ICU Exam-aphobia

I'm not sure why I was so scared.  I'm a smart cookie and a solid nurse.  But, for whatever reason, the thought of taking this ICU exam sent me into a panic.  I had flash-backs of nursing school, cramming for exams until my mind was numb, and the dreaded NCLEX.  The thought of sitting down and taking the test actually sent me into palpitations.  Ridiculous, I know, but I couldn't help myself.  So, I procrastinated.  I should have bitten the proverbial bullet and taken the test long ago.  I shouldn't have waited until the very last minute when I'm overwhelmed with packing, plus all of the other stuff one tries to squeeze in before moving to another city.  But, of course, that's exactly what I did.  So, tonight, I finally forced my own hand.  It won't be long before we're out of here and I'll be needing that new job, so I knew I couldn't wait any longer.  It wasn't fun.  It certainly wasn't a practical assessment of my knowledge, either, but it wasn't all that bad.  Over the years, I've grown accustomed to being tested on sh** that doesn't matter.  Besides, the built-in Mulligan provided me with the safety net I needed.  (And I DID need it.)  So, I passed.  It's another box I can tick off my list of pre-moving "to-dos".  Whew!

P.S. - For those of you studying for the HCS ICU exam, it's totally eclectic and random.  It includes basic stuff like ABG interpretation, ICU drips, and common signs/symptoms/complications of conditions that will land a person in the ICU, but it also includes stuff I haven't thought about since nursing school, and have never encountered working in the unit.  Nothing on hemodynamic monitoring or Swans.  And I'm pretty sure a couple of the answers were wrong.  I emailed my recruiter with my educated fact-based protests.  Feel free to comment if you have specific questions.

One of Those Nights

Last night was one of those nights all nurses dread. It was one of those nights that chews you up, spits you out, and puts you in your place. It's been a long time since I've felt so helpless, lost, and brow-beaten. Last night definitely took its toll on me. One thing after another went awry, in a never-ending cascade of complications. It wasn't anything I hadn't dealt with before, but there was no relief, not even a moment to catch my breath or my thoughts. And to top it off, I was at a new facility, with a foreign charting system, and no one familiar to rely upon. I was a little fish floundering in a sea of computerized confusion and mental disorganization. It left my head spinning, my body aching, and my spirit crushed. It isn't often that I have to fight back tears of frustration, but that's exactly what I found myself doing in the wee hours of the morning. After twelve hours of chasing my tail, and never getting caught up, I was ready to throw in the towel. But that's not really an option when your patient stubbornly refuses to stop coding, now is it? So I kept stubbornly plodding along, too, doing my best to put out the fires that continuously sprung up. It wasn't how I like to do my job, constantly being on the defensive, rather than the offensive, but it was the best I could do. Miraculously, I made it through. The clock struck seven and my relief arrived. No one died and I had managed to hold on to my sanity, even if only by a precarious thread. Like I said, it was one of THOSE nights...

Dead Tired

Last night, I was so tired that I slept in a dead woman’s bed.  It’s sad and a little creepy, but true.  That’s what night duty does to you.  It makes you so tired that you will throw all of your fears and superstitions out the window for a few moments of shut-eye.  In my defense, the former patient had passed eight hours previously, the room thoroughly cleaned, and the linens changed, but still… it was a little spooky.  The thing is, I couldn’t help myself.  It was my third consecutive overnight shift and I was becoming delirious with fatigue.  I was beginning to get that light-headed, dizzy-sick feeling that only comes with staying up for way too long.  I had to take a nap.  It would have been dangerous for me not to; titrating drips with a half-functioning brain is not a good idea.  And believe me, her bed was not my first choice.  I first tried the usual hiding spots, but they were all taken.  Next, I investigated the other empty rooms, but none of them had beds.  My stomach sank as I quickly realized the dead woman’s bed was my only available option.  So, at 4am, with my brain fading fast, I did the unthinkable; I crawled into the deceased’s bed and drifted off into a brief and weirded-out sleep.  As strange and guilty as I felt about doing so, I’m really glad I did.  I needed those 30 minutes of sleep like a fish needs to get off dry land.  I woke up recharged and ready to tackle the remainder of my night.  I was a safer, better nurse for doing it.  I may still be brushing off the heebie-jeebies, but I’ll get over it.  Besides, I don’t think that little old lady minded sharing her final resting place.

