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St. Louis Magazine - November, 2009
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Excellence in Nursing Awards Nomination Form

Excellence in Nursing Awards Nomination Form



St. Louis Magazine’s Excellence in Nursing Awards recognize outstanding nurses in the St. Louis area. The impact of their commitment and leadership advances the area’s level of health care and provides a service to the region’s citizens. These awards honor those nurses who exemplify the profession’s best standards of practice.

Criteria:
1)    The nominee must have been prepared in a formal nursing program.
2)    All nurses must be currently licensed, practicing Registered Nurses (RN).
3)    Categories may include—but are not limited to—hospital, private practice, occupational health, research, academics, home health, hospice, volunteer, and nursing homes.
4)    Nominee cannot be in active disciplinary action.

Winners will be chosen by a panel of distinguished selection committee members located outside of the St. Louis area. They will then be recognized in the May 2010 issue of St. Louis Magazine and honored at an awards reception set for April 22, 2010.

Click here for the complete nomination packet and information on the selection committee.

Deadline: All nominations must be postmarked or submitted online no later than December 14, 2009.
 
Nomination Form

Nominee's Name:
Nominee's Occupational Title:
Nominee's Academic Degree:
Nominee's Area of Practice:                    
Nominee's Employing Organization:
Nominee's Department (if applicable):
Nominee's Street Address:
Nominee's City, State, Zip:
Nominee's Phone (and Extension):
Nominee's Email:
1) Tell us about a specific example in which the nominee went above and beyond the call of duty while caring for a patient.  
2) Describe how the nominee demonstrates exceptional organizational skills, manages a patient load and/or charge responsibilities.  
3) Provide evidence of the nominee’s effective communication and interactions with other members of the healthcare team.  
4) Give an example of how the nominee consistently practices and/or impacts the organization’s standards of practice and policies.  
5) Share any other examples that demonstrate why this nominee should be honored with the Excellence in Nursing Award.  
Nomination is submitted by (full name):
How do you know the nominee?
Note: Only those who know the nominee in a professional capacity may nominate a candidate. Self-submissions will be considered.
May we contact you about this submission?  Yes No
Your Phone (and Extension):
Your Email:
Please contact Senior Editor Jarrett Medlin at 314-918-3036 or jmedlin@stlmag.com with any questions.
 
If possible, please attach a resume with relevant biographical information, including previous work experience, education, and additional skills.

You may upload an attachment with your submission. We accept the following file types:
pdf,doc,txt

File:


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