Tiwi

I know what you mean re: being a new grad and not knowing anything. Just when you think you are going ok, a new situation arises. I find the staff on my ward are fantastic as well, and I ask lots of "stupid" questions. I guess the only way we'll learn is to ask the experts - the other nurses, read, and do it ourselves! As for talking to doctors et al, I think that will just take time. Find out what the routine is...do you go through your team leader or do you contact the doctor yourself when you need something done? The scary thing is when they ask questions of you about your patients, but I guess that is where we need to be on top of current, past and prospective care and history. Our docs are great...but I don't know what other hospitals are like. Like the nurses, I can ask lots of stupid questions and they are happy to give answers. I know I sound confident here, but often I go home and stay awake for hours stressing, thinking have I done this right? Once I actually rang the ward at midnight to tell them something; they thought it was hilarious.

I have just changed from adult to paeds as part of my grad rotation. I feel a bit like a fish out of water; I am in isolated paediatrics, but I am enjoying it.

This may be a bit political, but as I am working up here, I thought I'd fish around and see how others felt. I am really upset that the Federal Government has decided to "invade" our indigenous communities and restrict their livestyles without consulting elders. How long will they be up here, and what will the role of the remote area nurses be? I believe that any trust built up by nurses will be lost. I think too that ppl may leave their communities and either go 'bush' to avoid the influx, or come into town as all communities are now being made "dry". Speaking to some indigenous ppl, they believe that it is going to create an "us" and "them" situation. I understand the problem is serious, but I think a knee jerk reaction may be counterproductive. My last point...what is done in indigenous communities should be done in nonindigenous communities...

1.Shout...when someone wants to shout you a drink, it means they want to buy you one. Of course, you usually have to be polite and shout one back. 2.Blue...to get into a fight. 3.Down the track...this is one particularly used by Darwin ppl meaning to go south. you know, I use the colloquialisms every day and I can't think of any?

I've had the experience recently when I required assistance from the "Hospital in the Home" visiting nurses. It was great to get out of hospital; all I required was IV ABs, and I think this should be the way of the future. But as quickly as ppl leave the hospital to be cared for by the community nursing services, the beds are filled by acute patients, and the temporary wards and lack of staff continue. Out of interest, do community nurses suffer a shortage of staff as well?

I am unfamiliar with your system, however is there someone senior to this lady that is not ward based? Could you notify them?

Thanx everyone. It is really hard trying to find places as you all know, in a town/city you don't know. My dream would be to buy an old mechanically sound bus, turn it into a mobile home, toss the dogs and cat (oops and husband) and travel/work around Oz....

Nights are good, though not great for the social life

That helps. Where I am they are really supportive, so I'm probably in a similar situation. You mentioned joining me as an RN. When are you planning to do it? You should find it helpful to have that medication background...

"Whistleblowers" are brave ppl. You've definitely done the right thing, I can assure you.

We have computers in our hospital, but they are basically used for theatre lists, appts, location of patients, statistics :angryfire, handover sheets, and path/radiology results. We have been told that medication administration recording will be computerised, as will everything else. How do you have access to the different systems? Palm pilots? With paper charting, it too is not infallible - I have been in an incident recently whereby an assessment sheet I completed had gone missing which had legal consequences. Thank God I had overdocumented and put the score elsewhere, thus proving I had done it....

I agree that you had to report your concern to the charge sister. It's jumping the gun a bit to think she was automatically on drugs. There could be extenuating family circumstances etc etc. Regardless of her personal situation meant that you had a lot more responsibility that night than you should have had, and you were put in a potentially dangerous situation, due to this behaviour. I feel for you...

Is this patient on dialysis / in renal failure / have a renal impairment? I was just wondering if there would be any relationship between that and sodium loss. I know nothing about renal except basics, so I am just asking... I would have thought that you would lose sodium via an ileostomy.

I think no matter where you are in nursing, whether you have completed your study programme, or are currently nursing, that you can never go past: 1 Mosby's Medical, Nursing and Adult Health Dictionary - I have the fifth edition and would love to update it. 2. Hitner H, and Nagle B (2005) Pharmacology: An Introduction, 5th Ed, McGraw Hill Higher Education, Boston The pharmacology book is great because it gives you a simple outline of each system as well as the pharmacology side of things. It wasn't the recommended text for my course (ie I had the other as well), but it is an extra reference which I think you will find really useful.

Good for you! :smiley_ab

Oh, you are definitely not alone...I have just noticed that you said you would transfer at the end of January. I really hope that this experience is going well for you. I imagine the transition will be difficult, but if the ambience prior to you even going there is calmer, then I hope it has been good to you...

I'm interested in the new grad programme there, as it sounds so different to our own... 1. How long are you mentored 2. Do you begin having your own patients straight away? 3. How many patients do you start off with? 4. How long is your supernumerary period for? 5. Do you have rotations to different areas/wards or do you specialise in one area? That being said, I find it quite hard as well to pick up what is expected, as there is so much to learn. And I found that my uni training in some things were behind the times, which didn't help... I'm on a surg ward at the moment, but I'm moving on to paeds next, and am really nervous because I feel like I'm going to be walking into another world...

in hospitals around Oz? Where I am it can be M: 1 to 5 L: 1 to 6 N: 1 to 8/9 It would be interesting to see...

Thanks, I will PM you:smilecoffeecup:

I was going to suggest education, but someone beat me to it. I do believe old nurses deserve heaven on earth, receiving all the attention they gave with heart and soul over the years...

As an RN student giving meds, I had to have an RN observe me dispensing and giving to the patients, and every med had to be countersigned, even acetominophen (we call it paracetamol in Oz, so I hope I have spelt it correctly). And of course, like anywhere, those RNs loved asking curly drug questions :imbar . When I finally started giving meds as a qualified RN, it was so weird - I was still looking for the apron strings!

An EN is an Enrolled Nurse. They have their own patients, and if they are medication endorsed, then they give their own medications as well. A typical uni/college course can be found at http://eagle.ntu.edu.au/NTU/Apps/coursere.nsf/P_Course_Select/99610E1D8443F75169256DE60005EB78?OpenDocument ENs have their own patients, admit them, create care plans for them, use assessment and evaluation skills, much like an RN, and discharge them. They liase directly with allied health professionals such as doctors, physios, community nurses etc etc. They can give meds as per above. However, they do work under the indirect supervision of a registered nurse, who depending on the ward could be the senior, so they are relatively independent, within those guidelines. They are part of the nursing team... And there are now Advanced ENs, whose role I'm not quite sure of. ENs can also obtain specialty certificates, eg in psych. In Victoria, ENs are called RN level 2. Hope this helps...

I was agreeing with you ppl in my usual confusing way by saying I refused as an "underling" to pass/give meds simply for my own and the RNs protection. I think the difference in the two systems should not weigh this conversation down - my 2 cents worth became 2 dollars worth *grin*. So I'm going to look for my pillow, and give this poor keyboard a rest. Its 0050 CST in Oz, on Tues March 6th... so, nighty night.

Done! That wasn't painful at all! Best of luck...

Can students in the US give meds without supervision?