Embed Size (px)
Citation preview
NOMINATION FORMCecile Thompson Award
The award will be presented to the gerontology nurse who best reflects the values of Cecile.
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.
How do they demonstrate respect and promote the patient’s dignity and spiritual integrity throughout the care episode.
The person demonstrates a goal to promote healing and wellness whether this means attaining self-care and independence, appropriate use of family or social support or to make a peaceful death.
The person’s professional practice is based on the concepts of expert practice cultural safety, partnership of person and self, collegiality with the health care team, liberation and equity.
Any other comments
(Maximum word count: 200 per section.)
