ICU nursing Australia vs The US - page 2

by 184859 | 9,347 Views | 21 Comments

Hi, So I am a dual citizen, grew up in oz, but moved to the us after highschool and have complete my BSN here and am currently an ICU nurse. I am thinking of moving back to Queensland and most likely working for Queensland... Read More


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    "as an overseas nurse, i was shocked by the autonomy of the icu nurses in australia. as i have observed, they are like 'doctors' in their own rights. "

    lorodz...just out of curiosity: where are you from then?

    if you are shocked by the ozzy autonomy, try a trip to icu denmark! the teamwork nurses/doctors are like heaven there
    but then we do all have a 2 year post grad icu education as required at the beginning of the employment - and during the post grad. education one is fully pay by the ward, so no loss of money - 100% gain for both parties. it's a great system. the end product is highly trained and specialized staff on all icu wards.
    Fiona59 likes this.
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    Interesting read.

    I am ICU RN from Canada now working in one of the largest Brisbane intensive care units.

    Pretty much everything said earlier is correct. I do however get an impression that North American nursing is somewhat superior (in terms of professional independence, philosophy and respect) to the Australian which generally follows the UK model of nursing. This is much very dependent upon each and every unit traditions and history. There are places where nurses treated as professional members of the same team, and there are places where you are looked at as a form of advanced domestic help of some sort. This is sad and hurts, but I guess if you donít have much to compare things with then you donít really know what you are missing.
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    Quote from sockeye
    interesting read.

    i am icu rn from canada now working in one of the largest brisbane intensive care units.

    pretty much everything said earlier is correct. i do however get an impression that north american nursing is somewhat superior (in terms of professional independence, philosophy and respect) to the australian which generally follows the uk model of nursing. this is much very dependent upon each and every unit traditions and history. there are places where nurses treated as professional members of the same team, and there are places where you are looked at as a form of advanced domestic help of some sort. this is sad and hurts, but i guess if you don’t have much to compare things with then you don’t really know what you are missing.
    in some of this i think i respectfully disagree in regards professional independence, philosophy and respect. after speaking to a few us nurse friends i was able to do more in the uk that what they could do in the us. i did things that in the uk did not require a doctor's order which in the us they couldn't do without a dr's order. i worked a several hospitals and wards in the uk and was always treated with respect by all the multidisciplinary team including consultants.

    at the end of the day each country works differently
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    In most of the decent units those things are protocol driven. The docs prescribe a protocol. It would be up to the nursing staff to implement it based on the specific requirements of patient under care. So lets say for blood sugar control the docs would give you Insulin drip order with the request to optimize the BSLs within 4-10 range. They would not be generally interested in how you achieve that as long as Insulin requirements were not dramatic (>15 units/h).
    In Calgary we had protocols for management of traumatic brain injuries where nurses could initiate fluid boluses, start Noradrenalin, bolus hypertonic saline when they see fit in order to achieve certain clinical goals (CVP, CPP, ICP, etc).

    Ventilation wise, we would be talking about an order to wean off ventilator. This is Brisbane now. It would be up to nursing staff to decide to ease up sedation to a level of tube tolerance, go down on FiO2/ PS/PEEP based on the gas exchange, transition from lets say SIMV to PS ventilation - generally bringing the patient to the point of extubation. And then, upon a medical review, receive an order for extubation and implement it.
    In contrast, Toowoomba hospital ICU would not let nurses make any changes to the ventilators at all.

    So again, everything seems to be very unit specific. Unfortunately, someone who used to a certain level of independence in practice would have a major culture shock borderlining depression when they come to a place where their expertise, experience, knowledge and skill set is not generally needed, and they are unable to practice to the full scope of their abilities, capabilities and desire.
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    Sockeye: I experienced this as an LPN moving from AB to BC. Basically treated as a glorified NA and not permitted to work in my specialty area after moving from a regional acute care facility to a small rural hospital. It's called protecting the turf.
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    Is there a way to answer private mesages? The board won't let me write to the people writing to me. Pls send your normal email with your message.
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    Quote from Sockeye
    Is there a way to answer private mesages? The board won't let me write to the people writing to me. Pls send your normal email with your message.
    Forum rules require 15 quality posts before you can reply to PM's. Only 9 more posts and you'll have access.
    Fiona59 likes this.
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    Agree that it very much depends on the specific unit - a great reason to remember when interviewing for jobs that you need to find out the culture of that unit as much as possible in detail as to what is expected & permitted.

    As a control freak ICU nurse, I preferred the Aussie model of doing everything for my patient. I greatly admire the expertise of the various team members such as respiratory therapists etc here in the US, but I feel that it makes the care a little more fragmented when you aren't 100% sure who's doing what sometimes. Of course this is minimized with good communication among the team.

    I agree that the US is probably further ahead in terms of professional issues and expectations, but overall ICU is ICU is ICU. The actual unit culture, management and colleagues will probably be the major determinant of your job satisfaction.
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    May 22, '11 by K+MgSO4
    The hospital that I work in is one of the 2 trauma hospitals in the state and a tertiary referral centre. I know that we run a 6 month supported introduction for those from a different Crit care unit such as CCU or ED resus or those from overseas.

    I know that other experience is acknowledged but you are expected to do a grad cert within a year.

    Good luck with fighting with AHPRA it took 2 months to get my practising certificate for this year!


    Hi. K+MgSO4.

    Would like to ask what's your hospitals name.;-)
  10. 0
    PM sent


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