2023 NSRC Respiratory Therapist of the Year Nominations

2023 NSRC Respiratory Therapist of the Year

Please fill out the information as completely as possible.

1. Your nominee for Respiratory Therapist of the Year, MUST be an AARC member and practice in the state of Nebraska.

2. The essay about your nominee must consist of a minimum of 2 or more of the requested character attributes: Patient/Customer Focus, Professionalism, Teamwork, Quality and Innovation, and or Other Characteristics.

3. Fill out the contact information completely for you and your nominee.

4. All nominations will be thoughtfully reviewed by the NSRC board, the nominee who the NSRC board feels best embodies the character attributes defined will be selected as the 2023 NSRC Respiratory Therapist of the Year.

Questions regarding this survey can be sent to Melissa Gulizia, NSRC Delegate at mgulizia@madonna.org, or Lil Oneill, NSRC President at Lil.ONeill@bryanhealth.org.
Thank you for your nomination.

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* 1. Person submitting the nomination. We may need to contact you regarding your nomination.

Name:

AARC Number

Address:

City/Town:

State:

Zip:

E-mail Address:

Phone number:

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* 2. Nominee Name and Respiratory Credentials

Name & Credentials

Nominee's AARC Number

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* 3. Nominee Contact Information

Company Nominee works for:

Address:

City/Town:

State:

Zip:

Nominee's E-mail Address:

Nominee's Phone Number:

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* 4. Your candidate works in the following respiratory care environment.

Hospital

Home Care

Rehabilitation

Sleep

Diagnostics and PFTs

Respiratory therapy education

Other (please specify)

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* 5. Patient/Customer Focus: Explain how the nominee has performed "beyond the call of duty" to provide safe and compassionate patient care?

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* 6. Professionalism: Describe the nominee's professionalism and dedication to their patients, colleagues, organization, community, state, and/or national professional organization.

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* 7. Teamwork: Give a narrative that demonstrates the nominee's "spirit of team work."

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* 8. Quality and Innovation: Tell the nominee's story on developing ideas, projects, initiatives, that resulted in benefits for their patients, organization, community, or state.