Nomination Questions Use only the nominee’s initials or the proper pronoun (he/she) when completing the form or attaching supporting documents to help reduce potential bias on the part of the judges. Please provide brief descriptions/evidence of how this nominee demonstrates each of the following criterion.
Question 1 - Advanced Practice Nursing How has this nurse advanced or contributed to clinical practice?
Question 2 - Advanced Practice Nursing Tell us about the advocacy work this nurse has done to promote healthcare policy.
Question 3 - Advanced Practice Nursing How has this nurse contributed to Advanced Practice education?
Question 4 - Advanced Practice Nursing Provide examples of how this nurse has shown leadership qualities.
Question 5 - Advanced Practice Nursing Does this nurse contribute and/or belong to professional organizations? (Provide an example)
Question 1 - Ambulatory Care Nursing Tell us how this nurse demonstrates critical reasoning and astute clinical judgment to expedite appropriate care and treatment.
Question 2 - Ambulatory Care Nursing Give examples of how this nurse provides high quality care across the life span to individuals, families, caregivers, groups, populations, and communities.
Question 3 - Ambulatory Care Nursing Give examples of how this nurse during each patient encounter, focuses on patient safety and the quality of nursing care by applying appropriate nursing interventions (i.e. identifying, clarifying patient needs, conducting health education, promoting patient advocacy, coordinating care, assisting the patient to navigate the health care system, and evaluating patient outcomes).
Question 4 - Ambulatory Care Nursing How does this nurse act as a partner, advocate, and advisor to assist and support patients, families, and caregivers in the optimal management of their health care, respecting their culture and values, individual needs, health goals, and treatment preferences?
Question 5 - Ambulatory Care Nursing Provide an example of how this nurse facilitates continuity of care using the nursing process, inter-professional collaboration, and coordination of and access to appropriate health care services and community resources across the care continuum.
Question 1 - Critical Care Nurse Tell us how this nurse demonstrates knowledge, skills and continuing education in Critical Care Nursing for Best Clinical Practice.
Question 2 - Critical Care Nurse Tell us how this nurse demonstrates excellence in patient/family care, communication, education and advocacy.
Question 3 - Critical Care Nurse Give us examples of how this nurse engages in collaboration and provides care coordination.
Question 4 - Critical Care Nurse Provide an example of how this nurse demonstrate professionalism and leadership.
Question 5 - Critical Care Nurse Give us examples of contributions this nurse has made in engaging within the community.
Question 1 - Emergency Nursing How has this nurse demonstrated practice excellence in emergency nursing?
Question 2 - Emergency Nursing Describe how this nurse provides evidence of knowledge creation and dissemination.
Question 3 - Emergency Nursing Give examples of this nurse engaging in community service.
Question 4 - Emergency Nursing Provide an example of how this nurse participates or belongs to professional associations or organizations.
Question 5 - Emergency Nursing Give examples of this nurse participating in advocacy work.
Please note: For 2023, New Hampshire Magazine and the NH Nurses Association is happy to award two winners in this category: one for a small hospital (less than 200 beds) and one for a large hospital (more than 200 beds). Question 1 - Front Line/Administrative Nurse Leader How does this nurse support the established vision and inspire colleagues to reach shared goals?
Question 2 - Front Line/Administrative Nurse Leader Provide examples of how this nurse engages, motivates and develops peers.
Question 3 - Front Line/Administrative Nurse Leader How does this nurse foster service excellence?
Question 4 - Front Line/Administrative Nurse Leader Provide examples of how this nurse fosters and encourages team collaboration.
Question 5 - Front Line/Administrative Nurse Leader How does this nurse build and manage relationships?
Question 1 - Hospice-Palliative Care and/or Gerontologic Nursing Tell us how this nurse demonstrates excellence in nursing practice
Question 2 - Hospice-Palliative Care and/or Gerontologic Nursing How is this nurse is acknowledged as a champion of the hospice and palliative care and/or gerontologic nursing specialty area?
Question 3 - Hospice-Palliative Care and/or Gerontologic Nursing Provide an example of how this nurse engages in care coordination.
Question 4 - Hospice-Palliative Care and/or Gerontologic Nursing How does this nurse demonstrate commitment to life-long learning?
Question 5 - Hospice-Palliative Care and/or Gerontologic Nursing Give examples of how this nurse demonstrates leadership and advocacy.
Question 1 - Maternal-Child Health Nursing Tell us how this nurse demonstrates a commitment to a positive professional work environment for care of women and newborns.
Question 2 - Maternal-Child Health Nursing How does this nurse address cultural diversity among colleagues and social responsibility in the care of women and newborns?
Question 3 - Maternal-Child Health Nursing How does this nurse demonstrate integrity in exemplifying the highest standards of professional behavior in the care of women and newborns?
Question 4 - Maternal-Child Health Nursing Give examples of this nurse promoting nursing excellence for quality outcomes in practice, education, research, advocacy and/or management in the care of women and newborns.
Question 5 - Maternal-Child Health Nursing Provide examples of how this nurse participated in research or has collaborated with other stakeholders to enhance the science and practice of nursing to improve the health of women and newborns?
