Nursing Assignment: Demonstrated Abilities and Skills

This nursing assignment showcases the student's demonstrated abilities and skills in assessing, planning, implementing, and evaluating nursing care, recognizing and responding to clinical deterioration, understanding own professional limitations, interacting effectively with people of diverse cultures, applying evidence-based decision making, and demonstrating application of WHS practices.

Nursing Assignment
“S STAR” format
Student name
8/10/2018

1. Demonstrated ability to assess, plan, implement and evaluate nursing care.
I am able to think rationally and can critically link theory to clinical practice for rationale
decision making in my clinical practice. While on the third year clinical placement in an
emergency ward I was given the handover of a 34-year-old male accident victim patient with an
abrasion injury on his right knee. I was actively involved in the discharge planning of the patient
after his wound care and dressing. I assessed the patient’s vitals including heart rate, blood
pressure, respiration rate, pulse and temperature. I observed his wound that revealed slough and
exudate. I assessed his previous medical records which revealed that patient had a history of
hypertension. He did not present with any chronic debilitating disease such as diabetes. I
informed the supervising nurse of my observations and consulted the multidisciplinary team
regarding the type of dressing required for his wound care. After documenting the observations
on the patient’s medical record, I gained patient’s consent for the new intervention plan. I
utilized aseptic technique for the wound dressing. On completing the dressing I made sure that
the patient felt comfortable and then I updated the information to the nursing supervisor and the
physician. Finally, I completed the ISOBAR handover for the next shift to ensure patient’s safety
from infection. After three days the patient was discharged home when the wound was free of
slough and exudate. This process allowed me in delivering a holistic patient oriented care plan
2. Ability to recognize and respond to clinical deterioration.
I am able to recognize and respond to clinical deterioration and I have the ability for rationale
decision making in my clinical practice in such scenarios. While on the second year clinical
placement in an emergency ward during the night shift I received a case of an infant who was
unable to breathe due to chocking resulting in airway obstruction. I was actively trying to
dislodge the blockage that resulted in chocking. I assessed that the patient was unable to breath,
his heart rate was constantly decreasing, his pupils were dilated and his parents were panicked. I

immediately held the infant in a face down position along with support from my forearm with his
head lower than his bottom position. I then used the base of my hand to give five blows on the
infant’s back in the middle between shoulder blades. However, in spite of repeatedly doing this
procedure, the blockage was not getting out, instead infant’s body started turning pale. I
immediately contacted the multidisciplinary emergency team for the rescue of the baby. The
team arrived within no time and performed CPR. The baby was laid in face up position and the
emergency team performed chest thrust by pushing the baby’s breastbone in the middle by
placing two fingertips. By giving 30 chest compressions at the rate of 100 to 120 per minute, the
child grasped for breath and was able to regain his consciousness after some time. The parents
were given training for the technique of removing any blockage in infant in future and the infant
was discharged home after checking his vitals including respiratory rate, heart rate, temperature,
and pulse.
3. Understands own professional limitations and seeks appropriate assistance when required.
I can work within my scope of practice as an undergraduate registered nurse and I understand my
own professional limitations and know that I need to seek assistance when I face a situation
beyond the scope of my practice. While on the third year clinical remote placement as a remote
area nurse, I received a case of 62-year-old male patient who presented with signs of
cardiorespiratory distress: chest pain, tachycardia, hypotensive, and sweating. I was actively
involved in the clinical assessment and care plan of the patient. I assessed the patient’s vitals
including hear rate, B.P, respiration and temperature. The patient was hypotensive and there was
diminished air entry on left side of chest. Based on my clinical judgment I assessed that the
patient had pneumothorax. I had not performed an emergency needle decompression previously
and I was not authorized to perform decompression as an undergraduate nurse. I called the
emergency service assistance team to assist me in the procedure. Within no time, the team
reached for help and performed the emergency needle decompression with a cannula after
cleaning the area with an aseptic cotton swab. I carefully observed the procedure. After
sometime the patient was stable, as his respiration rate and blood pressure became stable. After

