Shilu Gyawali

• Primary assessment skills with expertise in stroke protocol and neuro assessment/NIHSS screening for 5-6 patinets
• Responded to Code Blue and Rapid Response situations
• Patient and family education regarding diagnosis, prevention and recognition
• Champion for early mobility program, decreasing patient length of stay
• Cardiac rhythm recognition and interpretation
• Active participation in interdisciplinary rounding to formulate plan of care, advocate for patient needs and identify barriers to achieving outcomes
• Critical thinking regarding appropriate for level of care and plan of action/implement for patients
• Participated in unit practice council
• Support implementation of new products and equipment
• Charge nurse (responsible for maintaining the operation of the unit, optimize patient flow maintaining safety of all patients, supporting clinical needs of staff)
• Preceptor (responsible for training new and seasoned nurses, setting goals for assignments, implementing a learning plan, teaching time management and other adjustments according to the facility).

• Utilize clinical skills as per VA protocol
• Telemetry monitoring and plan of action in emergency situation
• Organized unit based social activities
• Served on Computerized Physician Order Entry (CPOE) support team
• Critical thinking and educating veterans based on their needs.

• Outpatient PACU: Monitor patients for bleeding, nausea, and vomiting after D&C
• Closely monitor vitals sign for early detection complication after a dilation and curettage procedure
• Administration of medication including, Depo-Provera, and RhoGAM shot
• Provide education regarding birth control, home care after procedure (D&C) and pain management
• Schedule for follow up visit.

• Specialized in sub-acute rehabilitation, clinical skills utilize includes tracheostomy care, advanced wound care, tube feeding, and Foley catheter care
• Administration of medication via Oral/IV/IM/SC
• Critical laboratory reports and interdisciplinary care plan
• Assist with ADL’s
• Long-term care, but not limited to Alzheimer’s and dementia patients
• Ensure and maintain a safe environment for the client, instruct client on safety practicing and increasing environmental awareness.

Staff Nurse - Emergency Department

• Managed emergency care for an average of 20 patients daily in a high-volume setting.
• Collaborate closely with an interdisciplinary team, including doctors, other nursing staff, and the EMS team.
• Implement patient triage protocol that reduces wait time.

Staff Nurse - ICU Department

• Oversaw critical care for a 10-bed ICU, attending trauma, cardiac, surgical, and medical patients.
• Coordinate with family, providing education on patient care and post-discharge instruction.
• Participate in the monthly staff meeting and quality improvement meeting, which increases the quality of care and patient satisfaction by 10% and decreases medication errors by 15%.

Staff nurse—labor & delivery, and postpartum

• Provide compassionate nursing care to women, including physical examination, medication administration, and vital signs.
• Assist doctors in delivering newborns.
• Evaluate medical risk for patient related to immune system deficiencies, medication side effects, poor nutrition, and heart conditions.
• Provide pre- and post-operative care to the patient undergoing a C-section.
• Provide post-delivery care to 8-10 mothers and newborns to ensure comprehensive recovery and lactation support.
• Administer medication and monitor vitals for both mothers and babies, focusing on preventing postpartum complications.
• Educate new parents on postpartum care, breastfeeding techniques, and newborn care.