Organisation: Royal Prince Alfred Hospital
Job Title: Registered Nurse Emergency F/T
Word Limit: 3000 CHARACTER LIMIT
Location:Royal Prince Alfred Hospital
Current registration with Australian Health Practitioner Regulation Agency (AHPRA)
I am currently registed with the Australian Health Practitioner Regulation Agency (AHPRA). My
Registered National number is NMW0001827837.
Recent post-registration experience in the ED or acute care setting
This current year I have operated as a Registered Nurse (RN) in the Cardiac Catheterisation
Laboratory (CCL) within the Sydney Adventist Hospital. The CCL is a critical care area in the
hospital with diagnostic imaging equipment used to visualize the arteries of the heart and the
chambers of the heart and to treat any stenosis or abnormality found. This area is staffed by a
multidisciplinary team, which includes, but is not limited to, a Medical Practitioner (normally
either a Consultant Cardiologist or Radiologist), a Cardiac Physiologist, a Nurse and a
Radiographer.
Often, cardiac arrests occur whilst the patient is undergoing investigation for indications of
coronary artery disease. When this does occur, the nursing staff split into two teams, one team to
commence cardiopulmonary resuscitation (CPR), the other team to assist the Medical Practitioner
to continue the investigation. The patient is required to remain sterile throughout the entire
procedure. Being the RN in the CCL, it is my role to assist the Medical Practitioner to continue the
investigation such as coronary angiography, as well as left ventricle angiography. Once the
catheter is in place, it can be used to perform a number of procedures including angioplasty, PCI
(percutaneous coronary intervention) angiography, balloon septostomy, and an Electrophysiology
study or Catheter ablation. During the procedure, I constantly monitor the vital signs of the
patient.
In 2013, I performed my nursing placement in Emergency Department in the Queen Elizabeth
Hospital in Adelaide. During my time there, I was recognised by the Nurse Unit Manager (NUM) as
the best student that they have ever had in their department. Also, in September 2014, I was
awarded “Nurse of the Month” by the NUM on Acute Medical Ward (Level 7), as I have constantly
demonstrated the mission of the hospital, which states: “Christianity In Action”. I provided
excellent nursing care to all my patients. This is a testament to my caring approach, hard work and
willingness to go beyond my role. Both occasions are proven with the evidence that I possess of
the nursing report. The extensive experience I possess in Sydney Adventist Hospital and Queen
Elizabeth Hospital clearly demonstrates my passion for working in the ED and Acute Care Settings.
Demonstrated proficient problem solving skills
When improved patient outcomes are the common goal, teamwork is emphasised and valued,
alongside with proficient problem solving skills, which is demonstrated by every team member
working unitedly to meet the patients’ needs. For example, the relationship between the RN and
the physician is paramount. The Medical Practitioner requires assistance whilst performing
necessary intervention and the nurse is responsible for obeying the orders prescribed by the
physician. It is crucial that all team members work together and communicate effectively. Any
changes in patient status, whether deterioration or improvement, would be shared between team
members, which in turn initiates problem-solving skills for each member of the team. Assistants in
Nursing, Enrolled Nurses and Student Nurses often requiring mentoring and guidance to establish
correct patient care. In my experience, my less experienced nursing colleagues often require
guidance in caring for a patient. Together, we were able to discuss the appropriate care of action.
This outlined the appropriateness for my colleague to continue the care, to ask for assistance in
providing that care, or to delegate the patient care to another colleague. We were then able to
conduct a reflection on this scenario and were able to implement a plan if such a situation were to
arise again for my colleague.
Another example of effective problem solving skills occurred when I was on shift in the early hours
of the morning alone. One patient was experiencing hypertension and requesting assistance. At
the exact same moment, another patient was experiencing harmful chest pains requesting
assistance. This was the critical moment that I utilised my proficient problem solving skills. Firstly, I
called out for assistance from extra nursing staff. Secondly, I positioned the hypertension patient’s
bed to the trendelenberg position to aid blood flow to gravitate towards the patient’s brain to
prevent unconsciousness. Thirdly, I increased intravenous (IV) fluids for the patient. Soon after,
extra nursing staff arrived to care for the hypertensive patient and I was able to care for the chest
pain patient immediately. I carried out an Electrocardiogram (ECG) to monitor basic heart rate and
heart beat rhythm. After assessing the results of the ECG, I notified the Medical Practitioner and
adjusted the medication as per advice. These experiences demonstrate my well-practiced and
capable problem solving skills within high-pressure departments and situations.
Demonstrated advanced communication and negotiation skills
Advanced communication and negotiations skills is paramount in ED and acute care settings. To
enable me to do my job efficiently, I have to communicate with a wide range of people, from
patients and co-workers, my superiors and subordinates as well as the numerous family and
friends that visit the patient during their stay in the hospital. Such communication is an integral
part of daily work. I am proficient in three languages. These include, English, Malay, Mandarin and
Chinese dialects. Being multilingual has greatly improved my value and resourcefulness as an RN in
the ED. One occasion, a Chinese patient that could not speak English was admitted to my ward.
