Job Title: Graduate Nurse
Word Limit: 250 per response
Question 1: Provide an example/s of how you assess, plan, implement and evaluate nursing care.
Throughout my clinical placements I have demonstrated the ability to assess, plan, implement and evaluate nursing care. Whilst on clinical placement in the Renal Ward of the Royal Perth Hospital, I was caring for a patient with an amputated knee. It was my responsibility to dress the patient’s wound, however when I removed the dressing, I observed slough and exudate.
Identifying that a change in care plan needed to be developed and implemented, I consulted with the multidisciplinary team to determine appropriate dressing options, and cross checked these against the hospital policy and procedure manual to ensure the new plan was compliant. Once I had selected the most appropriate option, I carefully documented the new care plan to facilitate continuity of care.
Having determined a course of action, I gained the patient’s consent and utilised an aseptic technique to clean and redress the wound in line with the new plan. I contacted the shift coordinator and the patient’s Doctor to inform them of the wound appearance and actions taken, and completed an ISOBAR handover for the following shift so they could monitor the patient for infection.
Three days later I again had the opportunity to care for this patient, and observed that the wound was free of slough and exudate. By following the appropriate process of consultation and documentation I was able to provide holistic, patient-orientated care, facilitating a continuous cycle of care framework. The result of my actions was that an infection was prevented.
Question 2: Provide an example/s of where your effective communication skills within a multidisciplinary team have resulted in quality patient care.
Throughout my career, in both customer service and as a student Nurse, I have demonstrated effective communication skills. As a student Nurse these skills have been integral to providing quality patient care, involving a range of stakeholders including the patient, allied health professionals and other nursing staff.
Whilst at Joondalup Emergency Department I was caring for a patient suffering with sepsis. The Doctor had prescribed an intravenous (IV) antibiotic, and I was responsible for its preparation. From the outset I ensured excellent communication with the patient, gaining consent and educating the patient. I also informed him that he needed to inform us if he felt any pain at the IV site.
After completing a number of checks, I began the infusion in accordance with hospital policy. The patient quickly began to experience pain at the cannula site, and in consultation with the supervising Registered Nurse the infusion was stopped. The Resident Medical Officer was called in to review the patient, and it was decided to resite the cannula. The remainder of the infusion proceeded with no further concerns.
My effective communication skills in ensuring the patient was completely aware of what to expect, and working with the team to respond to the event, facilitated a quick response when there was an issue, and limited the pain and discomfort the patient experienced. Following this event, I utilised my excellent written communication skills to create factual, concise and legible documentation, which facilitated continued quality of patient care.
Question 3: Provide an example/s that demonstrates how you have considered the rights of an individual or group.
As a student Nurse and Community Carer I consistently respect and uphold universal human rights for all of my patients by respecting their values, self-worth and dignity, and facilitating their privacy and comfort. During my placement at Royal Perth Hospital one of the patients in my care was Asian, and his English was not fluent.
Having consulted the WA Health Language Service Policy (2011) and the hospital’s applicable policies, I asked the patient’s relative to assist in translating as I explained his right to a free translator. Despite emphasising the benefits of this service, the patient continued to refuse this service.
Understanding that a number of considerations, including cultural and personal preference, could have influenced this decision, I endeavoured not to pressure the patient. Instead I documented the fact he had been offered the service and his decision, and informed the Clinical Nurse that the family would endeavour to be present regularly to assist in communication. Although this created an added layer of complexity to the delivery of exceptional care, respected this patient’s rights, both in the initial research of options, and in respecting his decision.
As a Nurse, I understand I will continue to care for and work with people from diverse backgrounds and whose cultural beliefs I may not understand. My practice has demonstrated a strong commitment to valuing and respecting diversity, and I utilise relevant policies to inform my actions when I am unsure of how best to demonstrate this respect.
Question 4: Demonstrate how you can ensure that your practice is of the highest professional standard with reference to the role of the ANMC competency standards, clinical guidelines and hospital policies
Throughout my clinical placements I have demonstrated an awareness of overarching policies, such as the ANMC competency standards, clinical guidelines and hospital policies, as establishing a standard of excellence in nursing care. I ensure my practice provides duty of care to all patients, and am committed to providing quality nursing care to all patients, regardless of age, gender, marital status, race, political or religious conviction, disability or impairment, pregnancy, family responsibility or sexual orientation.
I function accountably in providing care, ensuring I only engage in duties I have been deemed competent in, and which fall within my scope of practice. I demonstrated this when, whilst on clinical placement, I was instructed by a Registered Nurse to receive a hand over from the Theatre Nurses and bring a patient to the ward on my own. Understanding that this request did not fall within my scope of practice as a student Nurse, I politely refused, and insisted she supervise me whilst I completed what she requested. In doing this I protected the safety of the patient and maintained adherence to the standards set by the ANMC competencies and other overarching policies.
I endeavour to apply objectivity in all decision making, and to evaluate my practice, ensuring I acknowledge what is being done well, and what could be improved. I proactively seek to resolve any issues through effective communication, ensuring senior staff are aware of situations, and being open to adjust my practice based on feedback, whilst maintaining adherence to relevant policies.
