US RN new to Australian nursing

K+MgSO4, BSN · Mar 24, 2018

Holy hell!

I need to nap as I have been up all night with crewing for Trailwalker. Will try to answer some of your questions later.

sparticus2008 · Mar 24, 2018

What I can answer:

- registration is May to May, so it doesn't matter if you registered in May or March, you need the 20 hours CPD. (australian college of nursing has great online things)

- it is hard for grads to get positions because most places want experience. Most grads get what is know as a graduate or transition job which is a 12-18 month contracted position (paid at the normal rate, but no experience required, to help get a foot in the door & consolidate skills). Some do include ICU/ED rotations however you will not be eligible for graduate programs, as their order of preference is: Grads from that state, then Grads from Australia & NZ, then some will consider grads on a permanant work visa if they have places (which they don't, most states don't have enough for their state).

Standard Grad program structure is:

- 3-5 days orientation

- 1/2 weeks superanuemery (basically as extra staff)

- then you're on your own (i mean there are education staff etc to support you, but you are managing your own patient load)

- most grad programs will do 6 months in a med/surg general field & then 6 months in a more specialiased field, however it does vary

- you will not get a graduate program which is just ICU.

- It will often be easier to get a job if you are willing to go rural/remote

- most agencies & aged care facilities will request 2 years experience

Nurse Practioners:

1. You need as a minimum: 2 years full time work as a nurse in the specialised area (no time limit on how long ago) + 2 years recent experience in the specialised area in an advanced nursing role, clinical nurse, cinical nurse specialist etc (Recent means must be in the last 6 years)

* so yes you would need at least 4 years experience in ICU to become an NP However as far as I am aware there are no NP's employed in ICU's.

They are more commonly found in ED's & rural/remote. Some also have established private business doing things such as employment health checks.

Graduate certificates/diplomas/masters

- entry requirements depend on the course, but you do not need a gra cert or diploma to go into a masters.

Agency: Paid more but shorter shifts. So you get 20% shift loading as you are casual but you will typically work a 6 hour shift. Pay rate & penalities vary between the states. You will also be the first one cancelled/sent home if census decreases.

crok63 · Mar 24, 2018

So hello . . .

so u R an american RN, first of all i am going to tell you to go home and forget about working in Australia ! ! !

The reason ? ? ?

I am an ex-advanced care paramedic with 20 years service in Queensland and now a RN, plus i have lived ( not worked ) in America [ Florida ]. So simply put , if you land any nursing gig in Oz it is probably going to be two or three times better than 75% of gigs you will eventually have to go back to in the USA ...

Basically AU is a societal / welfare driven nation and America is primarily driven by the dollar factor. Thus most likely your always going to work harder in USA than Australia ; so if you do work here do not expect such treatments / conditions when you go back to N. A.

Next is YOU, i am going to post info for a 25 year old female ; please understand i am in my fifties and a guy, but been in Oz QLD HC my entire life ...

med/surg is your best bet, i will assume you do not want prisons or aged care or psych , they tend to be the big three people stay away from here. So they are an almost guaranteed placement 4 u. But they will not give you transferable skills.

Agencies will not touch you, simply because their placement contracts mandate one or two years experience. Thus they are an excellent place to try first to give you more knowledge of interviewing and making contacts ...

if you go rural you might find a j-o-b in a smaller hospital. my first job was a town of 999 people. if you go this small you get to RUN the hospital LiTERALLY. the doctor is offsite ( but close ) and once the NuM / DoN is offduty you run everything, thus by yourself with an EEN you get the ER / Acute / pharmacy / adminstration = EVERYTHING !!!

Hospitals around 20,ooo pop you might get FREE accommodation in demountables for the length of your short contracts ( under 6 months ) . If you go for anything over pop of 25,ooo your going to strike larger units and a rather competitive entry interview.

Anything in a large town or city is going to be very limited since your going to either have to kill an experienced nurse to get in or compete against highly skilled exp nurses.

Do not even think about TRUE rural, these hirings are NOT for you ! ! !

" the outback " [ literally , beyond the ' black-stump ' ] ( its an old tree ) is NOT the place for you unless your a VERY resourceful and skilled nurse ...

places like the N.T. and north W.A. want an absolute min of 3 years experience. Most will hang up on you unless they smell 4 or 5 years experience.

i work only for QH. they will want TWO CURRENT references, probably proof of immunizations and they will do a police background check. You might need a working with kids card but most RN's are exempt ...

