Happy Wombat

All these 'pay to get experience' sounds real dodgy to me...

It is just a stamp saying that it is a copy of a authentic certificate. In Australia, it is normally witnessed by a Justice of Peace.

Hi Sezza, I know about the course and requirements. I'm wondering about the job opportunity. I don't really want to be spending 30k and stress for a few years and end up with nothing because of 'I do not know how to get a position'. Is it offered by the hospital or by doctors. Or do I have to post my resume somewhere and hope I get lucky? From what I understand is that Medicare does not cover PNSA. In other words, they will have to work in private hospitals. And the PNSA have withdrawn their application they submitted last year for public funding. So I do not really see them in public sector any time soon. MSAC - Perioperative Nurse Surgical Assistants (PNSA) to gain eligibility as providers of services that attract a Medicare Benefit Schedule (MBS) rebate for eligible surgical assisting services provided during surgery or procedures.

Hey Ceridwyn, There is an association for them. And from what I understand, they do certain things which overlap with the registrars. Hence the debate with AHPRA regarding registration. AANSA | Australian Association of Nurse Surgical Assistants

Hi there, I'm curious about the above position and how the PNSA in Australia go about getting positions for themselves. I understand the requirements of how to be one. But how do someone register as one once they have the qualifications? I have spoken to a few surgeons and none of them have any idea what PNSA are.

Well, the best option is to have a chat with the surgeon and reach a compromise if possible as another poster have suggested. Another option is to improve the way you work. Scrub early and try to finish the jigs of TKR/THR/ACL before the case even starts. (If you are in private, then time is truly a luxury...) Pay attention to the phrase of the surgery and assemble the jigs during surgery yourself without relying on the rep, if you have not already done before the case starts. Yes, I understand the spaceman suits make surgeons' voice become muffy and hard to understand. If you cannot hear them, just make a guess on what they are doing and pass them the equipment they need. Take it as a challenge. =) No matter the system you use, the principles of the jigs for both TKR and THR should be the same. They may look different, but they serve the same function.

You don't have to as there is often (if not always) 1 in the nursing station or near the manual BP machine. However, it is always good to have 1 with you, as a personal 1 will allow you to use it whenever you want and in 100% working order. (Not to mention you won't know when is the last time the work stethoscope was cleaned.)

Hey Mopples, I know certain specialities such as ED allows new grads to do so. (If they are able to cope.) However, I understand not all departments allows that and that is also why I said 'if possible'.

Hey Leekiss, Pretty sure emptying catheter bag is not part of your 'skills'. Not to mention it is normally done by the ENs/AINs. However, you still need to have the skills to do catheterization. An ECG can be done by an experienced RN within 2min (Including printing and interpretating the results), but can a new RN do it within the time frame? Skills such as taking of blood pressure and pulse manually. (Not all hospitals have the luxury of automatic BP machines.) Then the knowledge to interpret the results and think through what is wrong and make decisions accordingly. Other things such as physical/mental assessment, drugs knowledge and preparation, ability to transfer patients without putting yourself or the patient at risk, wound dressings, communications, time-management are all considered skills. If possible, get the ward/hospital to send you for IV and blood taking course. It will save you alot of time. And Leekis, you make it sounds as if wards have fixed things to do. I can share with you 1 of my more traumatic experience during my grad year that was thrown at me. Call me jinxed or incompetence if you want and pray it doesn't happen to you. I was giving out medication during that time and was behind schedule. I was informed by my experienced EN that a patient under my care collapsed. I set everything aside and push the Emergency trolley to the side of the patient and have no idea what to do next. A 100 things went through my mind, things such as 'I need to seek help, but where and how?', 'patient needs cannula access, but I'm not trained in it!' 'I have never done a CPR on a person before!' 'What do we need to resus a patient?' - I was in panic mode as he was the 1st person that ever collapsed on me and I was truly freaking out. I have no idea how long I stood there and did nothing for. But what I do know, is that my experienced EN called the resus team and asked for help in my stead. The team arrived, but I still need to assist in resus of the patient as there was more than 1 code blue in the hospital and the resus team had a shortage of staff. After 3 hours of none stop actions, the patient was sent off to ICU. I learnt quite a few things from this experience. 1) ENs are a valuable source of knowledge and help, please show the appropriate respect to them. You learn heaps from them and will never know when you need them to cover your back. It is also times like this that you can see which one of your colleagues are the knowledgeable and skilful ones. 2) Being familiar with protocols is important, but keeping calm and thinking straight in situations like this is even more important. 3) Check and understanding the situation of your patient is important. It allows you to do the make the appropriate decision and take the necessary actions. 4) Breaking peoples ribs in theory and in practical is a totally different feeling. And CPR is tiring... An experienced and well versed RN would have taken better control of the situation than what an inexperienced RN like me during that time. You can ask yourself, what would you do if you faced a situation like this. So unexpected task like these do happen every now and then. So good luck for your placement!! ^_^