They were extremely frightened, were not able to convey their symptoms across accurately, and
the family of the patient were escalating the worry of the patient. During clinical handover, it was
discussed between the nursing staff of the difficult in understanding the Chinese patient. Seeing a
need, I volunteered to care for the patient and act as a translator for them between hospital staff
and medical services within the hospital. Upon meeting with the patient and their family, I was
able to provide clear communication, provided insight, understanding, and comfort to the patient
and their family. This resulted in clear understanding in patient symptoms, patient care and
medication required. The patient and their family were happy and relieved to have clear
communication with a health care professional as myself. Once my shift was completed for the
day, I then printed numerous communication cards of English to Chinese words and diagrams to
assist the patient to communicate with health care professionals on my behalf whilst I was absent
from the ward. This resulted in my promotion of being the hospital translator for Malay, Mandarin
and Chinese dialects spoken patients.
Currently working for a private hospital provides me the opportunity to liaise with many families
members of patients in our care. Patients have spent their own money in receiving health care for
their loved ones. Customer service is necessary and essential in working for private hospitals. On
one occasion, a family member became verbally aggressive due the patient’s room not being clean
enough for the standards that they expected as a paying customer. Seeing the demand for
answers and the necessary requirements of myself to negotiate and reach a mutual agreement, I
offered to speak with the customer in a private room away from the noise and chaos of the
medical ward. Calmly, I listened intently to the customer and validated her story. I was able to
establish common ground and reassured her I will make it my priority to solve the problem and
raise the issue with management, to ensure that this problem will not happen again in the future. I
apologised to her on behalf of the nursing team. These experiences are proven evidence of my
advanced communication skills, negotiating skills and team leadership skills that are suitable for
working for ED and acute care settings.
Demonstrated evidence of commitment to ongoing professional development
My career outlook is to become a Team Leader in my department. I demonstrate my professional
commitment to ongoing professional development in various methods, including but not limited
to, completing compulsory courses within the hospital, such as CPR and Manual Handling and
acquiring competency in my own time using my own finances include, Trauma Nursing across the
Spectrum and Wound Care in the Emergency Situation. Both have been attained through the
Registered Training Organisation Ausmed. Additionally, I have been enrolled in a Cannulation
Course and the Advanced Life Support Course, which begins in September and October this year.
Each decision made in supporting my commitment towards my ongoing professional development
builds the foundation required to become an excellent team leader. I am passionate about
working in ED and, or Critical Acute Care. Currently, I am making careful preparation to commence
studying Post Graduate Emergency Courses in the near future.
In order to become a successful Team Leader, it is fundamental that delegation of Patient Care
Team is made use of to enable successful management of the team. Appropriate and precise
delegation requires insight and knowledge of the current abilities of dissimilar staff members,
their aptitude and their scope of practice, to ensure correct and safe patient care. Effective team
leading improves team functioning and work processes that directly benefit the patient.
My objective in my scope of practice is to promote positive outcomes and experiences for our
patients and their families. In my studies and reflections, my personal observation is that
knowledge is promoted foremost in patient care. Even though knowledge is vital to carrying out
the duties of nursing, holistic care is a skill that cannot be discovered through studies, but through
experience, empathy and humility. Each team player has knowledge and experience to share,
regardless of how little, or how much experience they have working in the health industry.
Providing a supportive work environment and sharing knowledge in respecting patient values and
choices, promotes respect and continuity of care for the patient and their families. Having this
attitude and outlook in my career, demonstrates my commitment to ongoing professional
development that illustrates my suitability to utilise my excellent RN skills in the ED and Acute
Critical Care Unit.
Demonstrated evidence of ability to work as part of a team
Doctors, nurses and various health care providers come from diverse educational backgrounds and
offer diverse types of care. They share one fundamental common skill that is making decisions
quickly and compassionately. Emergency medical personnel make life-saving decisions for their
patients, sometimes with incomplete medical information and at top speed. Health care providers
should be comfortable with hearing when other team members think they are wrong, and rely on
them to speak up.
Working in the ED as an RN, I am able to demonstrate my variety of nursing skills. In addition to
drawing blood and starting IVs, I assess, monitor and educate patients and their families. Ensuring
my assessment skills are on point is vital in the effective, thorough treatment of the patient and
ease the workload of my team members. The medical physician on duty is responsible for
outlining treatment plans and overseeing the overall course of how a patient needs to be
diagnosed and treated. Based on the initial impressions presented by the patient, an emergency
physician may order a range of tests to help determine the patient's medical condition. Much of
the work revolves around investigating what is causing the patient present symptoms and
implementing an assessment plan. Demonstrating my excellent cognitive skills and showing my
knowledge and understanding of the disease process assists in the joint objective to obtain a
positive health outcome for the patient. It is essential to be excellent at multitasking in
accomplishing my goals within the complex hospital systems and to ensure appropriate
prioritisation for the treatment of each patient. For example, the relationship between the
medical practitioner and myself is vital. The physician orders essential intervention and I am
responsible for administering the orders prescribed by the physician. My excellent attention to
detail in assisting the medical practitioner to operate, administering medication and work within
specific treatments, that if carried out incorrectly, could prove fatal for the patient. Any changes in
patient status, whether deterioration or improvement, would be shared between team members.
Various departments of the hospital perform patient care. It is crucial that all team members work
together and communicate effectively. Maintaining calmness under pressure and the ability to
function and carry out care throughout urgent, life or death situation is essential in being a useful
member of the team. When attending physicians, hospitalists, and nurses work with effective
communication, teamwork is exemplified. My experience therefore demonstrates my ability and
proficiency in working as part of a team.
