Registered Nurses
Provide nursing care to people in aged care, community, welfare, hospital and other health care settings.
Your first Sunday afternoon on Ward 4
You are a new registered nurse on a medical ward, caring for five patients with a team that is one person short today. It is just after 1pm. Handover was rushed, medication rounds are due and the phone has not stopped. Three things are about to land on you at once.
Choose what you would do. Then see what happens. There are often good reasons for each choice.
Mrs Kelly in bed 12 keeps buzzing because she wants help to the bathroom, and Mr Osei in bed 9 looks more breathless than he did this morning. I am tied up with an admission. Which one are you going to?
Help Mrs Kelly first, because she has asked twice and it will only take a minute
Mrs Kelly is grateful and safer for it, but a minute becomes ten. By the time you reach Mr Osei his breathing has not improved, and you wish you had looked at him sooner.
Check Mr Osei now, and ask someone to tell Mrs Kelly you are coming
A change in breathing can matter quickly, so seeing him first is sound. An assistant in nursing helps Mrs Kelly, and you find his breathing needs a closer look. It is not always the loudest call that needs you most.
Finish the medication round you have started, then go to both of them
Routines matter, but you have left a possible deterioration waiting. When you reach Mr Osei, Sam has already noticed and called for help, and asks why nobody looked at him earlier.
I am in the middle of something on another ward. You said Mr Osei is breathless. Can you tell me quickly what is going on, and do you really need me now?
Say you are a bit worried about him and ask if the doctor could pop by when free
The doctor hears nothing urgent and says they will come when they can. Your concern was real, but it did not get across. Speaking clearly is a skill to practise, even when you feel new.
Read out every observation from the last two days so nothing gets missed
All the information is there, but the doctor has to dig for what matters and interrupts you twice. You get there in the end. A short, clear story would have been quicker.
Say who he is, what has changed, what you found, and that you want him seen now
The doctor stops and listens, then says they will be there in ten minutes. Handing over a clear picture and a clear request is a skill nurses practise for their whole career.
Nobody is telling me anything. Dad looks worse than yesterday and you have all been running past his room. Is he going to be okay? I want to talk to whoever is in charge.
Tell her everything will be fine so she can calm down and you can get back to work
It feels kind for a moment, but you cannot know that. When the doctor later explains the concern, she feels misled and trust is harder to rebuild. Honest reassurance is different from a promise.
Stop, acknowledge how worrying this is, say what is being done and offer the nurse in charge
Two minutes of real attention changes the conversation. She knows the doctor is coming and when she will hear more, and she helps by telling you what is normal for her dad.
Say you are very busy and that the doctor will explain things when they arrive
It is true, and she does wait, but she feels brushed aside and asks to make a complaint later. You are stretched today, and a family can still feel heard in a short conversation.
How it went
Mr Osei is reviewed and his treatment changes. You leave a little late with notes still to finish, and thinking about what you could have done differently. Nursing often means making the next decision with less time than you would like, while staying kind. How did that feel to you?
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 just seemed different
A fictional case set in a busy medical ward at a fictional regional hospital.
The situation
Ward 4 at Riverbend Hospital was short one nurse on a Sunday afternoon. Grace, a recently graduated nurse, was caring for five patients. One of them, Mr Tran, had been recovering well after surgery and his observations were within the expected range. His daughter stopped Grace in the corridor and said her father just did not seem himself. He was quieter than usual and had not touched his lunch. With two other patients waiting and medication rounds due, it would have been easy to say she would come back later.
What they did
Grace went in straight away, repeated his observations and sat with him for a few minutes. The numbers had shifted a little, though not enough to trigger an alarm on their own. She told the nurse in charge exactly what she had seen and what the daughter had said, and asked for a second opinion. The nurse in charge rearranged the rounds so Grace could stay close, and they called the doctor to review him.
How it turned out
The doctor found an early complication and started treatment that afternoon. Mr Tran stayed a few extra days and went home well. At handover, the team talked about how the concern had come from a family member and not a monitor, and agreed to ask families more often what they were noticing.
What would you do?
- What would have made it hard for you to stop in that corridor?
- How would you feel about raising a concern when the numbers looked almost normal?
- What could the team do to make it easier for a new nurse to speak up?