bukko

How was it possible? The newspaper story mentions how Dr. Patel was bringing half a million dollars a year into the Bundaberg hospital by doing esophageal surgeries. (Or is that "oesophageal?" Say what you will about American vs. Anglic spelling, ours is more stripped-down and efficient!) For a struggling hospital to suddenly have an enhanced revenue stream, he must have seemed like a dream. How very American, to regard health care as a profit center instead of a public service. You must not become like us, Aus! As for me, I shall never be able to drink that rum without feeling a rip in my (o)esophagus...

The New York Times newspaper had a front-page story summing up the Dr. Death case in the Sunday 19/6 issue. That's significant because the Times is the most important publication in the United States, the thing that opinion-makers read, with subscribers all over the country. (I live 5,000K from New York and I have it home-delivered, for instance.) Australian news doesn't often make our media, unless it involves cute furry animals or TV personalities dangling their babies in front of dangerous ugly ones... What surprised me is how little background checking the hospital did before hiring this physician. It took a newspaper reporter to do a Google search on the fellow to suss out his chequered past? And if not for a Qld legislator, none of this would have come to light? Thank goodness for the nurse who kept pushing the issue! That's a true case of patient advocacy. Yet she was labelled a "personality problem" by the hospital management; the same mgmt that gave Patel an "employee of the month" award when it was hitting the fan, if the NY Times report is correct. Unbelievable! Or maybe all too believable...

It is Au$120, which worked out to US$91 and change at the exchange rate in effect when the charge came through on my credit card in April. NSW only charges Au$50 for a licence. Your big surprise will come in December, though. Vic makes you pay for a new registration every year! And if you get your papers in any month prior to December, you'll pay the full rate for a partial year. That being said, I have nothing but praise for the Aussie licencing authorities. They DO want a lot of info, but look at their position. People who come to Australia sometimes do so because they're having trouble in their native lands. Have you followed the stories about the deadly doctor in Bundaberg? I wonder whether the demands for documentation and the delays are a way of weeding out the people anxious for a quick 'n' easy exit from what's bedeviling them at home. The nursing board officers I dealt with in NSW and Vic bent over backwards to help me when I contacted them on the Internet, telephone and in person. I can't imagine a nursing bureaucrat in the U.S. receiving a phone call, getting up from her desk, going to a file cabinet to pull an applicant's case jacket and analysing it quickly enough to give an immediate answer to a question. In the U.S., they just don't give customer service like that. But NSW officers did. So you get what you pay for.

I don't have experience with those three, but I can tell you about my dealings with two others: Eden and Acclaim. The personnel there were personable, as all Australians are, but in the end they couldn't deliver. At both, I had pleasant e-mail exchanges with recruiters. Also at both, my initial contacts abruptly stopped working there! At Eden, the replacement recruiter sent one e-mail and never followed through. My substitute at Acclaim set up a telephone interview at a hospital in Canberra (got an offer, but not keen on living in ACT) and promised to arrange an in-person chat at a private hosp. when I was in Melbourne. However, she didn't have the connections to get me in the door. I got the feeling that with some international nursing agencies, you're not really working with an organization behind you; you're dealing with whatever individual who's been handed your file. And if your particular recruiter is not on the ball, you're behind the 8-ball. (I suppose that latter bit of slang doesn't make sense in a country that plays billiards...) I appreciated the info in your recent posts, Ruthie, and I have a question for you. I'm now licenced in NSW and Vic. I'm working on lining up work at a hospital in Melbourne, but it's not happening fast enough for my taste. How hard was it to come from America and labor as a temp in Aus? The differences in work practises, medications, etc? What sort of orientation did you get? I'm a quick learner, and used to work agency when I lived in Florida. However, I was familiar with the basics of the American medical system. Did you have any background in the Aussie way before you started doing agency work there, or were you just expected to land on your feet and hit the ground running? Did you have any trouble getting the required 35 hours a week? I don't want to be in a position of having government agents knocking on my door saying "You haven't been working hard enough -- get out of our country, you lazy sod!"

