1. Demonstrated clinical knowledge and experience in the delivery of evidence-based nursing care within a clinical setting.
Evidence based nursing care is an approach that integrates the best available research evidence with clinical knowledge and patient values to deliver quality nursing care. One example of evidence-based nursing practice is Medication Safety. During my clinical placement in the Emergency Department at Sir Charles Gairdner Hospital (SCGH), I was tasked with administering the antibiotic Cephalexin via a peripheral intravenous cannula (PIVC). I reviewed the medication chart to check the order was charted correctly. I accessed MIMS online in order to provide correct education to the patient and gain consent. I located the Nursing Practice Guidelines on administration of intravenous medication to ensure I prepared the antibiotics as per infection control guidelines. I mixed the Cephalexin according to the Australian Injectables Handbook, confirming the correct diluting agent, volume and time to be administered. I completed the Six Rights of Safe Medication Administration plus allergies and expiry date at the patient’s bedside in the presence of my preceptor and a second registered nurse as per hospital policy. I performed a peripheral intravenous assessment score (PIVAS) to ensure the PIVC was safe to use. Once I administered the Cephalexin, I presented the medication chart to my preceptor to sign ensuring right documentation which finalised the Six Rights of Safe Medication Administration. The result was safe administration of medication using best practice guidelines to ensure patient safety by reducing the risk of medication error and the risk of infection and complication.
2. Demonstrated effective interpersonal, negotiation and conflict resolution skills within a clinical setting.
Effective interpersonal and negotiation skills are vital to manage conflict and requires a high level of communication skills. During my clinical placement at Homelink SCGH, I attended the house of a patient requiring wound management to a chronic leg ulcer. The patient appeared low in mood and refused treatment. This was my third visit to the patient’s house and I recognised that this wasn’t the patient’s usual presentation. Using the LASSIE approach to conflict resolution, I asked the patient if he could tell us the reason for declining his dressing. He stated he’d had enough of the pain and didn’t like waiting all day for nurses to attend his house. To demonstrate active listening, I summarised the patient’s concern and acknowledged his frustrations. I asked if we could sit down and discuss possible options, which he agreed to. Firstly, I enquired about his pain management regime and noted that he was not taking his pain relief as directed. I educated him on his prescribed analgesia and differentiated slow and immediate release medications. Secondly, I advised him that Homelink offer some flexibility in visiting hours and if he provided some parameters of visiting times, we would do our best to visit within that time-frame. By taking the time to communicate with the patient, he consented for me to complete his wound dressing, reducing the risk of complications and I was able to add a four-hour time-frame to the patient file, increasing patient satisfaction.
3. Demonstrated effective written and verbal communication skills within a clinical setting.
Effective written and verbal communication skills are vital for the delivery of safe nursing practice and the continuation of care between departments. During my placement on the High Dependency Unit at SCGH, I admitted a patient from the Emergency Department for respiratory distress, pyrexia and a productive cough. Following a head to toe assessment, I felt the patient should be nursed in an isolated room with droplet precautions in place. I phoned Infection Control and handed over the patient using the ISOBAR format, by which I identified the patient, discussed their presenting situation, detailed their current observations and gave information preceding their admission including past medical history. Infection Control and I agreed on a plan to commence droplet precautions. I read back their recommendations in order to solidify the plan. As it can be confronting for a patient to see staff members in personal protective equipment (PPE), I explained droplet precautions to the patient in order for them to understand the rationale and reduce anxiety. I also educated the patient’s visitors on droplet precautions and demonstrated correct application of PPE. In order to convey to medical and allied health staff of the initiated precautions, I placed a sign that read “Droplet Precautions” on the patient’s door, updated the hand over sheet on iSOFT and clearly documented the precautions in the patient’s nursing care plan and progress notes. These interventions resulted in minimising the spread of infection, patient centered care and the formalisation of a clear treatment plan.
4. Demonstrates an understanding of the principles of quality improvement and risk management within practise.
Quality improvement and risk management are managed by working in consultation with the National Safety and Quality Health Service Standards, which are designed for health organisations to deliver safe care and minimise harm. As part of my role as an enrolled nurse at The Hollywood Clinic, I volunteered to be responsible for Standard 5- Patient Identification and Procedure Matching. In 2018, I conducted an audit on the visibility of patient’s identification bands. The outcome of the audit concluded that it was an area in need of improvement. On review of the audit, I was able to determine two causes for the lack of patient identification band visibility. Firstly, due to the average length of stay on the ward, the details on the band were often faded. Secondly, patients were removing their identification bands when going on leave. Using the Quality Improvement Cycle, I implemented several changes to improve patient identification visibility including liaising with the ward clerk to initiate two bands being printed at the time of admission so there was always one spare kept in the patients file. I created a document with instructions to print identification bands and held an in-service to educate and demonstrate to my colleagues how to print identification bands. A nursing task was also created on Sunday afternoon shifts to check patient identification bands were intact and legible. The evaluation of the changes was positive leading to a 100% compliance rate on the evaluating audit.
Clinical Placements
Student Registered Nurse
April-June 2019- Sir Charles Gairdner Hospital- High Dependency Unit
Responsibilities included:
-Strict monitoring of physical observations
-Titration of inotropes
-Delivery of non-invasive oxygen therapy
-Care of arterial lines
-Monitoring of arterial blood gasses
-systematic head to toe assessments
December 2018- Sir Charles Gairdner Hospital- Emergency Department
Responsibilities included:
-A-E assessment
-Monitoring of physical observations
-Recognising and responding to clinical deterioration
-Risk assessment
-De-escalation
July 2018- Sir Charles Gairdner Hospital- HomeLink
Responsibilities included:
-Autonomous nursing care in the community
-Wound management
-Drain care
-Coagulation assessment
-Monitoring of physical observations
Student Enrolled Nurse
February 2016- Sir Charles Gairdner Hospital- Short Stay Unit
August 2015- Selby Lodge Older Adult Mental Health
April 2015- Brightwater Inglewood Aged Care
Additional Info
-Ramsay GradPlus “Graduate of the Year” 2018
-HESTA Australia- Finalist “Graduate of the Year” 2018
-WA Nursing and Midwifery Excellence Awards- Finalist “Graduate of the Year” 2018
-Sir Charles Gairdner Hospital Partnership Student 2018-2019
-Enrolled Nurse Graduate Program 2017/2018 in Oncology/Mental Health
-Committed to Professional Development- Completed courses in Cognitive Behavioural Therapy, Conflict Management, Immediate Life Support
-Experience in Quality Improvement- Ward Champion for Standard 5- Patient Identification & Procedure Matching
-Participation in Hospital Accreditation
-The Hollywood Clinic Employee of the Month: August 2018, December 2018, March 2019
-Regular preceptor to students and new staff
I am an enthusiastic graduate registered nurse with a passion for high quality nursing care. I have been an enrolled nurse for three years with experience in oncology and mental health. During my graduate year I was recognised for excellent leadership skills and commitment to patient centered care by being nominated for three Graduate of the Year awards. My commitment for professional development saw me take the leap to study a Bachelor of Science to further develop my career as a registered nurse. Throughout my studies, I have maintained a Distinction+ average and have continued seeking professional development by enrolling in courses to enhance my skill set. I was successful in securing a Partnership Program with Sir Charles Gairdner Hospital and completed all three of my clinical placements in a variety of areas broadening my skill set and igniting a passion for critical care. I have always received positive feedback from preceptors, clinical facilitators and patients on my bright, positive attitude, compassion, my ability to take initiative, critical thinking and teamwork. It is those skills and values that I wish to bring to a graduate registered nurse program.
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