Clinical Placement Experience Of A Registered Nurse

Rehabilitation Care Experience

Question:

Discuss about the Demonstrated Effective Communication.

During my clinical placement, I have worked in age care rehabilitation care for a period of 6 months as a registered nurse. I had an objective of improving my knowledge and learning skills while working in the Surgical and Melanoma Unit of Royal Prince Alfred Hospital in the year 2014.I was committed to the philosophy, mission and values of Mary Aikenhead Ministries
such as to maintain the dignity of the residents who were admitted in the old age rehabilitation unit. I learnt to be compassionate and treat the patients without any discrimination. The duration of this training was 120 hours. I gained experience in providing palliative care and patient-centered care to all the patients who were admitted in the rehabilitation centre. The rehabilitation centre focused in providing proper assessment, prevention, diagnosis, treatment, guidance and support to patients who were admitted. During this placement I was assisting residents who were suffering from ADLS (Activities of Daily Living) and used to face issues in walking, toileting and showering (Mosole et al., 2014). During my training period, I followed Occupational Health and Safety guidelines and the procedure of infection control. I used to provide support and guidance to the patients who suffered from several health disorders in the rehabilitation centre.

While working in the rehabilitation centre, I improved my communications skills with different health care services such as primary, acute, sub acute and community. It helped in fostering my professional growth in the area of old age rehabilitation care as a new graduate nurse. I used to attend meetings and training sessions as a part of multi-disciplinary team (Rantakokko, Mänty, & Rantanen, 2013).I used to build therapeutic and professional relationship with clients, health care team members, and families of residents.

I used to assist residents with ADLS and build up interpersonal relationships with the health care staff in the rehabilitation unit. I got along easily with the team members of the interdisciplinary team. I was effectively liaising with residents, preceptors, clinical educator and nursing unit manager. I also completed clinical assessment procedures such as pain assessment, head to assessment and handover for clinical portfolio in order to record if the patients are suffering from health issues (Stenholm et al., 2014).

While working in the Surgical ENT department at St Vincent’s Hospital Sydney from 7^th April, 2015- 24^th April, 2015, I learnt about generating mails in a professional manner and learnt to make sure that accurate documentation is done for residents through electronic patient record system .Important parameters such as vital signs, intake and output and Blood Glucose Level are recorder accurately. During this placement I gained knowledge and training with JP drains, abscess drains, nasogastric tubes, and peripherally inserted central catheter (PICC).I also learnt about administration of  medication in a safe manner by following proper medication protocols such as drug injectable book, Dr order a, six rights and 3 checks (Turner?Stokes et al., 2015). During this training as a registered nurse, I also learnt about clinical assessment procedure such as pain assessment, Clients span duty of Care, handover, and wound assessment for clinical portfolio.. I learnt about pressure area injury and the way assistance should be providing while patient care and positioning. I gain experienced regarding electronic patient record system and recognized indication time to administer medication.I have practiced and learned to write progress notes and care plan and giving handover. I have also learnt to operate ECG and bladder scanner.

Experience in Surgical ENT department at St Vincent’s Hospital Sydney

While working in the Mental Health Unit of St Joseph’s Hospital from 7^th September, 2015 to 25^th September, 2015. While working in this unit, I gained knowledge about mental state examination (MSE) through communication with my facilitator. I used to provide assistance to the patients who used to have issues with the activities of daily living. I used to integrate care co-ordination of patients and assess them properly so that a better flow of patients occurs in the rehabilitation setting. I was able to complete MSE of the patient that was allocated to me by going through the resident’s folder (Rowles & Bernard, 2013).

I used to attend the video conferences as a part of the multi-disciplinary team and also joined manual handling training. I also went on a bus tour with residents and several games and activities were organized for residents such as domino and playing cards. It was the best part of this clinical placement and it was an awesome experience for me.

During my clinical placement in from 1^st February, 2016 to 19^th February, 2016 in Colorectal Department, Concord Repatriation General Hospital,I experienced real emergency situations and   learnt how to deal with such patients. I learnt the importance of time management while dealing with emergency cases as it plays a significant role in health care systems as it impacts the health condition of the patients used to behave in a professional manner with the nursing staff and other health care professionals (Julayanont et al., 2017).

