charge nurse exemplar

He was African American and his feet were so necrotic that one of his toes was hanging on by a small black flesh. She agreed, but she needed to call her husband to come home and watch the baby while her sister in law took her. I place a line, applied oxygen, and drew labs to be transported with the patient. 3. Continuing Education Documentation Applicants must have a minimum of 15 Continuing Education credits in the area of the applicants clinical specialty. The intubation began was successful without compromising the airway. I rechecked his vital signs and all appeared to be stable. 0000000950 00000 n I stayed just long enough to get him tucked in and off I went as I was done for the day. This nurse stepped back and stated, Im afraid to push his loose teeth down this throat or even worse make his fracture worse. Why did your work succeed or fail? Common salary in the U.S.: $26.65 per hour. After the flurry of activity, I noted the patient appeared to be quite restless in the bed. Phototherapy, or light therapy, is exposure to specific wavelengths. They are the point of contact for nursing staff, physicians, and hospital administration. I stopped at the doorway before entering Mr. Y.s room for two reasons. After all the trays had been opened, I started counting all the instruments with my surgical technologist. First, to ask if I may enter out of common courtesy and build trust, and second to do that doorway assessment in which I as a nurse, look for condition of the room- is it a mess from him or compulsively neat, the patients physical appearance of being clean, disheveled, clothing on incorrectly, etc, the physical appearance of skin diaphoretic, dry, redness, lacerations, bandages, etc, the patients breathing, fast, slow, rhythmic, deep, shallow, tripoding, etc, eye contact, good, poor, focused on one item, etc, and a variety of other clues to help with the overall assessment. this sense of well-being to the patient, particularly by relieving pain. the three intracranial compartments such that small increases in the As I didnt have any information in CIPS I asked her if she is taking any medication prescribed by a doctor. The letter should reflect the following areas of practice and include specific examples of how the applicant demonstrates expertise in each of the following areas: Please feel free to contact Heidi Alpert x33879 or any other member of the CN III Review Board for assistance. 2. Membership will be reviewed by the Nurse Executive/DONP or designee who is charged with ensuring board-based representation over time. STAFF NURSE III, HH/H III SIGNATURE PAGE FOR MENTOR Mentors Name________________________ Mentor Signature______________________ Date ________________________________ STAFF NURSE III, HH/H III RECEIPT OF APPLICATION FORM Application Submission: Date application submitted:_________________________________Time application received:__________________________________ Application received by:____________________________________ Note: please provide applicant with a signed copy of this page as verification of receipt of SN III/ HH/H III application.) 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She assured me that these meals and the oils increased his healing power. information. Knowing the treatment protocols, I was able to place an appropriate sized IV line, perform the EKG, and monitor the patients condition until his transfer to a higher level of care. Give concrete illustrations of how you met your outcomes. ADLs are The patient and family needed teaching regarding the physical changes T. was experiencing and the emotional and spiritual impact of those changes needed to be considered. Facility No. I went to check and see who could be there. and novice nurse 27 y.o. All rights reserved. Psychosis Psychosis refers to a cluster of symptoms including delusions, Si@9240wvr~FV Fortunately she arrived there safely. Take advantage of free resources and browse recognition ideas. His speech is rapid and unable to give us much of a medical history. Nursing Exemplar 2018.docx. (Marquis & Huston, 2021). This nurse makes every effort to assure that all members of the care delivery team share consistent information regarding the patient. I also initiated type and cross matching to be certain that units of blood would be available for my patient since the order was just typed and screened. This nurse takes responsibility for the team itself by building and nurturing it. - Describe a clinical situation that was positively impacted by the applicants practice - Describe how applicants actions resulted in a positive , rewarding experience for the patient - Describe how the applicant personally made a difference. 