Not So Sure

This blog might be a little dry for my non-medical friends!

I have worked 2 shifts now at the local private hospital.  First thing I must say is that my feet have had it good until now!  Standing and walking on concrete for 8 hours is a form of torture to my feet and it usually peaks after 5 hours or so. I did buy extra insoles for my "Hush Puppy" shoes, but clearly I need to go and buy new shoes.  Let's see, the work........ hmmmm..   hmmmm...... it is not what I had in mind exactly.  I did not really know what to expect, but as an RN I envisioned I would have NAs and LPNs (AINs and EENs in OZ)  to help with the patients and to take care of the bedpans, urinals, transfers, bed baths, etc.  As it turns out, that is not exactly the case.

I have NO experience working on a "ward" or a "floor" in a hospital (only emergency), so I am trying to stay open to learning new things. The work on the medical ward can include the 5 palliative care beds if that is your end of the hall to cover.  For my first shift I was assigned 8 elderly medical patients.  Some of these patients had been here for many weeks either waiting for a nursing home bed or if they are a veteran or spouse of a vet, they can stay until they die or get better. No hospital criteria to meet.  I basically had to do the total patient care, including medications, getting ready for bed, answering the call lights, handing out bed pans, urinals and collecting them! (I must confess a nurses' aide did come in for 4 hours and help everyone on the floor get the patients ready for dinner and ready for bed, but there was only so much one person could do.)

They do have some interesting equipment here, I think it is from the 1950s.  Not much is disposable, for example the bedpans and urinals are made from very thick plastic and once "used", are taken into the dirty utility room and put in this machine (WITH all of the donated bodily contents). You then push the START button and magically the bedpan or urinal (aka "bottle" here) is transformed in to a sterile unit that is then handed out to the next needy soul (there is a separate machine for the wash basins). This system is nice (is that the right word?) to not have to empty the pee and poo into the toilet and then try to rinse out the disposable unit to give back to the same patient (at least this is what I think happens in the USA).

Let's see, back to the 8 patients and my first day of work......  I was briefly oriented by another RN, who by the way, is from California and had the same "yank drawl" as me! There are a few things that really slowed down the dispensing of medications. Here are a few: narcotics here have to be signed out by two nurses and both nurses must witness the patient swallowing the drug, and any injectable antibiotic and all anticoagulants must be double checked by a second nurse as well. So I was frequently being called out of trying to establish my own medication routine to assist the other nurses and vice-versa (not to mention all of the call lights going  off).

After a few hours at work I was told by the other nurse that I should go to "tea". Well, I said, "OK"! Then I realized I did not know exactly what she meant by "tea". Was I supposed to take a 10-minute coffee break or was I supposed to go to dinner?  I had to ask the charge nurse what she meant by tea. Tea here is a dinner break and a cuppa is a cup of tea or coffee.

I did meet some lovely elderly patients who asked frequently about "where I was from". At times we struggled with the accent differences.... I wasn't sure whether a patient was asking for a "pan" or something for "pain". :)  That made for a good laugh for both of us.

My next shift on sunday evening was more of the same, a different patient load, but I got into more of a routine.  Somehow I am not really looking forward to my future shifts (now about 3-4 days a week) of floor nursing, I know once I get there I will put my heart and soul into taking care of the patients, but I must say it is not my "cuppa", but it will work for now as long as my feet can keep on keeping on.

Being an RN in Australia

OK, I am going to start my first job here in the land on Oz tomorrow!  It only took me 13 months to get my basic RN license here--go figure!  I have been an RN in the USA since 1978 and a Nurse Practitioner since 1981.  I never enjoyed or wanted to work on a "floor" (ward) in the hospital and so I worked in the Emergency Department or ICU.  As an NP I worked in Family Practice most of my career at Group Health and LOVED the work.  So now is a new chapter in my work life-----back to an RN, working in the medical/palliative care ward in the local private hospital.  I just completed several hours of on-line learning in prep for the work, it was a great review on medication dosage calculations and IV drip rate calculations (I think I will need to carry a cheat sheet with me until I have done it a few thousand times).  Back to wearing a uniform too!  Only I don't think I have to wear white shoes :).  When I first started my nursing career I wore a white nurses dress, my white nurses cap, white nylons, white shoes, the whole 9 yards, as it was all required.  Thank god those days are gone.  Nurses at this hospital even wear long legged shorts and no nylons.  My uniform will be navy blue pants and a white shirt until my uniform tops arrive.  I was told to order a polar fleece jacket for the winter time, which makes me wonder if there is no heating in the hospital (not unusual here, as the chill does not last very long)  I hope they have a blanket warmer for the patients!  I will let you all know how it goes, tomorrow is orientation, then I work the weekend doing the evening shift.  I pray the nurses are good to me as I have little idea what I will be doing.  The work is "casual", which means that I will be only working on-call as there are shift openings which is just what I want.  Ideally working 2 days a week will work just fine!

OTHER JOB POSSIBILITIES
I also applied for work as a nurse in the outback with Northern Territories Medex.  I am hoping to get "relief assignments" of 2-3 week duration in the aboriginal communities.  I understand my first assignment will need to be for 8 weeks but I have not heard back from them yet (I only mailed my app off one week ago)  The job requires you be very independent with seeing patients, suturing, splinting, providing general clinics as well as emergent care (until the Flying Doctors arrive to transport the patient to a hospital).  I have plans to return to the USA to work in my previous job at Group Health doing vacation relief this summer (AND visit with my family and friends), but I might need to cut that short if I am offered an assignment in the outback.
I guess my days of slacking here in OZ are over!