Organisation: Children’s Health – Queensland Hospital and Heath Services
Job Title: Registered Nurse
Word Limit: 2 Pages Maximum
Location: Brisbane
Leadership
During my current role as a Registered Nurse within the Child and Youth Mental Health Inpatient Unit at the Mater Children’s Hospital, I have demonstrated leadership through being a role model in adopting and implementing the unit’s new eating disorder protocols. The protocols are a new set of guidelines to guide nursing staff in the care of eating disorder patients, including ensuring patients fit the criteria for the protocols, provision of family education and support, and supervision of patients in this category. Support after meals has been increased, requiring extra staff hours. I have been responsible for training and coaching new and temporary nursing staff within the unit to ensure they are aware of the protocols, and have encouraged them to adopt the solutions focused approach advocated by the protocols. The new protocols have resulted in a reduction in the length of patient stay, reduced patient’s needs for nasogastric feeds and reduced re-admission rates.
Within the CYMHS, some patients are admitted via the Mental Health Act as involuntary patients. Part of my role is to uphold patients’ rights and responsibilities by informing them of their specific rights and the behaviour expected whilst they are in our care. In addition, when voluntary patients have issues with their level of care or are unsatisfied, I refer them to speak to a Complaints Officer in line with policy. This demonstrates my knowledge and ability to adhere to standards and procedures, and also to uphold patients’ and families’ rights within the mental health environment.
I have demonstrated my active involvement in the achievement of department and organisational goals in variety of ways. One of these ways is in making decision around the patients who are admitted to the ward based on their behavioural traits aligned with their condition, and how they will affect other existing patients and overall harmony of the unit. One example of this was when a young 7 year old ADHD patient was existing in the ward with tendencies to be intrusive and inappropriate, and I was asked to decide whether to admit a 17 year old boy with psychosis and aggression issues. This clearly was a case where the potential for conflict was considerable and meant other arrangements had to be made for the new patient.
Quality Care
I pride myself on the provision of quality care for patients, whether voluntary or involuntary. Part of this approach is using the systematic approach to ensuring patients are looked after in an appropriate fashion, starting with ensuring all consents are signed by patients and parents or carers, checking patients’ belongings for potentially harmful contraband, having patients reviewed by a Doctor in a reasonable timeframe after admission, and ensuring treatment is monitored for the desired outcome. For example, the eating disorder patients are admitted on a Red Protocol and given consents for them and parents to sign before their meal plans are set and supported. A large part of a patient’s treatments are based on a systematic reviewable process, including behaviour management planning and observations documenting and charting effectively. Our 7 year old ADHD patient was required to have a medication review during his stay, and this required the reduction of his medication initially. During this process, I and the other Nurses were to monitor the patient and document his status and the effects of this reduction, ensuring his safety and meeting legal requirements.
I have exceptional communication and interpersonal skills and have demonstrated the use of these to communicate, negotiate and liaise with patients, families, Doctors, Psychologists and specialists, community organisations, GPs, School Counsellors, the Department of Child Safety, among other health professionals and public. I routinely receive phone calls from distressed and concerned parents, giving advice about where they can access services and assistance.
Learning, Research and Development
During my shifts, I have often been made responsible as the Lead Nurse, and am required to allocate Nurses to patients for their 12 hour shifts. Reflecting on the Nurse’s shift previous to the current one is an important consideration as sometimes our patients are demanding and difficult to deal with and nurses need some time with other patients. By varying patients and Nurses it also give staff the opportunity to develop their skills and be cross-skilled in more presentations. To ensure this process was happening, my suggesting of bringing the allocations information to each handover was implemented, giving the decision maker the instant ability to review based on patient load and Nurse’s temperament as a result. This process has been adopted throughout the unit.
I am a reasonably self-aware individual, and have undertaken a range of compulsory and voluntary training sessions, as specified on my attached resume. In addition, I have undertaken acting Clinical Nurse roles for varying lengths, further enhancing my professional knowledge and experience. I have taken responsibility on many occasions to induct and train new staff members within our unit to ensure they have a good understanding of policy and protocols, and have ensured my approachability for them to ask any questions should they need to. This training and my own practice demonstrates a commitment to the maintenance of a positive workplace culture, and also an acceptance and inclusiveness of patient culture and beliefs. I have provided places to pray for religions which require it, and am proud of my ability to accept and assist all patients with respect.
As mentioned in my attached resume, I have been actively involved in a number of initiatives within the CYMHS which have included new protocols for eating disorders and a significant reduction in seclusion rates within the unit. Both of these initiatives demonstrate my commitment to quality service improvement and practice within an evidence-based culture.
Teams, Partnerships and Communities of Practice
As mentioned previously, I have excellent and effective communication skills which allow me to collaborate and work with a large multi-disciplinary team. Good relationships are formed through communication with patients also, including morning routines of outlining the children’s day. These meetings include information around who is attending school, who is going to cooking group and other activities to ensure all patients feel like they are in control.
During my training and coaching of new staff members, there are a number of areas I cover around a safe working environment and communication processes, all of which I follow as well. These include being aware of the alarms in the unit which alert others that you require assistance, and being prepared to use these and not hold off; being aware that this is a swipe access locked ward when opening doors and entering or leaving; being aware of your surroundings and who is around; ensuring the kitchen is locked at all times; ensuring patients aren’t bringing in dangerous contraband; ensuring use of Security Guards when required.
