Australia Nursing from the USA

Working as a nurse is very different here from the states but so far I enjoy it. For one thing there are no RT's. And I'd say that is my weakest area, but I'm getting more comfortable. I've found the nurses here to be much more helpful than any hospital I worked back home.  Another difference is no orthoglass so that means using plaster which also isn't as bad as I thought it would be. Here's a good video on backslaps (http://www.youtube.com/watch?v=iGPDeHgyDVw (Preview) ) Also blood glucose is in mmol/L not mg/dL so a normal value is 5.5 mmol/L or 100 mg/dL. Other differences a roster= schedule, nurse/patient ratio = load, 

I like Sydney because I don't need a car, its fairly easy to get around on public transport, and there's plenty to do. However, anywhere outside the city you will need a car. Australia is a huge country. 

Starting work as an agency nurse you won't get the vented patients until you're comfortable. You will get some on highflow nasal prong and bipap but those are not too hard. Review a respiratory book and you should be good. I'd rather take two non-vent right now until I'm more confident. The nurse patient load in ICU is 1:2 for non-vent and 1:1 for vent patients. If you're working ICU when you have a vent patient I'd just start kinda playing with the vent and looking at the settings. Try to do everything as if there was no RT. Its not as hard as I thought. Understanding the ABG's is more difficult for me. I have very limited ICU experience and I'm still able to do it pretty well. Most of the nurses are much for helpful and in the bigger hospitals there's also more staff who just walk around helping.

The work load is about as busy as the US hospitals. 

I took contract travel nursing it for 2 months. I'm went to a very rural town called Cloncurry in Queensland. The hospital has apartments right behind the hospital which travel nurses live.  In Cloncurry the hospital consists of a 3 bed ED, medical, and aged care facility. When I left a two weeks ago there were 12 patients. 4 acute adults, 1 peds, and 7 aged care. It was an adjustment working in Cloncurry but I was paid so stinking much I can't complain (All of that extra money is being saved for my visa). I learned that Queensland pays the most for nurses and rural nursing pays very well. Rural nursing you almost take the role of a nurse practitioner. Nurses do just about everything. From suturing to diagnosing ear infections and giving antibiotics. Many of the rural nurses are what's called RIPRN trained and it opens up the scope of practice even more. In Cloncurry the doctors only come to the hospital for real emergencies (but you can consult with them over the phone) or on rounds for the inpatients twice a day. I've not had any major issues in rural nursing. Its pretty neat doing medicine without the luxuries, it was an interesting challenge. Its been such a good experience and I highly recommend at least doing it once. 

Back to Sydney I'm normally an ER nurse but because I was worried at first about not getting shifts I signed up for HDU (similar to stepdown unit), ICU, and the general medical floor. I work mainly ICU and HDU but I've worked just about everywhere. Its been a neat experience. I was so nervous! I had my training in a box and thought I could not survive anywhere but ER. I'm glad I took the leap. Don't expect to work ER right away. All nurses start out on the medical ward or if you have ER experience you can also do ICU. The reason is the drugs are different and the scope of practice is different and one can be supervised a little more. My ER shifts were not bad but again it is pretty different.

Rural nursing and urban nursing are so extremely different. In the city you pretty much have unlimited resources and backup. Its almost sad because nurses have such a limited scope in the city (one example you can't start an IV without taking a course first).  There are physio's who do the backslab (plaster splints for broken bones) in the city but in rural you will do it all and then some!

If I were preparing on such a big move I'd start by doing assessments as if you were a doctor. Including looking in the ears, nose, mouth. When you have a limb injury try to pinpoint exactly what area is likely injured (because x-rays are not always available) look at ways to diagnosis with limited resources. 

I use two nursing agencies one Nightingale is wonderful. I love them.  They explained things very well and I highly recommend them. The only downside is they only do Sydney region. But when starting I think that would be the best place to start. http://www.nightingalenursing.com.au The second one is Healthcare Australia (HCA). They are one of the largest and can offer positions in all states. The pay is good. And I'm just finished a contract with them in rural Queensland. http://www.healthcareaustralia.com.au/

There are many agencies to work with (I've spoken with almost all of them) and these two are the most friendly and helpful. I would avoid an agency called Koala Nursing they were flat out rude and not helpful at all (and I was just trying to as a few simple questions).

