Rebecca Noem

• Utilized critical thinking skills to make quick decisions in high-pressure situations, prioritizing patient needs and addressing emergent issues promptly.
• Monitored vital signs, lab results, and other indicators to detect changes in patients'' conditions promptly.
• Served as a preceptor for new nurses, sharing knowledge, expertise, and best practices to improve their skills and confidence.
• Participated in unit-based quality improvement initiatives focused on enhancing patient outcomes through process improvements.
• Enhanced patient care by implementing evidence-based practices and individualized care plans.
• Participated in staff meetings, shared governance meetings and action items, participated in unit educational projects such as postpartum hemorrhage drills, shoulder dystocia drills, precipitous delivery drills, care of premature baby, preeclampsia and eclampsia, gestational hypertension, and breastfeeding education. Co created a domestic violence screening tool, and introduced staff to the COWS template for assessing and treating patients in opiate withdrawal, as we did not have any screening tool or guide in the treatment of such patients, especially as it pertains to pregnancy. I created, in collaberation with hospital educators, several educational modules and taught at our quarterly education for women's services. Obtained my RNC in advanced fetal monitoring in late October 2023.
• I came to Mountain Vista in 2008 and was promoted to Clinical Coordinator within a year, and remained in that position until I moved to Colorado to help my adult daughter. I was there for about 1.5 years, then returned to Mountain Vista in a float pool capacity, floating to pre op, pacu, pain clinic, endoscopy, pre admissison testing, and of course, L&D.
• After approx. 1 year in the float pool, an opening came available on the day shift in L&D, so I applied for and got hired for full time in L&D again.

Participated regularly, approximately 2 days per week, as a contracted employee to perform Covid19 swabbing and vaccination on the Gila River Reservation. Steward Healthcare had won a contract with the Federal Government to run this program and as I love our native American citizens, I was eager to help with their devastating experience with Covid19. I also recruited several of my co workers to assist. I did this job in addition to maintaining my obligations in L&D.

• Educated patients on disease prevention and management, promoting healthier lifestyles.
• Provided compassionate and empathetic support to patients and their families during difficult situations.

• Utilized critical thinking skills to make quick decisions in high-pressure situations, prioritizing patient needs and addressing emergent issues promptly.
• Participated in unit-based quality improvement initiatives focused on enhancing patient outcomes through process improvements.
• Received training in postpartum for 6 weeks, then level II NICU for 6 weeks, then was placed in my permanent position in L&D. This was Army Hospital Protocol
• Received extensive training in potential disaster response, as this is an Army Hospital and is only a couple of miles from NORAD in Colorado Springs.
• Circulated many vaginal deliveries and cesarean sections. Worked with many new doctors and residents, and was able to present my experience in order to help them develop their skills.
• Resigned after one year of employment as their plan was to put all of the civilian nurses on the night shift, and put Army Nurses on days, to "increase their visibility". I was already rotating shifts, however the prospect of full time nights was not something I wanted, and my daughter was back on her feet, so I returned to Arizona.

• Enhanced patient care by implementing evidence-based clinical practices and protocols.
• Developed educational materials and presentations for both internal staff members and community outreach programs related to healthcare topics.
• Increased staff retention rates by fostering professional development opportunities and creating a supportive work environment.
• Implemented quality improvement initiatives to continuously enhance patient care standards and overall performance metrics.
• Started as staff, then promoted within a year to Clinical Coordinator. Performed as labor and delivery RN. Made daily staff assignments. Supervised newer RNs. Attended staff meetings and participated in QI projects.
• Assisted with shoulder dystocia drills, postpartum hemorrhage drills, peripartum cardiomyopathy education, and assisted nursery to obtain level II status by assisting with preparation for AZ Perinatal Trust inspection of unit. Continuously watched all fetal monitors and conducted strip reviews.

• Utilized critical thinking skills to make quick decisions in high-pressure situations, prioritizing patient needs and addressing emergent issues promptly.
• Night Shift RN in very small OB unit doing approx. 10 deliveries a month. Received extensive self defense training as this hospital is located very near to several State, County and Federal prisons. Circulated vaginal deliveries, transitioned newborns, performed medical screening exams and triaged patients, circulated for Cesarean Sections and did newborn transition care, and floated to ED as an extra pair of hands, often starting IVs on babies and toddlers.
• Educated staff RNs in labor and delivery as most who worked there had little experience except for working in this tiny hospital.

