The Luminary Project/Proyecto Luminarias : Share Your Story

Luminary Contact Information

* First Name

* Last Name

* Credentials

Job Title

Organization

Date

* Email

Would you like your email posted with your story?

* Phone number (for internal use only)

Type of facility

* City or Town

* State or Prov.

Region

The Luminary Story

* Type of change in which you were involved (select all that apply by pressing the CONTROL and C keys while selecting)

* Issue(s) you addressed (select all that apply)

* Problem - please provide a brief background about the problem you addressed

* Solution - what changes were you able to achieve?

* How it happened - what steps did you take?

Your constellation - who helped make this change a reality?

Timeline for change - how long did it take from the time you identified the problem until the time it was solved?

Motivation - what inspired and motivated you to keep going?

Moving Forward

What's next?

Advice from the Luminary - any lessons learned, barriers overcome, surprises along the way, or anything you'd like to share

Resources you'd like to share - helpful websites, documents worth reading, or useful tools

Have you developed tools nurses would find valuable in working with their patients, facilities or communities: fact sheets, hospital policy, teaching materials? You will be given full credit for your work, which will be linked to your story.

Upload a video or audio recording of your story

Upload a photo

Are you willing to be a mentor to other potential Luminaries?

Your brief biography (1-3 sentences)

Reference for your Luminary story

* Reference Name - please provide the name of a peer or supervisor who knows your story

* Reference Phone Number

* Reference Email

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First Name

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