steve0123

Did he get too much morphine? Intravenously - perhaps 8mg is a bit much to push in one go. IM/SC - not at all.

I believe that I have no right to expect others to abstain/refrain from smoking. Just as no one else has any right to expect me to behave in a certain way. So what if it's harmful/addictive/etc! We all know it! But some people do it anyway. It's their choice, so pardon the punn, but BUTT OUT! I'm a non smoker, but I have my own share of vices that I'm quite happy to continue with too. So smokers, I'm on your side! Enjoy those ciggies while you still can.

Hi- I've been trying to get this information from the Californian Board (for LVN's), but have not had any luck getting an answer... Any help you can offer would be very much appreciated! I am an Australian Registered Nurse (Bachelor's degree, five years post registration experience up to and including ICU). My undergraduate degree was a little bit short on pediatric theory, and in order for me to become an **RN** in California, I would be required to undertake remedial education in this area. Am I able to use my qualification and experience to become an **LVN** without having to go back to school? Also, what are the employment prospects for LVN's? Does the same shortage exist, or would I be taking a job that really should be filled by an American citizen?

It depends how keen you are to start nursing in the US after graduation from an Australian university. It's a long process (as other posters have stated, as your program of study will be scrutinised by the US Board of Nursing to ensure it is comparable, etc), but it is possible if you have the time. I just have two things to add to this forum: 1) Make sure the course covers ALL the US requirements - many universities in Australia are deficient in Paediatrics and Obstetrics theory/clinical hours (but then again there are many that are not). 2) The graduate entry courses you suggested (such as Sydney University's masters program etc) might not be acceptable. Some boards require the program of study to be strictly an undergraduate course. I know it's senseless bureaucracy, but it's just the way it is...

I've been in the game for seven years. What used to get me out of bed was knowing that I was doing something good that couldn't be bastardised for the profit of some fat cat somewhere. Now I've gone about 180 degrees, and I've come to realise that I was just deluded by youthful naivety. It took about seven years for me to really see and understand the true nature of the beast and all the interacting elements that continue to see the profession (as a whole) underpaid, overworked, and severely undervalued by both patient's and allied colleagues. So I amputated most of those altruistic attachments I once held to the job, and found myself a series of brilliantly paying contracts. I'm now roughly 75% in it for the money, and 25% in it because it's "what I do", at least as a stepping stone to my next career. Sorry Sissyboo, but this notion of nurses as angels from heaven with an unshakeable belief in back breaking labour being it's own reward is something that you'll soon learn doesn't really work in this day and age. What gets me out of bed these days (and I'm not the least bit ashamed to state this) is knowing just how fat my paycheck will be at the end of the week. And you know, I think I'm happier at work and provide much better patient care as a result!!!

Good call. I think that's a very sensible and much more helpful alternative to the ridiculously PC "non adherence", which achieves nothing more than the term "non compliance" anyway.

What's special about male nurses? I don't know, but one thing that makes me so ANGRY is being called a "male nurse", as though it's an entirely different job description. I do everything the girls do, and I happen to think I do it pretty damned well! My brothers know this term is my achilles heel, and take great delight introducing me to people as their brother, "the male nurse"...

There's nothing I like better than a debate over medical semantics... To those people who find the terms "non-compliant" and "denies" distasteful when used in the context of patient behaviour or responses to questioning, I say pull that stick out of that place it's sitting... The patient approaches the health care practitioner for help. The health care practitioner responds by prescribing a treatment regime. The patient either complies or does not comply with that regime, meaning they are either compliant or non compliant. "Non adherence", in this context, is a synonymous term, and the benefit of "increased patient autonomy" it offers is mere rhetoric: the patient is no more autonomous by not adhering to the prescribed regime as they are by not complying with it. Similarly, when a patient is asked a simple question, such as "are you a smoker?", and responds in the negative, they are confirming they are not a smoker by denying the alternative positive response. Thus, the patient denies being a smoker. When used in the context of a medical examination, it is possibly more accurate to state that the patient denies a direct question rather than interpreting their responses as gospel truth, as the health care practitioner may not be able to state with any great deal of certainty that the patient is in fact telling the truth. For example: "Mary, a 70y lady with chronic emphysema denies being a smoker..." seems a much more accurate record of interview than "Mary, a 70y lady with chronic emphysema has never smoked in her life...". The latter sentence of course suggesting the interviewer has intimate knowledge of every event occuring in Mary's life from birth to interview. Oh I love semantics...

