Organisation: Government of Western Australia GradConnect program 2016
Job Title: GradConnect 2016 Registered Nurse
Word Limit: Maximum 250 words per response
Location: Various within the Department of Health
SC1: Demonstrated ability of how you assess, plan, implement and evaluate nursing care
Whilst on placement with Hollywood Private Hospital, I cared for a 55 year old female patient that
had undergone hip replacement surgery, experiencing post operative wound leakage and
infection. I replaced her traditional dressing with a PICO negative pressure wound therapy (NPWT)
unit to draw out excess fluid wound and promote healing. The wound continued to leak for two
days and the patient presented a pain level of 10. Her Patient Controlled Analgesia (PCA) unit was
not controlling her pain levels so the team decided to remove the Pico unit and wash the wound.
The following morning I reassessed the patient who was still experiencing high pain levels; I
checked her PCA finding that the release button had been pressed 1200 times but only 65ml of
analgesics had been released. I arranged a Doctor to visit the patient who assessed her then
increased analgesic dosage and prescribed complete bed rest, including the use of a bed pan to
reduce patient movement. During the night the patient only passed urine once which made me
concerned so I completed Bladder scan. I then catheterised the patient easily draining 445 ml. Post
drain, I administered Bolus antibiotic to prevent infection and provided pain analgesics every 2
hours. Her pain levels reduced considerably to a 5 and I encouraged her to intake fluids to
maintain hydration. At shift end my patient was comfortable and her wound dry and intact.
SC2: Provide an example/s of where your effective communication skills within a multi-
disciplinary team have resulted in quality patient care
During placement with Royal Darwin Hospital receiving a bedside handover, I heard a distressed
elderly woman calling for help. Despite using a nasal prong delivering 2L/minute of oxygen, the
patient complained of shortness of breath. Handover staff informed us of her ‘not full resuscitate
order’ (NFR) and request for no ICU admission. Her vital signs showed oxygen at 85% so I
suggested trying a Hudson mask but unfortunately she was unable to tolerate it.
Alternatively I fitted Venturi mask aiming for 95% oxygen level and requested a Doctor provide a
consult. My preceptor asked me to recommend suitable oxygen therapies – I recommended a
Reservoir mask, which allows oxygen delivery of up to 85% /15 litres per minute. A physician
arrived and agreed with my suggestion to fit 5L/min to a Reservoir mask. Sadly the patient was not
able to tolerate this mask either so I suggested the physician supply humidification, which is an
ideal option I a case such as this. This method also helps to prevent mucous membrane moisture;
the physician agreed and I was able to increase the patient’s levels above 90%.
Post stabilisation, I monitored the patients vital signs and documented her progress. The patient
successfully maintained an oxygen level of 95% under hourly observations. From this experience I
learned how to successfully apply an array of oxygen masks, maintain patient’s stability and
collaborate with a physician and my preceptor to obtain best care outcome.
SC3: Provide an example/s that demonstrates how you have considered the rights of an
individual or group.
Whist at Royal Darwin Hospital, I was caring for an indigenous male patient admitted with
hypokalaemia (Low potassium levels of the bloodstream) and transferring him to a previously
scheduled renal biopsy appointment, which I confirmed by sighting the patient signature on the
consent form. Suddenly he became very distressed and jumped out of the bed crying and now
refusing the test. I gently asked about his change of mind – he explained that his specialist had
informed him that a requirement of the test was to be inside for a period of at least 6 hours and
said that he would not have agreed to the test if he had of been aware of this earlier.
I offered him a cup of tea and discussed symptoms and reasons for the biopsy, he felt reassured
but still unsure. I informed my preceptor, took the patient back to the ward and arranged for him
to call his girlfriend and mother in their home of TIWI Island. Under direction of my preceptor, I
worked with a social worker to arrange flights for his mother the next day. The specialist and ward
manager re-explained the procedure to them both and he allowed it to go ahead. I felt that I had
made a really helped him and also learned about a culture different from my own. I realised our
multidisciplinary team of Doctors, social workers, kidney specialist and nurses has collaborated
cooperated together to provide him quality care.
