Week 1 Labs by Melissa Singletary

Starting Acute Care Shift: S4/S8 med and emergency trolley checks

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RN responsibilities of S4/S8 medication checks and emergency equipment readiness with the resuscitation trolley

Step 2: Scarf Model Discussion and Slides

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David Rock, author of Your Brain at Work and Co-Founder & Chief Executive Officer of NeuroLeadership Institute

SCARF Model Information Sheet: Support your transition to practice

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SCARF Assessment: Pre-lecture activity

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https://neuroleadership.com/research/tools/nli-scarf-assessment/

Understanding the SCARF model helps RNs improve
communication, teamwork, and leadership by recognising how social and emotional factors impact behaviour.
It supports patient centred care, enhances self-awareness, and promotes psychological safety in clinical and learning environments.
SCARF connects emotional intelligence to professional communication

What is the SCARF Assessment?

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The SCARF® Model assesses the differences in people’s social motivation. Some people are more sensitive to status threats and rewards, while others are more sensitive to certainty and relatedness.
Knowing your strongest SCARF® drivers can help you:
- Understand how your role and work environment impact your current engagement
- Better regulate your emotions
- Better communicate your needs to others
- Make choices more suited to your own preferences

NSW Health Medication Handling

melissasingletary7_1 — 2025-07-28 23:22:14 UTC

Schedule 4 Appendix D and Schedule 8 medications must be stored separate to all other medications pending supply to the patient
An exception is for discharge medications supplied in a sealed, tamper evident container labelled with the contents and patient details which may be stored in the Schedule 4 Appendix D medication cabinet or Schedule 8 medication safe or cabinet.
Schedule 8 medications kept in the patient care area must be recorded in the drug register with a witness.

https://www1.health.nsw.gov.au/pds/ActivePDSDocuments/PD2022_032.pdf

Schedule 8 drug register info - p. 80

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Records in the Schedule 8 drug register The registered nurse/midwife in charge of the patient care area is responsible for ensuring that a record is kept of all transactions in a drug register relating the Schedule 8 medications stored in the Schedule 8 medication drug safe/cabinet. Unless otherwise approved in electronic form under NSW Health Framework for Use of an Electronic Drug Register Requiring Dual Signatures, the drug register must be the State Forms bound book with consecutively numbered pages (unless otherwise approved under facility procedures). A separate page must be used for each form and each strength of the Schedule 8 medication active ingredient. Where brands of the same strength and form need to be differentiated (for example, methadone liquid formulations) they may be on separate pages under facility procedures.

Handling Mistakes p. 81

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The authorised person making an entry in a patient care area drug register:

must not make any false or misleading entry 
must not make any alterations, obliterations or cancellations.
No lines may be drawn through entries, no entries scribbled out or crossed out in any way, nor numerals altered.
If a mistake is made, the entry must be left as it is, marked with an asterisk, rewritten as corrected on the next line (and countersigned by the second person) with a marginal note or footnote explaining the error (signed and dated by both staff members), also marked with an asterisk.

Witness to Schedule 8 medication transactions - p. 82

melissasingletary7_1 — 2025-07-28 23:27:09 UTC

The witness to a Schedule 8 medication transaction must be a person who is fully familiar with Schedule 8 medication handling and recording procedures.
This may include a registered nurse or registered midwife, an authorised prescriber, a pharmacist, and any other person authorised by the registered nurse/midwife in charge of the patient care area to complete this task, such as an enrolled nurse or anaesthetic technician.
The witness must be present during the entire procedure

Balance checks in the Schedule 8 drug register

melissasingletary7_1 — 2025-07-28 23:27:51 UTC

The registered nurse/midwife in charge of the patient care area must ensure that the balance of Schedule 8 medications recorded in the drug register is checked against the physical balance in the Schedule 8 medication storage unit(s) at least once every 24 hours

Schedule 8 drug register audits - p. 83

melissasingletary7_1 — 2025-07-28 23:29:24 UTC

In addition to balance checks, regular audits of patient care area Schedule 8 drug registers at intervals approved by the Drug and Therapeutics Committee must be conducted to confirm records are meeting legislative and policy requirements and also to detect any possible misappropriation.
Where an area of non-compliance or concern is revealed, appropriate steps must be instituted to rectify the issue.
Audits must be performed by two staff members

Groups

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Discus Team Communication and Collaboration Expectations

Handout group assignment/info

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UTS acknowledges the Gadigal
People of the Eora Nation upon
whose ancestral lands our university
stands. We also pay respect to the
Elders both past, present and
emerging, acknowledging them as
the traditional custodians of
knowledge for these lands.

Check uniforms and must have student IDs

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Time: 1510-1540

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NMBA Standards

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Promoting a culture of safety

Building confidence to reinforce the legal and ethical responsibilities of an RN.

Debrief

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What surprised you about the checking process today?
• How confident did you feel?
• In clinical practice whose responsibility is it to make sure these checks happen?
Reflection: Why are these checks
important to patient safety.

Subject Orientation

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Week 1 Objectives

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GI Colorectal Ward:

Pre/post operative care, pain management, time management, drain, stoma and wound care

The objectives of this session include:
1. Remember key RN responsibilities of S4/S8 medication checks and emergency equipment readiness with the resuscitation trolley.
2. Understand the SCARF model and it’s relevance to communication and clinical interactions.
3. Apply communication and teamwork strategies in simulated clinical and peer scenarios.
4. Analyse factors that influence practice including team dynamics and checking procedures.
5. Evaluate their own communication style and decision making during clinical tasks.
6. Create action plans for participating in group assessments and managing complex conversations (SLO1-5)

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Time: 1615-1635

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Time: 1540-1600

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Time: 1600-1615

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Time: 1655-1855

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Groups of 4: each group to rotate every 15-20 mins to each patient scenario and complete the workbook

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All patient charts are in CANVAS
Use your laptop to access the info
Some skills are repeated across more than one patient
Keep workbooks for Week 2

Pre-lecture work: A-H assessment

melissasingletary7_1 — 2025-07-28 23:54:04 UTC

A: Airway (airway obstruction)

B: Breathing (resp, SPO2, chest rise/fall)

C: Circulation (BP/Pulse, cap refill/skin colour, devices)

D: Disability (AVPU/GCS, falls risk/mobility)

E: Exposure (bleeding, skin integrity)

F: Fluids (FBC, VIP score, hydration, urine output/UA)

G: Glucose (BGL, s/sx hypo/hyper)

H: Holistic (ADLs, psychosocial needs, patient education)

Reflection

melissasingletary7_1 — 2025-07-28 23:56:59 UTC

Have you seen these domains challenged in clinical settings?

Patient Scenarios

melissasingletary7_1 — 2025-07-29 00:03:37 UTC

Bed 1: Douglas: 66 yrs old: Day 2 post Right Hemicolectomy secondary to diverticulitis

Bed 2: Fatmia Kan: 72 yrs old: Day 1 post Emergency Laparotomy, penetrating knife wound - came from ICU

Bed 3: Leon Tan: 58 yrs old: Preop laparoscopic hernia repair (new admission)

Bed 4: Dalia Singh: 71 yrs old: Day 2 postop Bowel Resection for colorectal cancer (stoma)

Bed 5: Paul Romero: 58 yrs old: Day 1 post Low Anterior Resection for colorectal cancer (has CADD pump)

Student Workbooks

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Patient charts

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UTS log in required

Take Attendance

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https://canvas.uts.edu.au/courses/37338/gradebook

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