I'm on a working holiday visa (allows me to work for 1 year) and I'm working on getting my long term visa. I don't want a sponsorship I want to do it myself so I'm  not limited to one area of Australia. 

I hope this isn't too long. This is a work in progress for me. And I encourage you to do your own research and figure out the best path for you.

The First Steps to Working as a Nurse in Australia from America

So I've been asked by a few people what the process of becoming a nurse in Australia. I figured I go ahead and make a few blog posts on my experience and hopefully it will help. So enjoy! This is the way I did it. I encourage you to do your own research and figure out the best path. I've included links that took me hours to figure out what-went-where and will definitely assist in educating you on the process.

The first thing you need is apply to AHPRA . Applying is mainly just a lot of paperwork you will need letters from your former employers, transcripts, proof of identity, your state board of nursing to send in a verification letter, a resume' (CV) and patience.  Follow the directions on the application exactly and you should do fine. With my application AHPRA requested another letter from my nursing school with a breakdown of the clinical and theory hours. I do not recall that being on the list of required documents but they might ask for it.  It does take a month or so to get an answer.

Once you are approved for a license you will get a letter that states you're eligible to be a registered nurse. After you will need to physically arrive at the AHPRA office and provide: 1.  proof of identity (passport and printed copy of your visa) and 2. evidence of Australian residential address or an original letter with an offer for employment. 

I worked with an agency and had a letter. And opened a bank account with Commonwealth Bank online before I arrived. Its also important to note this is probably the only time you will need an actual print out of your visa. When I arrived they specifically asked for a printout of my visa.

If you are under 30 you can do a working holiday visa (this is what I did) and this allows you to stay for 1 year. Its a good way to take a look and make sure moving overseas is right for you. Since the USA does not have a working holiday visa many countries won't offer it to USA citizens. Australia is one of the few that does. Since your working in healthcare for the visa you will need a physical, chest x-ray and blood work. Once you apply for the visa make sure you schedule the appointment with a doctor ASAP in the event there's a delay in appointments. You will need a few forms to take to the doctor from the visa application so its a good idea to have the printer handy or make sure you can save it to thumb drive.

If you're over 30 you will need either sponsorship Healthcare Australia  can give your more information on that (let them know I sent you I might get a little bonus). The application for agency nursing is almost as long as the application for AHPRA! And you will need two referrals from supervisors.

The other option is the 189 Independent skilled visa. I'm currently working on the 189 visa and will keep you updated on how it goes. You will need to be assessed my ANMAC and then invited to apply for the visa. You will need many of the same documents used for AHPRA.

Did I mention its a LONG application and a lot of paperwork?!?! It will get frustrating. Take one step at a time and it will work out. Keep copies of everything. You will need them later. I made the mistake of sending an original document and it's been frustration trying to get my former employer to write a new letter.

I hope this helps! Later I will share more on life in Australia and the adventures of being a nurse Down Under.

Lunch With GP

Its been a fun filled day! I took GP out to lunch at Red Robin. We got some yummy food. We ate a french onion soup and I highly recommend it. The food is kinda expensive there, but the soup was about $5 not too badl. 

After lunch I finished up some online education course needed for working in Australia. It sounds like I will have to start on the general ward (Tele/Medsurg) and progress into ER. It is disappointing but either way it will work out. I'm working with two agencies because I want to keep my options open. I figure I will be available to work Monday-Wednesday for one and the other agency Thursday-Saturday and off Sunday. One has better benefits but it doesn't offer sponsorship the other one offers sponsorship after 3 months but the perks are a little lesson.  Random tidbit of information all the shifts are 8 hours.

 Also I booked a room for 10 days at a hostel which is super cheap and I'm hoping to find a flatmate within 10 days!

Visit With Grandma

I went to visit Grandma P. We had a nice conversation. She told me a little about what life was like when she was little and growing up. When she was very little she was kidnapped by her father and grandma and moved to Colorado! A little background GP's parents were divorced and her mom had to work nights. Her mother dropped the kids off at a daycare and in the middle of the night GP's dad and grandma came and kidnapped them. Her father re-married a very abusive woman.

