Welcome to the Forum - General Aussie Chat

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Having been guilty myself of hijacking threads saying hello and just chatting to my fellow Aussies I thought it might be worthwhile for us to have a thread that is just dedicated to general Aussie chat. We can then discuss issues like the Morris - oops Davis inquiry in Queensland and what it will mean for Q health and for the rest of Australia.

We can talk cricket, sport and anything else that is just us.

Say hello to new members dropping by.

Generally find out what is happening in the rest of the country.

I will make this thread a "sticky" so that it will always be at the top of the forum.

Specializes in aged -adolescent.

Hi Talaxandra

The whole lot thanks, but mainly staff expectations. Take for instance yesterday a nurse told me that she was in trouble because she'd put 2 grams of vancomycin into 500mls of fluid. Now I wouldv'e though because I was told vancomycin is irritating that you'd need at least 1 Litre of fluid. Does this volume decrease though if the patient has fluid overload ? This girl has finished post grad. She also told me she first started on a bay of four and the staff were very supportive which is good. I am concerned in case they ask me to do a bladder washout for starters as an example or put a nasgastric tube in , I'e done neither, tried NG tube but didn't succeed, I can insert urinary catheters, change, flush and remove picc lines and do ECGs but there will be other skills I can't address at this level and they may find me wanting in some respects. I know there are some assessments you have to do as homework and that shifts are usually from 7-3.30,2.30-11 etc and what the pay rate is. I need help with fluid therapy because it scares me a bit and hints for getting the bubbles out of the syringe when you make up antibiotics and tips about safety and imeds, I am scared that my biggest downfall will be fluid delivery and not to panic when the alarm goes off. Sound familiar or am I just normal?

Specializes in Medical.

hassled, all the other grads will be in the same position as you on the technical front, though your aged care experience will give you a leg up on time management etc :) nobody will (or at least should) expect you to be proficient in things like performing a manual bladder washout, or even inserting a nasogastric tube - and that doesn't just go for grads. all of us have new skills to learn, all the time. for example, this week i learned how to irrigate under the foreskin of a man with balanoposthitis (inflammation of the gland and prepuce of the member) using a syringe and feeding tube! in all my years... and nobody's good at everything - some people are brilliant at phlebotomy, others at ng insertion, or at talking down confused and aggressive patients.

about the specific issues you raised - vancomycin needs to be infused well diluted and slowly because of a condition called red man syndrome.

it typically consists of pruritus, an erythematous rash that involves the face, neck, and upper torso. less frequently, hypotension and angioedema can occur. patients commonly complain of diffuse burning and itching and of generalized discomfort. they can rapidly become dizzy and agitated, and can develop headache, chills, fever, and paresthesia around the mouth. in severe cases, patients complain of chest pain and dyspnea. in many patients, the syndrome is a mild, evanescent pruritus at the end of the infusion that goes unreported. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=270616

the speed is most important, and 500ml (let alone a litre) is a lot of fluid, especially in a compromised patient. our renal patients, who are often on a 500ml daily fluid restriction, have vancomycin in 100ml but over two hours - giving them a litre of fluid with just one drug would put them into acute pulmonary oedema!

it's good to have some concern about giving meds and running ivs - it's easy to become blasé about them after a while, and lose sight of how potentiall dangerous mistakes are. what aspect/s of fluid delivery particularly concern you?

getting all the bubbles out isn't a big deal unless you're administering something like insulin or morphine, where an air bubble will result in a big difference in dosage. small bubbles can be absorbed by the patient in a push, and with practice you'll develop an efficient technique for drawing up fairly quickly.

pump alarms will go off with such regularity that you'll lose a sense of urgency in no time. the important things to remember are: read the alarm message (so you're dealing with the right problem), and check the line from one end to the other rather than focusing on just the cannula side, or just the fluid side.

the golden rule of nursing - when in doubt, ask for help :) i think you're going to be fine. i'm usually more concerned about grads who aren't afraid than those who are cautious. good luck!

