Created: September 22, 2021 at 9:42 am
Updated: September 22, 2021 at 9:42 am
Draft Status: 0

Employee Information

Team Member: Converge Test

Employee ID: 1234
Email Address: evan@cnvrg.us
Department Name: Test
Department Phone Number: 867-5309
Current Employment Status: FT
Current Level of Participation: Not active
Intended Level of Participation: Clinician II
Supervisor: Jackie Simms

Clinician Requirements Roadmap

Clinician II Requirements Completed:
Clinician III Requirements Completed:
Clinician IV Requirements Completed:

Transformational Leadership

Professional Nursing Organizations:

Educational Roles

Precepting
Precept AH Team Member: 0
Preceptor Travel: 0
Secondary Preceptor: 0
Preceptor Capstone Student: 0
Preceptor for Degree Completion:
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

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: 0
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

Recognition

Internal – Unit: 0
Internal – System: 0
External – Health-Care Related: 0

Clinical Resource Roles

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

Presentations/Publications

Structural Empowerment Supporting/Validation Documents

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: 0
Total SE: 0
Total EPP: 0
Total NKI: 0

Grand Total: 0