENTOR:
AH NPDP: 0
Student Daily Shift Support: 0

Shared Decision Making

Unit Based Council/Committee/Taskforce:
System-Wide Committee:
Shared Governance Council:

Transformational Leadership Supporting/Validation Documents

https://futureproviders.augustahealth.com/wp-content/uploads/formidable/3/ENA-Membership-Card.pdf, https://futureproviders.augustahealth.com/wp-content/uploads/formidable/3/AH-NPDP-Supporting-Documentation-Log-TL-Dylan-May-SIGNED.pdf

Structural Empowerment

Community Outreach/Events

Volunteer Event as RN or Medical Professional: 0
Other Volunteer AH Event: 0
Coordinate Nursing Event:
Conferences:
Educational Leadership:
Journal Club:
Activities Through Nursing Education
Present Formal Education: [105]
AHA Instructor:
Skills Fair Instructor: 3 sessions (1 pt)
Other Instructor:
Nurse Residency Instructor: 0
Hold Active Certification not required by job description: 0

Structural Empowerment Supporting/Validation Documents

https://futureproviders.augustahealth.com/wp-content/uploads/formidable/3/AH-NPDP-Supporting-Documentation-Log-SE-Dylan-May-SIGNED.pdf

Exemplary Professional Practices

Professional Development

BSN (4 pts), National Nursing Certification (3 pts) *Non-nationally recognized certification, see SE Activities through Nursing Education section

Recognition

Internal – Unit: 10 (10 pts)
Internal – System: 0
External – Health-Care Related: 0

Clinical Resource Roles

Shared Governance Council
Charge: Less than %50 (1 pt)
Patient Experience Rounding Nurse/Super-User Technology:

Presentations/Publications

Structural Empowerment Supporting/Validation Documents

https://futureproviders.augustahealth.com/wp-content/uploads/formidable/3/CEN-Certificate.pdf, https://futureproviders.augustahealth.com/wp-content/uploads/formidable/3/receiveECard4.pdf, https://futureproviders.augustahealth.com/wp-content/uploads/formidable/3/receiveECard5.pdf, https://futureproviders.augustahealth.com/wp-content/uploads/formidable/3/receiveECard6.pdf, https://futureproviders.augustahealth.com/wp-content/uploads/formidable/3/receiveECard7.pdf, https://futureproviders.augustahealth.com/wp-content/uploads/formidable/3/receiveECard8.pdf, https://futureproviders.augustahealth.com/wp-content/uploads/formidable/3/receiveECard9.pdf, https://futureproviders.augustahealth.com/wp-content/uploads/formidable/3/receiveECard10.pdf, https://futureproviders.augustahealth.com/wp-content/uploads/formidable/3/receiveECard11.pdf, https://futureproviders.augustahealth.com/wp-content/uploads/formidable/3/receiveECard.pdf, https://futureproviders.augustahealth.com/wp-content/uploads/formidable/3/receiveECard2.pdf, https://futureproviders.augustahealth.com/wp-content/uploads/formidable/3/receiveECard3.pdf, https://futureproviders.augustahealth.com/wp-content/uploads/formidable/3/AH-NPDP-Supporting-Documentation-Log-EPP-Dylan-May-SIGNED-1.pdf

New Knowledge, Innovation, Improvements

New Knowledge & Innovations

Complete 1 CEU & Present topic to unit: 0
Continuing college credits: 0
Clinical Resource Roles

Performance Improvement

Other Improvement & EPB Projects

Audits

Knew Knowledge Supporting/Validation Documents

Totals

Total TL: 12
Total SE: 1
Total EPP: 18
Total NKI: 0

Grand Total: 31