Just Like Riding a Bicycle

I was right; it was like riding a bicycle.  Last night ended up being not so bad, after all.  What a relief!  Sure, my shift was busy and a little stressful at times, but I dealt with it.  Admittedly, I was a bundle of nerves when I walked onto the floor and introduced myself.  It’s never easy being the new girl.  It’s even more difficult when the new girl feels like a fish out of water.  There I was, in an American ICU, scared out of my mind.  I plastered a smile across my face, but I was trembling inside.  I doubted myself.  I had grown accustomed to the practices and pace of my ward in Australia, and was certain I had forgotten every last bit of my critical care training and time management.  But, as I sat down with the outgoing nurse to take report, it all came back to me.  I remembered what questions to ask.  I understood what I needed to do.  I was able to formulate a plan for the night.  Even though I knew it wasn’t going to be an easy night, a wave of relief rushed over me.  I did belong there.  I could do the job.  It’s going to be a while before I gain all of my confidence back, but last night was a good start.

Readjustment

It’s strange, but it doesn’t feel like I’m really done with my Aussie nursing experience.  It just doesn’t seem possible.  I know I’ve turned in my badge and said my good-byes, but it still hasn’t sunk in that I don’t work there any more.  Rather, it feels as though I’m on my days off and will be expected back soon.  I’ve woken with a start every day, checking the time, ready to hop out of bed; until the sleep-induced cobwebs clear and I remember that I’m not late.  Right now, there’s no such thing as late.  (A difficult concept to embrace.)  I nearly had a mini panic attack yesterday, when my phone rang in the wee hours of the morning.  For a split second, I assumed it would be my charge nurse, inquiring as to whether or not I was planning to work my shift.  Of course it wasn’t, but my heart didn’t stop pounding until I heard my friend’s voice on the other line.  It’s funny how a little bit of social conditioning can so easily and deeply penetrate one’s psyche.  I wonder how long it will take me to get out of the habit of feeling like I should be at the hospital.  I wonder how long it will take for my body to readjust.  I imagine when Mouse arrives and my life begins to feel like less of a limbo, it will all hit me.  Until then, I just have to relax and embrace my newly-attained unemployment.

Last Day

I can’t believe today is my last day of work.  It seems like just yesterday, I was freaking about my visa status.  I remember the stress and urgency of it all.  I remember exactly how scared I was to start my first day.  I can still feel my heart pounding and my palms sweating as I walked into the hospital’s massive lobby.  I remember meeting everyone and hoping that I would fit in.  And now this experience is nearly complete.  It feels like I’ve just begun to settle in, hit my stride, and get comfortable; now it’s time for me to go.  It doesn’t seem possible.  I knew this wasn’t going to be permanent, but I never imagined it would fly by so quickly.  It’s bittersweet, really.  I’ve truly enjoyed my time here, and I’m going to miss it.  But I am ready to go home.  I’m ready to go back to American nursing, even if it is a tad more stressful.  And, more than anything, I’m ready to be rid of these ridiculous uniforms…

Emotional Exhaustion

Nursing can be exhausting.  The patients, their families, even the doctors, all take their toll on me.  I can handle the physical exhaustion.  A good night’s sleep is all I need to remedy that.  But the emotional exhaustion is a different story; it doesn’t fade so easily.  It gets to me - it permeates my brain, infects my soul, and drags me down.  It makes me feel so much older than I am.  Yesterday was so thoroughly draining that I could barely pull myself out of bed this morning.  And, as I sit here mulling it over, I still don’t feel right.

