Enrolled Nurses
Provide nursing care to patients in a variety of health, aged care, mental health, welfare and community settings under the supervision of Registered Nurses.
An afternoon on Ward Four
You are an enrolled nurse on an afternoon shift on a general ward, working under the registered nurse in charge. It is 2pm. The ward is full, two patients have been admitted since lunch, and the registered nurse is dealing with a transfer. Call bells are ringing in two rooms.
Choose what you would do. Then see what happens. There are often good reasons for each choice.
I'm sure it's nothing, dear, but I've had this headache since lunch and my vision has been a bit blurry. I didn't want to bother anyone because you all look so busy. I'll be right in a while, I'm sure.
Tell her to rest and press the bell again if it is any worse, since the nurses are so busy
Mrs Lee rests, and an hour later she is worse and too unwell to press the bell. A change like that is exactly what you are there to notice. Waiting helped nobody.
Take her observations, record them, and tell the registered nurse straight away
The registered nurse comes within minutes and calls the doctor. Mrs Lee is reviewed and treated. She says she nearly did not say anything, and thanks you for asking.
Check her observations, then write them down and mention it at the handover
You do the check and the numbers are recorded, but nobody who can act hears about it for three hours. A good measurement that nobody sees cannot help the patient.
I'm here to see how Dad's doing. I'm his son, and I'm very worried. The doctor never tells me anything. Can you just tell me what his blood tests showed and what the plan is? I'm sure it's fine for you to say.
Check what the patient has agreed to share, and ask the nurse in charge to help
Dad agrees that his son can be told, and the registered nurse sits with them both. Mr Kapoor leaves informed and calmer. His father's wishes came first.
Tell him what the notes say, since he is the patient's son and clearly concerned
The patient had asked that his family not receive details. Mr Kapoor now knows things his father wanted private, and the breach is reported. Concern does not give someone a right to private information.
Say you cannot tell him anything and that he should ask the doctor on the ward round
You protect the patient's privacy, but Mr Kapoor leaves frustrated and still in the dark. A kind word and a pointer to the right person would have helped.
I'm stretched thin. Can you set up and start the infusion for bed six? I know you haven't been signed off on that kind of pump yet, but you've watched it done, and I'll sign off the chart later.
Say yes, because she is in charge and you have watched it done many times
The pump is set up wrongly and the alarm sounds. The patient is fine, but an incident report follows. Watching is not the same as being signed off, and the responsibility would have been yours.
Say no and walk away, because it is outside your scope of practice
You are right on scope, but Helen is left without help at a hard moment. Saying what you can do instead keeps you safe and keeps the team working.
Say you are not signed off on that pump, ask who can do it, and offer to do another task
Helen sighs, then asks a colleague who is trained. You take over two of her other jobs. The infusion starts safely and your limits are respected.
How it went
By the end of the shift Mrs Lee was being treated, Mr Kapoor had the right conversation, and the infusion was started by the right person. Enrolled nursing is about careful observation, speaking up early and knowing exactly where your role ends. Do you think you could be the person who notices?
This is a simplified, fictional situation to help you explore. It is not professional instruction or a test of your ability.
Case study: The patient who said he felt a bit off
A fictional case set in a general medical ward in a fictional regional hospital, on an afternoon shift.
The situation
Marlon was an enrolled nurse on an afternoon shift. A patient in his sixties, Mr Barrett, had come in two days earlier and was recovering well. At about three, while Marlon was helping him with a cup of tea, Mr Barrett said he felt a bit off, though he could not say how. The ward was busy, a registered nurse was with another patient, and Mr Barrett told him not to fuss.
What they did
Marlon took Mr Barrett's observations as his role allowed and noticed that two of them were different from his earlier readings. He did not wait until handover. He told the registered nurse in charge straight away, gave the numbers and the time, and stayed with Mr Barrett until she came. He wrote the readings in the chart as soon as he could.
How it turned out
The registered nurse reviewed Mr Barrett and called the doctor. He was treated that afternoon and recovered well. The nurse told Marlon at handover that the early report made a difference. Marlon said that he had half expected to be told he was fussing.
What would you do?
- Why did Marlon report the readings even though Mr Barrett told him not to fuss?
- What would make it hard to speak up when the ward is busy?
- How do you think the team should respond to someone who raises a worry that turns out to be nothing?