Organisation: Queensland Health
Job Title: Midwifery Student
Word Limit: 3 pages
Location: Subiaco
A compassionate, proactive and community-focused individual with a desire to make a difference to the lives of others, I write with interest to be considered for the Midwifery Student appointment at King Edward Memorial Hospital for Women (KEMH). Enthusiastic to uphold and promote the hospital’s vision, I understand that KEMH promotes its philosophy of excellence through evidence-based, best-practice and patient-centred care as Western Australia’s only referral centre for high risk and complex pregnancies. As a committed healthcare professional, I am active in the development of positive key relationships with patients, colleagues and the wider community, treating all interactions with dignity, respect and compassion.
As a dynamic, highly motivated and committed individual, I am confident that I would make a valuable contribution as a Midwifery Student at KEMH due to my sound ability to assess, reflect and develop key technical skills to deliver excellence within my position. Currently completing a Bachelor of Science (Nursing) at Curtin University, I will be eligible to register as a qualified registered nurse mid-2016. Achieving exceptional academic standards appropriate for the midwifery course, I hold a current course weight average of 74.45%. Committed to ongoing professional development and lifelong learning, I have currently completed Senior First Aid Training through St John Ambulance in 2015, Manual Handling Training and Certification, The Role of Play in Hospital Certification, Hand Hygiene Australia Certification, as well as a First 2 Act Web Patient Deterioration Management program. Throughout my university studies and practical experience, I have researched and gained an excellent understanding of the National Safety and Quality Healthcare Standards, which outline the significant responsibility in providing safe and quality care.
Throughout my practicum placements in clinical settings, I have embraced the opportunity to learn and practice a variety of clinical skills that are applicable to midwifery. During my most recent placement at Princess Margaret Hospital, I was assigned to care for an adolescent who was newly diagnosed with type one diabetes. Upon admission, the patient and family were understandably anxious and worried, as the young child was displaying symptomatic signs prior to admission such as headaches, weight loss and being excessively thirsty. In my position as nurse, I was responsible in building a trusting rapport with the patient and family to ensure progressive management in the commencement of the patient’s diabetes treatment. Adept at reading my audience, I was able to alter my communication style and messages accordingly, listening to the words and interpreting the body language of others to gauge their level of understanding and acceptance of my points.
Working in collaboration and under the guidance of the Clinical Nurse Supervisor regarding the patient’s medical and social history, I was successful in providing the patient and family with optimal treatment and care. Possessing the natural ability to establish therapeutic relationships, I drew on my personal experience of caring for a child with diabetes to aid this relationship and the necessary education to promote active self-management of monitoring blood glucose levels and administering insulin. The success of my ability to establish a trusting rapport and promoting family-centred care, I was instrumental in providing the patient and family with the tools and knowledge required to regain a sense of control and empowerment, which in turn facilitated a positive health outcome for the patient.
Obtaining the knowledge and experience in caring for patients within the surgical ward at Sir Charles Gairdiner Hospital, I value this placement for the heightening of my clinical skills. With the transferrable skills of managing and caring for the postoperative patients, I am confident in my capabilities performing as a midwifery student at KEMH. Whilst performing as a nurse during a morning shift, I was handed over a patient who had undergone 48 hours prior a cholecystectomy procedure. Conducting patient observations, I assessed the patient’s fluid balance chart and identified that the patient’s urine output had significantly decreased over the 48 hours. Communicating with the patient regarding their current wellbeing and if adequate fluids were being consumed, I was responded to positively. Further investigating potential reasons, I checked vital signs, which were within normal limits, confirmed that the drainage bag was positioned below the bladder to facilitate adequate drainage, monitored tubing to ensure that it was not kinked and the catheter had remained in place. All this aside, I was still not content with the patient’s low output and after documenting this, I spoke to my buddy nurse, who instructed me to report my findings to the clinical nurse manager. After it was suggested that there was a blockage in the catheter, I worked in collaboration with my buddy nurse and intervened and flushed the catheter following hospital procedures, polices and guidelines. Throughout the remainder of my shift, I monitored this patient and over the following two hours, the urine output had increased. After completing my shift, I provided a clear and concise handover and ensured that I had documented all relevant findings accurately.
