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Michelle has spent nearly 40 years in critical care nursing — across ICU, ED, CCU, PICU, perioperative nursing, resuscitation education, and leadership roles. But her journey into nursing started long before that, after witnessing her grandfather suffer a cardiac arrest beside her at a local football game and watching medical and nursing staff save his life.
In this interview, Michelle reflects on the realities of resuscitation, the importance of teamwork during MET calls and Code Blues, supporting graduate nurses in high-pressure situations, and the emotional impact of death and dying in healthcare. She also shares powerful insights from decades working in critical care education and leadership — alongside a few stories about football, quilting, and life outside nursing.
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Introduction about yourself
I first started nursing in 1985 as a hospital trainee at Gippsland Base Hospital. I was drawn to nursing after my Grandfather suffered a cardiac arrest next to me at a local football game; he was successfully resuscitated by medical and nursing staff at a nearby small hospital. Since I finished my hospital based training, I have always worked in critical care areas but my jobs have changed as my family situation has changed.
Whilst I love my career, my family is my most important focus and I thoroughly love being a Nana, even if it officially means I am old! I also have a registered quilting business and the small free time I have is either filled with quilting or watching the following sport – North Melbourne AFL and AFLW, Melbourne Storm, Australian cricket (both Men and Women) and the Australian Swim team.
I will never forget my experience as a teenager with my Grandfather and his resuscitation. This gave our family more time with him which was so precious. Every resuscitation is an opportunity to give someone a second chance to live again.
Communication in a resus and information students need to know
Poor communication during Cardiac arrests is always a problem. Without good communication everyone is working in a silo and not working towards one goal; the best patient outcome. Medical and nursing staff often do not use each other’s names and do not ‘close the loop’ about what they are doing. Giving and receiving feedback during Cardiac arrests is also crucial to optimise each patient’s outcome.
I was surprised that some of our new graduates are not learning BLS during their undergraduate training; this is very disappointing that some universities are not teaching BLS at all to this group of nurses. I think the biggest thing that both students and graduates need to do about resuscitation is practice BLS and ask for feedback about their skills if and when they get an opportunity to perform these skills.
The psychomotor skills required to perform airway manoeuvres, BVM and compressions necessitate regular practice to develop and maintain proficiency. UG and GNPs are often reluctant to ask for feedback and practice skills regularly.
What about a responding nurse (MET/ICU/ED nurse) – what do you want them to keep in mind?
The MET response team we have at Alfred Health is a combination of very experienced RNs who provide expert knowledge and care during a crisis, such as a MET or Code Blue; they are experts in their own right or they do not have this role. Possibly the only comment that I would make here is that sometimes the response team does not know the deteriorating patient; an important aspect about caring for a patient, is that they are someone special to someone. Each patient should be treated like you would like your most important other treated.
What does a typical day look like as a Clinical Educator and Lecturer?
It is very variable; there is a lot of preparation for study days and teaching. Currently I have been working on our new Paediatric ALS program; previously we were using a licensed program that was very prescriptive. Developing a specific Alfred Health PALS program has involved working with our IT team to develop the online program.
I have also developed Assessment tools, training scenarios, instruction manuals and organised appropriate equipment for the practical assessments. All these aspects of the program have required feedback and approval of many stakeholders to go live.
Now that the background work has been completed I am actively completing ‘Train the trainer’ sessions with our education teams to roll out this program to all of the critical care areas.
I am a member of 6 different committees at Alfred Health to ensure that I receive feedback about our MET, ALS, PALS and BLS processes. Some of my work involves feedback and problem solving from these committees.
Death, Dying & The Emotional Reality of Nursing
It is far easier to disassociate with a death when you don’t know the patient. Death of a child or a young adult can be devastating, particularly when you have been caring for the patient for a while and you have built up a relationship with them and their family. Debriefing with someone is important. A formal debrief can offer opportunities to clarify what happened and why.
However if a nurse or medical staff member is emotional about a resuscitation, it is worthwhile discussing this with EAP or a Senior staff member on the ward where they are working. EAP can provide confidential support and direct staff to further supports if needed.
What mental checklist runs through your mind in the first few moments of a deteriorating patient?
DRSABC; what resources do I have to start the emergency care of this patient and how can I get a response team here as soon as possible. As 1 person, I can only do 1 thing well at a time, even though I am an experienced ALS/PALS responder.
What makes a resus/MET Good vs Exceptional
The teamwork, without doubt. When teamwork is coordinated and everyone is in sync, even when there is a poor outcome, everyone knows that all efforts have been exhausted to save the patient.
How do you approach mentoring someone who lacks confidence during METs
Encourage the RN to attend MET/Code Blues when able and initially take on roles they are capable of. Eg. priming Pump sets and drawing up flushes, performing BLS tasks or other tasks they are familiar with initially.
Junior practitioners should quietly watch other team members perform tasks in MET/Code Blue situations they are not familiar with as a beginner practitioner and then ask for practice later on manikins to develop psychomotor skills.
Junior practitioners need to complete ALS/PALS study days at some point and have practice on manikins prior to taking on advanced roles during ALS/PALS. When the junior practitioners first take on a new role for themselves in a Cardiac arrest, they should have CNE, CSN or Senior RN supervising their activities to ensure they are not overwhelmed and can perform to the level required to optimise patient care. Patient care should not be compromised during an ALS/PALS situation for teaching.
What do you wish every nurse knew about paediatric and perioperative resuscitation?
Paediatrics- the differences in anatomy and physiology between adults and paediatrics. This changes our Airway, Breathing and Circulation management in particular during deteriorating patients and Code blues.
Perioperative-difficult airway management is crucial to understand in managing a Cardiac arrest in most OT arrests. Defibrillation pad placement may need to be creative, depending on the patient position on the Operating table and the procedure the patient is undergoing.
What advice would you give to new clinical nurse educators?
You cannot teach anyone – UG, GNP, TSP, PG or any RN if you do not engage them in learning. Engagement in learning looks different for each individual and sometimes it means you have to work hard to understand the person that you are trying to teach, so that you can deliver curriculum in a way that meets their individual needs.
Recent career highlight?
I have just presented at the ACORN international conference in November 2024 on Perioperative Anaphylaxis and have published a paper on this topic prior to the presentation; this took many hours of hard work and was very rewarding to complete as a solo author.
Perioperative anaphylaxis: Management and risk reduction strategies in 2024
What are some big leadership lessons you have learned while working as an ANUM/CNE?
Honesty and clear communication are the cornerstone of any team. Optimal patient care only occurs with a coordinated and effective team. Nursing and Medicine require you to take on different roles at times within your team; it is about delivering the best patient outcomes, not your own ego. Egos need to be checked at the door of the ward or OT.
Looking back, how have you managed to remain up to date and fresh and maintain work life balance within your nursing career.
Throughout my career, I have always attended study days or completed PG study to keep up with the latest research and to ensure I practice my psychomotor skills. This year I have completed my re-credentialing of my own ALS- Level 2 and PALS – Level 2 ; this keeps my skills current and reminds me what it is like to be assessed as well.
As a mother and now Nana, it is hard to balance my career and life. I do have plenty of activities after work to ensure that I clear my mind such as quilting and following my sporting teams. I do acknowledge that I am a horrible loser and can be quite an ugly supporter at the football; you don’t want to sit near me at the football if North Melbourne are losing!
Do you have any final messages you would like to share?
Nursing is a challenging but rewarding career. Delivering patient care in the way the patient and their families want, not what you think is appropriate is sometimes challenging, but it is one of the most important aspects of patient care and consent.
