Published Mar 31, 2010
akj777
23 Posts
Hello all! I'm a senior nursing student in a BSN program in Michigan. I have been employed at a hospital as a tech for 7 years, so while I am not yet a nurse, I am no stranger to the difficulties that face nurses. High acuity patients, high patient to nurse ratios, arrogant physicians who treat RNs like dirt and never return phone calls (okay, they're not all like that...but a vast majority...). While I know that the grass is not always greener on the other side, I'm wondering what the differences are between nursing in the US and nursing in Ireland. I am aware that the health care system is different, though I am not completely sure what makes it different. I had the pleasure of visiting Ireland about two years ago and I fell in love. I am considering practicing nursing here in the states for a couple years to gain experience but I am looking ahead to a possible move to Ireland. Can any of you nurses who practice in Ireland give me a run down on what it's like to work in health care over there? Any information would be much appreciated. Thanks so much!
P.S--I miss Guinness. Once you've had it in Ireland you realize that something about Guinness in the states is sadly lacking. I don't know what that's about. Perhaps it was the atmosphere. Or maybe it's because Guinness in a bottle shipped from over seas just isn't the same as a Guinness built in a pub. Next time any of you have one, think of me!
caliotter3
38,333 Posts
I looked on a bottle of Guinness extra stout one time and was disappointed to see that it was brewed in Canada. Now that was a little surprising. Wonder how many have never looked on the label to discover that tidbit!
LOL, well that explains a lot! I live just across the Canadian boarder...so it's now safe for me to assume that my Guinness here is most assuredly NOT made in Ireland!
I thought I saw that the regular Guinness in cans and bottles, not the extra stout is brewed in Ireland and imported.
K+MgSO4, BSN
1,753 Posts
Hi will post later today or tomorrow when off nights!
Okay thanks!
I am also interested to hear what it is like and what the situation is currently for Americans to be able to meet their requirements for working there. I had read before that the European community was not too keen on hiring those from outside of the community. Rather perplexing a few weeks back when I saw an internet ad for nurses for an Irish nurses registry.
right, off the most hellish night I have had in a long time! 3 full spinal precautions plus 4 others including a delirious septic patient. Fun fun fun!! Anyway that is a different story!
OK first off my background.........I was educated in Ireland and worked in a hospital outside of the major cities of Dublin, Cork and Galway.........way up in the north west in Donegal! I worked in Letterkenny General Hospital so my experiences are based on that hospital alone. I studied for 4 years to gain a higher Degree in General Nursing BSc(Hons) gen. Nursing. there are currently 5 undergrad degrees in nursing and midwifery. general (RGN), Intellectual disability (RNID), Psychiatric (RPN) Sick children (RNSC) and midwifery (RM). If you have a qualification in one speciality you need to do a post grad to transfer to another speciality.
To get the ins and outs of registering go to http://www.nursingboard.ie. I am not to familiar with the criteria but it does state on there website that they do NOT accept applications from LPN/ LVN or CNA's.
The public hospital system in Ireland is funded through taxation and is the main entry point for most of the patients. The private system is a bit complex..... in the main cities there are private hospitals where people who have private insurance or want to pay privately for their healthcare can go but they have to be referred by either their GP or by a consultant in a public hospital and accepted by a consultant in the private hospital/ People often do this for elective procedures as the waiting lists are extremely long for non urgent cases (ie non cancerous / life threatening). Outside of the major cities a rather different thing happens. A patient can elect to be treated privately by the same consultant who would treat them as a public patient patient in an attempt to bump themselves further up the waiting list. These pt are treated in the same hospital and same ward as the public pt and are not gaurenteed a private room as the single rooms on the wards are allocated for infectious pt or palliative pt first.
The make up of the ward. Each ward is managed by a CNM 2 (clinical nurse manager level 2) often informally referred to as the ward sister. Often there is a CNM 1 who is the charge nurse and manages the ward in the CNM 2 absence. The CNM 2 takes charge of the ward 3-4 days a week and the other days is in the office or at meetings. If the CNM 1 is not rostered on a senior staff nurse will take charge of the ward. The In charge during the week 8-5 does not have a pt load. however after hours and the weekend they do have a pt load. ED and ICU are different as they always have a charge without a direct pt load but help out where needed and manage the running of their departments. After hours and at the weekend the bed manager is in charge of the nursing staff and the hospital usually as (s)he is the senior manager on site.
Assisting the nurses are Healthcare assistants (HCA) these are non registered assistants who assist the nurse with hygiene, bed making and feeding of pt as well as emptying drains and catheters. Dependent on the ward they may or may not be allowed to take vital signs (obs). On some medical wards they are but on the surgical ward that I worked on they were not allowed as set out by the CNM 2 and surgical consultants. There is usually 1 HCA to 2-3 nurses so expect to be making your own beds and assisting washing some of your own pts. If there are bed bound pt the HCA will assist the nurse with those first and then help the nurses to make their beds.
