Organisation: Manning Base Rural Referral Hospital
Job Title: Manning Hospital Transition to Specialty Practice Program 2016
Word Limit: No more than 500 words per criterion
Location: Critical Care Area
Current registration as a registered Nurse with AHPRA and RN2 or above at commencement of Transition
Program
I possess current registration as a Registered Nurse with the Australian Health Practitioner Regulation
Agency (AHPRA).
Currently employed as Permanent, Temporary Contract or Casual Registered Nurse at Manning Hospital
My current employment comprises a full time permanent capacity as a Registered Nurse at Manning
Hospital.
Demonstrated understanding of evidence-based practice and its impact on patient care
When I first started working as a Registered Nurse in the Cardiac and Stroke unit at Manning Hospital, I
dealt with a new patient who required an iron infusion. Upon first meeting the patient, I introduced myself
and used my excellent interpersonal skills to develop a rapport and achieve nurse-patient collaboration.
Following due protocols, I completed my clinical observations, researched his medical notes and
administered his required medications, which were in line with his current clinical requirements.
Additionally, I noted that an iron infusion was required and as such, checked the patient’s current
pathology results to correlate them to the diagnosis and the treatment that they were currently receiving. I
discussed current and past medical history with the patient and enquired as to whether he had received a
previous transfusion. Furthermore, I ensured that the patient was aware of what was occurring and what
was required.
Although I had the theoretical knowledge needed to complete an iron infusion, as it was my first practical
experience of administering one, I decided to research the New South Wales Policy and Procedures
guidelines. Additionally, I doubled checked my understanding of the procedure with my Clinical Coordinator
to ensure that the suggested process was in line with current Manning Hospital best practice.
Liaising with Pathology, again following due protocols, I obtained the required iron transfusion bags and
completed the associated paperwork. I then provided details of the procedure to the patient, explaining
that it was very similar to a blood infusion. My next step involved setting-up all equipment necessary for
the infusion and undertook a regular set of observations. For each planned observation, I ensured that the
patient was comfortable and was experiencing no pain, in addition to standard blood pressure and visual
observations.
By following evidence-based practice, I was able to complete this procedure within best practice guidelines,
taking into account the patient’s current clinical requirements and their understanding of the procedure. I
have since taken this approach with other more complex procedures and have had the confidence and
clinical expertise to follow evidence-based practice unsupervised, within the Cardiac and Stroke Ward,
often under tremendous pressure.
Demonstrated written and verbal communication skills
Whilst working on the Cardiac and Stroke Ward as a Registered Nurse at Manning Hospital, I have
developed a better understanding of how vital effective communication and teamwork is to achieve
optimal patient care. This has involved using my excellent written and verbal communication skills to deal
with a patient with clinical cardiac issues, who had low potassium levels. Whilst undertaking patient care
and observations on a night shift, I analysed the patient’s pathology results and noted that their potassium
levels were very low. I used my excellent interpersonal skills to liaise with the patient to ascertain whether
they were feeling well or had any particular illness symptoms. The patient was feeling well and this
correlated with my observations. Despite this, I understood that it was my duty of care to make a note of
the high potassium levels to ensure that they were at the right level for the prescribed medication. Utilising
my excellent written communication skills, I noted my findings on the medical notice board computerised
system. This is used for afterhour’s communication with Doctors, so it was important to use the correct
terminology, with clear and precise written notes. Additionally, I manually updated the patient’s progress
notes.
When the same patient presented with chest pains during a later day shift, I again checked their pathology
results and noted that their potassium levels were low. I then undertook an ECG and immediately
contacted the Doctor. Using Identity, Situation, Background, Assessment, and Recommendation (ISBAR)
communication techniques, I completed a professional and detailed handover of the patient to the Doctor.
By using ISBAR, I was able to ensure that critical clinical information was communicated effectively. In
addition to my verbal handover, my excellent written notes that I had previously provided regarding
potassium levels proved useful to the Doctor in treating the patient effectively.