Please note: For 2023, New Hampshire Magazine and the NH Nurses Association is happy to award two winners in this category: one for a small hospital (less than 200 beds) and one for a large hospital (more than 200 beds). Question 1 - Medical Surgical Nursing Leadership: Tell us how this nurse models professional behavior, engages in conflict resolution, and actively advocates for patients, healthy work environments and the nursing profession.
Question 2 - Medical Surgical Nursing Collaboration: Is this nurse a patient-care coordinator acting in collaboration with patient, family, significant other and healthcare providers, facilitating clear communication in an ethical manner while maintaining the most effective use of resources to decrease healthcare costs to system and patients?
Question 3 - Medical Surgical Nursing Research: Provide examples of how this nurse uses research and/or evidence-based practice to improve clinical care and identify clinical problems for research studies; or engages in or collaborates in the research process.
Question 4 - Medical Surgical Nursing Practice/Growth: Does this nurse engage in self-evaluation to identify practice development and actively seek learning opportunities through continuing education, formal education, certification, experiential learning and collegiality? Does this nurse recognize the need to share knowledge and teach others on the unit, and within the facility and in the community? (Provide an example)
Question 5 - Medical Surgical Nursing Professional Engagement: Give examples of how this nurse promotes professional nursing through academic achievement and community outreach.
Question 1 - Nurse Innovator Provide an example of an innovation developed by an individual or a group.
Question 2 - Nurse Innovator Describe how the innovation addresses a gap in quality or safety of nursing practice.
Question 3 - Nurse Innovator Describe how evidence was used in the creation of the innovation.
Question 4 - Nurse Innovator How does this individual or group demonstrates innovation?
Question 5 - Nurse Innovator Tell us how this individual or group demonstrates success in implementation of the innovation.
Question 1 - Clinical Nurse Educator Explain how this nurse actively establishes a stimulating and engaging learning environment to generate and transmit knowledge to improve nursing practice.
Question 2 - Clinical Nurse Educator Give examples of how this nurse facilitates continuous learner development/socialization from novice to expert.
Question 3 - Clinical Nurse Educator Describe how this nurse demonstrates leadership qualities, including but not limited to: adaptability, creativity, diplomacy, integrity and decisiveness.
Question 4 - Clinical Nurse Educator Tell us how this nurse engages in activities consistent with advancing national health care quality and safety priorities.
Question 5 - Clinical Nurse Educator How does this nurse contributes to the continuous quality improvement of nursing education with the generation of new knowledge or translation of current knowledge to reflect evidence-based practice.
Question 1 - Pediatric & School Nursing Describe how this nurse follows standards of practice set by the specialty practice areas of pediatrics and/or of school nursing.
Question 2 - Pediatric & School Nursing Give examples of how this nurse provides family centered care, addressing needs of the whole family.
Question 3 - Pediatric & School Nursing Provide examples of how this nurse demonstrates leadership qualities such as professionalism, problem solving, integrity, collaboration, adaptability and engagement?
Question 4 - Pediatric & School Nursing Tell us how this nurse engages in quality improvement initiatives and utilizes evidence-based interventions to improve the care of pediatric patients.
Question 5 - Pediatric & School Nursing What does this nurse do to contribute to the community, or to advocate for the profession at the local or state level?
Question 1 - Psychiatric & Mental Health Nursing Describe how this nurse demonstrates excellence in practice in psychiatric and mental health nursing.
Question 2 - Psychiatric & Mental Health Nursing How has this nurse demonstrated excellence in leadership?
Question 3 - Psychiatric & Mental Health Nursing Has this nurse been involved in any innovation projects? (Provide an example)
Question 4 - Psychiatric & Mental Health Nursing As a lifelong learner, has this nurse achieved excellence in their education? (Provide an example)
Question 5 - Psychiatric & Mental Health Nursing Tell us how this nurse has participated in research or advocated for the profession.
Question 1 - Public Health Nursing How does this nurse work collaboratively with other stakeholders?
Question 2 - Public Health Nursing Tell us how this nurses utilizes evidenced-based practice.
Question 3 - Public Health Nursing Does this nurse demonstrate expertise in caring for target populations? (Provide an example)
Question 4 - Public Health Nursing How does this nurse incorporate the social determinants of health?
Question 5 - Public Health Nursing Does this nurse have experience in promoting and advocating for policy change? (Provide an example)
Question 1 - Senior Nursing Leader Provide examples of how this nurse establishes common vision and goals.
Question 2 - Senior Nursing Leader Tell us how this nurse engages, motivates, and develops people.
Question 3 - Senior Nursing Leader How does this nurse foster service excellence?
Question 4 - Senior Nursing Leader Provide examples of how this nurse builds strong teams.
Question 5 - Senior Nursing Leader Provide examples of how this nurse builds and manages relationships.
Supplemental Supporting Documents Add files Uploaded documents should include direct evidence of your nominee's accomplishments in their field in order to give the judges a well-rounded view of their efforts. Remember to remove the name and any other identifying information from the files you plan to upload.
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