Organisation: Graylands Hospital
Job Title: Registered Mental Health Nurse Level 1
- Eligible for registration in the category of Registered Nurse by the Nursing and Midwifery Board of Australia.
I am registered with the Nurses and Midwifery Board of Australia [AHPRA] and the Nurses Council of Zimbabwe. My AHPRA registration number is NMW0000969426. I obtained a Diploma in General Nursing at Harare Hospital School of Nursing, Zimbabwe in 2002. I am due to graduate with a Diploma in Mental Health Nursing in December 2013.
- Demonstrates knowledge and skill in Adult Psychiatric Nursing.
As part of the requirements for my Diploma in Mental Health Nursing, I undertook clinical placement at Graylands Hospital from 27 May to 28 June 2013 in the inpatient (involuntary) ward. My second clinical mental health placement will be at Subiaco Clinic in December 2013.
At Graylands, I developed my knowledge and skill in adult psychiatric nursing by performing a range of tasks. I completed a mental state examination as part of my Diploma study requirements. With the assistance of the Preceptor, I undertook assessments of patients presenting with suicide ideation who were at risk of self-harm. I observed and assessed the patients, checking vital signs. I also administered medication together with one other Registered Nurse (RN), as required by the hospital procedures.
I undertook risk assessments. If a patient needed seclusion, I monitored them and adhered to regulations such as informing the doctor and the Mental Health Review Board of the patient’s status. I regularly performed security checks to ensure that the patients’ rooms were secure and free of knives, razor blades and other hazards. I performed patient head counts on an hourly basis, supervised meals and accounted for all knives and forks after meals. I remained alert and aware of my environment at all times.
I socialised with the patients by taking them for walks outside. I dispensed money for minor purchases, played soccer or rugby with them, and escorted them to the gym.
After practising as an RN for 12 years, I chose to specialise in mental health. During my clinical placement at Graylands, I discovered an ability to build positive therapeutic relationships in a mental health environment. I gained an understanding of my patients and learnt how to approach them in a calm, measured and non-confrontational manner. I established positive communication with the patients by actively listening to them and supporting them.
I performed administrative tasks related to mental health nursing, such as following specific procedures and adhering to regulations when admitting or discharging patients. I also documented the progress notes of the patients accurately.
I attended multidisciplinary meetings with nurses, doctors, psychiatrists, social workers and occupational therapists, and actively contributed to discussions on patient plans, patient conditions and progress, and patient admissions and discharges in order to affect a positive health outcome for the patient. Following the meetings, I ensured that I carried out the patient plans as discussed.
- Demonstrates knowledge and application in the following nursing domains: Professional/Ethical Practice, Reflection, Problem Solving and Enabling.
I have practised as a Registered Nurse in Australia since 2008 and I have applied my knowledge of the nursing domains in medical and surgical wards across a range of different facilities.
Professional/Ethical Practice: Practising professionally and ethically requires meeting professional, legal and ethical responsibilities; developing a sound knowledge base, and taking responsibility for my own nursing practice. I protect the rights of individuals and groups by following all applicable legislation, regulations and policies. I fulfil my duty of care and I follow the nursing codes of ethics and conduct. As an RN, I keep up to date with all policies and guidelines and ensure that they are followed in my workplace. I respect the dignity, values, beliefs, rights and cultural background of patients. I advocate for patients and I work within my scope of practice. I draw on the knowledge and skills that I have built up over the past 12 years to provide the best possible nursing care for patients. As an experienced RN, I understand the responsibilities of the various healthcare workers and nursing roles.
Reflection. Reflecting on my own nursing practice is part of my process of self-evaluation and is a critical aspect of my professional development. As part of this, I participate in quality improvement activities, such as reviewing my practice in relation to standards and guidelines, and seeking feedback on my performance. I also participate in ongoing professional development, and I participate proactively in performance review processes. I recognise the importance of evidence-based practice and refer to literature and research to improve my practice. Wherever possible, I share findings with my colleagues. After an incident, I attend a debriefing with my supervisors and I make a point of learning from what happened. If I was in error, I establish what went wrong and I use what I learn from the Senior Nurse to enhance my knowledge and improve my practice. I take note of and act on feedback provided by my Preceptor on my assessments.