Maybe I take things too personally, but it’s hard not to.  I’m supposed to be an advocate for my patients.  How can I do my job when the doctors won’t listen?  I would like to believe they’re the experts and they know what’s best, but I’m afraid this isn’t always the case.  I’m the one who watched this patient slowly deteriorate throughout the day.  I’m the one who saw her slip deeper and deeper into the abyss.  Maybe the doctors are right.  Maybe her symptoms are simply a part of the post-operative healing process, and will resolve of their own volition.  But a nagging suspicion tells me this isn’t so.  I was always taught that medicine should be proactive, not reactive.  So why are they simply waiting for the other shoe to drop?  Why are they happy to let her be until she becomes compromised?  It seems irresponsible. 

Most of the time, I try to avoid comparing American medicine to Australian medicine.  These are vastly different medical systems with vastly different schools of thought.  And, quite honestly, who am I to say which is better than the other?  I don’t have the statistics to prove or disprove either one.  But, as a nurse trained in the American system, it’s gut wrenching to see this type of thing happening.  Maybe my patient wouldn’t fair any better with more aggressive treatment, but I can’t stand feeling so helpless.  It makes me so angry.  But for now, all I can do is watch this situation unfold.  I hope my instinct is wrong.  I hope I go into work today and see that she’s improved.  I hope, I hope, I hope…

A Much-Needed Victory

I spend a lot of my time as a nurse feeling frustrated.  I get frustrated with the doctors.  I get frustrated with my patients and their families.  I get frustrated with the seemingly never-ending mountains of poo that abound on our ward.  I get doubly frustrated when I don’t see my patients getting better.  Many days, I feel like I’m fighting a losing battle.  With all of this frustration weighing me down, it’s a wonder I have the will to get up in the morning.  But then, along comes a patient who reminds me how miraculous modern medicine can be.  It gives me a warm fuzzy feeling, and a sense of pride in knowing we not only helped save this person’s life, but also preserve its quality.

Her story isn’t necessarily unique.  She is a very average, middle-aged woman who was getting ready for work one morning when she suddenly collapsed.  Her husband found her moments later, unable to speak or move the entire right side of her body.  He rushed her to the Emergency Department, where they determined she had suffered a massive, ischemic stroke.  Believe it or not, she was lucky.  She had been found in time and made it to the E.D. in time to qualify for lysis treatment.  It’s risky, but can also produce miraculous results.  When she came up to our ward, she still couldn’t communicate or move her right limbs.  But as time progressed, so did she.  By midnight, she was chatting with me, telling me about her job, and using both arms as if nothing had ever happened. 

I know it wasn’t a really miracle.  I know her recovery was a result of years of medical research and trial and error.  But for me, this was a little miracle.  After a long, hard, frustrating week, I needed a victory.  And there she was, asking me for a glass of water.  It’s ironic how one person’s medical emergency can be another’s epiphany.

The Bedpan Diaries

I swear - if I have to change another adult diaper or spend another day fetching bedpans at five-minute increments for little old ladies with teeny-tiny bladders, I am going to scream.  After today’s patient load, I have had my fill.  I don’t know as if I can even look at another bedpan without feeling a sense of dread.  But, of course, tomorrow will be more of the same.  I can’t get out of it.  Our patient population makes such undesirable, annoying exercises a constant necessity.  And, of course, I can’t really scream, as doing so would be unprofessional.  Nope – I just have to smile, be kind, and continue on with the menial tasks I have come to loathe, all the while wondering if this is really what I worked so hard for. 

Part of my frustration simply stems from working on a ward again.  Less acute patients require a different type of care than critical patients.  And, while I have appreciated taking a step back and working with more stable patients, I am beginning to miss the challenge of the ICU. 

The other part of my frustration stems from Australian nursing as a whole.  As I’ve alluded to in past entries, Aussie nursing is vastly different from American nursing.  The Australian nursing model seems determined to keep nurses functioning at a more domesticated, less medicalized level.  It’s what I imagine American nursing to have been ten (even twenty) years ago. 

