GNIE: Resume for Practicum and Preceptorship

Today we had to fill-up a template resume for the GNIE course co-ordinator and administrators to arrange for our Practicum and Preceptorship postings.

There was one section where we had to write about our RN experience. I wanted to get the item done quickly, so I listed my experience off the top-of-my-head.

Clinical Experience: Acute Paediatric Unit. In addition, overflow of Obstetrics & Gynecology, Medical & Surgical patients.

RN responsibilities:

• Patient assessment and charting, 
• Medication administration (PO, IV, SC, IM, PR, Nebulizer, Transdermal), 
• Oxygenation (up to 2L/min initiation by RN), 
• IV NS fluid initiation or termination (based on RN assessment if not pre-ordered, doctor’s order to follow), 
• Blood and blood products (e.g. Immunoglobulin) transfusion, 
• Pre-op care (e.g. bowel prep, pupil dilation, sedation) and post-operative care (e.g. dressing change, 24hr IV narcotic), 
• Witness for pre-operation consent, 
• Care and monitoring of patients’ in’s-and-out’s (e.g. oxygen, IV line, JP drain, urinary catheters, CSF drain, chest tube), 
• Specimen collection, 
• RN initiation of selected treatment (e.g. barrier cream, topical analgesic, ginger water, therapeutic diet), 
• RN initiation/termination of nursing monitoring  and charts (e.g. Intake/Output, Hourly VS, Hourly CWMS, Neuro Chart & GCS, Braden Scale, Morse Fall Scale, Wound/Broken-skin chart), 
• Assist doctors with minor procedures within unit (e.g. CSF extraction, chest tube removal, excision of cyst or small foreign), 
• Assist with venipuncture (by certified RN), 
• Admission assessment, 
• Discharge planning/teaching, 
• Patient/Care-giver education (e.g. incentive spirometer), 
• Multi-disciplinary team collaboration (e.g. Doctor, PT, OT, Speech Therapist, Dietician, Infection Control Officer, Patient/Next-of-kin) [Note: Oops, I've missed out our mutually supportive Pharmacists], 
• Emergency management of patient’s sudden change in status, 
• Dangerous Drug Act locker (i.e. Narcotics locker) shift stock count, weekly order re-order and refill

General nursing duties:

• Arrange and escort patient for inter-unit transfers (within same hospital), 
• Coordinating diagnostic orders, 
• Documentation of specific nursing procedures, 
• Documentation of recommended or template nurse-client communication, 
• Buddy new RN/LPN (i.e. RN/EN in Singapore lingo), 
• General patient hygiene, feeding, ambulation and transfer, 
• Linen change, 
• Prepare isolation room, 
• Co-ordinate post-isolation room disinfection, 
• Emergency equipment check (emergency trolley, defibrillator, Laerdal resuscitators, bedside stock), 
• Patient room assignment, 
• Billing (if needed, explain bill to patient/NOKs), 
• Dietary orders, 
• Unit stock (medication and supplies) check, weekly order re-order and re-stock, 
• Linen order and re-stock, 
• Unit inventory audit, 
• Patient charts documentation audit, 
• Orientate non-nursing students on career exposure

Even though the above is not a comprehensive list, when I looked at it, I suddenly felt a sense of personal achievement and satisfaction. I had only been a Staff Nurse (i.e. RN) for 1+ year, yet I have had exposure to a lot of different cases and situations, including being the most senior staff on the unit during a series of night duties. [Note: That said, I question the wisdom of putting a 1-year experience RN in-charge of the whole acute unit/ward, especially when considering patient safety.]

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During nursing theory today, we discussed Neurological related topics. When IJ saw the worksheet question on "status epilepticus", he immediately commented that the only thing left to do is to prepare for the patient's death. To which I replied, "No" and started recalling from experience how we handled such emergency cases at my Singapore nursing unit.

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Previously I did not think much of my Singapore RN work experience since I had only worked for 1+ year. With today's hindsight, I guess I can mark it with a small "mental milestone" for my humble achievement.