One story she told happened when she was around 17. Her step mom had a very dirty mouth and was swearing/yelling at her. GP was ignoring the rude/dirty remarks. So her step mom came around and yanked her long red hair, this was the last straw for GP she turned and punched her step mom in the face! She said it made her feel so much better, but knows it was probably wrong. When her dad came home he took her outside to spank her and she was out there with him and said “if you touch me I will never talk to you again”. He didn't spank her probably because he know the step mom was a witch and abusive. It was an enjoyable conversation. I also learned what I thought to be true. Grandma was married and divorced before Grandpa H. She was going through a divorce at 21. She's never talked about what happened with her first marriage to ANYONE. A while back I heard second hand from my brother who heard it from my Aunt who heard it from my Great Grandma that she was in a relationship at a young age. I'm interested to know what happened and why she's kept it secret all these years.  I'm thankful to have such a loving Grandma although she's had a difficult/painful life. 

Comfort From a Movie

On Sunday I was thinking about the second coming of Christ and the quote from Lord of the Rings came to my mind and gave me some comfort. 

Frodo: "I wish none of this had happened." Gandalf: "So do all who live to see such times, but that is not for them to decide. All we have to decide is what to do with the time that is given to us."

Mexican Food

I woke up an hour ago and can't seem to sleep.

Exciting adventures this week with Little D!

Yesterday we had a yard sale (actually Little D did all the work so I should say she had a yard sale). It was a success! Got rid of junk and made a little money.

To celebrate we went out to eat at a Mexican restaurant. Now my tummy hurts ;-) The food was good though. I jokingly told my sis to make sure she had her vaccinations before eating! You never know what the cook is doing.

Enough rambling for one night. Off to laying in bed, wishing I could sleep and my stomach would recover faster.

Party Time!

Btw I thought I posted this last night! Opps  :-)

I drove back from Irvine today. on my way back as I was at the 57 freeway going to Diamond Bar area I saw a deer right off the side of the freeway. Who knew California Even had deer!?!

I got home just in time to go to M's lesson in relief society. her lesson was from a talk by Neil Anderson from the last October Central Conference. It was about having faith even during our trials.

afterwards we went to the singles Ward and went to the Sunday School class there. the lesson there was on the law of consecration. M brought up an interesting thought about the law of consecration her feelings about it. She feels it is the same as communism. However I think it important thought she missed was in the law of consecration is everybody's equal and everybody get the same amount. And its all out of brotherly love.

Tomorrow is my birthday. We had a little party at mom and dads. We ate cake and ice cream. And had lasagna for dinner. My parents got me wheat and some neat tshirts! Its hard getting older and feeling like I've missed something important. But I have hope God is in control and if I keep turning to him it will work out.

Irvine!

I went for little get away down to visit my Aunt and her family.  She's showed me around the OC area and we went to the beach. Its been a lot of fun. I hope to take Little D and Beckinstine this summer. 

Fair Pictures

Well work was extremely annoying. I'm so happy to be off.

On the bright side I'm off for several days. And I'm getting my pictures ready to submit in.the country fair. I'm  submitting 5 pictures. I've never put anything in the fair. It should be cool.

Reflecting the Days Events

I had one of  those days at work! I and my patient were placed in a very dangerous situation because of an ahole/money hungry/poor time management doctor and a spineless supervisor. It could have ended very poorly for a patient.

Its caused me a lot of reflection this evening. I had a bad feeling about the procedure from the start. I was literally forced (although the hospital will say there's no mandatory overtime... utter BS in my department) to stay over and do the procedure.

The patient had a complication which could have been prevented by going slower.

Next time I will the big bad witch and follow my gut. I'm not making any friends at work these days.

Rushing around does not improve patient care... and it is extremely dangerous.

Summary of what I've figured out. Background first when things go wrong I often rethink them over and over, wondering if I did the right thing. I should have slowed down. I should have followed my feelings and rescheduled it for a time more appropriate. I did response rapidly. And those assisting responded fast with appropriate resources. There will be no long term injury to the patient. But I will be scarred for life, and I have learned a great deal.

