Organisation: St John of God Health Care
Job Title: Registered Nurse
Word Limit: 350 – 500 words per response
Location: Midland Hospital
Recent clinical experience in an acute care/relevant environment
A passionate Registered Nurse, I am committed to providing the highest standards of care to my
patients at all times. The Australian Nursing and Midwifery Foundation states that competent
nursing practice is “the combination of demonstrated skills, knowledge, attitudes, values and
abilities that underpin safe and effective nursing care”. As such, I strive to embody these values at
all times, regularly reflecting on my practice to enable me to hone my skills as a nurse and, in turn,
the care I offer to patients on an on-going basis.
In my current position of Registered Nurse at Regents Garden Aged Care Facility, one of the
residents under my care had a habit of eating food very quickly and was a choking risk. During one
of my shifts, I was alerted to a serious incident by the carer looking after this resident. I
immediately requested her to call for an ambulance and hurried to the afternoon team room.
When I first arrived, I thought she was having a seizure and presented with an ashen appearance,
bradypnea, and was unable to cough or speak. Knowing the patient’s history, I immediately
suspected choking and decided that first priority was to clear the airway and restore breathing in
order to get her oxygen saturation to greater than 90%.
The resident’s face was blue due to cyanosis. I attempted to open her mouth but she was
uncooperative, so I bent her forward to administer back blows which was unsuccessful. I
requested she then open her mouth and I gave back blows again, fortunately several large chucks
of food came out/ At this point, her breathing returned, although not completely, and I placed her
in the recovery position. Suction was attempted in order to remove the obstruction but was
unsuccessful as the resident was unable to open her mouth completely. When the ambulance
arrived they were also unsuccessful at suction to remove the obstruction and attempted nasal
suction which was finally successful.
The resident’s recovery post obstruction removal was quick, with her oxygen saturation returning
to over 90% and her colour restored. She also became responsive prior to being transferred to
hospital. To avoid further such incidents, she was changed to a soft diet with supervision. Further
to that, when I am on shift, I am mindful of the incident and always remind her to eat her meal
slowly. No further incidents have occurred since the change in diet, and my management of this
patient clearly demonstrates my skills, knowledge, competency and experience within the clinical
setting.
Ability to work collaboratively in a multi-disciplinary team.
One of the aspects I enjoy the most about my role as a nursing professional is the opportunity to
work alongside a range of professionals, all of whom are committed to assisting patients to
achieve the best quality of life available to them through the provision person-centred care. I pride
myself on my ability to build strong professional rapport within the workplace by utilising an open
and adaptable communication style, acting with professionalism at all times and treating others
with respect.
As a Registered Nurse working in aged care, the ability to communicate and work collaboratively
with a team is one that I utilise daily. This is demonstrated in my effective response to common
issues such as skin tears. Skin tears are a common and mostly preventable occurrence. All nursing
staff have a responsibility to follow all manual handling procedures and act with care to ensure
skin integrity. During a recent shift, one of the Carers informed me of a resident that suffered a
skin tear on their right elbow. After the tear was treated, an incident report was completed and
family and the assigned General Practitioner was notified to determine any further treatment
options. It was discovered that a new staff member was not following the correct manual handling
procedures and would most likely cause injuries to other residents. I liaised with the wound care
specialist to develop a wound care plan and implemented their recommendations in order to
avoid infection and promote rapid healing. Additionally, I was able to counsel the staff member on
the correct manual handling procedures but it was apparent that it would be desirable to have a
further training sessions with a Physiotherapist to review the initial training. The Physiotherapist
was able to organise another training session with the staff member. As a result of my ability to
communicate and work effectively with a team, no further incidents occurred, protecting both
residents and staff from infection.
The nursing environment, including the aged care setting, has a multitude of specialist
requirements and it is not possible to deliver high quality care without the collaborative effort of
all members within the multi-disciplinary team. I feel confident and supported as a nursing
professional with the ability to refer care to high quality specialty carers to deal with issues that
are out of my scope of practice.
Well-developed skills in communication, conflict resolution, negotiation and problem solving.
A confident and effective communicator, I readily adapt my style to suit the needs of my audience.
My well-developed rapport building skills enable me to maintain positive professional
relationships with both internal and external stakeholders. At Regents Garden Aged Care facility,
we have a significant proportion of residents affected by Dementia, and it is my firm belief that
their behaviour and psychological symptoms can be effectively managed by providing an optimal
level of person-centred care.
Recently, while on afternoon rounds, I encountered a female resident wandering the corridor
without her Zimmer frame. The resident was extremely agitated, calling her daughter’s name and
was behaving in a violent manner towards care staff. Recognising the need to de-escalate her
behaviour, I approached her and in a firm but patient manner and asked her to come with me to
another area to discuss what was troubling her. Although she was still rather agitated, the patient
complied and I led her to a quiet location where she could be seated.
As I was familiar with her and knew that chocolate was her favourite food, I offered her some to
interrupt her current behaviour pattern. The resident gladly accepted and it served to provide an
opportunity to discuss what was causing her to be so upset. She had become disoriented and
confused as to what day of the week it was, and was concerned with the whereabouts of her
daughter. I explained where she was, that it was not a normal time for her to receive visitors and
assured her that her daughter would be coming to visit her on the weekend as she always had
done.