SC4: Demonstrate how you can ensure that your practice is of the highest professional standard
with reference to the role of the ANMC competency standards, clinical guidelines and hospital
policies.
A Hospital’s library houses wide variety of manual materials available for nursing staff to access
that detail process, frameworks and instructions focussed on critical thinking and evidence-based
practices. Here I have access to the ‘clinical skills and nursing techniques book’ providing me with
a current information and sharing clinical skills & techniques that I can address for knowledge
around key safety issues or possible skill modifications, for specific patient needs. This resource
allows me to stay abreast of current and changing practice and assists me to provide quality care
to my patients.
My keen awareness of the safety practices of nursing were displayed whilst on placement with
Hollywood Private Hospital when changing a dressing before discharging a patient. During this
procedure I was required to remove a surgical drain, clean the wound under sterile antiseptic
conditions to prevent infection, and then apply a new sterile dressing. Conscious of providing my
patient with a sterile environment and to protect myself from blood contact I wore Personal
Protective Equipment (PPE) including gloves and safety glasses. Utilising these safety items
adhered to the hospital’s own safety policy and fell in line with Australian Nursing and Midwifery
Council (ANMC) competency standards that promote effective and responsive health care for all
Australian patients.
The above points clearly demonstrate how I can ensure that my practice is of the highest
professional standard with reference to the role of the Australian Nursing and Midwifery Council
(ANMC) competency standards, clinical guidelines and hospital policies.
SC5: Please give details about clinical placements you have completed during your studies
My ability to understand and interpret information has been proven by my consistent positive
results as indicted to me by my leaders and from feedback received by my patients, demonstrating
my ability to apply academic knowledge and concepts to practical situations.
My clinical placements spanning 18 weeks have been at a variety of sites over two different states.
The first placement of one week on Ward 4B -Tropical and Infectious Diseases Royal Darwin
Hospital (RDH) saw me learn many new techniques, medical terminology and abbreviations. I
practised bed making skills, controlling bed height for protecting my back and perfecting bed
height for correctly an comfortably re-positioning the patient.
The second years’ placement of four weeks on 3B Oncology & Neurology ward was also at RDH
and the third years’ placement incorporated four weeks elective placement with the Theatre Unit
of Hollywood Private Hospital followed by four weeks community placement with Altone Medical
Centre and the final two on a Mental Health placement with St John of God Mt Lawley. In each of
these placements I progressed solidly in my knowledge and was able to effectively communicate
with other nurses in industry-centric terminology, accurately and succinctly complete shift hand-
over sheets and demonstrate capacity to access, plan, implement and evaluate holistic patient
nursing care. Some of these practices included carrying out clinical post operative patient care
and assessment and observation of sedation score from zero to one and clear a patient for
transportation back to a general ward.
SC6: Please provide any "further" information that you believe may assist your application
Between January 2013 and February 2015, I held casual patient care positions at two separate
facilities in Darwin. Whilst working with Regis (TIWI Residential nursing home) as a Patient Care
Assistant I was accountable for carrying out personal care duties for patients including bathing and
pressure area care, eye and ear care, assisted with toileting, removed and cleaned bed pans and
urinals, applied anti thromboemboletic stockings and assisted with the collection of clinical data as
allocated by a Registered Nurse such as – gathering data on patient weight, observed patient
condition and assisted nursing staff with direct and in-direct patient care. At all times whilst
carrying out these duties I was dedicated to maintaining and preserving patient dignity, privacy
and confidentiality and strived to continually communicate with my patients and my supervising
Registered Burses and Enrolled Nurses.
As a Disability Support Worker with Somerville Community facilities in Darwin perform various
housekeeping tasks such as planned menus, administered medication, cooked and served meals,
provided companionship and support during daily activities – working both individually and as a
part of team. Supplementary to my previous practical experience I have also completed the
following courses First Aid Certificate and CPR with Australian Red Cross Society, Remote
Emergency Course certificate with CRANAplus and posses a Working with Children Clearance and
National Police History Certificate. Previously I have also completed volunteer work with St John
Ambulance.
