Kathryn M. Mullane Annual Application 2021
These awards are made possible by the contributions of the Mullane Family, who values the nursing profession and the outstanding care nurses provide for their patients.  These awards will be made in honor and memory of Kathryn M. Mullane.

Nominations may be submitted by any member of the Saint Francis Hospital staff, physicians, patients, family, and friends of patients.

Criteria:
Please consider nominating a nurse who exemplifies the qualities of the nursing profession.

•	Compassion
•	Sharing
•	Communication
•	Goes above and beyond to appropriately meet the needs of the patient and their family/friends
•	Team player, collaborates

Please print or type:

Name of Nominee (Credentials):  	

Unit/Dept:	 	

Nominated By:		Phone Number:  	

Please attach a type-written narrative describing why this nurse is being nominated. Include specific examples supporting the qualities listed above (required).
Letters recognizing outstanding nursing contributions of the nominee may also be attached and submitted.

A nurse may receive this award once in a five year period.

Applications will be reviewed and nominees will be selected by previous recipients of the award.

Please submit all completed forms to dlitvinc@trinityhealthofne.org or fax to 860-714-8190 or interoffice to Dawn Litvinchyk, Nursing Education Department by April 30, 2021