Problem solving. As an experienced RN, I have a sound understanding of the support networks and resources that are available to me when I have a problem. In the first instance, I make an evidence-based assessment of the problem and collect available and relevant data in order to understand its scope and identify possible solutions. I confirm data with colleagues before analysing and interpreting it. I follow policies and procedures and then establish the best option available to address the problem. I share my knowledge with the healthcare team in order to plan effective solutions.
My ability to solve problems competently is based on my understanding of the context that I operate within, including my own competency level, and knowledge of the policies and procedures of hospital and the support mechanisms and resources that are available to me.
Enabling. As part of building positive professional relationships with others, I promote the safety, security and professional integrity of individuals and groups by ensuring the work environment is safe. An example of this is the risk assessment checks that I performed during my clinical placement at Graylands Hospital. I work within my own scope of practice, I follow proper procedures when completing tasks and I ensure others follow proper procedure. For example, part of my responsibility as RN is to ensure that any medication is administered safely. I treat patients and colleagues with respect in a way that empowers them, rather than diminishes their sense of independence. I respect the beliefs and cultural background of others. I build strong therapeutic relationships with patients, while recognising professional boundaries. (This was particularly important during my mental health clinical placement in Graylands Hospital where I had to be careful to preserve boundaries with patients.) I communicate effectively with my patients’ families and I have a record of establishing positive interpersonal relationships with staff and colleagues. I assist and support patients to make informed healthcare decisions, ensuring that I communicate clearly using different communication techniques to help them understand me. I am an enthusiastic member of interdisciplinary healthcare teams. I understand the roles of the various members of the team, I ensure that I communicate relevant information to them timeously and I proactively assist with the planning and implementation of patient care.
- Demonstrates knowledge and skill in the application of the Nursing Process.
The nursing process stresses that the treating of a patient as a person and not as a collection of symptoms will result in improved patient outcomes and a better standard of nursing care. During the course of my nursing career, I have always diligently applied the Nursing Process. During my clinical placement at Graylands Hospital, the application of the Nursing Process gave me a greater understanding of patients with mental health issues.
The five steps of the Nursing Process are Assessment, Diagnosis, Planning, Implementation and Evaluation.
Assessment. During assessment, I gather the patient’s health data. I take vital signs and perform a full assessment. I communicate with the patient, asking him/her about health issues and symptoms, and observing reactions and interactions. Once I have the necessary data, I analyse it to establish the health status of the patient. During my placement in Graylands, I performed a full mental state examination as well as patient risk assessments.
Diagnosis. Following the assessment, I formulate a nursing diagnosis, which is a clinical judgement based on the patient’s responses and which will form the basis of the nursing care plans.
Planning. Based on the nursing diagnosis, I formulate a plan that will achieve a better outcome for the patient in terms of quality of life and improved health. The plan builds in all necessary actions and interventions to achieve the goals set for the patient. During my time at Graylands, I worked as part of a multidisciplinary team to formulate and implement a plan to manage patients who self-harmed.
Implementation. The proper communication of all aspects of the plan to all members of the team was a critical part of the planning process mentioned above. Every member of the team was informed of each patient’s health status, the diagnosis, the goals and the plans. All observations, interventions and reactions, and the patient’s outcome were recorded.
Evaluation. During the evaluation process, I assess the success of my nursing plans and of actions taken. When required, I adjust the plan to improve results. I gather input from all members of the healthcare team and from the patient to make an evaluation.
Demonstrates effective communication and interpersonal skills
My ability to build an immediate and strong rapport with my patients is based on my love of nursing. I enjoy interacting with patients and they respond positively to me. By establishing a strong rapport, I am able to communicate more effectively with patients, as they trust me. When meeting new patients, I greet them and introduce myself to them, and I tell them to call me if they need anything. I also listen proactively to my patients as a supportive and actively engaged audience.
