Australian nursing v.s. American nursing

Silverdragon102, BSN · Aug 18, 2016

Moved to the International Nursing forum

US RN in Oz · Aug 25, 2016

Although I prefer the Australian lifestyle and social aspects, when it comes to working and education in healthcare, America is the place to do it. I enjoy virtually everything about Australia, exept working in or consuming healthcare.

I've worked in both. My observations are based mostly on acute care med-surg, intermediate care, a little rehabilitation, and as a healthcare consumer. Anyone can feel free to offer another viewpoint of any of these are way off base.

Australia (Oz): Nursing is more task oriented.

America (US): More assessment, decision making, interdisciplinary collaboration, and patient advocacy.

Oz: Placement seems to be a major issue.

US: I never noticed any problems with placement.

Oz: The AMA successfully puts pressure on legislators that minimizes advancement of the nursing profession.

US: advanced nursing practice is highly encouraged.

Oz: I tell someone I'm a nurse and they say, "Oh", then either fall silent or change the subject.

US: Nurses have constantly been rated a the most honest, trustworthy, and respected professionals for over the party decade or so.

Oz: Nurses viewed more as subordinate.

US: View more as a contributing member of the team.

US: you can delegate work to LPNs, PCAs and RTs.

Oz: It's all you.

US: You will be using the latest technology in information management, communication, and med administration.

Oz: You will be most likely be using systems I haven't seen since the 1990's

Oz: The system is frustratingly inefficient.

US: Virtually instantaneous.

US: you well be expected to know every detail about the patient at handover or, if not known, able to pull up the info in mere seconds.

Oz: I've received a thorough handover only once.

Oz: Some physicians are good, but there are also a lot of incompitent hacks. They are not matched with the profession. They get bachelors in medicine and the path from there can be a bit dodgy for some.

US: It is rare to come across an incompetent physician. Medical school is post-graduate, there is limited space, it is very competitive to get in, and you have to be "matched" to a discipline.

Oz: You will be busy due to searching for the paper chart, clarifying orders, having orders written, getting lab results, toileting patients and in some situations, dealing with unsafe staffing ratios.

US: You will be busy trying to obtain high patient satisfaction scores from patients who are generally needier and, quite frankly, just big babies.

US: patients can be loud, demanding, and complete wimps.

Oz: Patients tend to be quieter and tough as nails. Although, when they do get nasty, it's bad. I belive assault rates on healthcare workers are higher in Oz.

Oz: You will see a lot more errors. This is attributed to the archaic system, not the workforce.

US: Although it does happen from time to time; medication errors, falls, pressure injuries and hospital aquired infections are know as "never events".

Oz: Delivery of substandard care is more frequent.

US: Some people are uninsured or under-insured. This deters them from seeking preventative care for chronic health issues.

US: Compensation for nurses is excellent and the cost of living is lower.

Oz: Compensation for nursing isn't nearly as good. Cost of living is higher, but the quality of life is better.

Oz: some nurses can't pass meds, place IVs, urinary caths, or NG tubes. Stellar bed makers, though.

US: Some nurses can't make a bed or wipe a butt.

RNsydneygirl · Sep 8, 2016

I've not worked in the United States but have experience in Emergency and now PICU across two states in Australia.

There are points Clarke Bar makes which are correct, however I would disagree that nurses aren't part of the team, particularly in critical care environments. Ive had very senior Emergency Physicians do exactly what Ive asked them immediately because I am concerned about a patient and have reiterated my clinical concerns with knowledge. I think if you're a nurse with knowledge and can justify what you want done for a patient you're going to be respected. For example; "I'm concerned this new patient whose arrived to the ED with SOB has a PE due to their history of sharp pain on inspiration, tachypnoea, low sp02, previously on Warfarin which has recently been stopped." versus "this patients isn't breathing too well?" Theres a big difference there and Ive seen wonderful nurses pick up things a doctor halfway into their training has missed.

Also in ICU we are the well trained individuals to make adjustments to ventilation and infusions to target haemodynamics and oxygenation, which happens long before a physician swings by unless the patient is in dire straits.

I definitely agree that there are limitations on advancement; my previous Emergency Department Medical Director blatantly said why train Nurse Practitioners when I can hire another Registrar?

Obviously with the research that comes out of the US the access to new technology and pharmaceuticals is greater than down under.

In regards to financial compensation I don't know the costs of living in the US, but Im a fourth year RN, 25 and will gross around $90,000 this year. Note this isn't enough to live off independently in our expensive cities of Sydney or Melbourne... but other places in Australia thats more than enough.

I have a colleague who worked in the US briefly who was trained to insert CVC's and ICC's - this just WONT happen in Australia.

US RN in Oz · Sep 16, 2016

There are points Clarke Bar makes which are correct, however I would disagree that nurses aren't part of the team, particularly in critical care environments.

Agreed. My context has only been med-surg, rehab, and SSU. Specialized nurses are more part of a team in Oz. Totes def. General nursing, not so much.