Child Health Directorate Starship Foundation Excellence in ... · Web viewNOMINATION FORM. Child...
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Transcript of Child Health Directorate Starship Foundation Excellence in ... · Web viewNOMINATION FORM. Child...
NOMINATION FORMChild Health Directorate Starship Foundation Excellence in Clinical Practice Award
This will be awarded to a Registered Nurse who is recognised by their peers as a nurse who demonstrates leadership in the development of excellence in child and family nursing practice.
Please complete ALL sections of the nomination form.
Nomination forms must be submitted on or before Thursday 24 March 2016
Completed nominations should be emailed to [email protected]
NOMINEE DETAILS (Their details)
Full name:
Current role:
Service area:
Email address:
NOMINATOR DETAILS (Your details)
Full name:
Service area:
Contact phone number:
Tell us why you are nominating the nurse, please include something in each of the appropriate sections.
Is professional, proud to be a nurse in our Directorate and raises the profile of nursing through their actions and leadership
Exemplary child health nursing clinical knowledge that others aspire to attain
Commendable interpersonal skills and works respectfully with teams
All nursing actions are compassionate and focus on infants, children, young people and their family/whānau care needs
Any other comments
(Maximum word count: 200 words for each section.)