( oh i forgot to mention , i used to run an nurses website for preparing for the NCLEX ; which i have passed in USA BTW, just as info i mention that ).

Do NOT worry about anything from AHPRA, your details will be online ; you do not need anything in writing saying your a nurse or not. You will be on the national registration database ...

my advice . . . run home to the usa and get another 6 months RECENT experience.

try anything and everything, but med / surg is the best bet ...

if you cannot land anything then try volunteering and networking ( which you should be already trying now ) . In nursing it is NOT what you know it is WHO you know for new grads ! ! !

as an RN you CANNOT work as a EEN (LPN) nor as an AiN ( Asst in Nursing ), that is an AHPRA rule [ ie : your 'over-qualified' ] ...

if you cannot find work within six or 9 months as a new grad, then go home N.A. and get experience ; or CANCEL your RN AHPRA rego and get a j-o-b as an AiN. Then make connections within units that you have already worked within and once your known and accepted if your offered an RN job simply RENEW your AHPRA RN Lic. [ do NOT tell AHPRA your going to work as an AiN etc, ] You MUST do a separate different course to be a EN / (LPN) in Oz.

in fact if you thought that was some bad news, expect experienced nurses to be caty and demanding. Nurses Literally " eat their young ", as you should already know by now ...

in addition, new grad positions are generally by special application and those processes are restricted to nurses with less than 2 years since graduating AND/or less than 6 months experience. so just be aware of that ...

my advice, really spick up your resume and make it relevant for the EXACT position your applying for, plus have generic resumes since MANY people will want to read your resume and 99.9 % of them will NEVER give you any feedback or acknowledgement.

show recent learnings ( i use nurse.com [ US$ 50/ year ] ) and get a copy of every short course i complete. show your a life long learner and the best thing you have going for you is an upbeat attitude, be a people person, politically correct and self-confidence ! ! !

FAKE it till you MAKE it is the golden principle in nursing and especially for getting a job ! ! !

be aware there are literally HUNDREDS of " pack nurses " in Oz, these are experienced nurses who travel around australia doing short term contracts 3-6 months for nursing agency's. If your planning on killing anyone you will need to knock these off since they are the ones holding jobs in your most likely hiring spots ...

I myself have a secret weapon to getting hired ( i have 15 months of exp in three locations now ) and no sorry i am not publicizing it ! ! ! oh it is not bribery nor blackmail :)

Contact those who are LEAST likely to hire you and sniff around working your way from the outside INWARD. eg: if you want a job in some preferred location then start at outlying places and make contact as you work inward so your primed up and organised / ready for the real interview at your real preferred location.

expect questions about patient care . generally they ask your initial actions in a sudden collapse, how you would handle an unexpected physical or medical or personal emergency.

be aware of things like elder abuse/ mandatory child suspect neglect reporting and the mental health act etc...

above all , do not burn yourself out ; if you keep hitting brick walls in applications , well SH** HAPPENS ; pick yourself up and dust yourself off and police your positive attitude off and prep better for the next rejection ! !!

good luck and keep going . . .

/ Hugz ...

K+MgSO4, BSN · Mar 25, 2018

Ok

Lets do this.

1) You need to complete all required CPD despite the length of time that you have been registered. AusMed is a good, free ap that you can use.

2)Check the AHPRA register of practitioners. HR want to check your current rego online not a hard certificate

3) If you have worked more than 600 hrs since initial registration you cannot apply for a new grad program

4) there are more graduates than there are graduate program positions. There is so little clinical hours (compared to my Irish program where I did 2,850 undergard clinical hours) that a grad program is required which is a supported transition to practice year

5) You may be OK going regional or rural but please stay away from remote. You do not have the skills to do it and you don't even know that you don't have them. Medications are different, policy and practice of Australian nurses compared to USA. there are many inland towns and cities that you could go to that young grads don't want to go to as they want to move to the big lights of the major capital cities.