As a Yank who was looing for work in Oz during the week when this story flared up, I was mighty embarrassed to see one of my countrymen blackening the name of U.S. medical workers. Just what we need, another fly-by-nighter who fled Down Under to do his dirty work.

Thanks again all for the advice. Just returned from two weeks Down Under. Managed to extract my Division 1 licence from the NSW board. When I rang them up they basically said "Well, as long as you're in town, we'll let you have it." Interviewed at a public hospital in Melbourne and received an offer of a job and visa sponsorship. I'd be there on the first flight out after Vic approves a reciprocal licence, but the wife now has cold feet. This despite the fact that we had nothing but good food, spirits, scenery and mateship during a fortnight of Qantas-hopping around the eastern edges of Oz. You folks are just unbelievably nice! Australia is like America was in the 1950s, before Kennedy got assassinated and everything started getting bitter and twisted...

I'm an RN from the U.S. who's trying what you're wanting to do. I've enquired at several agencies, but they've been flaky. I registered with one, Eden Health, and had a good e-mail exchange going with one of their recruiters. Like most Australians, she was very personable. Then abruptly (from my perspective at least) she sent a message saying she was going on maternity leave and assigning my file to a co-worker. I heard from that woman once, but she never replied to my further e-mails. So I registered at a second agency, Acclaim. The recruiter I was working with was also helpful, via e-mail and on the telephone. She arranged a phone interview for me with the directors of a cardiothoracic unit at a large teaching hospital in Canberra. They offered me a job, but the more I learn about Australia's capital city, the more I like Melbourne. So I asked the recruiter to line up a chat with at least one hospital there. (My wife and I are flying Down Under for a scouting trip next month.) She seemed kind of sniffy about doing that, and so far no results. I don't know whether the poblem is them or me. I've been a nurse for 13 years, the past three as an RN, with a clean and broadly-experienced nursing record. I don't think it's because I'm a bad employment prospect. I'm not sure whether these nurse recruiters have enough contacts at hospitals to shop potential employees around. At this point, I'm frustrated with agencies and planning to get hired based on my own efforts. For what it's worth, the enquiries I've made to hospitals directly have not been fruitful either. I've sent in my application for a nursing licence to New South Wales board, and have been busy supplying them with the extra paperwork they keep requesting. Perhaps when I have an actual registration to legally practise nursing I will be taken more seriously.

Looking over old posts on this old thread I don't see any mention of one possible cause of the sore hands -- latex medical gloves. I wash my hands so often at work that I could qualify as obsessive-compulsive. At times, especially in cold weather, the skin on my knuckles and fingertips spontaneously splits and bleeds. But I've found it's not so much the soap as the gloves. My hospital provides non-powdered, non-latex gloves for workers whose hands are sensitive to the standard brand. I keep my pockets stuffed full with the special sort and I'm usually OK. But occasionally I'll get caught in a sticky situation in a patient's room with none of my brand, so I'll have to grab a pair from the boxes on the wall. My fingers will be burning and bleeding the next day. So if your hands hurt, don't necessarily blame the soap. (The waterless, alcohol-based formulas also kill me, though.) Try some hypo-allergenic gloves. The clear vinyl ones are the best, but they're expensive. Are non-latex gloves commonly available in Australia? And if your hands are falling apart, A&D Ointment, a sort of Vaseline with Vitamins A and D blended in that we use as an incontinence barrier, is a great night treatment. Just make sure to wear white cotton gloves over it, unless you enjoy greasy sheets...

No offence meant -- that was a joke (hence the winking emoticon.) I thought Australians were perversely proud of their dangerous wildlife like redbacks, cone shells and box jellies, not to mention better-known sorts such as your 10-metre-long crocs. I realize that no one has been killed by a cassowary since the early 1970s. I certainly have no room to talk about the natural dangers in a country, having lost a chunk of my left leg to gangrene resulting from a strike by one of our Florida rattlesnakes in 1972. That should give me some cred when I encounter some of your "Dundee" types from the NT, I hope. And as for visiting, I booked one of those Quantas air pass deals last night for Sydney, the Gold Coast (my wife has a friend in Byron Bay), Adelaide and Melbourne. Skipping Canberra. Everyone tells me it's a nice place, but they wouldn't want to live there... Cheers!