To further calm her down, I retrieved her Zimmer frame and suggested that we go for a walk and
continue to talk as we had been. While walking throughout the corridors and later the garden, the
resident calmed down significantly and was focussed on the garden rather than on the location of
her daughter. She then indicated that she was tired and would like to return to her room to take
an afternoon nap. I assisted her to use the toilet before guiding her back to her room where she
was able to get comfortable and take a rest. After resting, the resident had forgotten the incident
and was in a much more positive mood. This example showcases my ability to communicate
sensitively and negotiate with stakeholders to achieve positive health care outcomes.
Commitment to personal and professional development.
A committed learner, I embrace all professional development opportunities offered and
consistently work to ensure that I am utilising the latest evidence-based protocols in my practice. I
have a strong interest in developing my practice, and my current position as a Registered Nurse at
Regents Garden Aged Care Facility allows me to use what I have learnt within the clinical
environment. My employer offers regular sessions on a variety of topics such as wound care,
providing information and techniques that I can use to assist residents at the facility on a daily
basis.
As part of my continuing professional development, I attended a wound care session which
provided insight into how to correctly examine, assess and manage complicated leg ulcers, as well
as when to refer the case to a clinical wound care specialist. I was able to apply this knowledge
whilst caring for a resident that was suffering from two chronic wounds post knee replacement
surgery 12 months ago. These wounds are reviewed on a regular basis by the Residential Care Line
team (RCL). Whilst changing the residents dressing according to the wound plan, I discovered that
the man’s tendon was clearly visible, and there was a large amount of purulent discharge. From
the knowledge gained at the wound care session, I surmised that the wound care plan may require
amendment to allow for further absorption of the discharge as the current plan was only the
application of iodine and a fresh dressing. I measured and took photos of the wound and referred
the case to the RCL team who attended and assisted in my development by further educating me
on the care of this particular wound, which included other measures for the client such as more
frequent dressing changes, encouraging correct nutrition, hydration and elevation to assist
healing.
The wound care plan was then changed to foam dressing with added silver which greatly reduced
the exudate level from the wound and improved the rate of healing. I continually assessed the
wound according to my training and referred to the RCL wound care nurse when I felt necessary.
Following the change in wound care plan, the resident is still suffering from his chronic wounds
but there has been a significant improvement with one wound completely healed and the other
greatly improved.
This incident has cemented to me the value of professional development in a clinical situation as I
was immediately able to use this additional training to have a major impact on a resident’s care
and quality of life. I remain dedicated to the process of personal and professional development
and will seek to engage with further education on an ongoing basis.
Ability to work within and contribute to the Mission and Values of St John of God Health Care.
A strong patient advocate, I support the Mission and Values of St John of God Health Care by
providing holistic care encompassing the physical, intellectual, social and spiritual aspects of a
person. St John of God Health Care’s, values of hospitality, compassion, respect, justice and
excellence are well aligned to my own professional philosophy of providing nursing care that is
driven by evidence, respects the individual and aims to preserve dignity, and is centred in care that
is of the highest quality.
These values are clearly demonstrated in my work as a Registered Nurse at Regents Garden Aged
Care Facility. While nearing the end of my shift around 10pm, I heard a resident screaming in pain.
I quickly attended her room, where I could quickly see the pain registering on her face. The
resident had a hobby of drawing and had not complained of any pain during the evening or while
drawing earlier in the day but when queried, she said she was experiencing severe leg pain. I
assessed the patient and checked her assertion of pain against her medication profile. I offered
Paracetemol and she accepted so this was administered immediately. A short time later, the
resident was calm and registering no pain so I resumed the tasks remaining to be completed
during the rest of my shift. During handover to the night staff, I heard the same resident crying out
in pain again, so I immediately called the ambulance to attend before going to the resident’s room
to attempt to calm and comfort her.
However, when the ambulance officers arrived, the resident denied she was in pain and, due to
her cognitive impairment, could not remember the incident. Understandably, the ambulance
officer was reluctant to transfer her to hospital as her symptoms were not present. As she
normally walks independently without aids or assistance, I suggested we try walking her around to
ensure that her pain was not physical and was of a psychosomatic origin. However, when she
stood up to walk, she almost fell and screamed in pain. The ambulance transferred her to hospital
and it was found that she was suffering from severe Arthritis. As a result of this diagnosis, the
patient’s medication plan was modified to include Panadol Osteo to manage her pain and ensure
she could continue her hobby of drawing.
By listening to and understanding my patient, I was able to advocate for her needs, resulting in a
clearly needed diagnosis and appropriate intervention being implemented. My work with this
patient demonstrates my capacity to embody key qualities that reflect the St John of God Health
Care core values within the nursing environment.
Registration with the Australian Health Practitioner Regulation Agency (AHPRA) as a Registered
Nurse or Registered Midwife.
I am a qualified Registered Nurse and hold current registration with the Australian Health
Practitioner Regulation Agency (AHPRA), having completed my Bachelor of Nursing with Charles
Darwin University in 2015. In line with AHPRA requirements, I undertake on-going professional
development in order to maintain my registration and continually develop my skillset in line with
latest evidence, and I provide care for patients within the scope of my practice at all times.
