2011 Nurse of the Year Categories
ADVANCED PRACTICE: Clinical nurse specialist, midwife, practitioner, psychotherapist, or
anesthetist.
AMBULATORY NURSING: Clinic, office, other ambulatory care setting, employee health,
occupational health, industrial health, infection control.
BEHAVIORAL HEALTH: Mental health and addictive services.
COMMUNITY CASE MANAGEMENT CARE COORDINATOR: Community case management,
quality management, risk management, utilization management, informatics.
CRITICAL CARE, ADULTS: Adult ICU, CCU, catheter lab, special procedures unit.
EMERGENCY/FLIGHT: Emergency department, flight, ambu
lance, pre-hospital, telephone triage.
FRIEND OF NURSING PROFESSIONAL: An individual non-nurse that supports the advancement of
the nursing profession, e.g. staff, physician, public official, administrator, etc.
FRIEND OF NURSING: An individual non-nurse non-medical that supports the nursing, e.g. ancillary
health staff.
GENERAL MEDICAL/SURGICAL: Acute or chronic medical and surgical nursing specialties.
HOSPITAL CASE MANAGEMENT CARE COORDINATOR: Hospital case management, quality
management, risk management, utilization management, informatics.
LEGEND NURSE OF THE YEAR:
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March of Dimes, 3209 Denali Street, Suite 200, Anchorage, AK 99503 907-276-4111 or fax 907-276-3375
An exceptional Alaskan RN who has dedicated their career to nursing. A nurse who displays
excellence in nursing. (limited to one)
LPN: Recognizing the years outstanding Licensed Practical Nurse for compassion and teamwork in
bedside care.
MATERNAL/NEWBORN: Maternity services in hospital (antepartum, labor and delivery, postpartum,
nursery), other birthing facility, or home.
NICU: NICU or care of babies with special needs.
NURSING ADMINISTRATION: Researchers, Consultants, CNE’s, CNO’s, VP’s and Administrative
Directors.
NURSING MANAGEMENT: Includes those with supervisory roles in a clinical or non-clinical setting:
full-time, shift/clinical coordinators and Department Directors/Department Managers.
PEDIATRICS, INCLUDING PEDIATRIC CRITICAL CARE: Hospital pediatric unit, pediatric clinic,
PICU, pediatric emergency, intermediate care unit.
PERIOPERATIVE: Preoperative, recovery, out-patient surgery, in-patient surgery.
REHABILITATION/LONG-TERM CARE/HOME HEALTH/HOSPICE: Rehabilitative and gerontological
services, subacute/transitional unit, extended care, home health, home hospice.
RISING STAR: RNs who, within the first 18 months of practice, exemplify outstanding caring
leadership & professionalism.
Please Indicate only ONE category per nominee
2011 Nurse of the Year Criteria
Nominee has resided in the state of Alaska as of January 1, 2010; military are exempt*.
Nominee is a registered Nurse in good standing with the Alaska State Board of Nursing.
Nominee must exemplify an extraordinary level of patient care, compassion, and customer service.
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March of Dimes, 3209 Denali Street, Suite 200, Anchorage, AK 99503 907-276-4111 or fax 907-276-3375
Nominee is perceived as a leader among peers and in affecting positive change in the profession,
workplace, and community.
Current members of the March of Dimes board of directors, staff, and members of the Nurse of the
Year Executive Committee are not eligible to participate as nominees in this award program.
All qualified nominees will be invited to attend the Nurse of the Year Awards Celebration.
NOMINATION FORM - DEADLINE 10/18/11
Please fill out one per nominee (print clearly)
Nominee’s Name:
Employer:
Home/Cell Phone: Work Phone:
Email:
Title:
Mailing Address:
City: State: Zip Code:
Your Name:
Phone: Email:
Mailing Address:
City: State: Zip Code:
What is your affiliation with the nominee?
Categories, Please Check One Only Per Nominee:
Advanced Practice Ambulatory Nursing Behavioral Health
Community Case Management Care Coordinator Critical Care, Adults
Emergency/Flight Friend of Nursing Profesional Friend of Nursing, Ancillary
General Medical/Surgical Hospital Case Mngmt Care Coordinator
LPN Maternal/Newborn NICU Nursing Administration
Nursing Management Pediatrics Perioperative
Rehabilitation Rising Star Legend in Nursing
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March of Dimes, 3209 Denali Street, Suite 200, Anchorage, AK 99503 907-276-4111 or fax 907-276-3375
Military Categories Please Check One Only Per Nominee:
Advanced Practice LPN Nursing Management
Nomination Processing Fee $50.00 Check EnclosedPlease Bill Hospital
Please charge my: VISA Master Card Amount $ Exp
Card#
Name on card:
Signature:
DO NOT FORGET TO ATTACH NARRATIVE AND RESUME/CV
Send to March of Dimes, Nurse of the Year, 3209 Denali Street, Suite 200, Anchorage, AK 99503 or
email FBlakeney@marchofdimes.com or fax to 907-276-3375
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March of Dimes, 3209 Denali Street, Suite 200, Anchorage, AK 99503 907-276-4111 or fax 907-276-3375