Requires NIH Stroke Scale Certification (or must obtain by end of orientation) AND 8 hours of Stroke related Continuing Nursing Education (CNE) contact hours annually if assigned to: Critical Care, Intermediate Care Unit, Emergency Department, Neuro Units, Cardiology Inpatient at Hopewell, Peds ED, PACU, Interventional Radiology, CNI, Observation, Hospital at Home. Uses discretionary judgments to appropriately modify patient care regimens; Facilitates appropriate response from other health team members using clear, convincing rationale; Evaluates the quality and appropriateness of care, identifies problems and initiates and documents improvement of care.