Thank you for the primer on what to expect. I suppose that patients are patients no matter where in the world they are. There are only so many ways for the human body to malfunction, and that's going to happen more to old people than young ones. I was thinking that maybe Australian hospitals were filled with younger people injured in pub punch-ups, road train drivers who flew through the windscreen after plowing into mobs of kangaroos crossing the highways, victims of taipans, cassowaries and the other deadly wildlife that prowls your continent...; ) Interesting the distinction between public and private hospitals. Publics get the harder cases, eh? A similar distinction exists in America. Corporate and religious hospitals such as the one where I work tend to get medically ill patients. But in big cities, there's usually a government-owned hospital where the gunshot victims and other socially troubled types are sent. Oddly enough for a violent society such as my own, I've only taken care of one person who was recently shot, my very first patient as a nursing student in 1992, a middle-aged fellow who got popped in the abdomen during a bar fight. My countrymen are not skilled in the art of fisticuffs, so we resort to technology to resolve our disputes.

I started working toward a masters with the University of Phoenix last spring while I was sidelined for four months with a broken hip (bicycle crash riding to work). I did some due diligence checking out UoP's rep. HR and bosses at my hospital had no awareness of it, but at an info session on the University of California's nursing master's program that I attended, the profs did not criticize the online degrees. If the competition wouldn't badmouth it, I figured it must be OK. I have a cousin who got a nursing masters through them online and she liked it, although she's not using the degree to move into management. I signed up and took four classes. Got A's and B's in all. But I dropped out. In part, it was because the University of Phoenix classes were too easy. I found that I could B.S. my way through them (I'm a good B.S.er) and that I wasn't actually learning much. The readings were OK, but I could pass without actually reading them. It wasn't like a formal classroom with lectures and tests where I'd have to prove what I knew. I wasn't getting $1,200 worth of knowledge from each course, and that's what I was paying from my own pocket. My classmates and the theachers were pleasant, but it was like a glorified chat room where you periodically had to chip in with a PowerPoint presentation. So I ditched it instead of investing more than $20,000 and two years to get a set of initials to put after my name but not that much learning in my brain.

I'm a registered nurse working on moving from the United States to Australia. (Filed my nursing licence appo with NSW in December and got a job offer this week from a hospital Canberra after a telephone interview.) I'm chuffed (is that slang term dated?) about the idea of going Down Under, and have learned a lot from the various threads in the ANZAC area. What I want to know is, what are hospital patients like in Australia? By way of explanation, let me describe the typical patient I deal with in America. (I've worked at a dozen urban and rural hospitals in our states of Florida and California, so I've got a good base of experience.) It's uncommon to have patients under the age of 65 (the age at which government-paid medical care kicks in.) Most of the people I take care of are in their 70s, 80s and older. Most are incontinent, demented, frequently combative and at risk of falling. The latter sentence is not meant to be pejorative -- the patients are what they are, and it is our duty to take care of them. Do hospital patients tend to be younger in Oz? Do people in Australia follow the advice of doctors and nurses? Because of its revolutionary past, America has a cultural attitude of rebellion, especially since the 1960s. Very often that translates into deliberate disregard of the sensible health instructions medical staff give. Patients refuse to take meds, families violate fluid and food restrictions for CHFers and diabetics, people are contemptuous of health workers... Do you have a nicer lot there? I currently live in San Francisco, an ethnic melting pot of a city, so more than a third of my patients on any night will speak a Chinese dialect, Russian or some other non-English language. In Florida, it was Spanish and Haitian Creole. I know Australia has a high proportion of immigrants, but are most of them from Anglophone origins? In American hospitals, almost every patient is on intravenous fluids, antibiotics or other medications delivered via veins. I stink at starting IVs (unless it's a younger person with good arms.) I've read that cannulisation is primarily the responsibility of physicians in Australia. Is that true? Lastly, and sorry if this seems creepy, but do Australian hospital patients get better? In America, it seems that the bulk of what hospital nurses do is extending existence, not curing people. Our typical admission is someone who's very old and seriously ill. We get them through the crisis, send them to their house or nursing home, and then get them in a month or three with a worsening of their ailment. I have many patients who I've seen on multiple hospital visits, to the point where I don't even have to look at their medical history to fill out the admitting paperwork -- I know it by heart. The stays get longer, and the outside intervals are shorter, until the person dies under our roof. I call it the "circling the drain syndrome." I don't begrudge these people the care -- again, it is our responsibility to tend to them. Their unfortunate condition is why I have a paycheque, after all. But often I feel like the U.S. medical system is only in the business of enabling superannuated people to take a few more breaths, at great expemnse to society, while the needs of younger, more cure-able people, are shunted aside. Is that how it is in Australia? Sorry for the long post. No matter what the answers are, I'm still moving, and glad to do it. But I'd like to get a better idea of the medical zeitgeist under the Southern Cross.