The Visa Is In!

This has been an eventful day... so I will start at the top!

Early this morning I took Moose to the dog park. We had a fun time, until two husky dogs came and they were bullies. Anyone who knows Moose know's he's a very gentle dog but they kept circling around him trying to make a fight. He was a good boy and just ignored them. But it was still annoying for both of us. Even their owner said the dogs are bullies. Why do people bring their dogs if they can't behave! Its one thing to have them at home its another to actually drag them in the car.... okay rant over! Its fun to socialize with the people and their dogs. Tomorrow I plan on taking him again. 

******THE MAIN EVENT!******

My working holiday visa came through!! So I could legally fly to Australia today and start working (dare I say another life?!?) :-D 

It is very tempting. But I think I will wait a little bit longer. I've spent the rest of the day speaking with travel agency recruiters, wired some money to my Australia bank account, and cleaned mine and Baby Bird's room. The recruiter I spoke with today said that since its getting into winter its getting really slow and it might be a good idea to wait. This work well for me anyways because I was thinking of waiting until January so it would be a new tax year. And it allows me to keep saving money.  I'm looking forward to what the future holds. 

Although there is so much happening evil/sadness in the world I take comfort that Jesus is my Savior and makes up for where I fail. 

Near Apollo Bay, Victoria, Australia 

Sermon of One

Today it was my weekend to work. My first procedure was not until 11am so I was able to sleep in. I did miss church still. After work I went to visit my parents and had a great discussion about world events. When I came home Baby Bird (my niece who's 5) is sick so I sat on the couch and held her. She's not normally very cuddly so it was kinda special to hold her and talk to her. 

After she relaxed more I spent the rest of my evening reading the scriptures (giving myself my own personal sermon). I started out in D&C 88, I've been taking several days to finish the section I want to really understand it. I came to verse 118  And as all have not faith, seek ye diligently and teach one another words of  wisdom; yea, seek ye out of the best books words of wisdom; seek learning, even by study and also by faith. Afterwards, I went to John and was reading more when a particular scripture again stuck out  Jesus had washed his disciples feet he said to them in John 13:17 "If ye know these things, happy  are ye if ye do them". 

What I learned from those scriptures although my faith is weak keep studying, look for opportunities to learn, and apply what I learn to my life and in return "happy are ye if ye do them". 



This is from my trip to Paris last year, it has nothing to do with this post. 

Some Medical Abbreviations Used in Aussie Hospitals

I'm preparing to hopefully move to Australia in next few months. I have my APHRA registration (the Australia nursing board). Working on my visa (I'm doing with a working holiday visa). I've been looking at a lot of jobs of nurses in Australia mainly in NSW, but I'm not too picky about the location. Its my plan to do travel/contract nursing at first until I'm more settled. Tonight I went over some of the common medical abbreviations used in Australian Hospitals. This list was from a travel agencies I'm planning on working with

Its neat how there are a lot of similarities, and  fair amount of differences in the medical abbreviations used in the USA.

ABG arterial blood gas

ACLS advanced cardiac life support

AF atrial fibrillation

ARDS acute respiratory distress syndrome

ARF acute renal failure

AS aortic stenosis

AXR abdominal X-Ray

BD twice a day

BIB(A) brought in by (ambulance)

BNO bowels not open

BO bowels open

Bolus one large single dose

BP blood pressure

BPM beats per minute

BSB backslap and bandage

BSL/BGL blood sugar level/blood glucose level

CABG coronary artery bypass graft

CAD coronary artery disease

Cap capsule

CCF or CHF congestive heart failure

CHD congenital heart disease

CNC clinical nurse consultant

CNS clinical nurse specialist

c/o complained/complaining of

COPD chronic obstructive pulmonary disease

COAD chronic obstructive airways disease

CPAP continuous positive airway pressure

CRF chronic renal failure

CT computerized tomography

CVC central venous catheter (central line)

CVP central venous pressure

CXR chest X-ray

d/c discharge

DSH dynamic hip screw

DVT deep venous thrombosis

DX diagnosis

ECG electrocardiogram

ECHO echocardiogram (ultrasound of heart)