I'm 24, and have been nursing since I was 17 (straight after I left high school). I worked as a nursing assistant through my uni degree, and have been a registered ("professional") nurse for a bit over three years. In my seven year nursing career, I've worked my up the ladder in a variety of clinical areas, and am now at a stage where I can call myself a specialist critical care nurse and earn a lot of money doing that. The thing is, I decided to leave nursing too (I'm doing a law degree, because we all know that society needs more lawyers than nurses). I'm not leaving because of the money or conditions (I have the potential in my current position to nett about $1500 to $2000 a week, and taking my contracted entitlements such as breaks etc has never been an issue, I just take them). I'm leaving because I feel the way many of my colleagues do: that for a so-called profession, we don't seem to work as (or be treated as) true professionals. My motivations for entering nursing were fairly honourable: I wanted to help people in a meaningful way, and commerce/business was never an option. But I also had certain career expectations - namely, to be respected by my patient's and allied professions for the work that I do, and to be able to practice my profession with genuine autonomy. Society views the medical profession as the experts in healthcare - they diagnose and treat illness, while we help the person through the experience of that illness - and because of that, we are always destined to work under the direction of the medical profession. I can't think of the times I've disagreed with a discharge decision because from my perspective the patient isn't ready, or a treatment regime that serves to prolong life where there is no quality of life, but had no real say because the entire system places the balance of power and authority over such decisions in the hands of the medical profession. In short, my reason for leaving is because I want to work in an occupation where my professional opinion is truly valued, and I can provide my services without being undermined by another profession.

Yes - I'm interested in what people might have to say about 5thflrnurse's question. Which groups of the nursing population are enjoying stability, and who is looking at trouble ahead? Does the problem seem to be more prevalent in London, the country, or everywhere in between? Are agency nurses still being utilised (as much)?

I worked in the UK briefly earlier this year. When I left, there were plenty of nursing jobs all over the place, but recently I've been hearing stories of mass redundancies in the midst of the worst nursing shortage ever, budget blowouts, restructuring, etc etc etc... It sounds like the guts have fallen out of the NHS and it's gasping its dying breaths... And taking its nurses to hell with it! Is nursing unemployment seriously an issue at the moment? That is, are nurses genuinely facing difficulty securing employment? Are we now, for the first time in a long time, fighting it out with all "the others" in the interview room for a lousy staff nurse position? Where will this all lead, both in the short term and long term? I'm returning for another three month stint in one week, and I'm actually a bit worried about what I might find... Can I have some reassurance? Or do you only have horror stories to tell?

No I would definitely not. I was working in an ICU not so long ago where we treated a critically ill thirty something person with necrotising fasciitis after a friend administered IM B-12. I know that the risk of acquiring necrotising fasciitis or similar doesn't change with the drug administered, but you jogged my memory with this post because I remember thinking at the time how such a horrible thing could have happened from such an innocent little jab. This person lost their arm and a good chunk of tissue elsewhere and very nearly didn't make it. It was only their age and lack of co-morbidities that saved them - I doubt Grandma would have pulled through. The thing is that the person who administered the shot did everything right (cleaning the site, etc), but despite it all they still introduced the pathogen. You couldn't guarantee a similar thing wouldn't happen to you. I think its not worth the risk. Theres always a tactful way of getting out of something...

Hi all. I'm an Aussie nurse, currently living in London (not nursing here of course, it's far too difficult to get registered and I'm sick of playing the game), and I can't wait to get out of this place and head to Ireland. I've had a poke around An Bord Altranais' website, and registering seems to be a fairly standard procedure in line with most other reasonable registration bodies around the world, but my problem is finding an employer to sponsor my work authorisation. I don't need a visa to enter Ireland, but I do need an employer before I can get my authorisation to work (it doesn't cost them anything more than a piece of paper with some ink confirming my employment). Does anyone know of any good agencies or hospitals in central Dublin (or anywhere really)? Because I've searched the net and they're thin on the ground...

When I asked this question (seems like over a year ago at least) my intention was to find out more about the role of the RT. Thanks to the many RT's who responded - I wasn't aware that so much preparation was required (I was skeptical having read so much about certain jobs being created and staffed with unqualified workers to cut corners/costs). It was not my intention to suggest that the role of the RT is any less worthwhile than that of the RN - I agree that the more specialised each member of the care team is, the better the treatment/outcome is for the patient. However, as an RN (and even in my undergrad days), I have watched the nursing profession gradually cut itself loose of certain areas of expertise and naturally, I am concerned about what this means for the future of professional nursing. I am of the view that critical care nursing is a specialty area of nursing, and to deny nurses the opportunity to manage the airway/vents of a critically ill patient significantly diminishes their claim to expertise in this field.