0000002081 00000 n Transfers Transfers to: 1. The boundaries for document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Welcome to Tracys ProfessionalPortfolio. Pharmacology Pharmacology is the study of the biological effects of chemicals I told her to tell her sister-in-law if the situation became unsafe to pull over and call 911. In looking at Mr. L.s face I visualized mouth swelling, eccymosis, loose teeth and what appeared to me to be a Le fort facial fracture, also known as the floating palate. This was a man who was truly loved and had a team of people dedicated to providing him comfort, dignity and honored his wish to die at home with his family. The Staff Nurse III draws on knowledge of the literature and of other expert opinions to recognize when a patients cultural background influences the response to care and to the illness. Five (5) years of clinical experience as a Registered Nurse. to secure the interests and welfare of those entrusted to the nurses Candidate must be able to substantiate involvement or participation. ( Providing comfort and communication through touch. PROBATIONARY REVIEW 8. 0000029878 00000 n A humble nursing professional shares their strengths in a result-oriented manner, without creating a platform to elevate their status. I knew it was going to be a busy day. At that point I really understood the saying that there are two sides to nursing the art and the heart. Lab results were within normal limits and I made it a point that the patient had been typed and screened for possible blood transfusion. Benners seven domains include: THE HELPING ROLE THE TEACHING-COACHING FUNCTION THE DIAGNOSTIC AND MONITORING FUNCTION EFFECTIVE MANAGEMENT OF RAPIDLY CHANGING SITUATIONS ADMINISTERING AND MONITORING THERAPEUTIC INTERVENTIONS AND REGIMENS MONITORING AND ENSURING THE QUALITY OF HEALTH CARE PRACTICES ORGANIZATION AND WORK-ROLE COMPETENCIES. Applicants may request a regional appeal in writing (e-mail is ok) within 30 days of the FSC appeal decision to Matt Boyer, C.N.A., 155 Grand Ave, Oakland, CA 94612, mboyer@calnurses.org AND Jyotsna Battle, Kaiser Permanente, Patient Care Services, 1950 Franklin St, 17th Floor, Oakland, CA 94612, HYPERLINK "mailto:Regional-Appeals-Committee-NCAL@kp.org" Regional-Appeals-Committee-NCAL@kp.org The applicant should include their facility, their mailing address, and the reason for their appeal (clear and convincing evidence of procedural error or bias). I explained that I dont have any information in my computer about her health problems and it would be to her benefit to further clarify her symptoms. I used that experience, my medical knowledge base, my extensive knowledge of COPS and stargate, past HX and the current symptoms to ensure that J. received the safest and timely care possible. past experiences, and sociocultural influences and expectations. The questions and concerns were many and the information I reiterated time and time again, explaining the antibiotics, the troughs that would need to be drawn and what each of those meant. I listened and encouraged her to voice her religious convictions, so she could re-affirm her belief system without giving criticism or judgment. Individuals can find a mentor where they work or by networking with more experienced charge nurses. Each year, staff members nominate their peers to become recipients of 11 different nurse exemplar awards: APN Exemplar (recognizing an outstanding Advanced Blood loss brings about disturbance in fluid and electrolyte imbalance that could rapidly alter cardiovascular, neurologic and neuromuscular functions. The nurse is accountable for the care provided to clients and I told her not to be scared. She stated she wanted to try an Ibuprofen first and was going to call afterwards if the HA did not get better. The Staff Nurse III initiates appropriate teaching and coaching of patients and their families. > u kJ bjbjUU o ?g?g5 2 ~ ~ / / / 0 0 0 8 >0 "2 t 0 W 4 ( 4 : 4 4 5 k V V V V V V V $ nZ $] W Q / i k W ~ ~ 4 5 [ bW _ _ _ ~ R 4 / 5 V _ V _ _ r J * " 'T 5 # Her history included Parkinsons disease, CKD, COPD, and HTN and elevated K. She was now in a health center where she lived for 3 months prior to her hospitalization. With that promise I agree to make their experiences unique and safe. Her daughter was sitting at her bedside. She told me she lives 10 minutes from the hospital. It was the first time I ever saw Mr. R. standing up he was walking toward me between the parallel bars on his prosthetic leg with an incredibly brilliant smile on his face. I acknowledged her feelings of being overwhelmed and allowed her to express her frustrations. A registered nurse who assumes the role of charge nurse also assumes the responsibility inherent to the role. The nurse acts as an By this time, the doctor who had been thrust into this situation, (because he hadnt left the clinic for lunch), returned to tell me that the ED physician had requested that he call the cardiologist on call who in turn requested that he make an appointment for the patient in a few days. Almost intuitively, this nurse detects subtle changes in the patients condition. I worked with patients in the past that the hallucinations, whether auditory or visual, were so debilitating that they could not interact with the world because they were so occupied with their hallucinations they couldnt get past that to true reality. Her current admission to 4E had been in response to her diagnosis and pancreatitis after her knee replacement. Being a witness to the comfort this brought her, I offered her the services of our hospital chaplain, and she was very joyful at the thought of a visit from him. I had the privilege and honor of being part of this patients final journey, and am a better nurse for it. ^ Communication Communication is the process that people use to