Specializes in Med/Surg/Ortho/HH/Radiology-Now Retired.
for starters we sandgropers are tribal, not parochial and the reasons for not accepting your comments was we had already tried it that way and it didnot work!!

since i'm married to a "sandgroper", you can tell me nothing about them!

and, sorry to disagree with you, but... they are parochial! very parochial! as for having 'already tried it and it didn't work', ha!

the place was so bloody backward, it still used wood chip heaters in the houses! a pre-requisite for moving there was to bring an axe to chop the wood! :rotfl: :rotfl: :rolleyes: :uhoh3: :stone

Specializes in Med/Surg/Ortho/HH/Radiology-Now Retired.

i am from queensland and i am used to those who live round that overgrown coathanger that they have down there bagging us!!:D it's jealousy - that is what it is:p

actually i find that it is more institute driven. unfortunately there are some institutes that because they can lay claim to being the biggest or the newest or the oldest, think that they are also the best and do not need to listen to anyone outside of that particular institution. happens everywhere - the outsider is bullied and put down because they dare to suggest change.

g'day mate!

us 'southerners' jealous??! never! :rotfl: :p

and, you're dead right about an 'outsider' being put down or, worse, bullied because they dared to suggest ....anything! back then, those folks were so insecure about themselves, they just didn't want to know, learn, share, you name it! it was unbelievable! and, from what i hear from very reliable sources still living there, not much has changed!

that aside, it mostly is institute driven, i agree with you.

hi iam jade from philippines, i just need some advice.... i just graduated BSN last march 24... my aunt in victoria can help to work in australia as a care giver. but the thing is I want to register as a nurse in victoria.... am I eligible to apply victorias Board even Iam not registered here in the philippines

Specializes in aged -adolescent.

Hi all

Even though I am finally an RN, Iwant to ask you all about something that happened as a student. I made a med error and gave the wrong oral antibiotic to a patient and was suspended from clinical. My preceptor had to go and get the DD keys as the patient also wanted something for pain. At all times I had the chart. When I was hauled over the coals later, the preceptor told the person in charge she had the chart. I said "No, because I was going to bring it into you after you got the drug keys and I wouldn't have given anything without it because it's not legal" . I had told the patient not to take the tablets (antibiotic and panadol) until I had had them checked by preceptor and put them on bedside table. I took the med chart while I looked for preceptor and in that time the patient had taken the tablets prior to them being checked. When the preceptor bought out the medication from the treatment room, the tablets were gone, so I pointed to the box I had taken it from and was told it was the wrong one. I felt terrible, apologised to the patient and said " I am very sorry and I will need to fill out an incident report" to preceptor. This preceptor on her report about me said that I was not duly concerned about the incident. Nothing bad happened to the patient but I still feel that I was done over, so to speak. I made the mistake though and the responsibility rests on my shoulders. The incident report of which I was given a copy, really made me out to be very negligent but I knew I had that chart in my possession at all times. Was she just covering herself as she should really have had that chart in her possession when she took out the meds from the DD cupboard so she and her other RN could check the order and dosage?

Specializes in Theatre.

I have been navigating my way around 'allnurses' for sometime now - glad to find Aussie Chat amongst all the US orientated postings. I have trouble with some of the US terminology!

Welcome to jdelyn from the Philippines - suggest you contact the Nurses' Registration Board for infomation about registration, but remember you also have to get a work visa.

Specializes in Theatre.

hassled

This situation was a learning experience for you in more ways than one! Remember always complete an incident report yourself, even if someone else is also reporting the same incident. Detail facts & avoid emotion or subjective comments, if possible identify a witness, and keep a copy!

Everyone will have a different version of the same situation. and a desire for self preservation (or fear of blame) can lead to a variation in account of events. Forget about your preceptor's attitude and actions in this situation - you can't change them now. Learn from the experience and move on. The situation did not have a disastrous impact on your career - you were a student when it happened, you are now an RN! Nursing can be emotionally draining and you don't need the angst associated with past situations dragging you down.

Have a great career in nursing!

Specializes in ICU.

:groupwelcome:

Can I say that is excellent advice Nambour?

Specializes in Theatre.

Thanks Gwenith! Hope it helps hassled!

Specializes in aged -adolescent.

Thanks Gwenith and Nambour. It does help and I did burn the copy of her report so I could move on. I just wondered re other opinions so now I can bury it. Much appreciated. This site has probably meant the difference between nurses carrying on and giving up and we don't want any of them to give up.

Specializes in ICU.

Hassled I did try to Google the answer but I could not remember the current title of the legislation. Originally it was titled the "Drug administration act" but I think that has been changed to the Therapeutic goods act. Anyway some years back I had to Give a lecture on this subject and realised that the legislators had neglected to even include students!!!:eek!

I think, and now I have stumbled on this my curiosity bump is well aroused, that legally you are not in the equation as SHE, as your preceptor, was the person and the only person who is able to administer drugs to the patient. You are doing so under HER registration.

This is going to be like an itch I cannot scratch until I find the answer:p

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