Aussie nurses don’t collect patient’s medical histories or complete head-to-toe exams.  They don’t draw blood or start IVs, unless specially certified to do so.  And they have to double-check almost everything.  The lack of autonomy is often astonishing (and maddening).  From my perspective, they simply don’t oversee and organize their patients’ care to the same extent as their American counterparts.  Instead, they are obligated to focus on the very basics of care:  bathing, changing the linens, fetching bedpans, and dozens of other tasks, which could easily be carried out by aids.  To my American sensibilities, it seems like a waste of nursing education and resources.  (More importantly, it seems like a waste of my nursing education and skill set.)

Maybe I would feel different if I were working in an ICU right now.  Maybe I would feel less like a cross between a pill-pusher and pooper-scooper and more like a real nurse.  Please don’t misunderstand me, I do enjoy my job and I am loving this experience; I wouldn’t trade it for the world.  But I would really love to go an entire day without changing diapers!

Not All Rules Are Meant To Be Broken

It’s funny.  In my everyday life, I’m not a big fan of rules.  As far as I’m concerned, rules exist for the sole purpose of being broken.  I like being unconventional.  I like living my life in the land of “what if”.  But as a nurse, I thrive on rules.  I see them as a necessary means of protecting our patients, their families, and even us nurses.  A hospital cannot function without rules.  Our patients’ treatments and outcomes could easily be compromised without them.  The rules may not always be popular or fun, but they are a must in the hospital setting.  Even the most inane rule has a purpose.  

As staff nurses, we are required to follow these rules and enforce them.  And it never fails to astound me when patients and their families somehow think they are exempt.  We post signs.  We provide explanations.  And yet, these people look right through us, as if we don’t exist, as if the words coming out of our mouths are unintelligible.  Even worse, they become hostile, calling us names, questioning our competency, and making threats.  And this doesn’t just happen here; it’s the same in the states.  

I know it isn’t easy having a loved one in the hospital.  I’ve been there and know they’re scared.  But I can’t do my job when I’m constantly running into roadblocks.  I can’t concentrate on my patients when I’m wasting time fighting the families.  It’s frustrating and nerve-wracking.  It makes me want to give up.  I just wish these people could see I’m on their side.  Just because I’m not telling them what they want to hear, doesn’t mean I don’t have their best interest at heart.  My intent is to provide the best possible care for all of my patients.  I wish they could see the big picture and comprehend the clinical rationale behind my words and actions.  I know it’s a lot to ask, but I wish they would just try to understand.

Let the Chaos Begin

It’s funny how work can go from a nice, relaxed pace in one moment to cluttered chaos the next.  Take, for instance, last night.  One moment I was laughing and chatting with my patients, breezing my way through their evening observations and medications.  The next moment I was rather frazzled and frustrated.  And it’s not like anything catastrophic happened to turn the tide.  No - it was a series of little things that just kept gathering momentum until they became a full-blown storm, leaving me feeling winded.

It all started when I had to run downstairs to pick up a narcotic from the pharmacy.  (What a pain!)  When I came back, I received orders to prep a patient for CT – STAT!  (Even though he’s been waiting ALL DAY.)  Then I found myself traipsing through the hospital, going from ward to ward, hunting for a medication no one had bothered to restock in our supply.  Next, another nurse needed help checking out narcotics, which she promptly spilled, requiring the entire lengthy process to be repeated.  Oh – and then I had to search for a doctor, any doctor willing to write a simple insulin order for my diabetic patient because his regular team had forgotten and left for the day.  Then another patient required an immediate ECG.  And just when I thought I was getting organized, another nurse dragged me into her room to start IVs on her patients, because no other nurse on the ward can.  All the while, I was trying to squeeze in my normal evening duties, amid my homeless patient (who thought he’d just landed himself in a 5-star hotel with me being his answer to room service) vying for my attention to complain about the hospital food, demanding I find him salt, pepper, sugar and a cup of tea.  Aghh!!! 

Separately, each event was nothing.  But when all of these nothings came crashing down at once, I barely had time to breathe, let alone think.  (And finding the time to relieve my bladder was totally out of the question!)  So, while this job isn’t really stressful, it can be very busy.  Sometimes, it’s too busy, leaving me spinning and wondering how I got myself so far behind.  Sometimes I leave work, shaking my head, simply trying to figure out what happened.