EEN endorsed enrolled nurse

EN enrolled nurse

ESRD end-stage renal disease

FFP fresh frozen plasma

Hb haemoglobin

HTN hypertension

Hx history

IM intramuscular

IV intravenous

JVP jugular venous pressure

K potassium

Mane morning

MI myocardial infarction

MO medical officer

MRI magnetic resonance imaging

MSU mid stream urinalysis

NBM nil by mouth

Neb nebuliser

NFA no fixed address

NFR not for resuscitation

Nocte night

NOF neck of femur

N/S normal saline

NSAID non-steroidal anti- inflammatory drugs

NUM nurse unit manager

OD once daily

PCA patient controlled analgesia

PE pulmonary embolus

PO oral

POP plaster of paris

PR per rectal

PRN as needed/ when required

pt patient

PU passed urine

PUIT passed urine in toilet

PV per vagina

q4h, q6h.... every 4 hours, every 6 hours etc.

qid four times a day

RMO resident medical officer

Rx treatment

SC or Subcut subcutaneous

SL sublingual

SOB shortness of breath

STAT (statim) immediately

Tab tablet

TEDS compression stockings (TEDS is a brand name)

t/f transferred

tspn teaspoon

tbspn tablespoon

Tds three times a day

Top topical

Tx transplant

UA urinalysis

US ultrasound

w with

w/o without

# fracture

< less than

> greater than

A Windy Day!

Title says it all, a lot of wind. Makes it so I can't do much outside. Gives me time to clean and write in the blog.  My sisters Keamy and Ginger came over and we are attempting to play a video game. We stink! It is a good thing my life is not actually dependent on saving some warrior person. 

The bombing in Boston has made me think more of the importance of being prepared for emergencies/disasters. And the importance of spiritual preparedness. 

After thought: 

When I was in Utah I went to visit my Grandma. It was a very nice visit. We talked about a lot including some of her thoughts about the future and her testimony of Jesus. She told me she felt the Savior would return in her grandchildren's lifetime. And although there are difficult times ahead that if I stayed close to the Lord, life would work out okay. I wish remembered and wrote down sooner all she said.  It was a touching experience it left me feeling so loved. I felt that I was listening to a great sermon such as when Alma was talking to his son Helaman sharing his testimony and important advice Alma 36-37.

Happy Saturday! Day 103

I'm doing a year long journal. And figured I'd try to keep this blog more active. And since its pretty easy to copy and paste... there ya go :-P

Little Brother's (LB) house has come a long ways. He's done a lot of work and it shows. The house is very comfortable.We came to Cedar in the morning and did shopping. 

Afterwards we went to Frisco for some exploring.There's so much to see around area. There were not any do not enter signs (last time I went there was a large sign that said "do not enter your life is in danger)", so we went all they way up to the mines! I gotta say it is VERY cool! Thankfully we lived. The mines go down so far you can't see the end. We dropped a rock or two down and it took a good 10-12 seconds to reach the bottom! Moose (my dog) came along as did LB's dog Valkyrie (a black lab mix). Look below see the treasures we found! I love exploring. 

There's a lot of wildlife around this area of Utah. I love to see animals in the wild. It brings me happiness. Animals I saw today: Bald eagle, antelope  deer, cow and cow babies, horse and horse babies, coyote, rabbit, lizard, crow, and a mouse (dead)!

This evening(night?) I went to visit my old work and had a nice visit with some of the awesome nurses there. 

The Quiet Life

Its been an amazing day. I got notice that I'm a registered nurse in Australia! And then offered two very tempting jobs here in the USA. I'm still going to Australia. I will probably leave in January... lots to do. I spent the rest of today touching bases with travel agencies in Australia. And was able to obtain more information that was very useful. I also applied for my working holiday visa. I need to do the medical side of it and that requires a trip down to San Diego. I will call the doctor down there tomorrow and schedule and appointment. I've been so excited I only ate a salad at lunch... and I'm still not hungry  Oh and I exercised for 30min with M.M. and played with Moose!

Someone said something that made me thing they must think I'm so boring! If they only really knew me. I don't post everything I do on facebook. I get to do a lot. And I have many "boring" adventures :-)