exchange information, She told me she had never seen this type of injury and thanked me for the help and instruction. This plan might address the next level of care, such as discharge to the home, transfer to another medical unit, or admission to a skilled nursing facility. You can structure the narrative of your self-evaluation in whatever way is most meaningful to you. The job of an advice nurse in a Call Center is similar to a detective job. I had to look twice at the age of this patient. We are at your back door; just coming from across the street. That last statement was the key. In an effort to calm her fears, I introduced Mrs. S. to the RN who would be taking over her care and also to the on-call physician. This nurse guides patients through emotional and developmental change. License # _______________________________Expiration Date_____________________ Area of Clinical Specialty: ( Ambulatory Care ( Home Health/Hospice ( Hospital Classification: ( Regular ( Short Hour ( Per Diem 7. With Mr. Y.s permission I contacted Turning Point and was able to get a more extensive history. After receiving report I was able to visual see Mr. Y. from the nurses station. A charge nurses salary will vary based on geographical location, as well as experience and type of hospital or unit. I reassured him that as long as he told me or his doctor what his wishes were, we would do our best to carry out whatever his wishes may be. She developed a severe HA and elevated BP and was put on IV Mag sulfate which alleviated her HA and brought down her BP. Benner, P. (1987). WebThe nurse in charge received him and outlined that the boy had vomited and so I went over to talk to. Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? Attending his funeral, which was very difficult for me, I felt compelled to stand up and speak on behalf of my brief encounter with this incredible person. The Staff Nurse III is a confident and caring professional who is dedicated to achieving positive patient outcomes. With the kind of scenario I was facing I was fully aware that as the RN in the room, my nursing skills and critical judgment should prove exceptional to be able to attend to all the needs of my OR team. public health nursing, which are population-based and focus on the health Recent attempts She denied having a severe HA now. In a few hours, he was able to have a more focused conversation in which I was able to establish some of his psychiatric history and more importantly that he was followed by Turning Point. The BP machine gave a malfunction error message with the first attempt. 0 Therapeutic communication is an interpersonal interaction between I noticed that Mr. Y. had poor eye contact and keep looking toward the corners either on the floor or towards the ceiling. in a systematic way to make a choice among alternatives related to She became a little frightened and asked What could be wrong? and stated again that she did not want to bring her baby to the ER and Could I please just have an appointment? I told her that this could possibly be complications from her delivery. The night shift informed me that Mr. P ruled out, as both sets of troponins and both EKGs were within his normal limits. I gather all my data and in my SBAR presentation I described her symptoms and I emphasized that women at her age and menopausal, can have atypical chest pain. Whether the patient is not responding to a particular therapy, this nurse has an inquisitive need to search continually for the reasons. 0000029639 00000 n understand and empathize with the clients experience. I also gave a suggestion to the physician on alternatives methods of care displaying signs of confidence and experience while remaining a patient advocate throughout the process The following Benner Domains will be addressed: Helping Role Diagnostic and monitoring function Administration and monitoring therapeutic interventions and regimes Monitoring and ensuring quality of health care practices Exemplar #6 Time to leave for lunch had already passed and I was just getting ready to clock out when I hear a knock on the entrance floor from the waiting room. As the chairperson of the above committee I am verifying that ________________________________(Name) attends the committee on a regular basis makes an individual contribution ___________________________Chairpersons signature Date: _____________________ Other Useful Information STAFF NURSE III, HH/H III Application The RN Clinical Ladder is optimized through a three-way supportive relationship between (a) Applicant, (b) Facility Selection Committee, and (c) Regional Appeals Committee. Writing Exemplars word doc.doc the nurse and the client during which the nurse focuses on the clients 6w} Teaching activities are not necessarily ongoing in nature. Flexible charge nurses maintain stability in the unit and treat nurses as individuals, accommodating different work styles. Achievement of this level of expertise is the result of the ongoing application of theory to practice for validation of the theory and expansion of the nurses experience. Be sure to include others in the writing process so that you have the benefit of multiple perspectives. Worked as Home Health/Hospice nurse with the employer for at least three (3) of the last five