Organisation: Wide Bay Hospital and Health Services
Job Title: Clinical Nurse
Word Limit: Maximum 2 pages
Location: Bundaberg Hospital
With four years of nursing experience, I have been acting in the position of Clinical Nurse in the Medical Clinical Decision Unit (MCDU) since November 2014. My responsibilities have involved full management of the ward on shift to shift basis, including maintaining the inventory, allocating staff and overseeing the care of all patients. In this time I have continuously demonstrated my good judgement and ability to apply critical thinking in clinical situations. Having an understanding of the need to view every patient’s situation as diverse and individual, I have been able to identify unique medical situations through evidenced-based nursing and continual inquiry within the clinical environment which has led to the provision of correct and timely medical attention.
An example of my ability to respond rapidly to emerging situations was when on commencement of one night shift, I routinely attended a patient to check their vital signs. I noted that the patient had intravenous fluids with sodium currently infusing. On checking the patient’s oxygen saturation, I found it was decreased. On investigation, I noticed that the patient was displaying shortness of breath, a bouncing pulse and tachycardia. My clinical skills allowed me to determine that potentially there was fluid overload occurring, so I immediately stopped the intravenous fluids. I then listened to the patient’s chest and found that crackles were present. I notified the medical officer, and while awaiting their arrival I arranged for an ECG to be performed. The medical officer then reviewed the patient and confirmed that fluid overload had in fact been the cause of the patient’s symptoms.
I have a proven ability to effectively use risk management strategies in order to solve clinical issues and to meet emergent needs and report or escalate issues that may require further intervention. Another situation which required me to apply advanced professional judgement involved a patient on the ward who was suffering from chest pain. A troponin test showed a level of 14 ug/mL, which is indicative of a heart attack having occurred. An ECG showed significant changes. I notified the doctor of the patient’s condition and monitored the patient closely. I proceeded to prepare equipment such as application of Defibrillation pads; in order to be ready should an emergency situation arise. By thinking and acting quickly in situations such as these I am able to provide optimum patient care in a complex clinical environment.
Currently responsible for the MCDU ward of 14 patients, and supervising three to four nursing staff per shift, I effectively lead and coordinate the activities of the unit. Working in a busy environment with continually evolving pressures, I achieve efficiency and a high standard of patient care through prioritising patient and staff needs according to urgency and responding appropriately. My years of experience have provided me with a solid understanding of the concept of patient-centred care and through being respectful and responsive to the preferences, needs and values of patients I am able to provide the best possible patient care in a way that provides for appropriate patient flow and optimum MCDU service capacity.
Adept at managing the needs of people in my work environment, both colleagues and patients, I have previously had to display my people management skills when faced with a nurse who was unhappy with her allocation on my shift. I had allocated the staff by assessing the staffing level (2EEN and 1RN), while keeping patient’s conditions in mind. I appreciated my colleague telling me that she didn’t feel confident caring for her allocated unwell patient being a junior RN. I understood that my colleagues lack of confidence could negatively impact on patient safety, and the nurse may have not being able to apply safe practises, perform tasks or monitor patients safely, affecting high quality performance. By spending additional time with that nurse and assisting to ensure that she did not feel overburdened by her workload, I was able to resolve that situation. In another example, requiring the display of my negotiation skills, I was called on to liaise with a patient requiring urgent transfer to another hospital for a heart procedure. The patient was resisting the transfer, stating that this was because he didn’t have his clothes with him. Communicating clearly and concisely, I negotiated with the patient and explained why the transfer was necessary. Calling on available resources to achieve the objective, I facilitated attendance by a social worker who organised clothes, and the cardiologist who reiterated the urgency of the situation to the patient. As a result of this process, the patient eventually agreed to the transfer.
My computer literacy skills, and capacity to use health related information technology systems are highly developed. I pride myself on my comprehension of various health related information systems. Confident in handling all of the programs available on the ward, I can also easily learn new programs. I currently utilise Trend, Auslab and Patient Flow Manager Software to assist in performing my role.
Capable of managing a professional portfolio, since commencing in a Registered Nurse role in February 2013 I have had responsibility for a documentation portfolio. In this capacity I undertake a monthly audit of patient records and charts to ensure compliance with professional standards. Cognisant of the purpose of the MCDU, I liaise with doctors regarding the prognosis and anticipated care plan for each patient to ensure that they remain a suitable candidate for the ward. Where necessary, I liaise with other wards and hospitals regarding transfer of patients.
With a commitment to continuing to develop my nursing skills and knowledge, I regularly attend both internal and external training and conferences. Most recently, I have attended conferences regarding cardiac nursing and respiratory nursing. I also foster the ongoing learning of my colleagues. In my current role I have demonstrated my ability to facilitate and deliver training and development activities for nurses, particularly placement registered nursing and enrolled nursing students, whom I mentor and guide. It is my responsibility to ensure student nurses, as well as new staff on the ward, are provided with the relevant information and trained thoroughly. When delivering training, I apply adult learning principles in order to encourage my trainees to identify specific learning needs and pursue opportunities to achieve learning objectives. By maintaining a warm professional demeanour, I ensure that students and new staff feel welcomed to ask questions and discuss with me the key objectives of their placement.
Throughout my career I have demonstrated the ability to identify potential issues and initiate and support innovation by utilising effective negotiation and problem solving skills and presenting ideas to management in order to establish new processes and structures that result in patient‑centred outcomes and a positive work environment. As part of the monthly quality activities undertaken, I recently developed a system of stamps to identify when a cannula had been checked and flushed. This arose out of my observation that required cannula checks were frequently either not being performed, or not being recorded. By creating a stamp system, eliminating the need for a written note, time was saved for nursing staff and the performing and recording of required cannula checks increased.