Feeling Like a Fraud

It never ceases to amuse me when I turn up to work and find I’ve either been assigned the team leader role, or am paired with a student.  (Today I was blessed with a double-whammy.)  I can’t help but chuckle.  (Quietly, on the inside, of course.)  Because, let’s face it, I just don’t see myself as qualified to fulfill either role.  I don’t see myself as a leader or a mentor.  I don’t feel old enough to have anyone answer to me.  I feel like a fraud.  I certainly don’t feel like any sort of authority.  It wasn’t that long ago when I was the student.  A few years’ experience hardly makes me an expert.  Couple that with the fact that I’m still trying to gain a firm grasp on Aussie nursing, and the situation almost becomes laughable.  What are my superiors thinking?!?  I can only hope I sound somewhat knowledgeable and avoid making a complete fool of myself!

Just Close Your Eyes and Count to Ten...

I like my job.  I really do.  I like my coworkers.  I like my ward.  I even like the hospital; it’s a great organization to work for.  My current employer definitely has many redeeming qualities.  Unfortunately, their medication administration system is not one of them.  I HATE IT, HATE IT, HATE IT with a passion. There isn’t a day that goes by that I do not curse the entire system.  It’s a source of constant frustration; just thinking about it makes my blood boil.  It’s incredibly outdated and unsafe - a handwritten sheet filled with scribbles, cross-outs, and barely legible writing.  No pharmacy pre-checks or official computer printouts.  Nope – any doctor is free to come along and prescribe or discontinue any medication he or she sees fit, with little more than a slash here or a sloppy notation there.  The result is a nursing nightmare and a medication error waiting to happen.  I wish I could take a picture, as the image would make anyone cringe.  Trust me, any sane nurse would be appalled.  Medications get written in twice, simply because the team physicians don’t communicate and are too lazy to review the med chart.  Other times, the docs can’t be bothered to write in correct dosages, leaving us to interpret the order for ourselves.  The list goes on and on.  Like I said, it’s a nightmare.  And when I complain, my coworkers stare at me blankly, as if I’m whining like a spoiled brat.  I can tell they are not actually listening to me.  My words are falling upon deaf ears.  They don’t seem to see the inherent danger in such an unregulated system.  To them, this is just the way things are done.  What’s a girl to do?  I can’t change the entire system and I certainly don’t want to be seen as an angry, negative person.  So, I try to keep my frustrations to myself, only allowing them bubble over when something is particularly appalling or unsafe.  Otherwise, I just have to remind myself that this is all a part of the foreign nursing experience.

(Oh - and don’t even get me started on how we go about procuring the patients’ medications.  That deserves it’s own, individual rant.)

A Sinking Feeling

Everyone makes mistakes.  We’re human.  It’s bound to happen.  But, as a nurse, I do my best to keep my work-related mistakes to a minimum.  My patients are my responsibility, a fact I take quite seriously. 

So, this morning, when I realized I had made a pretty big mistake, my stomach sank.  My heart began to race.  I became nauseated.  One of my patients missed two doses of an important medication.  To top that off, his early morning obs hadn’t been completed.  I wish I could pinpoint exactly why.  My best explanation is that this was a prime example of team nursing gone awry.  A simple miscommunication led to this oversight.  Everyone thought the other person had completed the tasks.  And, in the flurry of our pre-dawn activities, the chart went unchecked.  We didn’t catch our mistake until shift change. 

I felt like a failure.  I was mortified.  I’m pretty sure all of the color drained from my face when I realized what had happened.  It would have been easy to blame the agency nurse, but that wouldn’t be fair.  I should have checked her work.  That was my responsibility.  I’m the one familiar with our policies and procedures.  I know which medications are crucial.  I shouldn’t have assumed anything. 

Luckily, no harm was done.  The patient was fine and incurred no adverse effects.  We got him back on schedule with his medications.  We reported the incident to our charge nurse and followed the appropriate channels.  Still, this was a hard lesson learned.  Self-doubt has clouded my mind all day, causing me to question myself and my practice.  But, I guess, this may be the “silver lining” of mistakes.  It forces self-introspection and demands improvement.  So, I’m trying to take this incident in stride.  I’ve learned from last night’s events.  I will not make the same mistakes again.  Now, I just need to get rid of the guilt, because I have another long night of work ahead of me.

