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Aged Care/Dementia/Palliative
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alsal41 specializes in Aged Care/Dementia/Palliative.

Endorsed Enrolled Nurse

alsal41's Latest Activity

  1. alsal41

    Working with pca's

    I'm glad I got to read this thread, it gave me a greater understanding of who feels what when. I don't want to sound down on either side in particular but ............ Having been a PCA in aged care, I can actually see her side ..... having worked with some pretty atrocious RN's, I can REALLY see her side. PCA's can be treated awfully .. maybe not by you, and maybe not by some of the rest of you, but there are RN's out there, who make Hitler look like the nice guy. You don't know who she has had to deal with before, and I'm actually impressed she actually noticed something wrong with the resident .. I've seen too many residents ignored by PCA's whilst an underlying infection turns septic, I've seen too many RN's blow off a cerebral bleed, a CVA, a heart attack. Yes, this PCA could have approached this in a much more professional manner, but sadly, there is a breed of PCA out there that do think they own the place and yes, a little bit of knowledge can be a dangerous thing. I am now a Nurse .. in a hospital, and there is no way, in God's earth I would go back to Aged Care even qualified now. Aged care is brutal. It's all about the damn paperwork and the $ ... I have worked in a variety of NH's and trust me, from the PCA side, they're all the same. Maximum nursing for minimal $, whilst the RN's and EEN's have to jump through the paperwork hoops, answer to supervisors who know nothing about nursing and only see the business side of things. Everybody is stressed. When I was a PCA, I had a resident having a stroke. I noticed one eye had blown. I rang the RN who said "So what?" 1/2 hour later, she had a lopsided smile .. rang the RN who said "So what?", yes, all minor things but I KNEW what was happening and nobody was listening. 1 hour later, this residents arm was paralysed, rang the RN .. yeah .. you got it "So what?" .. within 5 hours, this lady was fully paralysed down the right hand side .. THEN the RN rang the doctor .. bit late sunshine ........ pity the "caring" part was ignored *sigh*. That's one of the reasons I got qualified. So I CAN make a difference. So I CAN educate upcoming PCA's and let them, those at ground zero, help me give better care. I probably would have sat this PCA down and explained what I was doing and why. I'm asked to qualify my judgements in hospital, I would expect no difference in Aged Care. Yes .. ME TOO!!
  2. alsal41

    I married Santa

    That is just beautiful . . . and I think that's what nursing is all about, looking outside the box and taking the caring role that little bit further. You are a wonderful nurse, and your fiancee is a caring soul too. Thankyou!
  3. alsal41

    Melts in Your Hand, but Not in Your Mouth

    OH how so very true! I had a dementia lady who had been given metamucel to make her bowel motions have more form (she has IBS and often has loose bowel motions) ... well, one day, we saw her eating an oreo or something similar, until we got closer ..... yes, you got it. She had retrieved her bowel motion from her incontinence aid, patted it into a round cookie type shape and ........... (*shudder*) was eating it. When she offered some to the carers, the look of horror on their faces was obvious ....... one little non-compliant patient was raced into her room, teeth and mouth wash, shower, ewwwwwwwwwwww I still shudder........ lol Rule of thumb at my hospital is "never take anything that isn't wrapped" yes, well, I'll be telling them to watch out for just this case now ! LOL LOL
  4. alsal41

    No Name-Calling Allowed!

    That story *so* sounds like something I would do .... thanks for the laugh (and the warning, always look behind you LOL LOL)
  5. alsal41

    Misadventure in the Psychiatric Disease Department

    My son is in a psych hospital at the moment (he's a most unwell mess) and each and every nurse I have spoken to has been patient, tolerant and able to have a giggle whilst reassuring me at the same time. I love you guys!
  6. alsal41

    When Good Phone Calls to the Doctor Go Bad

    ? circling the drain????? priceless LOL
  7. alsal41

    The Voice of God

    LOL .. I have used that trick on a dementia patient who was not compliant with receiving any kind of care.. I crept outside his window and said " ****, this is God, have a shower, get dressed and have breakfast" and I heard him say "Hey, God wants me to have a shower! Hurry up" .. LOL-LOL
  8. alsal41

    Why I'm A Nurse

    I have worked as a Carer (Personal Care Worker or Assistant in Nursing) for 3 years. Looked after aging in-laws for 3 years. That's what spurred me on to get "official". I did Aged Care Cert III, then gained work and asked about Enrolled Nursing. Did Aged Care Cert IV whilst I waited for the waiting list to go down for the EN course. Got accepted to the EN course, then picked up a scholarship!!! I'm livin' the dream career! I would like to dabble in midwifery, but I think I will have to continue my studies and complete my training which will take 6 years (part=time) and I'm not sure if I really want to do that y'know? Right now .. I'm happy where I am :-) Cheers .
  9. alsal41

    Why I'm A Nurse

    HI there. I'm glad my story has touched a few :-) I needed to get it down in print, a bit cathartic for myself too. I am in the Cardiac step down unit (which is a good thing) and sometimes I help out in the Coronary Care Unit (Cardiac ICU sort of). I have spent the last 3 years in Aged Care as an Assistant in Nursing (actually, the cheaper version, PCW = Personal Care Worker). What aspect are you in? Cheers Sally
  10. alsal41

    another one !