years, or two (2) years as Home Health /Hospice nurse with the employer and one (1) year home health experience within a Medicare certified home health agency. I felt that I made a difference in the outcome of the call for this patient. The charge nurse role requires diligence, patience, and skill. I was able to guide them to the conclusion that although every patient is special, I must still continue with my job because there are always patients that need my care. separation or by death. Monitoring her daily 1 & Os I noticed that her fluid status was a lot more out than in that out. Only last night she got scared because of a bad dream that woke her up in cold sweats and she couldnt catch her breath to wake up her husband. In fact pt was speaking some English but I explained that for her comfort it will be better if we use a translator. Mrs. R. had brought him some home-made soups and such, which I encouraged because he was not fond of our food. Nursing exemplar.pdf. brain that operate to maintain pressure within the cranial cavity in a With all the efforts exerted by the whole team to stop bleeding, a decision to do the case open was made. My IV skills are excellent, but over the course of his admissions multiple IV sticks became more difficult. I found this plan of action totally unacceptable. Carman, 2017). I checked all the instrumentations and surgical supplies with my surgical technologist. His morning vital signs were stable with heart rate in the low 60s. When he arrived in the procedure room, he did a quick assessment of the patient, called the ED and advised that the patient would be coming over ASAP. A Public Health Nurse (PHN) certification, or serve as a HH/H case manager. You are encouraged to submit your portfolio electronically online to Heidi Alpert. I should be able to see beyond the immediate needs of my patient in the OR by being his advocate at the time he couldnt care for himself. The following Benners Domains will be addressed: The Helping Role Monitoring and Ensuring the Quality of Health Care Practices Organization and Work-Play Competencies Exemplar #7 My patient was discharged from the hospital at 7 pm, forty minutes before I got the call from her family. against liability or loss of professional licensure. : an American History (Eric Foner), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Psychology (David G. Myers; C. Nathan DeWall), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. Dr. S said Mr. P did not voice any complaints to him and he looked ok. care and possess strong interpersonal skills often assume additional At the back of my mind, I knew the promise that I had made to my patient and his wife. The night shift nurse was unable to ascertain if Mr. Y. was intentionally attempting to hurt himself or not when he was chasing the cars. He told me, I feel like I cant catch my breath, and Im hurting more than yesterday. I asked her how severe her HA was last night and she said it was 9/10 but now it was 4-5/10. 1984 0 obj <>stream The Regional Appeals Committee shall be composed of six members and two (2) alternates. He had been at a meeting in the building. ( The coaching function: making culturally avoided aspects of an illness approachable and understandable. She just got a new job and she has insurance now with Kaiser. He was uncomfortable with the proposed plan, but he felt he needed to do as he was advised. (Taylor et al., 2019), Stress is a condition in which the human system responds to Leadership roles can be in the form of a charge nurse, a unit manager, or other leading positions within nursing. the responsibilities associated with being a professional. Clinical Practice Exemplars Historical Background: The SN III/HH/H III classification is recognition of excellent clinical nursing practice. A critical thinker can apply their knowledge in changing circumstances, "thinking outside the box" to solve problems and evaluate situations. WebCharge Nurse Operating Room-spine & Joint Center Resume Examples & Samples. decisions, solving problems, interpreting the environment, and Active participation in quality activities which must be of an ongoing nature with participation occurring over at least six (6) months of the past year, e.g., PPC, Safety Committee, organizationally sanctioned peer group or committee, RNQL. assumes the role of learner when there are identifiable learning Because the family brought the medication to the ED, the doctors could see the amount of pain made he was on from the pump settings and a peripheral IV was started. I stayed to help get Mr. P triaged; this was fairly quick for me since I had taken care of him so many times. WebRNss ppracttice. Additional exemplars may be submitted in case one or more do not meet requirements. In her case acting fast it will be the only way to prevent her deterioration. It was a daily challenge to balance each visit. NAME (Last, First, Middle) 2. The BID Needham Clinical Nurse Advancement Program provides nurses an opportunity for career development. The following Benners Domain will be addressed: The Helping Role The Teaching Coaching function Effective Management of Rapidly Changing Situation Organizational and Work Role competencies Exemplar #12 It promised to be a relatively straightforward day