The Whole Story

I was reading through my work entries, the other day, when it dawned on me I haven’t been painting the most flattering picture of my employer or my job.  One could, justifiably, question if I even like working out here.  I guess this is because it rarely occurs to me to write about the positive things.  Let’s face it, good days are boring; they don’t translate into an interesting story.  I suspect if I only wrote about how wonderful things are, this blog would become VERY boring VERY quickly.  Somewhat unfortunately, it’s the annoying, frustrating, and shocking things that get me going and inspire me to write.  So, I complain about infection control, silly uniforms, and pay debacles.  But, by focusing on the bad, I’ve failed to provide the whole story.  The fact is, despite my occasional frustrations, I really like nursing in Australia.

Stuck in the Middle

March 25, 2010: Queensland Health apologises to staff after new payroll mix-up, The Courier Mail

April 8, 2010: Queensland Health pay bungle continues, The Medical News

April 13, 2010: Government still fixing Queensland Health pay bungle, ABC News

June 2, 2010: Queensland Health pay bungle continues into June, The Medical News

June 29, 2010: Queensland Health to change payroll system again after bungle, The Australian

Shut Down

It’s official.  Our ward has been shut down. We got the call this morning, confirming that yet another patient contracted VRE, bringing the total to seven patients in three weeks.  We were aghast and embarrassed.  (We wash our hands!  Really!)  Before we could blink, Infection Control had swooped in with their menacing signs and stern looks of disapproval.  The doors to the ward were shut.  The patients who had tested positive were whisked away to the infectious disease ward.  The remaining patients must stay put - no campus privileges (Sorry, smokers!) and no transfers, save for a medical emergency.  No new admissions permitted, either.  We were lectured at length on the importance of hand hygiene.  Oh – and everyone working on the ward, doctors included, must wear little plastic aprons.  (Which we don’t change between patients, so how is that is going to prevent the spread of anything?)

The entire situation is mind-boggling.  I’ve never heard of an entire ward shutting down for infection control purposes.  (I haven’t been a nurse too long, though, so maybe this is more common than I realize?)  But, I’m also surprised of this nature hasn’t happened sooner.  The majority of our patients reside in ward-style rooms, each housing four beds.  Private or semi-private rooms are virtually non-existent.  The bathroom is shared.  The shower room is shared.  The vital signs machine is shared, so the BP cuff goes from one patient to the next.  And when one bed is discharged, another one is immediately wheeled in to fill the empty space.  We wipe down the bed and equipment, but the entire room isn’t disinfected.  The floor isn’t mopped.  The curtains aren’t changed.  How does anyone expect germs not to get spread?

But, as far as I’m concerned, the clincher for this entire debacle is the lack of full contact precautions (gown, gloves and mask), once we know a patient is positive. Instead, we are to don the afore-mentioned plastic apron and gloves when entering said patient’s room.  (We can’t even get our hands on the full disposable gowns, as they’re not stocked on our floor!)  How is a little piece of plastic going to do any good?  Maybe full contact precautions (as practiced back home) are a little bit of overkill, but that policy seems to have prevented entire units from closing down.  I realize I’m not an infection control expert and, certainly, am not up to speed on the latest literature, but I’m seriously questioning the current policies.  It’s going to be interesting to see how this entire situation plays out and if it incites any policy changes.  Don’t worry… I will be sure to keep you posted.