During my clinical placement in the Colorectal Department of Concord Repatriation General Hospital, I have gained theoretical knowledge and clinical skills, critical thinking and analysis in daily practice as a registered nurse gained knowledge about colon and rectal disorders and also learnt about how to care stoma through research regarding stoma care and experienced myself during the clinical placement by emptying the stoma bag. I looked after the patient who suffered from liver cirrhosis and observed ascites tab insertion.  I used to write progress notes, give handover and perform evidence based research regarding the condition of the patient. These were my roles and responsibilities for each day. I have also completed the clinical assessment as part of clinical placement such as medication administration, pain assessment, and clients span duty of care and wound assessment ( Iwasaki & Yamasoba, 2015).

I have obtained knowledge about ambulatory outpatients and the procedure of their treatment while working in the Ambulatory/Outpatients in Bankstown-Lidcombe Hospital, I have learned about different types of IV infusion such as Iron, Remicade, Actemra and their indications. I also understand that how important to monitoring patient during the IV infusion in order to prevent any type of adverse reactions. I was able to acknowledge the patients pain during the infusion and manage it by thinking critically and applying my theoretical knowledge to clinical situation (Edgren et al., 2107). I had an opportunity to check blood product with the allocated registered nurse. I have also attended Hospital Seminars regarding the ISBAR handover which help in delivering the information about the patient. I learnt to provide ambulatory services to the patients in order to reduce the hospitalization of patients and promote their discharge process earlier from the health care setting.

Mental Health Unit Experience

While working in the cardiothoracic, vascular unit in Strathfield Private Hospital, I have learnt about different types of heart surgery such as CABGS, Coronary Angiogram and Carotid Endarterectomy as well as telemetry and its care. I learnt performing ECG independently and filling the result accurately in patients’ folder. I have completed Patient care plan and assessment such as falls risk, pressure injury and mobility (Birren et al., 2013). I utilized judgment supported by nursing theory and practice in the delivery of nursing care. I learnt safe administration of IV medication and monitor the deteriorating condition of the patients.

Currently registered as a Registered Nurse (Division 1) with the Australian Health Professionals Regulation Agency

I am currently registered as a registered Nurse with the Australian Health Professionals Regulation Agency. I have learnt to handle patient and provide quality care to the patients in the old age rehabilitation unit. I learnt to develop a therapeutic relationship with the patients by being an active listener and being empathetic and courteous towards them. I  have learnt to follow all the ethical and the legal requirements as an undergraduate registered nurse and treat my team members and patients  with respect.  I performed my roles and responsibilities properly in order to maximize the independence of old patients and reduce their health care issues.

References

Birren, J. E., Cohen, G. D., Sloane, R. B., Lebowitz, B. D., Deutchman, D. E., Wykle, M., & Hooyman, N. R. (Eds.). (2013). Handbook of mental health and aging. Academic Press.

Edgren, J., Salpakoski, A., Kallinen, M., Arkela, M., Kokko, K., Nikander, R., … & Sipila, S. (2017). Rehabilitation And Quality Of Life: Effects Of A Home-Based Rehabilitation Program On Health-Related Quality Of Life. Innovation in Aging, 1(suppl_1), 945-946.

Iwasaki, S., & Yamasoba, T. (2015). Dizziness and imbalance in the elderly: age-related decline in the vestibular system. Aging and disease, 6(1), 38.

Julayanont, P., Phillips, N., Chertkow, H., & Nasreddine, Z. (2017). Cognitive screening instruments. A. J. Larner (Ed.). Springer.

Mosole, S., Carraro, U., Kern, H., Loefler, S., Fruhmann, H., Vogelauer, M., … & Hamar, D. (2014). Long-term high-level exercise promotes muscle reinnervation with age. Journal of Neuropathology & Experimental Neurology, 73(4), 284-294.

Rantakokko, M., Mänty, M., & Rantanen, T. (2013). Mobility decline in old age. Exercise and sport sciences reviews, 41(1), 19-25.

Rowles, G. D., & Bernard, M. A. (Eds.). (2013). Environmental gerontology: Making meaningful places in old age. Springer Publishing Company.

Stenholm, S., Westerlund, H., Head, J., Hyde, M., Kawachi, I., Pentti, J., … & Vahtera, J. (2014). Comorbidity and functional trajectories from midlife to old age: the Health and Retirement Study. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 70(3), 332-338.

Turner?Stokes, L., Pick, A., Nair, A., Disler, P. B., & Wade, D. T. (2015). Multi?disciplinary rehabilitation for acquired brain injury in adults of working age. The Cochrane Library.