I have worked with a number of nursing agencies and in a number of hospitals, where I have a reputation for being able to build positive relationships with staff and colleagues. I am able to communicate with influence in multidisciplinary meetings as I draw on sound knowledge and experience, and I participate in the meetings proactively. I demonstrate respect in my dealings with my colleagues and communicate at all times in a positive and engaging way.
I am meticulous about communicating any changes or relevant patient information to the healthcare team. As a highly experienced RN, I understand the importance of clear and unambiguous communication in a patient handover.
I communicate effectively with people of all backgrounds, and can adjust my communication style to suit all levels, from troubled mental health patients to busy medical specialists.
- Demonstrates knowledge and application of the Mental Health Act
The current legislation applicable in WA is the Mental Health Act of 1996. The object of this Act is to ensure that patients with a mental illness receive the best care and treatment with minimal restriction of their freedom and minimal interference with their rights and dignity. The Act protects patients and the public, and describes the roles and responsibilities of people who deal with mental health patients. The Act covers Involuntary Patients, Interstate movements, Treatment of patients, the Mental Health Review Board, the Protection of Patients’ rights, Community support services, Council of Official Visitors and other areas.
During my clinical placement at Graylands, I applied specific regulations and procedures of the Act that relate to dealing with Involuntary Patients when completing the admission or discharge of patients, and when notifying the Mental Health Review Board of the patient’s admittance. I also ensured that my nursing practice protected the patients’ rights at all times and met the requirements for the proper treatment of patients.
- Current knowledge of legislative and regulatory requirements in the areas of Equal Opportunity, Disability Services and Occupational Safety & Health, and how these impact on employment, people management and service delivery.
Throughout my career, I have maintained a current knowledge of legislative obligations for Equal Opportunity, Disability Services, Occupational Safety and Health, and how these affect employment and service delivery.
WA Health endorses the objectives of the Equal Opportunity Act 1984 (EO Act). These include the elimination of direct and indirect discrimination, and sexual and racial harassment in employment, and the promotion of equal employment opportunity for all. The WA Health Equity and Diversity Plan promotes an organisational culture that values diversity with a work environment free from racial and sexual harassment; workplaces free from employment practices that are biased or discriminate unlawfully against employees or potential employees; and employment programs and practices that include strategies to achieve workforce diversity for identified EO/Diversity groups.
As part of the Plan, all employees are responsible for creating an environment in which all employees and patients are treated with respect, dignity, fairness and without discrimination or harassment. Employees may not use, cause, instruct, aid or permit another person to engage in discriminating or harassing behaviour in the workplace; they are also responsible for completing Health Service training relating to Equal Opportunity and Diversity, and seeking advice and reporting any discrimination and harassment matters.
In terms of service delivery, equity and diversity gives us a better understanding of the needs of patients. In terms of people management and employment, a culture that values diversity promotes work productivity and can have positive effects on the community. Equitable work practices encourage the recruitment and retention of staff.
The object of the Occupational Health and Safety Act 1984 is to protect and secure the safety and health of people at work and to protect them against hazards. It promotes safe and hygienic work environments, and involves employers, employees and registered organisations in the implementation of best practice safety and health standards. The Act also aims to provide OH&S policies and promote awareness of OH&S issues.
Employees have a responsibility to work within their capabilities, to minimise or eliminate hazards and to ensure work that is carried out meets OH&S standards. They are required to take care of their own health and safety, and that of others; to report hazards, incidents and near misses to management; to use safety equipment and personal protective equipment properly; to assist with the investigation of accidents and incidents where required; and to comply with all OH&S regulations and proactively participate in OH&S consultations.
DESIRABLE REQUIREMENTS
Evidence of continuing professional development, participation in professional group/organisation
I am currently studying my Diploma in Mental Health. I participate in two or three workshops annually. The most recent workshop that I attended was an epilepsy workshop held in October 2012. I am a member of the Nurses and Midwifery Board of Australia and the Nursing Council of Zimbabwe.
Relevant experience in acute Psychiatric Nursing
I undertook clinical placement at Graylands Hospital from 27 May to 28 June 2013 in the inpatient (involuntary) ward.