The Question of the Day

I could kick myself.  I totally came across as a self-righteous, know-it-all, b**** at work today.  I didn’t mean to – I swear.  My stomach is actually a tad sour from the whole thing.  My intent was merely to point out a specific difference in Aussie v. American nursing practice, something that had been bothering me for a while.  I also meant to encourage my coworkers to think about their own practice.  But, how does one do that without sounding “holier than thou”?  I’m fairly certain it’s impossible.  Maybe if I possessed even the slightest amount of tact or finesse…

Hospital life is simply different here -not worse or substandard – just different.  So, I ask a lot of questions.  And I don’t just want to know how they do things, but why they do things. Sadly, my curiosity is often answered with, “That’s the way we were taught in university, so that’s how we do it.”  (Huh?  Isn’t such thinking the exact opposite of evidence-based nursing?)  Thus, I often find myself holding my tongue.  I don’t want to be seen as a negative, critical person.  And I certainly don’t want to be known as a stereotypical, arrogant American.  (I already catch enough flack for being a Yank!)  But, my inquisitive nature prompts me to question the theory behind certain practices.  And then I end up falling into the trap I was vigorously hoping to avoid. 

So, it’s safe to say, I’m still caught in the transition period where I’m learning how to adapt my skills and knowledge to this new environment.  It’s interesting, and I am learning a lot.  I just hope I get through it without alienating myself!

Hanging by a Thread

“You fool!” yelled Thelma*, stomping her feet.  “You don’t know anything!”  I had been at work for less than five minutes and was already being berated by one of my patients.  It was my seventh shift straight; I had walked into the hospital with a fried brain and shot nerves.  This was definitely not how I had hoped to begin my day. 

Thelma may have looked like a sweet, little old lady, but she had a ferocious mean streak.  Her dementia, coupled with hospital-induced frustration, made her incredibly difficult to deal with.  So, here I was, kneeling on the bathroom floor, trying to maintain my cool and goad her into putting on underwear after an episode of incontinence.  Apparently, she wasn’t pleased with this proposition, hence the foot stomping and spittle on my face.  Just breathe, I thought, stay calm.  I tried to reason with her, to explain the situation, but she just wouldn’t (or couldn’t) process what I was saying.  It was futile.  My sanity was hanging by a thread.  I just wanted to get her clothed and back to bed – if only it were that easy.  Ugh!  Welcome to life on a neuroscience ward.

It’s been an interesting transition, going from the ICU setting to something less acute.  Some days, I enjoy it.  The opportunity to interact and bond with patients has (mostly) been a nice change of pace.  And, since our ward takes all of the non-ventilated, post-op neuro patients, I’m able to utilize my skills.  But, days like today are tough.  I can’t lie – I don’t enjoy chasing around after old, incontinent ladies.  It just isn’t my cup of tea.  But, these scenarios do provide me with lessons in patience, humility, and understanding - all of which I could probably use.  And, if nothing else, I do come home with great stories.  So, overall, this is proving to be a good work experience, which is all I can really hope for.

*The patient’s name has been changed to maintain her privacy.

It's Not as Easy as it Looks

When I first began formulating my plan to live and nurse in Australia, I had no idea where to begin.  I was naïve and, admittedly, pretty arrogant; certain the process couldn’t be too difficult. After all, I was an American, with a solid American education and training.  Who wouldn’t jump at the chance to hire me?  It didn’t take long to knock me off that self-important pedestal.  I quickly learned being American wasn’t much of an advantage.  Obtaining a foreign license and finding work proved to be a much more lengthy, difficult, and humbling experience than I could have imagined.

My first hurdle was finding information.  I tried researching online, but was unable to find much useful information.  I located numerous agencies dedicated to helping foreign nurses find positions in America, but not vice versa.  The agencies that did specialize in New Zealand or Australian placements catered to nurses from Canada, the United Kingdom, and Ireland.  I sent resumes and email queries to countless agencies without receiving any response.  I began feeling like my efforts were futile.  I was frustrated before I had even begun.   But, eventually, an agency did show interest in me and walked me through the basics.  Regrettably, they didn’t land me my current position, but they did provide a wealth of information.

Since I’ve been out here, a few people have contacted me, querying about the licensing and job-placement process.  So, I thought it might be helpful if I dedicated a page to outline what I learned.  By no means do I consider myself an expert, but I have learned quite a bit over the past year and a half and am more than happy to share the wealth.  If you are interested in learning more, please check out the new page tab, located at the top, “So You Want to be an Aussie Nurse?”