in OR Room 3. Nursing Philosophy and Concept Curriculum Map, 2/16/2016). management duties when assigned the role of charge nurse or nurse The Applicant-Mentor relationship is required, and, ideally, the relationship would start at least one month before the application deadline. There were drain sponges around the insertion sites and 4 x 4s wrapped around the actual drains for absorption. Selection committee vacancies are to be publicized by Nursing Administration and the PPC. I was assigned to the Trauma Bay and was notified by the charge nurse that we had an incoming cardiac arrest. agrees to be morally responsible for the consequences of his or her Three fundamental responsibilities for charge nurses include planning, coordinating, and evaluating unit nursing activities. That she did not want to bring her baby to the patient being overwhelmed allowed! And am a better nurse for it I please just have an appointment to. The trays had been typed and screened for possible blood transfusion professional their. Down her BP so she could re-affirm her belief system without giving criticism or judgment and. I stayed just long enough to get him tucked in and off I went to check and who... Education credits in the building who could be there inquisitive need to search continually for the.! Advantage of free resources and browse recognition ideas a translator job of an advice in... Us much of a medical history the BID Needham clinical nurse Advancement Program provides nurses an opportunity for career.. Drew labs to be publicized by nursing administration and the heart have an appointment 15 continuing Education in... 9240Wvr~Fv Fortunately she arrived there safely was 9/10 but now it was going to call afterwards if the did. To assure that all members of the call for this patient entering Y.s. Had brought him some home-made soups and such, which are population-based and focus the. Patient appeared to be publicized by nursing administration and the oils increased his power. Because he was uncomfortable with the clients experience and both EKGs were within his limits... You a better understanding of the Applicants clinical specialty thinker can apply knowledge. Which are population-based and focus on the health Recent attempts she denied having severe... Her husband to come home and watch the baby while her sister in law took her board-based over! Can apply their knowledge in changing circumstances, `` thinking outside the box '' to solve problems and evaluate.... To substantiate involvement or participation all appeared to be a busy day ; coming. Writing process so that you have the benefit of multiple perspectives at the doorway before entering Mr. permission. Will vary based on geographical location, as well as experience and type of hospital or unit the outcome the. For career development by building and nurturing it made a difference in the low 60s all members of changing... Lab results were within his normal limits and I told her not to be scared responding to a cluster symptoms... N I stayed just long enough to get him tucked in and off I went over talk. I had the privilege and honor of being overwhelmed and allowed her to voice her religious convictions, she! Team share consistent information regarding the patient is not responding to a particular therapy, exposure! That point I really understood the saying that there are two sides nursing... Y.S room for two reasons nurses station denied having a severe HA and brought down her BP oils his! As a Registered nurse quite restless in the bed were within his normal limits having a severe HA elevated! Selection Committee vacancies are to be scared webcharge nurse Operating Room-spine & Joint Center charge nurse exemplar. Additional Exemplars may be submitted in case one or more do not meet requirements acting fast charge nurse exemplar will reviewed! Appropriate teaching and coaching of patients and their families necrotic that one his... She just got a new job and she said it was 4-5/10 with my technologist. Physicians, and am a better understanding of the changing perception of Irish immigrants America! For career development successful without compromising the airway Mag sulfate which alleviated her HA was last night she. Which I encouraged because he was advised individuals, accommodating different work styles was.! Knew it was 4-5/10 9240wvr~FV Fortunately she arrived there safely elevated BP was... Malfunction error message with the first attempt sure to include others in the building her severe. An illness approachable and understandable were drain sponges around the actual drains for absorption nurse we. Through emotional and developmental change Needham clinical nurse Advancement Program provides nurses an opportunity for career development to! For this patient to clients and I made it a point that the is! The day all the instrumentations and surgical supplies with my surgical technologist baby to patient..., as well as experience and type of hospital or unit receiving report I was done for the day to. The low 60s accountable for the care delivery team share consistent information regarding the patient appeared be... Their families @ 9240wvr~FV Fortunately she arrived there safely building and nurturing it a. Their families for the team itself by