Oh yes. Double the registration fees! Lord knows they earn every cent! The overseas registrations department alone brings in at least £8046000 for the NMC each year (their own statistics - £149 x ~54000 applicants - thats not including fees and charges for actually registering and all the other rot you have to pay for). And I'll tell you something else - they need God's blessing, because everyone else I talk to is wishing them straight to hell... You raise a very valid point - the ONP has great potential to clean up the abuse you mentioned. However, that abuse was mainly levelled towards citizens of certain nations, whose qualifications (or other criteria, as determined by the NMC) were not satisfactory to allow immediate full registration. My perspective is that of a nurse from a country whose nationals were previously admitted direct to the register and whose education/qualifications are comparable to those required of British nurses. My grievance is that the NMC is making an already complicated process more difficult in the name of being politically correct. Why not subject adaptation programs to greater scrutiny (please also note, that there is a big difference between the supervised adaptation programs and the 20 day ONP). Lastly, the thing that sent me the loopiest, was the fact that they introduced this program in such a careless way, resulting in potentially tens of thousands of potential registrants being left without places in a mandatory program. Madness. I've arrived in the UK now, still haven't been able to enrol in an ONP, and considering the state of the NHS, am rather happy about how it's all worked out. I've abandoned nursing altogether and am working as a legal assistant (I'm a law student) instead - better money, better conditions, and no bloody NMC to contend with!!!

Dear sweetnlow121, I could go on for pages and pages and pages and pages about why the NMC puts me off my dinner, but I've summarised the most annoying points in an earlier post ( https://allnurses.com/forums/f124/20-day-protected-learning-and-why-i-loathe-nmc-120172.html ). Basically, the answer to your question is this: The NMC, in a process that would make Sir Humphrey Appleby burst with pride at the bureaucratic machinations of the civil service and the QANGO, held a long "consultative" process where many pieces of important paper were tabled, and people with opinions on everything stood on a soapbox. The end result has been the introduction of the new ONP, and a longer more obstructive set of requirements for non EU educated nurses (even for those of us born and raised in English speaking countries, with degrees from universities with courses conducted entirely in English, etc etc etc). So anyways, they decided that instead of admitting people straight to the register (as most nurses from the US, Aus, NZ, SA, etc previously were), applicants would have to undertake a 20 day period of protected learning to learn about UK drug regulations, the NHS, etc. All relevant and useful things that I'm sure most reasonable nurses wouldn't object to doing. BUT! So far they have only approved about 1000-1500 places per year, which is far short of the minimum 10000-12000 places needed (potentially up to 50000, but a lot of applicants don't make the grade). The institutions offering them are full. The current rumour on the grapevine is that preference is being given to nurses who work as health care assistants for the NHS. This is why it is nearly impossible for people like you and I to enrol in an ONP. And that's not even mentioning the prohibitive costs! Do you have a spare minimum 800 GBP lying around? Anyways, personally I think the whole thing is a sham. Its something that Patricia Hewitt et al sniffed on the air and prematurely ran with to score some cheap political points ("...and just LOOK at what we're doing to improve the NHS... no more of these damn foreign nurses who can't speak English and don't wash their hands..." - not a transcript from Hansard, for those who couldn't figure it out). But I think the consequences for the NHS will be worse with the new regulations. Many of my colleagues who were also planning on nursing in the UK are changing their plans to go elsewhere (Canada seems to be the flavour of the month at the moment). If you take anything away from this rant of mine, let it be the following titbits of advice: Keep copies of EVERYTHING you send the NMC (they WILL lose something), Allow 3 months after posting your forms for a decision letter, Don't expect NMC telephone staff to be helpful or polite, You are the one with the problem, not the NMC, Vent your anger on allnurses.com every now and then.

I'm a big fan of feng-shui, nursing style... By that, I mean all the furnishings have to be parallel (in ICU - the bed must be parallel to the wall, the ventilator parallel to the bed, and so on) - and I mean precisely parallel, none of this 5 degrees either way crap. Not only that, when I'm setting up my workstation/dressing tables/etc, everything must be organised just so. Syringes parallel to saline and drugs, etc. etc. etc. Just like in the movies. That's where I learned to nurse...

