Created: October 12, 2021 at 4:27 pm
Updated: October 12, 2021 at 4:27 pm
Draft Status: 0

Employee Information

Team Member: Jennifer Williamson

Employee ID: 18219
Email Address:
Department Name: Hospice
Department Phone Number: 540-332-4909
Current Employment Status: FT
Current Level of Participation: Not active
Intended Level of Participation: Clinician III
Supervisor: Joey Mooneyham

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

Precept AH Team Member: 2 Orientees (6pts)
Preceptor Travel: 0
Secondary Preceptor: 4 shifts+/ team member (2 pt)
Preceptor Capstone Student: 0
Preceptor for Degree Completion:
Student Daily Shift Support: 0

Shared Decision Making

Unit Based Council/Committee/Taskforce: Member (2 pts), Chair (4 pts)
System-Wide Committee:
Shared Governance Council: Members (4 pts), Vice Chair (10 pts)

Transformational Leadership Supporting/Validation Documents×150.jpg,,,

Structural Empowerment

Community Outreach/Events

Volunteer Event as RN or Medical Professional: 24 hours of event volunteering (4 pt)
Other Volunteer AH Event: 0
Coordinate Nursing Event: Occupational Health Peer Vaccinator (3 pts)
Educational Leadership: Competency Validator (3 pts)
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,

Exemplary Professional Practices

Professional Development

Healthcare-related Masters (6pts), BSN (4 pts)


Internal – Unit: 10 (10 pts)
Internal – System: 0
External – Health-Care Related: 1 (6 pt)

Clinical Resource Roles

Shared Governance Council
Charge: 0
Patient Experience Rounding Nurse/Super-User Technology:


Structural Empowerment Supporting/Validation Documents,,,,,,,

New Knowledge, Innovation, Improvements

New Knowledge & Innovations

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

Performance Improvement
PI Unit based education (4 pts)
Other Improvement & EPB Projects
PI Unit based education (4 pts)
Short Term (1 pt), Ongoing (3 pts), Hand Hygiene Coach (2 pts), Hand Hygiene Observer (1pt)

Knew Knowledge Supporting/Validation Documents,,,,,


Total TL: 30
Total SE: 11
Total EPP: 26
Total NKI: 12

Grand Total: 79