helloworld

Where I work the typical nurse to patient ratio varies with acuity. We have several areas - resus is ideally 1:1 but often 1:2 when really busy, but they don't tend to linger in resus long if the systems are working as they should and patients move on to definitive care (OR, ICU, etc); monitoring (cardiac and more unwell patients) is 3:1 with a coordinator assisting and coordinating patient flow in and out of the area, and acutes (your renal colics, abdo pains, etc. area) is 1:6. You generally have a float nurse wandering around assisting if resus is not too busy. The ambulatory area can be 1:12 and often worse, but these patients are basically GP type patients so not too heavy, but it can get frantic. These ratios can vary with staffing, and turnover can be high in both ambulatory and acutes. Because of six hour targets to move patients out of Emergency Departments within 6 hours in New Zealand hospitals, most EDs now have designated short stay areas where you keep patients who need to be in the department for more than 6 hours but won't be admitted under a specialty team. These tend be 1:4 or 1:6 as well. Bear in mind that I'm speaking for my setting and for some of the EDs I'm familiar with in the Auckland area, this may not apply to Waikato. In the ED I'm quite independent as a nurse. Once I assess a patient I'm able to initiate a lot of the investigations, cannulate, order blood tests and initiate standing orders for pain relief. We have a duty consultant on every shift (what you'd call an attending) who i can approach for things that aren't on the standing orders that I think a patient needs and he or she will sign them off for me. Of course the duty consultants have to trust the nurse who's approaching them to ask for stuff, so you have to have proved your competency and shown you know your stuff and if they're unsure they'll come and eyeball the patient and get a bit more of a story, but they're usually happy for us to order preliminary stuff. Again this will vary from ED to ED. In my ED nurses are treated with respect and as an integral part of the team, and they're acknowledged as knowledgeable colleagues. Yes there's the odd weirdo who thinks we're still the handmaidens of the doctors but those weirdos are everywhere. I can't speak for the wards, but that's my experience with working here. Hope you find that helpful, and bear in mind that it might be helpful to pay a visit to the actual place where you want to work and have a chat with them, and maybe even pay a visit and do a temporary contract and see how you like it, maybe get one of those working holiday visas, it's a great way to check a place out without committing fully :) Good luck!!

I have worked in the US and now work in NZ (but not in Waikato), and while I love NZ (there's a reason it's called Godzone :) ) it's not 100% paradise, like every other place on earth it has its pros and cons. If you ask me specific questions I'll be happy to answer them. I work in an ED, inner city, super busy, Trauma 1 teaching hospital. NZ unlike the US is not very litigious so we don't practice under the gun fear of being sued nursing, which is kinda nice. Tell me what specific questions you have and I'll give it my best shot.