Latest Comments by squeek

squeek 1,174 Views

Joined Oct 3, '03. Posts: 32 (0% Liked)

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    Hi all,

    I have really enjoyed reading your posts on nursing ed. I have tonight jotted down pages of interesting ideas that I can use in nursing ed. also a great number of websites to visit! Thankyou :flowersfo

    I currently work as an RN in OR, however have applied for and been accepted for an interview as a nurse educator at a government run Australian technical school, teaching Enrolled Nurses ( I think similar to your LPNs ). I was an EN prior to further study. long nursing history, incorporate lots of teaching into my current role but in an informal manner.

    My question is, as experienced nurse educators, what knowledge would you expect from me at interview for this position? what kind of questions would you ask? Any suggestions would be very welcome.

    cheers Squeek

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    thanks for your reply, I live and work in South Australia, we do not have nurse anaestheologists in SA, Anaesthetic nurses can be RNs or ENs who assist the anaesthetist and look after the patient. we do not have tech's yet although they do in some states, NSW at least.

    as to working here, each state of oz is different, there is a nurses board in each state and to work in that state you must register with that nurses board. Not hard to do after your initial registration.

    Our pay rates (and everything else) are different too state to state. In SA the ANF (australian nurses union) just won us a lovely payrise, currently a level 1 Registered Nurse, year 9 earns $26.00 per hour in a public hospital.

    I am not sure how that equates to your nursing levels. An RN, has a 3 year hospital training certificate or (for the last 11 or so years) a Bachelor of nursing, 3 years from university.

    Level 1 means a worker , level 2 are our clinical nurses (still work but are the experts ), 3 are our clinical nurse managers (in charge of the experts), 4 our executive managers, 5 our directors of nursing etc. etc.

    year 9 is the years of experience post registration, starts at 1 up to 9.

    although I would love to earn more money and probably deserve it, our pay rates are reasonable in comparison to our economy. Medical officers earn a lot more but they are welcome to it. Australia has a shortage of nurses and I think every state would love to have you (or any experienced nurse). please feel free to pm me if you would like any more details.

    cheers Squeek

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    Hi,
    Have been a member here for a long time, but never thought to start a post!

    we have just had 2 anaesthetists arrive from the states (not sure where yet) and they tell me that they do not have an anaesthetic nurse in America?? I am amazed, I have always thought that Australia follows the American standards. I was told that in theatre you only have a scrub nurse and a circulating nurse (who also cares for the anaesthetist a little), while we in Australia have at least (per Australian standards) a scrubber, circulator and an anaesthetic nurse preferably 2 circulators for large cases. Just wondering if this is the case generally all over the States or is it only in certain areas?

    also they carry a little black bag of intubating equipment with them, is this normal practice? Here we have a difficult intubation trolley with all the emergency equipment on it to share!

    Cheers Squeek

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    I agree with talaxandra, go the Anf (Australian Nursing Federation), I too am a union rep (recently recruited) ... as well as fighting for conditions and pay rates, they represent you when you are in trouble, ie workcover for me .... employer appeared to want me out of theatre but the ANF helped me fight to stay there. The ANF also offers some incentives to members, just small things but worth having, cheap health insurance, travel insurance, movie tickets ... etc etc :hatparty:

    unions are definately not the saviours of the universe but they sure help.... our union has negotiated zero tolerance to violence policy, no lift policy, on call allowances, occ health and safety improvements and more

    the union, any union is only as strong as its members, without them the union is nothing. 1 nurse fights an establishment = establishment wins, 200 or 7000 nurses fight the same establishment ....... nurses will only achieve more by standing together.

    the ANF has a poster out at the moment, we have just completed our enterprise bargaining agreement here in South Aus, over the past 10 years they have fought and won for nurses wage increases totalling over $380 per week in comparison to the offered amount of approx $42 ....

    speaks for itself really.

    go the nurses union!!!