During my clinical placements, I have proven my ability to recognise a deteriorating patient, promptly alerting staff, and implementing appropriate measures. Whilst on clinical placement at Sir Charles Gairdiner within the medical ward, I was performing morning observations on a patient and questioning the patient on their current wellbeing. Whilst identifying that the patient’s symptoms were in line with low blood pressure readings of 90mmgHG, my findings were confirmed in that the patient expressed to me that they had been feeling faint and weak since waking that morning. Reviewing the observation chart, I was aware that the low blood pressure met a criterion for a medical emergency team (MET) call. After documentation, I immediately spoke to my buddy nurse and the clinical nurse manager, who alerted the senior nurse in charge and it was decided to implement effective methods to increase the patient’s blood pressure with the interventions such as bed positioning, encouraging fluid intake and elevating the patient’s legs. Following these measures, I conducted observations of vital signs every five minutes, until the patient began to show signs of improvement. After thirty minutes, the patient’s blood pressure had increased and they were no longer feeling faint. I continued to survey the patient closely throughout the rest of my shift and gave a succinct and accurate description of the events during the handover.
As a midwifery student at KEMH, I will strive to further develop my skills and understanding of catering for diversities in patient care and healthcare team performance. In a commitment to personal continuous improvement, I am comfortable seeking advice from my fellow colleagues regarding their experiences within their nursing practices, and are welcoming of their feedback about my practices and strategies, with no hesitations to trial new approaches that may be suggested and discussed. Possessing the expertise to work and communicate effectively within a multidisciplinary team, I present as a warm and approachable professional. Confident in my strengths in working within a collaborator environment, I possess the technical knowledge to practice within my scope and relevant legislation.
With a proven ability to display situational awareness within the clinical setting, I have developed an imperative skill to facilitate effective multidisciplinary communication. During clinical placement at Princess Margaret Hospital (PMH), I drew on my situational awareness discovering that an anorexic nervosa patient was tampering with their feeds. To manage this, I informed my buddy nurse, who then alerted the clinical nurse manager and in collaboration with the dietician, I embraced the decision to make up for the patient’s nutritional loss, a bolus feed was to be administered for the patient’s next scheduled intake. After being advised of this action plan, the patient became extremely distressed, the psychologist and doctor were notified, and I was able to confidently speak with the doctor and psychologist as well as actively listen to their suggested interventions. The patient was prescribed Olanzapine, which reduces anxiety, and testament to the collaborative approach, I was able to administer the patient’s bolus. The outcome of my situation awareness, combined with my communication skills, were acknowledge by my managers and peers in delivering excellent and effective results in the positive continuity of care for the patient in collaboration with the multidisciplinary team.
With sound knowledge and understanding of current clinical governance systems, I draw on my ability to research and develop current and future trends. Through my learning, I have embraced ideology from articles such as Grey, C “What is clinical governance?” As quoted, clinical governance can be defined as “a framework through which NHS organisations are accountable for continuously improving the quality of their services and safe guarding high standards of care by creating an environment in which high excellence will flourish”. (Grey, 2005). Additionally, “the seven pillars of clinical governance include, education and training, clinical audit, clinical effectiveness, research and development, openness, risk management and information management. (Grey, 2005). The Australian Nursing and Midwifery Accreditation Council comprises an independent accrediting authority and plays an imperative role in ensuring that nurses and midwifes are accountable for the quality and safety of care in which they deliver to all patients. This in turn, instils confidence within the community that nurses and midwifes who continue with professional development can therefore provide healthcare for individuals in a safe and competent manner.
Through my understanding, I am committed to my position of providing quality and evidence-based care to patients, ensuring patient satisfaction and adhering to hospital polices and guidelines. Employing clinical governance during my clinical practice at Princess Margaret Hospital, it became evident that many of the anorexia nervosa patients were tampering with their feeds by using the flushing syringes to extract nutritional fluids from their nasal gastric tubes. Collaborating with the staff, I assisted in the implementation of a planned focused decision and agreement that after all clinical flushing had been performed, syringes were not to be placed in the bins in the patients’ room, but in the waste in the sterilisation room. Clinical governance was therefore evident as adverse events were prevented and the safety and quality of care was ensured for the patients, along with trust instilled in the respective families.
Key elements that encompass the role of the midwife are providing women-centred care, providing safe and supportive evidence-based care, and working in collaboration within the multidisciplinary team, to ensure optimal outcomes for the mother and newborn. The role of the midwife also involves implementing preventative measures, advocating normal birthing practice and monitoring any complications in the reproductive years and the childbearing cycle. The midwife also provides antenatal care, parent education, assistance during labour, postnatal care and breastfeeding support. (Government of Western Australia, Department of Health, 2015). Cultural awareness is another key component to midwifery; ensuring that mothers’ cultural needs are met and attended to throughout the pregnancy and birthing process. My lifelong goal has been to work as a midwife, and I am eager to work at King Edward Memorial Hospital caring for mothers and their babies in the public healthcare system. I would be extremely grateful for a position in the Midwifery program for mid-year intake during 2016 at King Edward Memorial Hospital, and would be honoured to have the opportunity to be able to be an advocate for care for mothers and their babies.