6) My Quaternary trauma centre is not going to accept you to ICU without a clinical post grad or a transition to specialty course (these are often internal programs where you have to be employed by the hospital first to transfer into them). ED may accept you but you would be hanging out in general cubicles nowhere near triage, trauma and resus unless you have a post grad or are in a program

7) New grads that get into TTPP are usually offered 2 years - 1 year TTPP and then another year of guaranteed work either on a ward they apply to or on a pool / nursing resource team

8) New grad programs here are very different to what I read about here on AN. You have 1 week of orientation / supervised practice then you have a patient load. your preceptor also has a pt load. The way I manage my ward is 6 weeks on same shift and first round of nights together. My hospital does 2 x 6 months, others do 3 x 4 moths

9) Agencies are used to fill short notice shifts such as sick calls or increase in acuity such as 1:1 specialling etc. My hospital has a massive focus on reducing agency use so joining bank (internal agency) or pool (guaranteed shifts just not guaranteed ward) may be a better option with greater education support. I had 2 years experience when I joined an agency. It is about being adaptable but aware of your own limitations e.g. I was called to cover a maternity ward - I am not a midwife so was in post natal with a midwife. All maternity units are staffed by midwives in Australia

10) Any agency that takes new grads is in it for the $$

11) ??

12 & 13) General agency work in cities is short term shift by shift bases. When I have worked remote it was a 3 month contract similar to what US refers to as "travelers"

14) Agency is the first to be cancelled if there is no need for the staff member e.g. part timer, pool or bank can pick up

15) pros - not getting involved in ward politics, picking and choosing availability, refuse to go to certain wards / hospitals

cons - no sick leave / annual leave pay, first to get cancelled, limited shifts available in Feb -May period due to last year grads filling staffing gaps, often get the worst patients if ward staff want a break, often going back to poorly staffed / poor culture wards due to staffing issues

16) Pay is at a premium compared to regular staff, but no sick leave, annual leave. Super contributions fluctuate due to work

17 & 18) casual is another word for agency, or bank. Irish & English nurses either work agency, bank or some join pool and then move to a different employer after 6 months. I can only talk for Victoria public systems but each hospital is a separate employer.....not sure if QLD, NSW, SA public are the same. There are also multiple private hospitals where you could work as well. While most networks are national there are enough that you can work in the same city for 2 private health providers

19) Practice nursing is working in primary health in a General Practitioners. Pay is not regulated as the GPs are independent employers and are not bound by enterprise bargaining agreements (EBA). It is often used by international trained nurses who cannot get any other work or by highly skilled nurses who need a better work / life balance with young children etc-- it is very varied and under regulated

20) plenty of graduate programs, they are run in conjunction with a hospital and university. As a non resident you would be required to pay full fees, no access to HELP or HECS.

21) NPs are not used in Australian ICUs. There are some in EDs, diabetes, IBD etc but I have never seen one in an ICU.

22 & 23) Yes - grad cert, diploma, masters

24) aged care - under staffed, private industries that are all about the $$. New grads don't have the support or clinical knowledge to do this role safely. You are also managing a team of ENs & AINs

Other things to consider

Most Aussie wards still do rotational shift work

Pay is non negoitalbe via state EBAs Victoria is the worst paid state but has mandated ratios

If you are looking at PR stay away from the major city trauma hospitals and aim for referral hospitals in outer suburbs of cities, regional towns, private hospitals that are expanding. Off the top of my head, St John of God, Epworth, Ramsey, St Vincent's Private and Mercy Private are all expanding.

While pay is controlled by EBAs for health employees as an agency employee you are working for an independent contractor and that is why your pay is higher as the agency are providing staff to fill shifts.

I have worked 9 years in Australia. i am a ward NUM. My recruitment is looking for highly skilled, experienced nurses are there is a glut of junior nurses looking for jobs but not those with experience.

Scooby-Dooby-Doo · Mar 25, 2018

Thank you all for the responses and the insights that you've shed light to. I have a better understanding of how many things work now. I will try my best when it comes to job hunting, and have been given hope that it's not all bad! I'll be coming on a working holiday in hopes for PR next year. Thank you so much again!

K+MgSO4, BSN · Mar 25, 2018

Another consideration is that that health insurance is not provided by employers in Australia. You will need to source it as part of your visa requirements as you will not have any reciprocal rights.

However depending on how much and where you work you should have a delightful tax return when you lodge with the ATO at the end of the financial year. I bought a decent second hand small car with mine when I was on my WHM visa ( RIP potatomobile).