Alex Stuetze Pediatric Award Nomination
This award honors nurses who demonstrate extraordinary dedication to pediatric care. Use the prompts below to describe how your nominee exemplifies excellence in caring for children and their families. Including specific stories or examples will strengthen your submission.
Nominator Full Name
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First Name
Middle Name
Last Name
Nominator Email Address
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example@example.com
Nominee's Full Name
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First Name
Middle Name
Last Name
Facility Name
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Please provide the name of the healthcare facility where nominee works.
Nominee Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Nominee's Personal Email
example@example.com **Please note that some healthcare facilities have security protocols that prevent work emails from receiving messages from external sources.
General Directions
Use the prompts below to describe how this nurse exemplifies excellence in each category. Specific examples and stories will help bring your nomination to life. Please do not include the nominee's name or place of employment in your submission.
Understanding Children's Physical and Emotional Needs (250 words max)
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How does this nurse recognize and respond to the unique physical and emotional needs of pediatric patients?
0/250
Inclusion of the Child's Family in Care (250 words max)
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How does this nurse involve and support families as essential partners in the child's care?
0/250
Empowering Patients and Families in Decision-Making (250 words max)
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How does this nurse encourage shared decision-making and respect the voices of children and their families?
0/250
Going Above and Beyond Their Daily Job (250 words max)
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Share examples of how this nurse has exceeded expectations to improve the experience or outcomes for pediatric patients and families.
0/250
Submit Nomination
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