During this period, I provided my ongoing assistance to the Doctor in term of observations, note making,
and communication with the patient using empathy and professionalism. Furthermore, I informed the
Clinical Coordinator of the situation and ensured the entire team was aware of the medical emergency.
Ultimately, the patient received clinical treatment that followed best practice and evidence-based practice,
which was made possible due to my outstanding written and verbal communication skills.
Demonstrated ability to work well within a team environment
Whilst working as a Registered Nurse on the Cardiac and Stroke Ward at Manning Hospital, I observed that
a patient of mine was beginning to slur his words, complained of left sided weakness, and was struggling to
talk in full sentences. I immediately recognised the symptoms of a stroke and initiated an emergency by
contacting the Rapid Response team. Following the application of ISBAR communication techniques, I
clearly and efficiently communicated the emergency to the Emergency Response Administrator.
When the team and the patient’s Doctor arrived, I again followed ISBAR communication techniques in
order to deliver a rapid handover, and continued to administer assistance to the patient, including taking
bloods, administering medications and undertaking observations. The rapid response was a great success
and the patient began to stabilise, however, this situation now required my intervention to create an
amended patient care plan.
Initially, I created written referrals for the associated allied healthcare practitioners such as Occupational
Therapy, Physiotherapy, and a Dietician. Working together, we developed a holistic approach for the care
of the patient based on their immediate and future medical needs. During this process, I used my
exceptional influencing, negotiation and diplomatic skills to coordinate the allied healthcare response,
ensuring that efficient handovers occurred, in addition to providing my assistance to each stakeholder
during their visit to the patient. If there were any further patient requirements such as a special diet, I
ensured to contact the kitchen to communicate the patient’s dietary request. Throughout this period, I
additionally maintained constant communication with the patient, keeping them, and their family informed
of any progress and updates. My assistance with the family was gratefully received and the collaborative
partnership that we developed ensured that I was able to educate the family on potential patient care
needs for the future.
Responding to a medical emergency and then initiating and delivering a post emergency healthcare plan,
which involved multiple stakeholders, requires exceptional coordination, organisation, communication and
interpersonal skills. These very skills enabled my patient to begin to recover from an extremely traumatic
event.
Demonstrated time management, prioritisation and organisational skills
In my role as a Registered Nurse in the Cardiac and Stroke Ward at Manning Hospital, a routine shift
requires that I attend to four to five patients, who are often critically ill and demand intensive nursing. This
role is particularly challenging when a colleague is sick, which requires the remaining team to take on the
extra work. During one such shift, where I was responsible for six patients, in addition to providing extra
support to my other nursing colleagues, one of my patients developed chest pains. This occurred at the
exact moment that another patient needed to go to the toilet whilst I was processing a new patient
admission.
Using my judgement skills, I recognised that the patient with chest pains was a priority; however, I could
not just ignore the other two patients. Therefore, I quickly liaised with the patient that required assistance
to go to the toilet to ascertain whether they could wait. Unfortunately, they could not and it was at that
point that I realised that without delegating some of my tasks, a patient was in danger of not receiving
critical emergency care. I instantly contacted my Clinical Coordinator and informed them of my situation
and using exceptional influencing and negotiation skills, persuaded them to deal with my existing patient
load. This left me free to contact the on-call Doctor, who responded immediately. In the meantime, I
communicated with the patient using empathy and professionalism, whilst I undertook an ECG and ensured
that they understood that the Doctor was on the way and that he would receive the attention that he
clearly required.
Using ISBAR communication techniques, I conducted a rapid patient update for the Doctor and then
provided him with the assistance that he required to attend to the distressed patient. Although the
majority of my attention was on assisting the Doctor, administering Glyceryl trinitrate (GTN) and pain relief
with a complete set of observations, I maintained my interaction with my other patients and the Clinical
Coordinator, to ensure that everything was under control.
