Organisation: St Charles Gairdner Hospital
Job Title: Registered Nurse
Word Limit: 500 words maximum per criterion. Only 4 of the criteria required
- Demonstrates effective communication and interpersonal skills
Effective communication and interpersonal skills are particularly important when completing a complex patient discharge from hospital. For example on one occasion, during nursing a male patient following a Halo Vest application, the medical team cleared the patient for discharge during their morning rounds. My role was to enable him to have the safest and easiest transfer from hospital to home so I needed to involve a larger team, including occupational therapy, physiotherapy, and pharmacy.
I referred the patient to the allied health team and clearly explained the discharge process to the patient keeping him informed of the progress. I referred the patient to occupational therapy to determine what additional services the patient and his family required to manage at home. I also referred the patient to physiotherapy to determine if he was safe to go home due to his altered mobility status. The physiotherapist determined if he required any walking aides on discharge and to assist him with his altered centre of gravity. I liaised with the pharmacist and medical team to organise the discharge medications. After which I liaised with the multidisciplinary team to determine what services the patient required.
Through communicating with the multi-disciplinary team the patient had a discharge from hospital positive, organised and safe. The patient had all his required medications, a discharge summary to provide his GP, and had equipment required for his pin site care and emergency Aspen collar. The patient and his family expressed that they were happy and relieved that things had been organised for them. I was able to assist them gain appropriate help which meant they viewed the situation positively.
Another example of effective communication and interpersonal skills was demonstrated when an elderly lady approached me in the orthopaedic clinic, she enquired how long it would be before she would see the doctor as she had already waited over one hour, and would normally have already gone for her X-ray prior to seeing the doctor. I apologised for the extended wait and explained that the average wait time is one and a half to two hours. She was concerned about having her X-ray and was getting quite agitated. I assured the lady that I would investigate her situation. On reviewing the ladies notes: the doctor’s plan was no X-ray but a review of the CT scan; I also sought the advice of a senior doctor as corroboration. I spoke to the lady conveying my empathy with her concerns regarding my findings and spoke further to her about her concerns, it seems that the lady was quite concerned about the lack of healing in her leg and feels another X-ray would indicate changes that may be significant. I assured the lady that I would organise an X-ray for her so that her anxiety could be alleviated. My compassionate and caring nature assured that I was responsive to the preferences, needs and values of my patient. The elderly lady was happy with the outcome and was seen by the Orthopaedic Consultant.
- Identifies work related problems and determines appropriate interventions and evaluates
Outcomes
As a dynamic and relevant team member, I make myself approachable, valuable and welcoming to both new and experienced staff members. For example during mentoring a student nurse applying wound management I observed she placed the aseptic dressing she had removed from the patient onto the sterile field thereby making the sterile field aseptic. I instructed her in the protocols of what to do with aseptic dressing and also in how to prepare a new sterile field. This included re-educating the student nurse so this does not happen again
On one occasion I was requested by a senior nurse to administer an intermuscularly injection without using the correct protocols for such a procedure. I was very uneasy about this as the patient in question had a history of adverse reactions to various medications. I looked up this particular medication in MIMMs and determined it could be potentially dangerous. In addition by not following the protocols I was putting the patient in danger. I immediately informed the patient’s doctor and he then administered the medication himself.
In another example I was nursing in an isolation ward and a patient was isolated in the ward due to the high risk of infection related to his medical condition. A doctor walked into the isolation ward
and had not followed the correct hygiene protocols to ensure they are not contributing to the risk of bacteria entering the isolation unit. I had to gently and diplomatically escort the doctor out of the ward and ensure he followed correct procedure such as scrubbing his hands and donning the appropriate protective clothing for that ward.
An elderly lady approached me in the orthopaedic clinic, she enquired how long it would be before she would see the doctor as she had already waited over one hour, and would normally have already gone for her X-ray prior to seeing the doctor. I apologised for the extended wait and explained that the average wait time is one and a half to two hours. She was concerned about having her X-ray and was getting quite agitated. I assured the lady that I would investigate her situation. On reviewing the ladies notes: the doctor’s plan was no X-ray but a review of the CT scan; I also sought the advice of a senior doctor as corroboration. I spoke to the lady conveying my empathy with her concerns regarding my findings and spoke further to her about her concerns, it seems that the lady was quite concerned about the lack of healing in her leg and feels another X-ray would indicate changes that may be significant. I assured the lady that I would organise an X-ray for her so that her anxiety could be alleviated. My compassionate and caring nature assured that I was responsive to the preferences, needs and values of my patient. The elderly lady was happy with the outcome and was seen by the Orthopaedic Consultant.
