LEAD Nurse Award Nomination

Listens to and values each other’s input

Empathizes to understand and put our patients first

Achieves our goals together

Dedicates him/herself to make quality care and attentive service our priority

This nurse’s commitment to exemplary service is evident in their daily patient, peer, and interprofessional interactions. They consistently role-model the following award criteria:

1. Exemplary direct patient care.

2. Dedication to the highest standards of nursing.

3. Outstanding communication.

4. Dedicated Patient Advocacy

5. Notable contributions to the community.

Note: This award is for nurses to be recognized by their resident and/or fellow colleagues.

Your Name*
Confirmation*
- Agree
By checking the box above, I confirm that I am a resident or fellow who is nominating a nurse for the Nurse of the Month award.

Note: this award is NOT for nurses nominating other nurses, or to nominate attending physicians.
Your Email Address*
Your division or department
Name of the nurse you are nominating*
Floor/Department the nurse works on*
I am nominating this nurse because...*
Please describe a situation involving the nurse you are nominating that clearly demonstrates how he/she meets this award criteria.