Wisteria Village is a not for profit 80-bed facility (which includes a 15-bed dementia unit)

located in the centre of town. The Village also has 25 independent living units onsite.
You are the Registered Nurse – you started at the facility seven months ago after completing
your degree and started working night shift four weeks ago. The staff and consumers have
made you feel very welcome as a new graduate and you feel well supported by the
management in your role.
Rachel is the facility manager and David is the clinical care coordinator, they are both
available to you via their work mobiles.

Your night shift at Wisteria Village commences at 2200 hours. Tonight, you are working
with:
• Priya, an Enrolled Nurse who completed her Diploma of Nursing two years ago and
has worked in the facility since completing her degree.
• Diana, an ECA (extended care assistant) who has worked in the facility for the past
23 years. All the residents know Diana very well and she is highly respected by the
consumers and the management of the facility. Diana has completed a Certificate lll
in Individual Support (Ageing, Home and Community).
• Thomas, an ECA who works as a casual employee, he also works part-time in the
community (working with consumers as an ECA in their own homes). Thomas has
completed a Certificate lll in Individual Support (Ageing, Home and Community).
• Jorja, a second-year Bachelor of Nursing (BN) student from the University of
Tasmania.

The shift begins with the normal routine, you are aware from handover that Mrs Peterson is
receiving end of life care, her daughter and granddaughter will be staying the night with her.
On your medication round you check on her, you note her extremities are cool to touch and
her breathing is irregular, and her eyelids are half open.
At 0210 you respond to a call bell for Mrs Lee - she is complaining of sore knees and
requests some paracetamol, her Voltaren gel and a hot pack. Your pain assessment confirms
that this would be a suitable management strategy as you are aware this has provided relief
in the past. Mrs Lee is an impatient resident who becomes verbally abusive if she is kept
waiting.
On your way to the medication room, Thomas comes to inform you that Mr Lloyd is not is
his room and he has searched nearby and can’t locate him. You know that Mr Lloyd often
gets up at night, he is a very thin man who mobilises with a walking stick. He has Parkinson’s
disease and has type 2 diabetes.
During your conversation with Thomas, Diana phones you from the secure unit to say Miss
Bell is on the floor next to her bed, she informs you that she doesn’t appear hurt but Diana
can’t get her up off the floor.
You also note that the call bell from Mrs Peterson’s room has been activated. Priya responds
to the bell and returns to tell me Mrs Peterson has died and her daughter is very distressed.
As the Registered Nurse in charge of the facility on this shift - what is your plan of action?
What are you going to do and what are you going to delegate to others?
You need to consider:

• Scope of practice
• Leadership
• Teamwork
• Preceptorship
• Legislation and any mandatory reporting requirements