4 Participates in and supports nursing and multidisciplinary team processes and goals
My goal as a registered nurse is to show empathy and compassion to patients as demonstrated by my strong patient focused nursing care over many years of nursing as driven by my desire to provide patients with a unique overall experience of care in all hospital settings.
During the time Royal Perth Hospital was undergoing Accreditation; I was involved in the process by promoting clinical governance, resulting in quality patient care. National Safety and Quality Health Service (NSQHS) Standards set down by the commission includes:
- Governance for Safety and Quality in Health Service Organisations
- Partnering with Consumers
- Preventing and Controlling Healthcare Associated Infections
- Medication Safety
- Patient Identification and Procedure Matching
- Clinical Handover
- Blood and Blood Products
- Preventing and Managing Pressure Injuries
- Recognising and Responding to Clinical Deterioration in Acute Health Care
- Preventing Falls and Harm from Falls
As a registered nurse I am responsible for maintaining these standards. For example, when administering a blood transfusion I am required to perform both standard 5 and 7. I use a patient identification and procedure matching process with another nurse in order to verify the correct blood is administered to the correct patient.
I also demonstrated an ability to work collaboratively within a multidisciplinary team environment. An example is when I was nursing a male patient following a forefoot amputation. The vascular surgical team cleared the patient for discharge during their morning rounds. My role was to enable him to have the safest and easiest transfer from hospital to home. In order to do this I needed to involve a larger team, including occupational therapy, physiotherapy, podiatry and pharmacy. I referred the patient to occupational therapy to determine what additional services the patient and his family required to manage at home. Silver Chain was organised to complete the daily wound dressings due to their complexity and the ability of the patient to self-manage. I referred the patient to physiotherapy to determine if he was safe to go home due to his altered mobility status. I liaised with the physiotherapist to establish if he required any walking aides on discharge. I contacted podiatry for the patient to get altered shoes for his surgical foot. I also communicated with the pharmacist and vascular interns to organise the discharge medications. After the referrals I liaised with the multidisciplinary team to determine what services the patient required and kept the patient informed of the progress of his discharge.
Through communicating with the multi-disciplinary team the patient had a discharge from hospital which was positive, organised and safe. The patient had all his required medications and an explanation of them, a discharge summary to provide his General Practitioner, and had equipment required for his foot post operation. The patient and his family expressed that they were happy and relieved that things had been well organised for them. As I was able to assist them gain appropriate help they viewed the situation and therefore the hospital services positively.
- Demonstrates ability to adapt to changes in the workplace (including clinical situations)
I have worked in several areas including Oncology, Acute Care medical, surgical wards and orthopaedic and am able and willing to be adaptable to changes in the workplace in how I am called to provide patient health care provided it is within the nursing guidelines.
I have been quick to learn and assist in the integral in increasing falls awareness on 5G by promoting the use of the Falls Risk Assessment Management Tool (FRAMT). I used regular audits to ascertain a focus area which was “Communicating with Our Patients”. I designed a poster which is placed in all nursing files and reminds all staff to communicate with their patients regarding their falls risk status. There was a 60% increase in compliance after the poster introduction and staff education. The poster also highlights the need to constantly rescreen our patients.
Being a Falls Champion I am a member of the Fall Focus Group which is a ward based group of interested parties: Physiotherapists, Occupational Therapists and Nurses who foster a multidisciplinary approach to patient centred care. We evaluate risk assessment, falls prevention, harm minimisation and rehabilitation.
I have participated in quality improvement practices by performing an audit on Preventing Falls. I completed an audit of the compliance of the use of the Falls Risk Assessment Tool (FRAMT) since its inception and highlighted strategies to further improve its use. I presented an education session on my findings to Ward staff and interested parties. I developed a poster on “Communicating with our patients”, ensuring that all patients and caregivers know they are a falls risk. I am a role model for other staff members in the use of the FRAMT and I conduct regular follow up Audits.
Overall, I have demonstrated over time that I show respect for others and am an open and honest communicator. I understand my boundaries and scope and I have a role to play in mentoring and dealing with conflict, all in the best interests of patients. This means I am a contributor within multidisciplinary teams and an advocate for patients and families as well.
