Organisation: Calvary Health Care Emergency Department
Job Title: Emergency Nurse
Location: Calvary Health Care
Selection Criteria
Mandatory: Registered as a Registered nurse (Division 1) with the Australian Health Practitioner Regulation Agency (AHPRA)
I graduated from the University of Southern Queensland at the end of 2007 and since January 2008 have maintained my registration with the Queensland Nursing Council and then the Australian Health Practitioner Regulation Agency. My Registration Number is: NMW0001445845
Highly desirable:
Professional Practice
- Ability to practice in accordance within relevant legislation framework
I demonstrate an ability to practice in accordance within relevant legislation framework by maintaining competency to practice with a safe and ethical manner; that is; practice within my scope according to area of practice and competency within that area. To attend nursing interventions in which I have been educated, deemed competent and authorised to perform. For example, to become an Immunisation Provider Nurse I completed an authorised course through the Cunningham Centre (Queensland Health) and am aware that to give immunisations I need to have access to the relevant Drug Therapy Protocol, Health Management Protocol, Health Drugs and Poisons Regulations, The Australian Immunisation Handbook and a current MIMMS. In the past I have declined to run Immunisation Clinics in rural areas unless there have been at least two appropriately trained health care professionals in the unlikely event of an episode of anaphylaxis.
- Ability to practice within the professional and ethical framework
Working within the professional and ethical framework requires me to have an understanding that the National Competency Standards for Nursing currently reserve decision making about the planning and co-ordination of nursing care to Registered Nurses. I am aware of the differing knowledge base for Enrolled and Registered Nurses (having practised as both) and have a great deal of respect for the function of both roles. When working in an area which requires delegation of workloads I gain an understanding of each team members’ scope and abilities and work towards allocating equitable workloads with the team members’ abilities, ensuring that the patient’s needs are met within the skill set of staff. For example, allocating patients with higher acuity to staff members with a greater scope of practice to ensure an appropriate level of care can be given.
- Ability to practice refecting the Calvary values of Healing, Hospitality, Stewardship and Respect
I believe I have an ability to practice in a way which reflects the Calvary values of healing, hospitality, stewardship and respect by offering a high standard of nursing care in whatever area I am working, having a respectful, professional attitude towards my colleagues and all health care team members, and having a non-judgemental, holistic approach towards the individuals I meet during my working life. By using active listening and communicating skills I am able to establish a therapeutic relationship with patients in my care, to facilitate a comprehensive understanding of their requirements and to consider the needs & role of their families, to use a consultative, enabling approach to assist with managing health care needs of individuals and groups.
Critical Thinking and Analysis
- Ability to practice within an evidence based framework
To practice within an evidence based framework, I recognize that the most important motivation for any care activity/nursing intervention is to address patients’ health care needs and to enhance outcomes, and should only be attended when there is a justifiable, evidence based reason to perform the activity. For example; when working in a Queensland Health rural facility Emergency Department I utilize the evidence based, current Primary Clinical Care guidelines and Health Management Protocols as a guide to my practice.
- Participation in ongoing professional development of self and others
Since completing an Enrolled Nurse Qualification at the Royal Canberra Hospital in 1987 I have consistently sought professional development corresponding to my area of practice. When I commenced working as Registered Nurse in a rural context I completed the Professional and Clinical Skills for Rural Nurses Course offered by the Cunningham Centre (Queensland Health), gaining suturing and cannulation competencies, along with some degree of ECG interpretation skills. When I worked in a rural Emergency Department I completed the Trauma Nurse Core Course offered by the Emergency Nurses Association. When I worked between a rural hospital and a general practice treatment room I completed a Graduate Certificate in Primary Care through the University of Queensland to facilitate triage, chronic disease management, care planning and systems management relevant to both areas of practice. Currently I am working in theatre and have just completed the Peri operative Transition to Practice Program; next month I will attend an Intubation and ventilation workshop.
Throughout all the areas I have worked I have assisted with the facilitation of student nurses, both registered and enrolled, and have often mentored beginning practitioner Registered Nurses.
Provision and coordination of Care
- Demonstrated ability to use the Nursing Process in the provision of safe evidenced based care to patients in an acute and sub acute environment.
The Nursing process is appropriate to all context of nursing care. To assess the patient and determine their needs, plan care, implement the care and evaluate the effect of those interventions is fundamental to the nursing process.
For example when working in an Emergency Department, the process begins at triage. I would assess the patients’ health status and history, obtaining objective and subjective information. If the patient was complaining of a sudden onset of crushing central chest pain, was hypertensive and tachycardic, and had a previous history of myocardial infarction, I would implement a cardiac pathway immediately, notifying/consulting a medical officer as soon as possible. Ensure an ECG was attended, apply oxygen therapy if the patient was hypoxaemic, give aspirin and anginine as indicated (as per current treatment guidelines), insert intravenous cannulas and obtain blood for pathology. Monitor the patient and evaluate the effect/result of the interventions before proceeding with care in consultation with the medical officer.
If an adolescent presented with a three day history of flu like symptoms, whose main concern was a headache and getting a medical certificate for work purposes, I would assess the patient; determine if their vital signs, physical examination and neurological status were within normal limits, before moving on to discussing symptom management (offering and evaluating the effects of simple analgesia and oral rehydration fluids), hand hygiene and liaising with a nurse practitioner or medical officer to facilitate the medical certificate. Giving education and advice appropriate to the patients needs and ensuring that patient understands that if symptoms persist they need to return to their medical officer for further review.
Collaborative and Therapeutic Practice
- Demonstrated effective interpersonal communication skills within a multidisciplinary team. The ability to liaise effectively with patients, their families and members of the community
Acknowledging that the best health outcomes are achieved when well prepared health professional work in collaboration, I endeavour to use effective interpersonal communication skills to facilitate effective patient care. For example during an early hours working in a rural emergency department the Queensland Ambulance Service presented with an acutely unwell elderly gentleman who was complaining of shortness of breath and central chest pain. The patient was diaphoretic and dyspnoeic. While communicating with the paramedic I was able to learn the patients’ details and some previous history and commence documentation of the patients’ presentation while settling the gentleman into a bay & commence monitoring and assessment. The patient had a long cardiac history, had been previously diagnosed with heart failure and type two diabetes melitis, and had an allergy to morphine. The patients’ dyspnoea was exacerbated by his concern at leaving his disabled wife at home alone.
I was then able to contact the on-call senior medical officer (SMO) and using the SBAR acronym I was able to relay the patients’ current situation, his background, my assessment findings and recommendations. While waiting for the SMO to attend and review the patient I was able to start implementing the verbal orders I had received (give intravenous furosemide and sub cutaneous fentanyl), call in the on call pathologist and on call radiographer in anticipation of treatment orders.
When the patient had begun to settle I was able to telephone the patients wife to check her situation, to reassure her about her husbands’ condition and enable the couple to speak to each other. I also gained consent from the couple to contact their next of kin and relay the couples’ situation and organize support for the elderly pair.
