Las Kannangara, Nurse Practitioner: My three year old is in the waiting room. Take the consult room just around the corner.
Hello, hi there. My name's Las, I'm one of the Nurse Practitioners in the Emergency Department. How are you?
Cynthia is a three-year-old girl who had a fall yesterday, but she came kind of clutching her right arm.
Pick thumbs up, really strong. Perfect. Point your finger out like a gun. Good keep that really strong, really, really strong.
So we got her pain under control. Did an x-ray. Unfortunately, it showed a fairly nasty break to her elbow.
What you'll get today darling, is a plaster from here all the way down to here. Okay. And that's going to help with your pain.
Tristan Black, Nurse Practitioner: A Nurse Practitioner is a registered nurse, who's completed postgraduate qualifications at the masters level. We practice as independent practitioners. We see, treat and diagnose patients.
That feels normal, spread those fingers out like a big star. Don't let me push them in and let me push them down. Perfect.
Las: Not only to triage the patient, but to order and administer analgesia.
So, what I'll do is I'm just going to examine you, okay?
To be able to then examine the patient and do those diagnostics. To interpret those diagnostics, and then to explain in layman terms, "Hey, this is what's wrong with you, but it's okay, this is the management."
Tristan: Very swollen, aren't you? Sore in there too?
Patient: Yeah
Tristan: And if I push them down, try and keep that one down. How's that feeling?
Patient: Oh, that hurts.
Tristan: That one? And what about this one?
He got his legs caught up in some weeds essentially, and he fell backwards onto his left hand.
You can straighten those arms, both out all the way out, bend them up at the elbow. That's okay? All right. This is where I get a little bit mean, although you seem quite tough.
I think people feel very trusting, and I think that's the skill that we have and all the Nurse Practitioners that I know you have that ability to kind of communicate clearly, and just make patients feel at ease.
He does have some central risk tenderness but to be honest, there's no gross displaced or comminuted fracture.
That is delicious!
Las: All right, let's do this.
Dr Clare Skinner, Director of Emergency Medicine: To me the lovely thing about the Nurse Practitioner role is that it's a way for really capable clinical nurses, to build their skills and become expert clinicians, and contribute to the health care system.
Rosalyn Ferguson, Nurse Manager: The great thing about it, it's not only their clinical expertise, but the leadership they provide, the more junior of their colleagues.
Las: Tell me a story, what happened?
Patient: I fell off a bike.
Rosalyn: The expertise really shows what they can achieve in nursing.
Las: I don't think there's any rotational deformity here.
Tristan: Every day, you are teaching, you're reviewing patients for junior medical officers. You are assisting nurses in educating them, whether it be wound management or putting the cannula in, or how to look at x-rays.
Las: So, I tell my little boy, that when I come to work this is my arts and crafts.
You’re being so brave, you really are.
Tristan: You doing okay?
Las: So, as a nurse, I have the ability, to change lives and I'm mindful of that. It motivates me to keep learning and pushing myself academically to be the best clinician that I can be.
Bend that elbow for me, that's it, perfect.
Tristan: The Emergency Department can be quite a stressful environment. And I see the impact that nurse practitioners have on patients and our colleagues. And that's what drives and excites me to come to work every day. Just being able to help people when they're at their most vulnerable, and seeing that, really is a humbling feeling.
Las: Okay. So, you need to call this number here. Okay, let them know that you've come to the Emergency Department today. You are all good to go. Can I get a little high five before I leave? Before you leave?
Mother: High five. Bye.
Las: Thank you so much. You were amazing. Okay. All the best take care.
And that rapport with patients is kind of the reason why I wanted to do this.