Physiotherapy and Occupational therapy and dieticians are very evident on the wards. Physios will assess pt mobility status and chests and do some interventions for those who have developed RTI. OTs become involved when a person requires help or appliances to assist them with their ADLs on discharge. Dieticians are involved in education and assessment of optimal diet and any supplements are prescribed by the dietician. Also TPN and EN guidelines are set down for the team by the dietician.
The ward may or may not have a ward pharmacist who will do an assessment of the pt meds pre admission and talk to the medical team about their medication choices esp antibiotics!
The medical teams are made up of a consultant, senior registrar, registrar, senior house officer and intern. All of these are licensed registered doctors and the hirearchy dictates that when a nurse is concerned about a pt they first go to the intern and work thier way up the chain of command. However often nurses will go to the registar directly if concerned about a pt.
Daily routine - Arrive to the ward and change into uniform - not scrubs but a uniform! Check the narcs and go to the office for report. Get allocated pt load usually 6 and start your day. The ward I worked on this meant 1 or 2 major bowel or urology surgery pt post op day 1 an ICU/ HDU step down an appendix or gallbladder pt and possibly an abdo pain for investigation or a palliative pt or pt form a NH with a bowel obstruction or pressure sore. Pathology team around to take bloods. Obs if not done by the night staff. A few differences from the US most wards do not have pyxis machines so it is taking the drug trolley into your 3-6 beded roomsand administering medications. Making up you own antibiotics the pharmacy doesn't send them up ready made! Showers or bed baths and bed making, Morning tea for the staff a 15 min beak for a cup of tea and toast off the ward while one of your colleagues looks after your patients. Back do the same for that nurse so she can go for tea/ update your fluid balances. Assist pt to mobilise. Dressing changes. Check blood sugars pre lunch and another round of meds. Vitals again. Rest period for the pt. nurses lunch break. Half an hour if working an 8 hr shift (paid) or an hour (unpaid) if working a 13 hr shift. up and down to X ray dept with pt handing them over to dept nurses and recieving pt from ED, ICU and collecting pt from Theatres. 4 pm tea break for the nurses working 13 hr shift half an hour (paid) for a meal. 5 pm. One of the staff nurses and in-charge goes off shift. Each of the other 2 nurses picks up her pt 3 each. Continue the day. 8.30 pm hand over to the night staff and they start a drug round and obs before settling the pt for the night.
Night shift. Pretty much as above!!
When applying for a job in the EU as Ireland is a part of the EU there are the same rules as apply to the UK. Irish citizens first, then EU citizens and if the job cannot be filled the rest of the world. I know of a few Australians who worked in Ireland in the past few years but a friend of mine (Australian) spoke to an agency a few months ago and was told that there was no jobs at the moment. Pretty much the reason I stayed in Australia!
I hope this answers some of your questions but if i went off on a tangent please let me know what you want to know and I will try to answer for you.
Slan!
Also student nurses. there are no clinical educators on the wards with the students only 2 co ordinators for the whole hospital. education and assessment of these students are the responsibility of the 2 nurses allocated to them on the start of their placement - anything from a week to 4 months. They are taught by the ward nurses how to be nurses on the wards. The students 2 preceptors have the power to fail a students' clinical placement if they do not meet the requirements as set down by the university. Obviously this does not happen out of the blue. first the placement co ordinator is contacted and a meeting is held, if there is no improvement then the student is placed on a learning contact where they have to meet specific goals in order to progress back to the original placement time frame, if that doesn't work then their link tutor is called in from the university for a meeting with the preceptors and placement co ordinator for a final chance to pass the placement. If that all doesn't work the nurse can fail them for not meeting the placement goals.
and documenting!! not very common i.e. rare for computer charting. It is all paper charting and paper referrals! If you want to refer to OT physio dietician etc it is a referral card and then fax it to their dept.
And no such thing as respiratory techs Trachy suctioning and nebulisers are the responsibility of the nurse and 2 daily assessment from the physio,
Your information has been invaluable! Thank you so much! If I can think of anything further, I'll come a-begging you for more info. Just curious, and not at all my business, so feel free to tell me mind my own, but how did you end up in Australia? Where you looking for a change or was it just one of those things? And do you find the nursing in Australia is much different than in the UK?
Not a problem! It is a very Irish thing to go travelling around Australia for a year when you have finished uni and worked for a year or so!! However the health service was in a bit of a crisis and I was told that my contact would not be renewed so off I went to travel. Fell in love with the life Down Under and got a permanent job so quite happy here!
Both my parents did something similar when they were my age as well mum went to the States and Dad to England so its in the blood!!
Nursing is quite similar to nursing in Ireland as it is a similar health system and attitudes and hierarchy! on the good side I work in Victoria and in the acute public sector there are patient ratios on day shifts only 4 per RN!! It is great coming from 6 but less HCA support. Also am working as a senior now so get the sicker patients!
Happy Easter.
WildcatJen
36 Posts
I, too, was curious about this as we lived in Eire for 3 years, and miss it terribly. My husband would love to return again someday, so I am looking at what is required to practice there. It is a bit dismal to think of the heirarchy and the economy has been such that jobs are scarce.
Thanks a mil for your info Karenmaire, Go raibh maith agat!