• Trained new nurses in proper techniques, care standards, operational procedures, and safety protocols.
• Coordinated nursing care on unit through staff assignments, assisting and rounding with physicians, monitoring patient orders, and communicating with ancillary departments.
• Conducted daily shift briefs to inform staff of changes in patient care assignments.
• Mentored and supervised junior nurses, fostering a supportive and professional work environment.
• Began as staff RN for first 3 years, then applied for Charge position and was promoted. Very busy unit doing approx. 400 deliveries a month. Learned a wealth of knowledge due to working with a variety of physicians and midwives. Circulated vaginal deliveries, cesarean sections, recovery room, pre op and OB triage.
• As permanent charge, supervised approx. 17 RNs on a daily basis. Supervised OB triage, and assisted with expansion of triage unit from approx. 6 beds to 25 beds.
• Created new position within the dept. after obtaining approval from unit Director, which greatly increased the safety of the unit. At the time, Chandler Regional was the only hospital in a rapidly growing community and the waiting area always had a dozen or more triage patients waiting to be seen. I had an idea to create an actual triage position in which an RN would staff the waiting area, perform a quick assessment, obtain vital signs, and then decide which patient needed to be seen first in triage. Before this, patients would be seen on a first come first serve basis, which I felt was dangerous as so many patients would consistently be waiting out there having only been seen by a registrar. My supervisors were very happy with this change.
• Created a new policy from my Clinical Ladder project. At the time, labor inductions were done at the discretion of the obstetrician without input from management, which created abuse of the system. We had many complications due to long inductions such as chorioamnionitis, cesarean section, hyperbilirubinemia in newborns, sepsis of both moms and babies, and failed attempts at breastfeeding. After implementing my ideas which were to obtain documentation of medical reasons for induction PRIOR to beginning the induction, not allowing elective inductions on primips prior to 39 completed weeks of pregnancy or without a Bishop score of 7 or greater, and not allowing elective inductions on multips prior to 39 weeks of pregnancy and with a Bishop score of 6 or greater. I had many disussions with all of our OB/GYNs regarding how this would create better outcomes. I got 100% cooperation with this protocol, and one other feature of my protocol was that every OB was allowed one induction per month which did not meet the criteria, in case the OB simply had a gut feeling that the baby would be better off delivered than staying in the womb. This was not a popular decision but it proved to work well. It acknowledged the fact that doctors do have intuition, and their feelings should be acknowledged. Six months after initiating this protocol, we experienced a significant decrease in chorioamnionitis, unplanned cesarean sections, infant sepsis, infant hyperbilirubinemia, and breastfeeding failure. My project won an annual award from the NIH. Unfortunately, my supervisor at the time took 99% credit for creating the protocol, and lied to everyone via hospital email, stating it was a collaberative effort of "many nurses and doctors". Subsequent to that I resigned, although I loved my job and went to Mountain Vista. I would have been completely willing to share the credit, but as it was, the lying was something I could not live with.

• Utilized critical thinking skills to make quick decisions in high-pressure situations, prioritizing patient needs and addressing emergent issues promptly.
• Monitored vital signs, lab results, and other indicators to detect changes in patients'' conditions promptly.
• Maintained clinical competency through ongoing professional development activities such as workshops, seminars, conferences, and certifications related to nursing practice.
• Staff RN in L&D, postpartum, and newborn nursery
• Attended Childbirth Education classes and became certified, then taught childbirth education classes for approx. 2 years.
• Attended several management classes and acted as relief charge
• Left due to the unit closing

• Administered medications accurately and safely, reducing medication errors and adverse reactions.
• Enhanced patient satisfaction through effective communication, empathy, and timely response to their needs.
• Collaborated with interdisciplinary teams for comprehensive patient care plans, resulting in better health outcomes.
• Administered medications via oral, IV, and intramuscular injections and monitored responses.
• Trained in seizure management for adults and children with developmental disabilities
• Trained to administer medications to individuals having seizure activity, with RN supervision
• Administered tracheostomy care, GI tube care and feedings, patient assessment, and direct care and feeding of clients, behavioral management of agressive clients, and supervision of CNAs and Habilitation Technicians.
• Exposed to and educated about care of patients with various neurological diseases, including birth trauma and sequelae of abuse.
• 
  

• Administered medications via oral, IV, and intramuscular injections and monitored responses.
• Performed various nursing interventions such as wound dressing, vital sign monitoring, and specimen collection.
• Assessed physical, psychological, physiologic, and cognitive status of patients.
• Monitored patients' conditions and reported changes in physical presentation, appearance, and behavior to discuss treatment with physicians.
• Learned L&D at this facility, floated to postpartum, pediatrics and newborn nursery

• Utilized critical thinking skills to make quick decisions in high-pressure situations, prioritizing patient needs and addressing emergent issues promptly.
• Monitored vital signs, lab results, and other indicators to detect changes in patients'' conditions promptly.
• Served as a preceptor for new nurses, sharing knowledge, expertise, and best practices to improve their skills and confidence.
• Participated in unit-based quality improvement initiatives focused on enhancing patient outcomes through process improvements.
• Monitored and treated client seizure activity on a daily basis, administered tube feedings, trach care, and supervised direct care staff.
• Participated in monthly neurology clinics to hear discussions about various neurological conditions

• Monitored vital signs, lab results, and other indicators to detect changes in patients'' conditions promptly.
• Participated in unit-based quality improvement initiatives focused on enhancing patient outcomes through process improvements.
• Enhanced patient care by implementing evidence-based practices and individualized care plans.
• Head to toe assessments of residents on a regular basis, provided wound care, oxygen therapy, and administered medications.
• Position included holding the keys to the county morgue and accepting bodies coming in from the community.

• Assisted patients with daily living activities, promoting independence and dignity.
• Checked patient vitals such as temperature, blood pressure, and blood sugar levels.
• Promoted good oral and personal hygiene by aiding patients with shaving, bathing, and teeth brushing.
• Enhanced patient satisfaction by providing compassionate and attentive care.
• Attended and monitored dying patients, providing comfort at the end of life and assisting family members with grieving process