NUR346 Transition To Practice 2


Case study

Shannon Doe is a third year undergraduate nurse on clinical placement at Charles Darwin University Hospital Emergency Department (ED).

Day 1. Mon 24/09/2018. Shannon’s preceptor, Jennifer Lee, says “Hi. You are with me. We are short staffed and there is a poor skill mix on today. I will introduce you around and then I will get you to start your orientation to ED by doing this ‘search and find’. Once you have done that, if you sit in the tea room here and log into this computer with these generic log in details (hands you piece of paper with log on and password), you can work through the self-directed learning modules on WHS, infection control, mandatory reporting and aggression management. That should fill in your first shift. OK?” Shannon replies “OK then.” Shannon’s preceptor then walks away. She did not approach Shannon for the rest of the shift.

Day 2. Tues 25/09/2018. Jennifer greets Shannon before handover and says “How did you go yesterday?” Shannon replies “I got through it all. I would like to discuss the placement, my scope of practice and placement objectives”. Jennifer replies “I am aware of your scope of practice but we will find time today to discuss your placement and your objectives” Then she adds “Much to learn you have young padawan” and smiles. Shannon thinks that Jennifer’s comment is ageist and stereotyping.

After handover Jennifer advises Shannon that she will be looking after two patients. Bed 1 has an 11 year old girl with Leukemia. Jennifer asks Shannon “Where should you look for bleeding?” Wanting to demonstrate her knowledge Shannon describes the coagulation cascade and states that “If the girl has low platelets she may bleed and one of the first places to look for signs of bleeding is the gums and mucous membranes”. Jennifer replies with an ambiguous compliment “Wow, you’re a walking text book” and smiles. “Well done” she adds. Shannon thinks Jennifer is being sarcastic.

Bed 2 has a two year old boy with croup. Shannon can hear his barky cough and inspiratory stridor.  Jennifer says “Can you tell me what you know about croup?” Just as Shannon was about to respond, Jennifer says “Nah, don’t worry about that, just go in and make sure the parents have some breakfast. Hear that? (pauses to listen) We need to get the family up to Paeds as soon as possible”. Shannon feels a bit dismissed but understands that the clinical need is a priority over her clinical education at that time.  

Day 3. Wed 26/09/2018. Shannon and Jennifer are allocated to cubicles 1 to 4. After handover Shannon walks into cubicle 1 to do a set of vital signs on a male patient admitted with pneumonia. He is non-responsive. Shannon pushes the emergency call bell, checks his airway for blockage, checks his breathing using ‘look, listen, feel’. He is not breathing. Shannon commences CPR. Jennifer arrives at the same time as Dr Tim Coloton and RN Anna Roberts. Jennifer asks ” What have you done?” Just as Shannon is about to respond Jennifer says “Finish that cycle of compressions then step back, we’ll handle this”. Shannon completes the cycle of compressions and stands back and observes the resuscitation. Later in the day Jennifer goes to the clinical debrief. Shannon notes that Jennifer did not invite her.

Day 4. Thurs 27/09/2018 . Shannon calls the Nursing Unit Manager, John Matthew, and advises “I am not coming in today. I feel like I am being bullied”. 


  • Complete the incident report in the template provided as the worker (Shannon) in the case study provided.
  • Discuss informal and formal procedures for dealing with conflict; link to case study.
  • Criticallyanalyse what has occurred in the case study.
  • Draw on the literature to provide recommendations to foster Shannon’s resilience in future placements; link to NMBA standards.
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