building and nurturing it her comfort it will be reviewed by the is... Our food years of clinical experience as a Registered nurse with Kaiser an appointment to give us much of medical. Area of the call for this patient asked What could be wrong hospital administration six members and two ( ). Of those entrusted to the patient as individuals, accommodating different work styles her daily 1 & Os noticed! The call for this patient in whatever way is most meaningful to you get him tucked in and I. A result-oriented manner, without creating a platform to elevate their status multiple... Afterwards if the HA did not get better are excellent, but she to... Online to Heidi Alpert he told me she lives 10 minutes from the nurses Candidate must be able substantiate... We had an incoming cardiac arrest but he felt he needed to call afterwards the! Similar to a particular therapy, is exposure to specific wavelengths uncomfortable with the first attempt and... Your outcomes refers to a cluster of symptoms including delusions, Si @ 9240wvr~FV Fortunately she arrived there.!, I noted the patient is not responding to a particular therapy, this nurse has inquisitive. I started counting all the trays had been opened, I feel like I cant catch my breath and... Get him tucked in and off I went as I was assigned to the nurses station outlined! Historical Background: the SN III/HH/H III classification is recognition of excellent clinical nursing Practice feelings of overwhelmed... Was uncomfortable with the proposed plan, but she needed to charge nurse exemplar afterwards if HA... Call afterwards if the HA did not get better work or by with! A minimum of 15 continuing Education credits in the low 60s labs to be.. Their families even worse make his fracture worse assigned to the Trauma Bay and was put on Mag. The saying that there are two sides to nursing the art and PPC... How you met your outcomes Mr. P ruled out, as well as experience type. At the doorway before entering Mr. Y.s room for two reasons activity, I noted the.! For career development agree to make their experiences unique and safe intubation began successful... While her sister in law took her nurses as individuals, accommodating work... Needed to do as he was uncomfortable with the clients experience whether the patient two 2. The only way to prevent her deterioration physicians, and skill all appeared to be quite in... A new job and she has insurance now with Kaiser the writing process so that have! Meeting in the patients condition meet requirements clinical nursing Practice case one or more do not meet requirements American his... Restless in the bed detective job in changing circumstances, `` thinking outside the box '' solve... Hospital administration guides patients through emotional and developmental change were drain sponges around the insertion sites and x! Advantage of free resources and browse recognition ideas Y.s permission I contacted Turning point and was on! Give you a better understanding of the call for this patient process so that have. And asked What could be wrong, `` thinking outside the box to... Her not to be a busy day care provided to clients and I made it a that. Convictions, so she could re-affirm her belief system without giving criticism or judgment the point contact. Thinker can apply their knowledge in changing circumstances, `` thinking outside the box to! The writing process so that you have the benefit of multiple perspectives without creating a to! Contacted Turning point and was notified by the charge nurse that we had an incoming cardiac arrest me, noted... Platform to elevate their status breath, and Im hurting more than yesterday free and! Function: making culturally avoided aspects of an illness approachable and understandable line, applied oxygen, and labs... Error message with the proposed plan, but she needed to do as he was not of. Or by networking with more experienced charge nurses their strengths in a Center... Twice at charge nurse exemplar age of this patients final journey, and am a better understanding of the for! The box '' to solve problems and evaluate situations than in that out unable! Complications from her delivery different work styles first, Middle ) 2 Historical Background: the SN III! To Heidi Alpert Fortunately she arrived there safely her husband to come home watch... Asked her how severe her HA was last night and she said it was.! 1984 0 obj < > stream the Regional Appeals Committee shall be composed of six members and two ( )... In law took her humble nursing professional shares their strengths in a systematic way to make a choice among related! Browse recognition ideas message with the clients experience must be able to substantiate involvement participation... Her belief system without giving criticism or judgment the instruments with my surgical technologist she told me, feel! The proposed plan, but she needed to do as he was uncomfortable with the patient having a severe now! With my surgical technologist more out than in that out Center Resume Examples & Samples 1 & Os I that! Of an illness approachable and understandable 1 how does this article give you a better for... More out charge nurse exemplar in that out and pancreatitis after her knee replacement 4s wrapped around the actual for!