Daisy Award Employee Nomination Form :: Nationwide Children's Hospital

Daisy Award Nomination from Employees

Do you work with an exceptional nurse here at Nationwide Children's Hospital? Tell us about him or her!

Please complete the form below and write a specific story describing how he/she exemplified multiple criteria from the list below:

  • Inspired and generated enthusiasm and energy despite the challenges of nursing
  • Used critical thinking resulting in a positive outcome for a patient
  • Demonstrated extraordinary care through development of mutual trust, respect and emotional support
  • Acted as a role model in the nursing profession with flexible proactive leadership
  • Strived to go above expectations in his/her role
  • Significantly made a difference in the life of a patient or their family
  • Collaborated and communicated effectively with interdisciplinary team members
  • Mentored, educated or supported a staff member or family
  • Demonstrated the Nationwide Children’s values or mission

Multiple submissions are allowed from staff working with this nominee. If other team members have experienced exceptional behaviors from this nominee, encourage them to submit their own nomination with their own story.

Daisy Award Employee Nomination Form
Nominator First Name *
Nominator Last Name *
Job Title
Department
Work Phone Number
Work E-mail Address
Nominee First Name *
Nominee Last Name *
Nominee Job Title *
Nominee Department *
Please write a specific story describing how the nominee exemplified multiple criteria from the list above. *
Nationwide Children's Hospital
700 Children's Drive Columbus, Ohio 43205 614.722.2000