5 days in the ward, the patient was discharged home with medication intervention and observing
hemodynamic stability.
4. An ability to interact effectively with people of diverse cultures.
I attempt to practice in a culturally safe clinical practice. . While on the third year clinical remote
placement, I was involved in the care plan of a 16-year-old indigenous male patient who as
recovering from drug addiction. I was actively involved in the clinical assessment and discharge
care plan of the patient. I assessed the patient’s vitals, his medical history, psychological and
lifestyle factors. As the patient was a minor, it was important to involve his family members in
the care plan. The patient lived with his mother and father in a two bedroom house. He had two
sisters and a younger brother. As the patient was an adolescent, he was undergoing from
emotional and mental distress due to social isolation from his friends and family. I felt that it was
important to involve his parents in his care plan and discharge process. I arranged a meeting with
his parents and arranged an English translator and an aboriginal health care worker to remove the
language barrier. The patient was planned to be discharged on community treatment order, and
the discharge plan was discussed with his parents. I also explained them about the emotional
support that their son required at home with assistance of an aboriginal health care worker. The
parents were happy that their son was to be discharged home on CTO and they agreed to this
discharge plan and promised for regular follow up of the patient. On the day of discharge a CTO
order was faxed to community’s health clinic. The patient was discharged home with all the
support in place.
5. Demonstrated ability to apply evidence-based decision making.
I am able to use Evidence based practice in my clinical practice framework for best patient
outcome. In my second year clinical placement in the night shift ward, I was given the handover
of a 55–year-old male patient who presented with signs of acute exacerbation of COPD. The
patient presented with acute shortness of breath and his medical records indicated long standing
history of COPD, increase in quantity of phlegm and change in the color of phlegm. He was a

chronic cigarette smoker and was unable to quit his smoking habit despite several efforts. His
medication history included the use of Salbutamol. Based on my knowledge of evidence-based
practice approach, I knew that the patient required three EBP interventions to help in the
management of his COPD. The interventions included pharmacological intervention, patient
centered care plan, and management of depression associated with chronic COPD. After
discussion with the physician and utilizing my knowledge of EBP I realized that his medication
regime should be changed from budesonide to tiotropium as it is effective in preventing acute
exacerbation of COPD episode and hence preventing further hospitalization. Also, it has
comparatively less adverse drug reactions (e.g. Cushing’s symptoms). The physician changed his
medication to tiotropium. Also, using patient centered approach I counseled the patient for
quitting his smoking habit by explaining the long term side effects and health risks associated
with chronic smoking. The patient started recovering from the signs of acute exacerbation of
COPD gradually after medication intervention and counseling. The patient was discharged home
after 15 days of intervention after significant improvement in exacerbation symptoms.
6. Demonstrated application of WHS practices.
I have thorough knowledge of workplace health and safety measures and I utilize WHS practice
in my clinical practice. During my second year clinical placement in the ward, I received a case
of a 28-year-old male patient who was diagnosed with hepatitis B. I assessed the patient’s vitals
and medical history. His medical report and blood reports revealed bilirubin value as 12, his
SGOT and SGPT were also raised. I assessed his B.P, which was 110/80 mm of Hg. The patient
presented with high grade fever and history of dysentery. His sclera had yellowish discoloration.
I know that hepatitis B is contagious via serum and blood of the affected patient. I coordinated
with my nurse supervisor to move the patient in an airborne infection isolation room. Once the
patient was moved to the AII room, I placed a signboard outside the room door mentioning all
the necessary precautions that were needed. I also placed protective equipment inside the
patient’s room to prevent contamination such as gloves, hand sanitizer, mask and a yellow bag
for waste disposal. When the patient’s relatives arrived I educated them about hand hygiene
precautions and also educated them about respiratory hygiene. These precautions prevented the

spread of infection and ensured a safe clinical environment for the patient as well as his care
takers.