Maybe it's more like a state of mind...

One nice thing I notice about Australia, when reading these and other posts about which city/state is superior, is the FRIENDLY rivalry between regions. It's kind of like the good-natured razzing over sports teams and brands of beer. A lot of bragging, a little slagging, but no absolute trash-bagging. Sadly, in my own increasingly divided country, rivalry has turned into hatred. We had a friend over for dinner last night who's a South African, transplanted to Byron Bay in NSW,although he's been in the U.S. for a decade doing computer programming. Naturally, he thinks his community Down Under is the best. So, you Aussie state partisans, here's a chance to weigh in. I've heard Melbourne is more laid-back than the hustle-bustle of Sydney. Adelaide is supposed to be beautiful, but I've heard it's a tad slow, like a retirement area. Queensland sounds super, but doesn't the weather there tend to be rather Indonesian-level torrid? This might sound odd, but my wife wants somewhere that gets cold. In Melbourne, I'm told, you can experience four seasons within two hours... Another question here -- are international nurses regarded generally as good additions by in-country nurses, or are we seen as interlopers who depress wages by diluting the overall supply of labor? I know there's a strong union tradition in Oz, although Latham's loss might belie that. I live near Silicon Valley, and foreign high-tech workers are reviled as pay-packet busters. Is that how it is with o'seas nurses in Australia?

Your replies do help. Many people do come over independently, eh? The nursing agencies I have been in touch with have not asked for any fees from me, but we're early in the relationship. They have to make money somehow to pay the nice RNs I've been chatting with, though. No one deals with the paperwork for an international nurse out of the goodness of their heart! I'm assuming there is a fee that these headhunters extract from the hospital, in return for doing the vetting the hospital's human recources department would otherwise handle. (Does Australia use this terrible "H.R." American term, one of the many cases where our country takes three multi-syllable words to obfuscate the simple, understandable label of "Personnel Office"?) The agencies do mention contracts of a year or more. I'm not averse to that. It might sound contradictory coming from a person who wants to "country-hop," but I'd like the stability of a guaranteed workplace instead of the prospect of job-hopping. Emigration is a gigantic step, and I want to have a place to land before we jump. My wife and I (no kids) are leaving a comfortable situation in which we have stable jobs and a beautiful home overlooking the Pacific in San Francisco, one of America's more liveable cities. We just dread the economic collapse and social chaos we see coming under four more years of Bush. I won't go into a political rant here. But I love Australian rock (Hoodoo Gurus! Radio Birdman!) and have many Internet friends and a few real-world ones from the your land. Australia seems to have the friendly, can-do spirit that America used to have before we became a nation of fat, angry planet-killers. Oops! starting to rant... Anyway, I'm doing the research and I'm sure we'd be good, hard-working additions to Oz. We're both well-traveled, and not exactly impoverished. Aiming more for Victoria, South Aus. or someplace where it's a bit colder than Queensland. (My wife suffered through living in our state of Florida, so that's enough sub-tropics for us...) Looking forward to being your mate, mates.