Organisation: Sunshine Coast Hospital and Health Service
Job Title: Clinical Nurse
Word Limit: 2 pages max
Location: Nambour Hospital
Proven ability to comprehensively assess, plan, implement and evaluate nursing care at an advanced level
My ability to assess, plan, implement and evaluate nursing care has been demonstrated through not only my own work, but also in overseeing the ward as team leader. Recently whilst on night duty, I demonstrated my skills with a patient whom I had nursed over the previous couple of days and who appeared to be in some respiratory distress. The patient had been on high flow oxygen when I had been on shift the night before and hadn’t showed any signs of distress however during the day shift, had been transitioned to nasal tongs. I made the decision to assess the patient given his apparent distress and measured his oxygen saturation, which was only 82%. After giving him some time to relax, I took the reading again at 88%. As this was still a low reading, I checked the notes and found that the medical officer’s instructions were that he should remain above 90%. After performing a global assessment using his observation chart, progress notes, history and by talking to the patient, I put the man back on the high flow oxygen. As a result, his saturation went up to 92%, in line with the instructions given. In evaluating the patient over time, he felt much more comfortable at the higher oxygen rate and I ensured my shift handover made this clear.
Further to my individual patient care, as a Clinical Coach, my role is to enter the ward and talk to around 20 patients, observe them and make sure they’re comfortable. I often ask if they have any concerns and ask them about their health journey. If I have any concerns I will speak to their nurse and see if we can rectify the situation to their satisfaction. Often during this role, I answer questions for the patient which they might not have been able or game to ask their doctors, and ensure their nursing care is being administered professionally and adequately. This role has given me a different perspective on patient care and one that I now carry and am mindful of during my Clinical Nursing role.
Demonstrated ability to build and maintain effective relationships with team members, patients and other stakeholders, including participation in relevant networks to achieve work unit outcomes
Over the past 7 years on Medical Ward 4FW at Nambour General Hospital, I have built many productive and professional relationships with team members within a multidisciplinary team environment. I have provided leadership and have maintained an approachable and positive attitude through change. During two specific times where staff levels have been downsized and where the oncology responsibility of the ward was replaced by endocrine, I have lead with positivity and practical problem solving skills to ensure the ward ran smoothly and there was harmony among the nurses. I actively promoted a sense of unity and confidence that we could achieve excellent patient outcomes despite the changes, listened to staff and gave feedback on how to solve their issues at hand. Liaising and networking across our and other wards has enhanced my knowledge and understanding of the hospital as a whole and this knowledge has assisted in understanding and passing on that understanding of changes to others.
My ability to build effective relationships with patients is demonstrated through being aware of how to approach patients and ensuring proactive listening forms the bases of any discussions. One recent example was a patient who didn’t wish to be transferred to the Caloundra Hospital. He was disgruntled with the palliative care system and felt he had just been told he was going with no discussion. I was able to listen to the patient and explain why he needed to go there, after which he at least understood reasoning and was better prepared for the move. On another occasion I approached a patient who had suffered multiple pulmonary embolisms and who was worried about what was going to happen. I explained to her the Clexane and Warfarin procedures and the taking of both medications in the crossover. This simple explanation was all it took for the woman to relax and get some sleep.
Ability to provide nursing leadership in the clinical and professional setting including the demonstration of an advanced level of interpersonal, written and oral communication skills
In addition to my high level verbal communication skills in communicating with patients and colleagues, I have demonstrated my interpersonal skills through ensuring I understand the patient and their journey before giving them any suggestions or advice. Patients feel more able to talk when they are being listened to and doctors do not always have enough time to do this. As a Clinical Coach, part of my role is to talk to patients and find out their issues, as mentioned earlier.
On the ward, I like to lead by example first and foremost through work ethic, knowledge, working within my scope of practice and providing assistance to others should they require it. I lead the team to provide care to patients which adheres to nursing standards and which gives patients a sense of security. After the changeover of the last Government in Queensland, staff ratios were amended from 5:1 down to 4:1, affecting our team numbers and workloads. There was a large amount of negativity becoming apparent within the ward and I took it as my role to remain positive and not get caught up in the negativity. I did this by providing practical solutions to problems as they arose, by getting assistance for the ward when required, by networking to solve problems, by coaching and mentoring staff and by admitting that it is not what we wanted, but that we can certainly adjust to the new arrangements.
My written communication skills are such that I can successfully manage all of the written and reporting mechanisms required at Clinical Nurse level, including writing replies to the Nurse Unit Manager (NUM), facilitating performance appraisals and reviews, writing of progress notes to identify exactly what has occurred and writing of incident reports as required. In addition, my role includes ensuring handover sheets are completed comprehensively.
Proven ability to use information and reporting systems appropriate to the position
My use of the TrendCare system within my role as well as my demonstrated practice in accordance with legislation affecting nursing practice and health care are both demonstrations of my proven ability to use information and reporting systems appropriate to the Clinical Nurse position. Often when I come on shift, I enter the TrendCare system and make sure it is updated for the previous shift, inputting any extra information as required. This system helps to supply information for the business planning framework within the hospital and in budgeting for the ward ensuring hours and activities are properly reported and fed into the planning process. My role includes both the use of the system and educating others on the importance and accuracy of its use, encouraging independent use ongoing.
Reporting mechanisms within the Clinical Nurse role falls into Nursing Standard 1 and include a range of requirements, including the PRIMEing of incidents such as falls on the ward. When incidents such as falls occur, I remind nurses of their obligations to PRIME the incident, as well as the requirements for observations to be recorded, post-fall planning and a chest x-ray if there is any chest pain associated with the fall. These incidents are duly reported to the NUM and feedback on its analysis is provided to staff via email, ward meetings about the outcome and future procedures taking the incident into consideration. I have a strong working knowledge of other reporting processes including complaints from patients and workplace health and safety issues.
Proven ability to provide clinical education and support at an advanced level and demonstrate own professional development.
As a current Clinical Coach, I have demonstrated my ability to provide clinical education and support at all levels. This sharing of knowledge is something which comes naturally to me and I have an expert ability to provide solutions to problems quickly and easily. For example, on a recent shift as Clinical Coach, there was a patient who was having a blood transfusion and the nurse asked me if she had the correct giving set. Using this as an education opportunity with the nurse involved, I showed her the standard blood giving set incorporating a filter and gave her an explanation as to why this was the correct one to use. I went on then to ask whether the tick and flick sheet had been filled out, whether the patient’s temperature and blood pressure had been recorded and whether consent was in place. In giving this and other various forms of on the job education, I usually point the nurse to the right policy for what they are doing and teach them in a way where they will become independent the next time they are performing a similar task.
Other recent examples of education and support have included a patient which came to the ward wearing a venturi mask and directing the nurse to find out why they were wearing the mask rather than just accepting it, even though I knew it was for patients who retain C02. Similarly, one patient came to the ward wearing a Hudson mask and the nurse asked me what that equated to on the high flow oxygen equipment. I produced a conversion chart which I suggested she may like to carry in future.
My own professional development has included identifying my weaknesses and undertaking professional development and research in those areas, reading countless journal articles on new processes and evidence, attending a broad range of continuous professional development modules both online and in person and learning through the ward’s blood portfolio and more recently infection control portfolio responsibilities.
