Aussie nurse trying to Understand Canadian Nursing

[AussieKylie]

Hi there

Okay, I asked if I could watch a nurse draw up morphine and sign on book. I was waiting for another nurse to come in and witness the vial that is being drawn up, the date, pretty much the 5 R (Right patient, right route, right drug, right time, right amount). Anyways, things are so much different here in Calgary or if its national wide too. As back in Oz, we get the drug keys for the restricted drug medication cupboard, have another witness and count the drug and sign out how many tablets or vial/mgs used. Check the drug, the order, draw it up, sign the drug book, and we both go to patient and have patient tell us their name, check their patient number and allergies.

Though at the moment I am not nursing in Canada. I am inquisitive and looking at what happens in the units here. Its hard to break a system of what is taught back in Oz and watching what happens here in Calgary.

Pretty much what I witnessed is that one nurse gets drug, draws it up and has another nurse witness how much disposed and sign.

Anyways, I wish there was a booklet with what Canadian Nurses do with medication administration.

Any other info you wish to share with me, I would be happy to know

[loriangel14, RN]

It may be different where I work but the only things we have witnessed and cosigned are any wastes of drugs.We handle a fiar bit of palliative care where i work and a lot of morphine, it would take a lot of time if we needed two nurses to draw up morphine. We have computerised med cart with the narcs in it on the floor so everyone has access( we each have our own code).

[Fiona59]

Pretty much the same system here. Only wastes are witnessed. Counts are only done prior to shift changes. Our computer system keeps track of the amount that should be present on the carts. It's always a female dog to make sure everyone logs off the narcs at the right time.

The only thing that we are really vigilant about the drawing up part is Dilaudid 10mg. Somewhere in the region there was mix up/overdose due to it and we're all being told to double check that one. We rarely use it or have it on the unit, so in reality it's not a biggie.

The UofA has the pxysis system but I've never worked with it. The health region keeps threatening us with it but have never spent the money.

[Corvus]

Don't fear the Pyxis! It's really nice not to have to fetch keys every single time you need narcotics.

Also, Kylie, don't sweat it. Much of the difference will be site-specific policy and procedure, which you really can't learn until you're actually working. Have you looked through a Canadian basic nursing textbook? That might give you more insight.

[Fiona59]

Don't fear the Pyxis! It's really nice not to have to fetch keys every single time you need narcotics.

Nah, we don't do the keys thing. We have the carts with the narcotics that you access via a PIN number.

Oh, a

[Fiona59]

Don't fear the Pyxis! It's really nice not to have to fetch keys every single time you need narcotics.

Keys? We have the carts with the locked narcs drawers that you access via a PIN number. Every nurse has a PIN, so in theory it can be determined who accessed and when.

I think the OP needs to stop thinking like an "Australian Nurse" and think like a nurse on her unit. We've got a batch of New Zealanders in my hospital who aren't having any difficulties with the way we do things. As a few have said, they found the orientation to Cdn. nursing course helpful.

You never forget how you were trained, you just have to adapt to the flow of where you wind up.

[AussieKylie]

So what happens with the use of PCA's and Epidurals?

I would love to know more about Canadian Medication Administration. I am oblivious as I wasnt trained in Canada and only in Oz, obviously. I am used to the way Oz nursing is done. Yet I would like to know how other International Nurses coped with adapting to Canadian way.

[Corvus]

We had keys at the Mis. PITA, I tell ya.

[AussieKylie]

I am actually not working as a nurse as yet. I am just watching how some nurses do things. If there is an opportunity I watch.

I am in the process of trying to find out where I am gonna work.

I do apologise if I am offending anyone. I am curious and just asking questions thats all :)

[Corvus]

I don't know how different Australian nursing is, but I suspect it isn't as different as you might think it is.

If you have access to a library, leaf through something like Potter & Perry. It gives a good rundown of the Canadian health system, too, which is something you'll need to know in order to practice there.

[AussieKylie]

Thanks Corvus, I know that book, I used it so many times in my essays back home. It really is a good book

[Fiona59]

PCA morphine, dilaudid, are kept on the narcotics carts or cupboards. Two person to change, start as two sigs. are needed for the flow sheets.

Epidural bags are sent up every 24 hours by pharmacy and kept in the fridge. Two person to start, change and discontinue just like the PCA routine.

The biggest pain with the PCA is someone usually forgets to return the key (which is also counted every shift) to the lock up and you wind up doing a "keys to the desk call".