    All nurses, RN's and EEN's have to do a medication competency when they start work with a new employer. That is, lots of little questions that involve the calculations. You get to do it mostly in your own time, you can liaise with other staff about it, you can use a calculator and in some aged care homes, you can take the exam home with you and do it quietly there. And as for hiring people from OS .. yes, telephone interviews are quite the norm. Cheers & Goodluck!
  11. alsal41

    another one !

    For example: I am an Enrolled nurse, but I have my endorsement (I can give out most but not all medications), so my employer has hired me as a Division 2, level 2 EEN, whereas another worker who does NOT have her endorsement, is only a Division 2, level 1 EEN. Yes, t'is confusing. I also heard that even when I finally get to Division 2, level 5, the pay rate difference is only about 30cents ... hardly enough to really fuss over eh?
  12. alsal41

    Why I'm A Nurse

    Sure! I'm glad you liked it :-) Thanks!
  13. alsal41

    Why I'm A Nurse

    I've wanted to be a nurse for as long as I can remember. I don't know why - I wasn't classified as a sickly child to have the aura of nursing invade my young mind. I remember being very little (about 5) and having my tonsils out, and tossing my "pinky" (soft toy) through the cot bars then buzzing for help and having this wonderful nurse come and give me pinky back and not ONCE did she get cross. I remember having my appendix out as a teenager, but all I wanted to do was go home. I wasn't interested in staying. So, no, no real immersion in the medial side I remember being told at school that I would never be a nurse because my maths was too poor. I remember my pleasure at becoming a medical secretary! I was close! And I remember my glee when I was hired as a patient liaison when Nuclear Medicine first came out in Australia. But always, in the back of my head ... "I'm not a nurse ...". Sure, I did some geriatric nursing as a teen, but got too involved, too emotional .. it was not the right time. Not then. But here I am now! I made it! And so, I began my new job in a flash private hospital, chuffed that they thought me clever enough to hire me (regardless of the nursing shortage, and knowing they hire anybody because they're desperate) here I stand. I am going to make a difference! I am not a tired, jaded nurse. I am here, doing the job I have wanted to do for so long, and I am going to do it with empathy, understanding, education, and love. My first patient loads weren't too mind-boggling. I'm too new to be given anything terribly complex just yet, but keeping on top of the meds and obs is enough in the early days with the odd dressing (I hate dressings ...) thrown in. I'm not allowed to play with the pumps, so I have to find an RN to do the tricky stuff, so really, my job, right now, isn't taxing enough. I had one gentleman, and I will call him Frank. A funny fella who would spit his upper dentures out constantly! He was a mess! His bed was a mess. His PJ's were a mess. He had food in the bed, on the bed, under the bed. He had tissues that had been shredded and mangled in the bed, on the bed, under the bed. I tossed him in the shower, cleaned up his room with the help of the domestic, and with fresh linen on the bed, hauled him out of the shower, put him back to bed, and in less than 2 minutes, he was a mess again! He was swollen and leaking fluids. His skin was so dry it was cracked and bleeding. He was on a fluid restriction and was miserable about it. He was hard to understand because of the lack of teeth, but he did have a jolly sense of humor. I dressed his dry and cracked skin. Sat down and found a happy balance in his fluid balance chart, wrapped his leaky legs up, and gave his wife comfort when she asked how she was going to cope when he came home. I discharged him a day or so later, knowing he was headed home, happy with a Fluid Balance Chart he could comply with, knowing home nurses were going to come in twice a day, 5 days a week to bath, dress and keep an eye on him, giving his wife a bit more peace of mind as well. 4 days later, he was re-admitted. Swollen up like a balloon. Apparently sneaking into the bathroom and getting more water doesn't count when on a fluid restriction! I sat in with him and the doctor when the doctor said: "your kidneys are failing". Frank shrugged and said, "So, give me a kidney transplant". The Doctor patiently explained that Frank's heart wasn't so good either, surgery wasn't really an option, and sadly, it's now only a matter of time before you die" Frank shrugged again and said, "look into other options doc, it ain't my time". The Doctor smiled and said, "not a hope, sorry". I was aghast. Frank obviously didn't want to go, but his body was failing him, yet he appeared unworried at an outcome the doctor made quite clear. The Doctor knew this patient well enough, to be honest with him and the expected outcome. "You won't be going home". 2 days later, Frank was on his way out. The children had been called. The wife was doing a bedside vigil. She was distraught. Frank was not expected to see the night out, and yet there were more children to come from far away. Frank wasn't given the palliative med's that would ease his discomfort. At last, in the early evening, the children and wife by his bedside, the vigil continued. Frank was having some alert moments, but fewer and farther between. As I tended to Frank, his hands made a movement towards his mouth. I laughed, and my colleague said "Whatcha laughing at?" and I said, "He's having a beer!" Yes, Frank was somewhere lovely in his head, having a nice cold beer. He was chugging away at a non-existent bottle, and loving every drop! I went out and told his family, and the boys immediately went and bought some cold ones. I gave them a sponge, and they lovingly wiped a beer-soaked swab around their Dad's mouth, and boy-o-boy did he suck on that! The next morning, I came on duty to find the man in the next bed had passed away, but here was Frank .. still gurgling and battling on. The wife was beside herself. Begging Frank to stay. To get better. She didn't know what to do if he left. Frank kept breathing but was more and more non-responsive. Moving him to hurt him. He was drowning in his own fluids. I was based with other patients, but this one touched my heart, perhaps because I wasn't there when my own father died suddenly, and I felt a bond with Frank and his family. I don't know, but I do know that I walked past his room and the wife came flying out to me, flung herself in my arms and said: "Oh thank God you're here, don't leave me". I was lucky enough to have a light patient load, and the nurse looking after Frank didn't mind the extra help, so I helped out as much as I could. Often, we would find the family in our handover room, nurturing their distraught mother. One daughter would come to be and we would discuss the hereafter as she doesn't 'do the God thing terribly well'. Another daughter wanted to pray constantly. The boys wanted Dad's peace. The wife? She wanted her husband back. There came a time when I said to here "You need to tell him it's time to go" and she looked at him, looked at me and said, "I can't do that, I can't let him". The kids rallied beside her and all agreed. It's time for Dad to go. "Not yet ... a little more time" she begged. By the next morning, Frank was, by all accounts, no longer with us. His body was functioning, but there was no response other than pain when moved. I dragged the whole family into a room and sat them all down. I held the wife's hand and said "Now c'mon .. what would Frank want? You know him best of all, what would he say?" "Let me go" she sobbed. The kids rallied around her. I noticed the doctor outside motioning for me to come over. "It's his pacemaker that's keeping him alive, and we need to turn it off. The family need to agree and understand" And so, in my first month of nursing, I sat the family down and explained to them a process I have never witnessed (or knew about at that stage!!). The children immediately said "Do it!" the wife, however..." not yet ... a little more time" she begged. The children sat her down and 15 minutes later she finally said: "yes, he's had enough". The doctor came 3 hours later, and the family was having a breather. They knew why the doctor was there and what was going to happen. We didn't know exactly what would happen when the pacemaker was turned off. Franks heart might go into its own rhythm for a little while, it might stop straight away ...nobody could give me a straight answer either. So, I held Frank's hand, while the doctor put the pacemaker machine's mouse on top of the pacemaker. He pressed a few buttons, and I could see a perfect rhythm on the monitor. He pressed a few more buttons, and it flatlined. As it flat-lined, Frank took a deep shuddering breath, flung his arms out and at that moment, a daughter walked in saying "should Mum be here?" I looked at her and said "errr .. yeah" knowing that as Frank relaxed on the bed, he was gone. He had a few more gassy breaths, but for all accounts and purposes, he was gone. It was that quick. It was an honor to be there. It was an honor to hold this man's hand while he passed over. I felt shocked, relief, horror and love all at one time. The family thanked me for my support, they dealt with their grief rapidly and were gone in 30 minutes after Frank had passed away. I fell apart after that, and an older nurse came up, handed me wads of tissues and said: "Be thankful you still have a heart ...." I still love being a nurse. I'm doing exactly what I was supposed to do, heartbreaking as it can be, this is what I am meant to do. I AM A NURSE. PROUD.
  14. alsal41

