Elana Hiew Yi Chih

Orthogeriatrics Rehabilitation (19/2/24 to 24/08/2024)

• Pain management: I used standardized scale to assess and record the pain level, location, and type. I Provide prescribed pain medications to the patient and monitor their effectiveness by reassessing routinely. Reassured patient to ask for pain medication when needed.
• Wound mangement: I conducted wound assessments by observing its appearance, size, exudate, and the condition of the surrounding skin.Used the right solution to clean the wound, depending on the condition of the wound. Applied the appropriate dressing or treatment such as gauze, transparent, hydrocolloids,hydrogel,foams,alginate dressings. I have continuously monitored for signs of infection, such as erythema,eodema,exudate and heat. Collaborated with the healthcare team including wound nurse to address any complex wound management needs.
• Early recognition of deteriorating patient: I have successfully identified acute deterioration of patients, such as changes in vital signs, level of consciousness, or respiratory distress.I initiated MET calls, and provide life-saving interventions such as A to E assessment and oxygen until MET arrives.If the patient is unconscious I will commence basic life support using DRSABCD.
• End of Life/Palliative Care: In palliative care, I have assessed and monitorred indicators of agitation and restlessness, which can manifest in facial expressions, body posture, and behaviours due to anxiety and emotional distress. Additionally, managing excessive secretions, dysphagia, dyspnea, and pain may be alleviated through medication.I created a space where the patient and family feel safe and comforted and providing end of life care which in line with the person’s wishes and respecting the cultural beliefs and rituals of the person and the family.
• Continence management: I am confident in conducting continence assessments, such as bladder scans and monitoring fluid intake and output. I have also implemented toileting schedules or bladder retraining method to reduce incontinence. I have also used appropriate continence products while closely monitoring for any signs of skin irritation or breakdown. Additionally, educate the patient and their family on proper continence care and management strategies.
• Falls Prevention: To effectively preventing falls,I conducted fall risk assessment and using standardized tools such as FRAMP and made referral to the multidisciplinary team if risks were identified.I have also implemented interventions such as lowering bed height and providing mobility aids, liaising with OT and Physiotherapist.Lastly, educated patients about fall prevention strategies. Regularly reassess fall risk, particularly after any changes in the patient's condition.

Open Adult Mental Health Ward (22/8/24 to 16/2/25)

De-escalation technique

• Activie listening and validation:

Through active listening and validation, I ensure patients feel acknowledged, as aggression often results from a lack of validation. Recognizing that their behavior or emotions may stem from fear, pain, or mental distress helps in fostering a safer, more supportive environment

• Collaborative approach: I have also worked with patient for implementing coping strategies that accommodate their preferences and culture.
• Self-regulation: I can work under high pressure environment as it important to be able to self-regulate maintaining efficiency and decision making.

NOCC,Kessler and RAMP: I am confident and familiar in utilising tools to monitor the progress of the patient and evaluate the effectiveness of treatments in mental health settings.It helped me in developing treatment plan that is recovery orientated approach and providing holistic care to my patients.

Iclinical Manager and eReferal: I am also familiar in using ICM for handover and blood result. I am capable in making eRefferal for my patients through Bossnet as well.

Aged Care Placement

• Attended clinical placements starting from my first year of nursing that enhanced my communication and clinical skills such as assisting patients to perform activities of daily living such as getting out of bed, bed making showering, dressing, using toilet, pad changing and assisting patients with mobility during my placement in aged care.
• I also have enhanced my clinical skills such as taking vital signs, oral medication administration by following 6 rights and 2 checks assisting patients with mobility, and assisting patients with meals ensuring they have sufficient nutrients. I have learned and applied the IDDSI Framework for patient meal plans and care plans.

Cockburn Community Clinic Placement

• In this placement, I have learned and applied communication skills such as active listening, maintaining eye contact and acknowledgement and clarification of patients' feelings, and building rapport with patients.
• In this placement, I have also learned and applied subjective and objective observations of patients by having a short consultation about their past medical history and current health problems. For objective observations, I have conducted vital signs observation and some fitness tests.

Armadale hospital-Rehab,MAU and Canning ward

• I have enhanced my clinical skills such as IV medication administration, subcutaneous and intramuscular injections as well as oral medication.
• I have applied pressure area care by repositioning patients and applying wound dressings on pressure injury. I have also assessed the patient's fall risk using FRAMP and apply intervention appropriately.

Greylands Hospital-Mental Health placement.

• I have enhanced clinical skill on conducting MSE, provide social and emotional support as well as applying de-escalation techniques.
• I have also learned and applied my knowledge of the side effects of antipsychotics and antidepressants and mood stabilizers by monitoring any side effects such as constipation, and any signs of medication toxicity, liver function.

Rockingham Hospital-ED

• Conducted A to E assessments and obtained patient presenting symptoms and health history to form an ISOBAR handover in the progress notes.
• Early recognition of deterioration and using MET call criteria. I followed prompts, policies and procedures and worked closely with the MDT for care escalation. One example is inserting a female catheterisation due to 900mls of urine retention in the bladder.