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The Ottawa Hospital Nursing Bursary for RPNs

INFORMATION SHEET

Attention:
 Registered Practical Nurses

Program of Study:
 Enrolled or accepted in a degree program leading to a baccalaraureate degree in nursing and
eligibility to write the Registered Nurse Exam.

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Eligible:
 Employed at The Ottawa Hospital for two years as a full time, part time or casual RPN.

Application Forms:
 Available as of January 21, 2016
 The form must be completed and submitted electronically word document (not hand written).
 Please ensure that all sections are completed and the supporting documents have been
enclosed. This is the only information that can be considered by the bursary committee.
 This form must be submitted electronically. To obtain an electronic application:
 Email to Louise Klaassen at: lklaassen@toh.on.ca and request an application; or
 Complete form found on myHospital-Employee Services- Education and Training-Nursing-
Funding Information and Applications-Tuition and Bursaries
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Application form must be submitted by Thursday April 21, 2016:

 Email your completed application form to: lklaassen@toh.on.ca.
 Please send paper copies of all of your supporting documents to Louise Klaassen, Informatics
Administrator, Corporate Coordinator Nursing Education, Nursing Professional Practice
Department,
Mail Box 305, General Campus.

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Application
for
RPN NURSING BURSARY
Name: Jacob Benzaquen

Address: 1724 Kilborn Avenue

City Ottawa Postal Code: K1H 6M9

Department: The Rehabilitation Center

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Phone: (Work) 613-737-7350 (Home) 613-709-1727

Civic Campus General Campus Riverside Campus

TRC ✓ Corporate Other:

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I agree to submit transcripts of appropriate credentials from the educational institutions I attended. I am
in agreement to carry on employment within one of the Portfolios/Programs of The Ottawa Hospital, for a
period equal to one-year full-time employment. Failing to do so, I agree to refund the Bursary in full.

I further agree to submit a copy of my major paper or project report to the Corporate Coordinator ~
Nursing Education, within three (3) months of the completion of my school year.

Signature: Jacob Benzaquen (Type Name)

Date: April 15, 2016

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Please submit application on or before Thursday, April 21, 2016 to:

Nursing Education, Nursing Professional Practice Department

General Campus, Box 305

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Currently I am enrolled in the following University Program:

(This Bursary application is for one academic year or two semesters)

Bachelor of Science in Nursing AT University of Ottawa

(Degree Program applied for) (University)

Check most Accepted or Full-time or ✓

appropriate: Acceptance Pending Part-time

If part-time study - how many credits will you carry per semester?

University courses and grades attained to date (if applicable).

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Completed to Date:

Year 1 Phase 1 of Bridging Program Number of Credits 3

Year 2 Phase 2 of Bridging Program (Fall Semester) Number of Credits 12

Year 3 Number of Credits

COURSE Attach copy of transcripts of grades obtained to date, if applicable.

Have you received an Ottawa Hospital Bursary before? Yes

If yes, for which year(s) 2015

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1. EDUCATION
Completed Nursing Education:

Diploma Algonquin College- Practical Nursing 2013

(School of Nursing) Year

Other:
(Community College or University) Year

Other than Nursing:

B.A. (or)

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(University) Year

Masters
(University) Year

2. PROFESSIONAL DATA:

List nursing employment from current position to past experience for the previous 6 years.

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Length of
EMPLOYING AGENCY POSITION/SPECIALTY FT PT CAS
Service
The Ottawa Hospital Registered Practical Nurse March 2014 - ✓
Rehabilitation Center Present
Duke of Devonshire Registered Practical Nurse December 2013- ✓
May 2014
Retirement Residence

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3. Please list your educational activities for the past 12 months.

I am currently enrolled in the RPN to BScN bridging program that is collaborative with Algonquin College
and University of Ottawa.

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4. Have you presented at any nursing rounds, conferences or at an inservice within the last 2
years?
Yes No ✓

If yes, please state title, date and to whom you presented:

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5. List the Committee(s) and/or Taskforce(s) you have been involved within the past 3 years.
Please indicate with an asterisk those Committees required by your position:
Year(S) & Status
# of Mtgs
Committee Length I.E. Secretary,
Attended Per Year
Of Term Chair, Etc

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6. List memberships and/or office held within the past 3 years in professional Nursing
Associations and/or Health Care Organizations.
Organization Position/level of involvement

Registered Practical Nurses Association of Ontario Regular Membership

(RPNAO)

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7. Have you been a Preceptor to a student nurse or an assigned “buddy” or “resource” to a new
staff member within the past 5 years?

No Yes ✓

If yes, most recent year:____2015___________

8. Please tell us about the ways you have tried to improve the care you provide to patients.

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Being hospitalized can be a very difficult experience for many people often making them feel
more vulnerable as patients. As a nurse, one of the things I value the most is patient dignity and
integrity. Every shift I strive to promote and preserve the dignity and integrity of my patients. I
focus on maintaining the privacy and confidentiality of my patients at all times. I encourage my
patients to be independent in their care as much as possible and also to direct their care the
way they want it to be done. I am a strong advocate for my patients but I also try to encourage
my patients to be advocates for themselves. I believe it is important for patients to know they
have control in their care and to not be afraid to ask if they have any concerns. Above all, I
focus on making my patients feel comfortable, valued and respected. I believe maintaining
patient dignity and integrity will enhance patient satisfaction which will hopefully lead to
improved patient outcomes.

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9. Where you involved in any research projects? Please tell us how you were involved:

PRINCIPAL CO- DATA

NAME OF STUDY YEAR
INVESTIGATOR INVESTIGATOR COLLECTION

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10. Write an abstract describing your career goal in Nursing and indicate how this degree
will help you to reach this goal. (DO NOT exceed 100 words.)

Once I graduate from the BScN program I would love to work on a medicine unit. I believe
working in medicine is a good place to start my career as an RN. I feel that I will be able to
develop my skills as well as improve my nursing knowledge and critical thinking in complex care
situations. Eventually, I would like to pursue a Master’s degree to become a nurse practitioner.

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11. Other information of interest: (DO NOT exceed 100 words.)

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