    Patient Care Assistant Pay Rates in Australia?

    Thankyou! Tonight I had my first patient load. 4 patients except one got discharged. But the buddy I had last night had two horror admissions so I ended up pretty much looking after the rest of his, so I really sorta had 9. Busy? Yes, but nothing horrible. I'm in a cardiac unit so unless they're having an episode, they're all pretty independent. Gives me time to concentrate on learning the little bits now :-) And the $ will come in handy LOL Cheers
  15. alsal41

    Patient Care Assistant Pay Rates in Australia?

    Having just left Aged Care as a PCW (Personal Care Worker), I was earning $17.49 at one job (because I have done Cert III and Cert IV in Aged Care) and in the other job it was $15.63 because they wouldn't recognise my 3,800 hours of *nursing* service and they didn't recognise my Cert IV. I'm now an EEN, and I'll be earning $21.39ph. Not a bad pay rise! LOL
  16. alsal41

    Nursing Career

    from an Australian point of view, I have been a medical secretary for some 25 years, and sorta fell into nursing by looking after my in laws for a couple of years. This gave me the confidence to do a "carer' course which gave me the skills to work in nursing homes. THAT gave me the confidence to accept a scholarship, and as of YESTERDAY, I am now a qualified Endorsed Enrolled Nurse. I have not long turned 47. This career has been what I have always, always wanted since I was a very little girl. So ...... *go for it* You've got nothing to lose, and as of Day 2 in the job, I'm havin' a ball! Cheers