My ability to multitask, recognise priorities and use my initiative with sound judgement to make important
decisions, enabled me to effectively time manage a particularly busy period of time, resulting in
maintaining the exceptional level of patient care that I am trained to deliver.
Demonstrated willingness and ability to undertake the educational obligations to fulfill the requirements
of the Transition Nurse Program
Committed to continual professional development, I have consistently taken advantage of the range of
personal development opportunities that are available to me. This includes being uptodate with all of my
mandatory Health Education and Training Institute (HETI) online education program instruction.
Additionally, I have undertaken further training using the Edmore New South Wales Health Online Training
Portal, the most recent of which was Advance Life Support.
Within Manning Hospital, I have attended the majority of in-service training, which has consisted of a wide
variety of subject matter presented by Doctors, Clinical Coordinators, health specialists, and Nurse
Educators. One such subject included the policies, procedures, guidelines, and practical use of Patient
Controlled Analgesia (PCA) machines. Having only just started working in the Stroke and Cardiac ward for
Manning Hospital as a Registered Nurse, I knew that this information would prove useful in efficiently
undertaking my responsibilities. Within the same week, my knowledge was put to the test in a real life
situation and I was able to effectively use the PCA machine without supervision or guidance. During this
instance, I ensured that I followed due protocols concerning the Schedule 8 morphine medication, and
completed all administrative requirements as per the guidelines.
Throughout my nursing career to date, I have discovered that nursing requires a knowledge base far
beyond purely clinical matters. By committing myself to further personal development, I have become an
effective and positively contributing member of the nursing team.
Demonstrated understanding of Excellence and the CORE values
As a Registered Nurse, I understand my responsibilities to my colleagues, my patients, their families, allied
health stakeholders, as well as my employer. Working within the New South Wales public service, I
consistently strive to adhere to excellence and CORE values, including collaboration, openness, respect, and
empowerment. This includes acknowledging that every action and interaction that I undertake has a
consequence. Within my role, I am dealing directly with people across a broad range of cultures and
socioeconomic backgrounds, therefore upholding respect, cultural sensitivity and exceptional interpersonal
skills enable me to deliver best practice and patient care.
In my current role as a Registered Nurse for Manning Hospital working on the Cardiac and Stroke Ward, my
team is constantly under pressure to maintain high service levels in a very busy and continually demanding
work environment. This is where team collaboration, openness in communication and taking accountability
ensures that the team as a whole can cope with the pressures, without losing sight of their CORE values.
When I first commenced work with the hospital, I immediately dealt with the Schedule 8 drug
administration procedure that is required prior to, and after, administering Schedule 8 pain medication to
patients. The procedure requires two nurses to observe, check paperwork and signoff on the process of
taking the drug out of its secure location, delivering it to the patient, and disposing of any unused
medication. When I was confronted with a Nurse who stated that they did not have time to work with me
throughout the entire procedure, I was reminded of my commitment to excellence and the CORE values.
Despite that fact that I was a relatively new Registered Nurse, and this individual was a Nurse with
extensive experience, I took accountability and had the integrity to insist that the nurse provide me with
100% assistance whilst reminding them that these protocols are there for a reason. The other Nurse
immediately realised her error, was happy to assist me, and respected my position.
As time went on, I recognised that this behaviour was often repeated by the majority of nurses during
particularly busy times and on each occasion I took responsibility, stood up to the other Nurse and insisted
that we follow due protocols. I am confident that my actions have significantly reduced this behaviour,
which has subsequently strengthened team bonds and our ability to deliver exceptional patient care.
Compliant with all mandatory education
Demonstrating my compliance with all mandatory education, I possess a Bachelor Degree in Nursing,
attainted from the University of Newcastle in 2014, in addition to current registration as a Registered Nurse
with AHPRA. Furthermore, I am up-to-date with all Health Education and Training Institute (HETI)
requirements, and have voluntarily attended the majority of in-service training within Manning Hospital, in
addition to undertaking additional Edmore training.
