1. Demonstrated clinical knowledge and experience in the delivery of evidence-based nursing care within the practice setting.
Situation- As a part of my job as a registered nurse in Saini children’s hospital for a year, I had handled a number of cases for children while on duty. A particular case was that of a child who was rushed in with an acute asthmatic attack in the emergency at night and I was the only person in the wardon duty. He displayed symptoms of ineffective breathing pattern, anxiety, tachypnea, nasal flaring and audible wheezing and sounds. The doctor on duty was not available at the time and the patient was gradually losing consciousness. There was not much time available and immediate treatment was to be needed in time to save the child.
Task- I decided to immediately remedy the situation and manage the case of asthma exacerbation in the child and reduce the risk of him slipping further into respiratory distress.
Action- I took immediate history of the patient about his condition of asthma from his parents and assessed him for airway clearance, breathing pattern and other danger signs, lest he goes into respiratory distress. I cleared the obstruction to ease his breathing pattern and immediately put him on the required high-flow oxygen. I alerted the doctor on duty and also administered Salbutamol to provide him with rapid relief. Multiple people are required in order to begin treatment and for history-taking in a case like this to establish if it was the first asthma attack, or a previous diagnosis of asthma has been given to the patient. Since I was alone, both the things had to be done simultaneously in order to save the patient in time.
Result- As a result, the patient gained his consciousness back and his breathing pattern returned to normal in some time. The patient’s family was grateful for my timely intervention and appreciated my timely response to the emergency. My supervisor, nurse manager was also satisfied with my work. I later conveyed all the necessary information about the patient’s status, condition and history along with current medications and treatment protocol given to the doctor and my supervisor as well. This incident helped demonstrate my confidence in my clinical skills and knowledge and my ability to provide effective and timely nursing care based on evidence while keeping the patient’s safety foremost, in tandem with the vision of the hospital as well. It also helped emphasise on my ability to look for details and accurately demonstrate my written communication skills as well.
2. Demonstrated effective interpersonal, negotiation and conflict resolution skills.
Situation- Once, while on duty as a junior nurse in the hospital, an argument broke out between the members of a patient’s family and one of my colleagues on duty. The patient was a difficult patient of a mental illness and was required to be kept in the hospital for an extended period of time. His family was not very cooperative with my colleague and was also complaining and arguing about the quality of care being provided to the patient. I was on duty in the other ward and noticed the argument and decided to help in some way.
Task- I planned to remedy the situation and manage the conflict and help in negotiation between the two parties.
Action- I intervened and tried to reason out with both of them to find a common place around the “right idea” of patient care that both the parties had in mind for the patient. I patiently and actively listened to both the sides and made them understand that they were both looking to work for the same goal but, in different capacities. I heard the family’s point of view and helped reduce their anxiety and assured them of my colleague’s well-intentions with the patient and tried to reason out the plan of care with them. The patient’s family understood the reasoning behind the treatment plan and the way of providing care to the patient.
Result- The patient’s family was satisfied with the explanation and was not angry or argumentative anymore. They were on-board with the plan and cooperative as well about it. My fellow nurse was also satisfied with the resolution and was grateful to me for the intervention and help. I believe the situation helped me portray my effective communication skills and conflict resolution ability as well. It helped me show empathy and patience towards the concerns of my patients and their families and help negotiate effectively with them and help provide high-quality healthcare to them in tandem with the vision of the hospital.
3. Demonstrated effective written and verbal communication skills.
Situation- During my tenure as a registered nurse in the Saini Hospital, a patient suffering from Type 1 Diabetes was admitted for a hypoglycaemic attack and the complication of ketoacidosis. The required treatment was provided to the patient and the necessary care was given to the patient. The doctor-in charge had specifically observed and pondered upon the causes of the attack in the patient and had deduced poor dietary management and insulin use was responsible for the hypoglycaemic attack. Poor treatment adherence and ineffective following of instructions had led to the emergency situation for the patient. The doctor instructed me to provide the necessary instructions and do patient education as well to remedy the situation.
Task- I decided to manage the patient by providing health education to the patient and his family by utilising the teach-back technique.
Action- I counselled the patient’s mother regarding the condition of her disease and the most common complications associated with it. I decided to find out the reason for her improper adherence to treatment for the patient. The mother had not received any education prior this and was apprehensive about the same. I explained the complications along with the required dietary advice and instructions for using insulin and monitoring her blood sugar levels as well. After the education, I asked her to explain the entire regimen and precautions back to me. She was able to recapitulate most of the points and understood the education well.
Result- The patient came back to the hospital after a month for a regular follow-up and she was stable, following the treatment protocol and dietary advice as well. She was taking the necessary precautions and was clearly more satisfied with the management of her condition. Her investigations were towards the normal side and her diabetes was in good control now. The doctor in-charge praised me for the good results of my effective health education, in tandem to maintaining and ensuring patient safety and quality of care. I believe the situation helped me portray my effective verbal communication skills and ability to reason out with patient and their families and clearly and concisely collaborate with the patients as well.
4. Demonstrated ability to work effectively within a multi-disciplinary team environment.
Situation- I took charge of a new patient that had been diagnosed with diabetes insipidus, while I was working as a registered nurse in Sangha Hospital. I observed that his blood glucose levels (BGL) were being monitored twice daily. However my knowledge regarding this condition reflected that this could not have been a necessary measure or protocol of management for the condition.
Task- I decided to review the patient’s files and observed that his blood glucose measures were usual and normal. So, I engaged his GP for further investigations. The GP then advised that the patient’s condition could effectively be managed through a healthy diet and a change in lifestyle. He also advised that no regular blood glucose monitoring was necessary anymore.
Action- For assisting my patient well, I arranged a dietician for him to see and consult along with a specialist in diabetes to provide an informative session to the patient who later implemented a specific meal-planner for him for the management of his diabetes. I also got him enrolled in a local gymnasium and engaged with them to make sure he attended it at-least once a week in order to lose weight. I also engaged with a psychologist for him to discuss his issues related to food and help him with appropriate strategies for eating and help in treatment adherence as well.
Result- My ability to engage in a multidisciplinary team to assist my patient has led him to lose around 5-6 kgs only in 2 months, thus being on the right track towards treatment and no longer having to continuously monitor his blood glucose .I believe, I demonstrated strong skills of effectively working within a multidisciplinary team environment along with displaying strong collaborative skills as well in the example above, whilst also contributing to excellent patient care within a hospital setting.
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