Organisation: Northern Sydney Local Health District
Job Title: Clinical Nurse Specialist
Word Limit: 500 words per point
Location: Northern Sydney
Actively contributes to the development of clinical practice in the ward / unit / service
As a Registered Nurse within the Short Stay Surgical Unit (SSSU) of the Royal North Shore Hospital,
I actively contribute to the development of clinical practice. My role involves regular quality
improvement and auditing assessments of the standard of care provided within the unit. My skills
and knowledge in this regard are backed by an additional six years working at Canberra Hospital,
initially as a participant of the Graduate Registered Nurse Program, and then through eight
Registered Nurse levels to Acting Level 2 Grade 1 Registered Nurse.
My active contribution to the development of clinical practice in this unit is demonstrated within
my role expertise (pressure injury champion) and my constant assessment of patients. I recently
cared for a 55-year-old patient who had suffered a stroke and was admitted from his high-level
care facility. He was classed as high-risk due to numerous pressure-sore areas, and he was unable
to move independently. Upon commencement of my shift I identified that the patient had been
provided with a regular mattress, which was not recommended for a patient in this condition.
Utilising my high-level knowledge in this area, I ordered an air mattress for the patient, knowing
that it would alleviate the pain from his sores. As a result, the patient’s comfort increased and he
was appreciative of my assistance.
In order to facilitate the development of clinical practice within the unit, I completed an audit
report and discussed the issue with staff during the next clinical meeting where a discussion
ensued with those who were unaware of the process for ordering such physical aids for patients.
While it was noted that aids such as these are rarely required, I highlighted the need for all staff to
be aware of their use and suitability of such facilities for patients, rather than relying on one
colleague, such as myself, to identify these needs.
An aspect of my current role involves reviewing graduate and junior nursing staff to ensure that
they maintain a high-quality standard of care. On a recent shift, a patient had suffered an
aneurism and their condition had significantly deteriorated between nurse changeovers. The
previous Junior Nurse had not identified this, and the new nurse on shift was confused as to what
care the patient required. The patient had vomited, was complaining of a headache and her blood
pressure was increasing, however her pupil size had not changed and she had not lost
consciousness. Recognising the fact that the patient had undergone acute neurological changes, I
conducted an assessment and identified that she had bleeding on the brain. I contacted the
Neurosurgical Doctor, who immediately arranged a Computed Tomography (CT) scan to assess
intracranial bleeding, and the patient was transferred to the Intensive Care Unit (ICU) to be closely
monitored. I used this example as a case study at my next in-service presentation, in order to
provide an awareness of the importance of neurosurgical patient deterioration. To further stress
this topic, a full training package will be developed in the future.
2. Acts as a resource and mentor to others in relation to clinical practice
As a commitment to my ongoing development as a Registered Nurse, and my strong desire to help
patients on a broader scale, I obtained my Preceptor Certification in 2010. Since that time I have
continued to act as a resource and mentor to others in relation to best clinical practice within
surgical wards. I utilise my certification by working with graduate nurses, on a one-on-one or
group basis, to ensure that they are practicing in line with hospital directives.
Throughout my career, I have found that an effective method to educate my colleagues is through
the presentation of case studies during ward in-services, as well as passing on relevant
information to the Ward Educators and Clinical Nursing Consultants. I have gained over 7 years of
experience as a presenter in a clinical environment, including at both Canberra Hospital (2008 –
2013) and Royal North Shore Hospital (2013 – present), as well as regular in-service education
sessions this year with the Short Stay Surgical Unit. Through these presentations I have
contributed my clinical knowledge and expertise in order to provide advice and educate other
nurses in regards to the provision of high-quality patient care.
For the past six years, I have had the responsibility of supervising new graduate nurses. In my
current role, it has been especially important to closely monitor new graduates and other staff to
ensure consistency of quality care practices. The SSSU is a specially established unit to manage
short stay and day surgery patients, and assists with the emergency department when necessary.
As such, these nurses experience variety in the provision of acute nursing care, than a regular
ward nurse who would repeatedly perform nursing within the same specialised area of scope.
When monitoring new graduates or junior nursing staff I endeavour to encourage them to develop
critical thinking abilities. Looking beyond what they initially see, and utilising their full range of
knowledge and skills to assess and attend to each individual patients’ needs. I stress the
importance of identifying the full needs of each patient as an individual, and in direct relation to
the surgical procedure that they are admitted for. I encourage research and assist students to find
answers to their own questions through medical journals and appropriate Internet-based medical
resources. Within this ward I am a key resource in terms of neuroscience, cerebral angiography
and pressure area care.
My professional goal is to continue to mentor and assist less experienced colleagues in order to
facilitate growth of their skills and knowledge in relation to clinical practice, while simultaneously
continuing to develop my own knowledge in the ever-advancing nursing field.
3. Actively contributes to their own professional development
As a Registered Nurse with a background as a Junior Doctor, I am fully committed to ongoing
professional development. I have completed a number of postgraduate studies, including a Master
of Clinical Nursing, where I developed specialist and advanced skills in the area of Critical Care
Nursing. I also regularly undertake in-service education and attend external conferences as a
resource to obtain up-to-date knowledge on a variety of topics so I am able to disseminate
relevant information to my colleagues. I am currently enrolled in a 5-day Orthopaedic Nursing
Workshop and plan to share information gained from this workshop with my colleagues in order
to provide a greater in-depth understanding of new or modified treatments, thus increasing their
overall practice.
My ability to apply newly gained knowledge was demonstrated when I was assisting with a patient
who was about to undergo a craniotomy and a Junior Nurse asked me to check the Intravenous
(IV) fluids she was about to administer. In this patient’s case, they could not have glucose prior to
the surgical procedure due to risks of brain swelling resulting in potential complications post-
surgery. As the IV fluids contained glucose, I immediately stopped the nurse from continuing and
issued alternative advice. As a result, I received commendation from the Nursing Doctor due to my
prompt attention and knowledge to foresee the risks and prevent potential complications.
I am a member of the Association of Neurosurgical Nursing in Australia (ANNA) and attend regular
training days and conferences that relate to my working practices. Additionally, I receive updated
information frequently via email. The Chairman of the ANNA New South Wales Branch is located
at the Royal North Shore Hospital where I am placed, and as such I am in a unique position to
converse directly with her whenever necessary.
In addition, I have commenced a structured reading program as suggested by my Nurse Unit
Manager. The most recent program was designed to grow efficiency in admission, recovery and
discharge. The program became a project-based and light-hearted competition where posters
were created to highlight the best nurse at following processes, acting as the best team leader and
gaining the highest number of early discharged patients prior to 10am. While this proved to be an
entertaining approach for all participants, the underlying messages instilled a dedication in all staff
to complete the readings and their duties to the highest of standards. It is worth the mention that
I maintained first place for the competition as identified by the recorded graphs.
I am passionate about my own professional development, as well as my colleagues. While I have a
background as a doctor, I have chosen the Nursing path because I believe it enables closer contact
with the patients facilitates a personalised level of service. I am committed to continue to develop
skills and knowledge in order to ensure nurses are reliable resources to doctors, allied health
professionals and patients, and to ensure a trusted nursing service focused on accuracy, safety
and high-quality patient care.