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    an LMA is simply an oral airway, the large bulbous part at the base holds up the tongue, therefore reducing airway obstruction. It was designed simply to take the place of the face mask during the shorter cases and therefore free the anaesthesia providers hands up.... they are easy to introduce and do not actually sit far down the throat. A little discomfort afterwards is to be expected but ten days is far too extreme. I doubt this would be the cause.

    an ETT endotracheal tube is admittedly smaller than a LMA however as the name suggests it sits in the trachea and is passed through the vocal cords to obtain an adequate airway. It is usually used in the majority (some would say all) of laparoscopic surgery and in most long operations. I would imagine that this would have been used during your surgery. A sore throat for up to 2 weeks may be expected, unusual but possible. You must be paralysed, have local anaesthesia to the cords or be very deeply anaesthetised prior to intubation, otherwise you may have some vocal cord spasms (laryngospasm)this can often be a cause of further sore throat.

    although a LMA may be the preferred option of the anaesthetist, due to ease of insertion and minimisation of complications, there is always the possibility of problems maintaining the airway and the need to change techniques and intubate the patient at any time during the procedure if necessary for safety. safety of the patient always comes before preferences!

  • 0

    How sad it is! So glad they found someone who cared. I think you did a great job... :angel2:

  • 0

    hi Chris

    thanks for your suggestions, they are a great help! (even in Oz) I have been a bit concerned that I may be out of my depth, but from your suggestions I feel much happier, I would be competent in those positions..
    thanks again,
    Squeek

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    you are all very lucky to have your positions.

    I am an OR nurse with a permanent back injury ... only mild (discectomy), I can still walk :hatparty:

    I have been looking for a new field of practice with minimal physical exertion ... and have chosen OH&S ... hopefully this is a good idea. I have a lot of personal insight hehe.

    my problem is finding a position !! I am halfway through an external uni certificate in Occ health ... but am not sure where to go now??? any suggestions appreciated??

    cheers Squeek

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    ps. not a standard of care here yet, many procedures are done without antibugs!
    squeek

  • 0

    hey I should have been a little more specific, we do give Abs before incision but not on ward pre-op. I wonder if else where in Oz they are following your trend [as we invariably will do, it is just a matter of time]

    squeek

  • 0

    ditto to shodobe and stevierae!

    I did not mean literally ... I realise all do not have ETT, this was a bloody unlucky situation.

    in Oz we do not start Abs prior to surgery {maybe we are a LITTLE behind}.!!! in litigation too happily.

    I can manage ANY airway>>> 10 yrs of recovery ensured that... I can place an LMA if required; obviously a guedels or nasopharyngeal; I have placed ETT under anaesthesia supervision, but would not do so without .. it is not in my scope of practice in Oz. I will not lose my licence for such a reason ... bag and mask til they wake will work for me.

    cheers Squeek

  • 0

    we were about to start a nephrectomy,
    triple Abs before start ... NKA ...

    registrar was pre oxygenating pt,
    anaesthetist gave Keflin ..
    patients face just got bigger and bigger!
    we tried everything, every drug....
    bougie, trachlight, LMA, guedells ... but we couldnt get any air movement.
    finally cut down trachy .. her neck was so swollen by then it was difficult to find landmarks. got the tracheostomy in but it was too late.
    I have an anaesthetist who swears never to give Abs pre op ... wait til the tubes in .. I say whats the rush.

    doesnt matter how many other people were there .. the outcome would have been the same. we were prepared, it didnt help. we knew what we were doing. just real bad luck :stone

    squeek :angryfire

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    informed consent - hahaha :chuckle

    how can anyone give informed consent after having sedation .. are they not told not to make any important decisions for 24 hours!

    If the procedure was an emergency - OK
    if the consent included the possibility for further procedures - OK
    but for a knee arthroscopy with menisectomy - that is what they are consented for.

    I would not like to be the scrub RN in this situation.

    squeek.

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    ditto to the protected airway and the cool and controlled environment!

    only code I had trouble with was an anaphylaxis to Abs prior to induction ... couldnt get an airway for that one!

    we never call the code team ...

    I only have BLS certification.

    i work as a team with my anaesthetist ... and scrub team if necc.

    Squeek

  • 0

    we all work on the same team!

    squeek


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