squeek

thanks for your reply, I live and work in South Australia, we do not have nurse anaestheologists in SA, Anaesthetic nurses can be RNs or ENs who assist the anaesthetist and look after the patient. we do not have tech's yet although they do in some states, NSW at least. as to working here, each state of oz is different, there is a nurses board in each state and to work in that state you must register with that nurses board. Not hard to do after your initial registration. Our pay rates (and everything else) are different too state to state. In SA the ANF (australian nurses union) just won us a lovely payrise, currently a level 1 Registered Nurse, year 9 earns $26.00 per hour in a public hospital. I am not sure how that equates to your nursing levels. An RN, has a 3 year hospital training certificate or (for the last 11 or so years) a Bachelor of nursing, 3 years from university. Level 1 means a worker , level 2 are our clinical nurses (still work but are the experts :rotfl: ), 3 are our clinical nurse managers (in charge of the experts), 4 our executive managers, 5 our directors of nursing etc. etc. year 9 is the years of experience post registration, starts at 1 up to 9. although I would love to earn more money and probably deserve it, our pay rates are reasonable in comparison to our economy. Medical officers earn a lot more but they are welcome to it. Australia has a shortage of nurses and I think every state would love to have you (or any experienced nurse). please feel free to pm me if you would like any more details. cheers Squeek

Hi, Have been a member here for a long time, but never thought to start a post! we have just had 2 anaesthetists arrive from the states (not sure where yet) and they tell me that they do not have an anaesthetic nurse in America?? I am amazed, I have always thought that Australia follows the American standards. I was told that in theatre you only have a scrub nurse and a circulating nurse (who also cares for the anaesthetist a little), while we in Australia have at least (per Australian standards) a scrubber, circulator and an anaesthetic nurse preferably 2 circulators for large cases. Just wondering if this is the case generally all over the States or is it only in certain areas? also they carry a little black bag of intubating equipment with them, is this normal practice? Here we have a difficult intubation trolley with all the emergency equipment on it to share! Cheers Squeek

an LMA is simply an oral airway, the large bulbous part at the base holds up the tongue, therefore reducing airway obstruction. It was designed simply to take the place of the face mask during the shorter cases and therefore free the anaesthesia providers hands up.... they are easy to introduce and do not actually sit far down the throat. A little discomfort afterwards is to be expected but ten days is far too extreme. I doubt this would be the cause. an ETT endotracheal tube is admittedly smaller than a LMA however as the name suggests it sits in the trachea and is passed through the vocal cords to obtain an adequate airway. It is usually used in the majority (some would say all) of laparoscopic surgery and in most long operations. I would imagine that this would have been used during your surgery. A sore throat for up to 2 weeks may be expected, unusual but possible. You must be paralysed, have local anaesthesia to the cords or be very deeply anaesthetised prior to intubation, otherwise you may have some vocal cord spasms (laryngospasm)this can often be a cause of further sore throat. although a LMA may be the preferred option of the anaesthetist, due to ease of insertion and minimisation of complications, there is always the possibility of problems maintaining the airway and the need to change techniques and intubate the patient at any time during the procedure if necessary for safety. safety of the patient always comes before preferences!

ps. not a standard of care here yet, many procedures are done without antibugs! squeek

hey I should have been a little more specific, we do give Abs before incision but not on ward pre-op. I wonder if else where in Oz they are following your trend [as we invariably will do, it is just a matter of time] :) squeek

ditto to shodobe and stevierae! I did not mean literally ... I realise all do not have ETT, this was a bloody unlucky situation. in Oz we do not start Abs prior to surgery {maybe we are a LITTLE behind}.!!! in litigation too happily. I can manage ANY airway>>> 10 yrs of recovery ensured that... I can place an LMA if required; obviously a guedels or nasopharyngeal; I have placed ETT under anaesthesia supervision, but would not do so without .. it is not in my scope of practice in Oz. I will not lose my licence for such a reason ... bag and mask til they wake will work for me. cheers Squeek

we were about to start a nephrectomy, triple Abs before start ... NKA ... registrar was pre oxygenating pt, anaesthetist gave Keflin .. patients face just got bigger and bigger! we tried everything, every drug.... bougie, trachlight, LMA, guedells ... but we couldnt get any air movement. finally cut down trachy .. her neck was so swollen by then it was difficult to find landmarks. got the tracheostomy in but it was too late. I have an anaesthetist who swears never to give Abs pre op ... wait til the tubes in .. I say whats the rush. doesnt matter how many other people were there .. the outcome would have been the same. we were prepared, it didnt help. we knew what we were doing. just real bad luck :stone squeek :angryfire

informed consent - hahaha :chuckle how can anyone give informed consent after having sedation .. are they not told not to make any important decisions for 24 hours! If the procedure was an emergency - OK if the consent included the possibility for further procedures - OK but for a knee arthroscopy with menisectomy - that is what they are consented for. I would not like to be the scrub RN in this situation. squeek.

ditto to the protected airway and the cool and controlled environment! only code I had trouble with was an anaphylaxis to Abs prior to induction ... couldnt get an airway for that one! we never call the code team ... I only have BLS certification. i work as a team with my anaesthetist ... and scrub team if necc. Squeek

thanks guys, I cant find another thread similar? maybe I m looking in the wrong place! I want to work and wc have been good to me generally..... but I just need a non clinical (ie non lifting) job to aim for ( I dont like the idea of having a spinal fusion, and thats my next option).

Hi everyone, I need some suggestions on a new direction for my nursing career. I had a back injury (at work) early last year followed by a laminectomy. I am back at work full time (40 hours + a week) but with a lifting restriction. I am only in my 30s and feel that I need to find an alternative direction to clinical nursing, to limit the probability of needing further back surgery. I have worked in the OR, PACU, Pre-op clinic, Endoscopy suite and Day surg over the past 10 years, and slow stream rehab and gerontic care before that. I am thinking of doing a grad. dip. next year in either management and leadership or clinical teaching .... would love some ideas. ANY great suggestions?? Thanks Squeek :kiss

Hi everyone, I need some suggestions on a new direction for my nursing career. I had a back injury (at work) early last year followed by a laminectomy. I am back at work full time (40 hours + a week) but with a lifting restriction. I am only in my 30s and feel that I need to find an alternative direction to clinical nursing, to limit the probability of needing further back surgery. I have worked in the OR, PACU, Pre-op clinic, Endoscopy suite and Day surg over the past 10 years, and slow stream rehab and gerontic care before that. I am thinking of doing a grad. dip. next year in either management and leadership or clinical teaching .... would love some ideas. ANY great suggestions?? Thanks Squeek :kiss

are your scrubs just for OR?? We are only allowed to wear those supplied to us (all blue pyjamas) because of the ACORN reccomendations for washing of theatre attire. I do sneak my OR hats in though in every different colour and pattern you can imagine ... my pts get really jealous, but the littlies love it.

hear hear, It is rarely the PACU nurse responsible for this decision ... ALL patients should be recovered in PACU, ration of 1:1 while unconscious or unable to maintain their own airway, 2:1 when stable... most patients in PACU will need 1 on 1 care to enable adequate and effective pain relief .... I suppose sending these patients to ICU is more appropriate than sending them directly back to the ward area ... but I pity the ICU nurses who must find the time to care for them.... I doubt that the PACU nurses are the ones to blame, try validating your concerns and approaching management! good luck

any op over 30 minutes, or any pt. with high risk factors wears teds in OR, we place them in OR usually before induction, intermittent calf stimulators are also used for all long OPs. Organised by the nursing staff ... its our call.