Hi Ceridwyn, I disagree on not having 'tasks' in nursing in Australia. The nurses' duty (in general) is to take care of the patient and plan out the needs of the patient. Tasks such as keeping the patient safe and up-keeping their hygiene are needed to fulfil the duty of care. (However, please do not shave/cut the patient's beard/hair/nails no matter how messy they are. It can be considered a tort and can lead to court cases.) Having the skill to complete certain tasks is good, but nurses cannot be too task orientated and needs to have the ability to assess the situations/orders. Things such as doctors ordering too much medication for a patient. Eg. A doctor ordered 2L of N/S IV over 2 hours for a patient with CCF. Eg. An elderly patient had a fall. The nurse needs to do the necessary assessment for the patient, inform the people involved (next of kins and allied health), and book things such as x-ray. These are all considered tasks. In short, Australia needs nurses that can complete their duties and tasks with understanding on what they are doing. Not nurses that can complete tasks within the allocated time and not plan and think for the patients. @leekis: New graduate nurses will not have the skills required to handle the workload given to them within the allocated time during the initial few shifts. (At least not within the 1st month if you have no experience.) However, the graduate needs to have the ability to assess, prioritize and plan out their daily tasks. The initiative to do self-learning and research. Not just following a set routine everyday and neglect the care of individual patient.

I understand the feeling of dragging your feet to work and feeling stressed throughout the journey and your situation does seems 'normal'. I have been through these negative emotions when I first started out too! I also have many friends that did free overtime everyday when they started to learn the ropes of the workplace. Some managed to cope well after a month or 2 and stopped working free overtime, some felt totally burnt out and dread going to work everyday and eventually gave up. Have you ever tried going earlier like 20-30 mins to work everyday to assess the 'situation' on the ground and plan out your day? Write out your plan and keep it with you, so you do not miss out the things you have to do. Plan some 'luxury time' in between for toilet and meal breaks, but it is perfectly 'normal' to use those time for unplanned urgent tasks. The 'luxury time' helps buffer the impact of those unexpected task on your timetable and allow lesser deviation from the original plan. Again, don't be surprise you do not have time for a meal or toilet break for the entire shift even if you planned them. (Welcome to nursing!!) Delegate your helpers (ENs/AINs) if you have any and try to teach the students and delegate task to them. The students are an asset once they are properly instructed and assessed, please do not view them as burden. It might disrupt 1-2 shifts to teach them the basic routine of what the wards normally have to do. Once they learnt it, they can help buy some breathing space for you and your colleagues for the rest of their placement~~! Do more self studies at home, so you will have lesser trouble planning the needs of your patient and lesser issues understanding the medications that are prescribed for the patients. (Lower the chance of medication error.) Have a short meet up with some of your uni mates/colleagues. It can help you unwind the stress that is building up and sometimes offers tips/solutions to your troubles. Remember, graduating from uni and stepping into the nursing world is the beginning of your career. Hang in there!!

I agree with iamnomad. If an EN/RN have poor command of English, handing over of information to the next shift can be prolonged and mentally exhausting. It will also compromise patients' safety and level of comfort while that EN/RN is on duty. During emergencies, people just shout what they want and every second counts. Having a sub-par level of English will slow down the entire team during the life saving process. In short, poor communication in English hampers the efficacy of the team and compromise the standard of care for the patients.

@Ceridwyn, What do you mean by 'Hang on though, they are contemplating lowering the IELTS to 7 in several sittings.'?

An EN can only give medication if they are certified to do so. However, they are not allowed to give S8/S4 Drugs, bloods and anything through IV. I'll like to know what kind of 'work visa' are they applying for you? As it sounds really dodgy as it is not part of the SOL occupation.

I personally find this question impossible to answer... It is like comparing apples, oranges and pineapple. Which taste the best? But generally speaking, major hospitals such as RPA and St George offers better learning opportunities as they have better facilities and can see more complex cases.