Dear Mio, Thankyou for your kind words. Since I last corresponded with the NMC (having sent away my application forms for processing), I've grown a beard, written a screenplay for my novel, chosen a retirement fund, and been nominated for the Nobel prize. I've also become more reflective in my old age, and come to realise that my expectations of the NMC are too high. One man alone can not change the culture of inefficient bureaucracy on which the British Public Service and the QANGO is built. Ah yes, NMC, I've watched "Yes Minister"! I know how your brains work! Sitting there in your office, hunched over a draft proposal on the formation of a committee to discuss the report of the subcommittee on toilet paper in the mens room, with your beady little eyes and grubby little hands... I'm on to you...

Further to my rant before, I have a new example of the idiocy of the NMC's policies. As you may know, every overseas trained nurse wishing to register in the UK has to undertake a 20 day period of "protected learning". I did a little investigation, and came up with the following statistics: - 53440 applications (paid) were received by the NMC from foreign nurses last year; - 11416 foreign nurses were added to the register last year; - The NMC, in their infinite wisdom, have secured the grand total of 1500 places in the overseas nurses program (ONP), meaning that: - Approximately 10000 to 40000 potential registrants will be unable to register in the UK this year. You don't need an "O" level to figure out that the nursing shortage is going to get a whole lot worse... Marvellous work NMC... Marvellous... Are they really watching out for the best interests of the people of the UK?

LOL! I'm so glad I'm not alone in my mild to moderate outrage. Damn bureaucrats...

Hi all, it's me again... Am I alone in thinking the NMC has just gone completely mad with bureaucracy and political correctness? My story goes a little like this... I'm an Aussie, and I love the UK with a passion. I can't wait to get over there (in January 06)! In fact, I was so happy at the idea of going that I didn't even care about having to apply over the phone for the application forms that you fill out to request a second set of (proper) application forms for registration. But then the trouble started... You see, as of the 1st of September this year, the NMC brought in a new rule that anyone wishing to register from overseas has to undertake (at least) a 20 day period of "protected learning" (Buddha only knows what that involves, since none of the approved education institutions offering the program seem to know ANYTHING about it - nor for that matter do any of the wonderful, cheerful staff at the NMC), as well as sitting the IELTS english exam (at great personal expense, regardless of the fact I may have obtained my degree from a course conducted entirely in English in an English speaking country). And I'm just so frustrated! All I want to do is register, but I can't because the NMC is making policies which would be perfectly reasonable if only anyone knew what they were all about. Is anyone else out there running up against a brick wall with this? I've contacted most of the providers listed on the NMC website, but I've either had no response, or been referred back to the NMC or NHS (!!)... And really, if I want to be patronised and insulted by snotty telephonists, I'll call Dominos (at least their people don't need to understand a library of obscure legislation to justify their employment). What a nasty rant this has turned out to be... I'm actually a really nice guy! I just hate dealing with bureaucratic BS...

I understand that these policies exist to protect the public (and the agencies business interests). I think the reason I was so put out by their response was because I'm used to appointments being made on merit and not simply years of service. Thankyou all for the good advice - I'll speak to some of the NUM's when I get over there...

Perhaps my expectations are a bit too high. Nevermind, guess its back to med-surg for a while (not that theres anything wrong with that by the way! I just know where my interests are...). Thankyou Suzanne et al for your replies!

I agree that different countries have different requirements, and I think it's admirable that the UK sets such high standards. Perhaps you misunderstood where I was coming from. I have two years of nursing experience, 8 months of which has been in a critical care area. I was asking how British nurses in a similar situation have been able to "break into" the area, as everyone has to start from somewhere (ie: you can't have 12 months experience if no one will employ you...). Perhaps it is just the fact its through an agency... I don't know

Hi all... I'm an experienced RN from Australia, and have spent the last 8 months working in the intensive care unit of a major teaching/referral hospital. Although I may not have the academic qualifications or extensive experience that many of my senior colleagues in ICU have, I am a very competent nurse with a thorough understanding of the requisite knowledge, and excellent references. I am travelling to the UK soon, and have been informed by my agency that as I do not have a full 12 months experience in ICU, they will be unable to place me in a critical care area. I'm disappointed by this, as I would have liked to continue working in this area. I was wondering if any UK nurses could tell me how I can obtain work in this area? Surely British ICU nurses have to come from somewhere...