NJHA
Nomination Form
ONL NJ Nurse Leader Award – presented to a manager/director from healthcare practice or academe who demonstrates exceptional leadership, guidance and service to their organization and to the profession of nursing. The nominee must be a member of ONL NJ.
1. General information:
a. Nominee’s name & job title
Name:
Title:
b. List major areas of responsibility
2. Practice environment – in 500 words or less describe how the nominee:
a. Provided nursing leadership in the area of responsibility
b. Created an environment fostering evidence based, exemplary clinical practice
c. Created an environment supportive of nurse retention
d. Supported clinical nursing research
e. Took an active role in health care advocacy outside of area of responsibility
Narrative:
3. List the nominee’s leadership roles in other professional organizations.
List:
4. Submitted by:
Name:
Organization:
Phone:
Email:
5. Attach nominee’s resume or curriculum vitae
6. Send to scholewka@.
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