twistedpupchaser

I was once told that I'm not very nice, my reply left the Pt speechless. "You can have nice or goodlooking, not both!" Needless to say my supervisor took a dim view of my wit. (Not for the first time.)

I get the feeling that there are a lot of Nurses that are only 4 foot tall every time I do a spinal turn. I have seen some very petite Nurses who can keep up with the heavy side of Nursing, usually their fitness is a huge bonus.

I had work that was very flexible with hours, as long as the work was done. I worked nights, weekends and sometimes between lectures.

Before I started my Nursing degree I saved up by working OS. That money didn't last and I found myself working full time and studying fulltime. I had to cut back on a lot of things, TV, sport and Me-time. Somehow I found time to coach my sons Rugby team and that became my fitness, Me-time, social outlet and quality family time rolled into one. It isn't easy but if you prioritise, it can be done.

We have Universal Healthcare in Australia and guess what?...The sky hasn't fallen. It is far from perfect and it works reasonably well. There are a number of models of Universal Healthcare around the world, maybe looking at a number of them and make an educated decision based on that and your own situation. Dont let the media make up your minds for you. BTW as a relativly junior nurse working 34 hours a week I make more than $40k (thats taking exchange rates into account)

To the little old man making silly noises at the staff everytime they walked past his cubicle for the 10/24 night shift....."Zibbida, Gonk, Boing Boing, Boing to you too!" (It was funnier to think at 0400 than it apears in writing.) "You asked for a good-looking Nurse, not a nice one, you can't have both!" "Don't worry, I saw how to do this on 'All Saints'" (an Australian hospital based drama, as realistic as Grays but with actual nurses) "And the Oscar goes to.........." Scary thing is, I have said one of these....and I'm not saying which.

I only mentioned the Mercy because I was aware of her Humanitarian Missions, I in no way meant that there was poor planning or preparation for the medics. My thought was in line with the Medics possibly lacking a depth of knowledge in caring for some population groups and not to suggest I knew what their training was. Our Irish mate mentioned that the Military should not be a conduit for degrees or certification and suggests that this extra training would distract from the operational tempo, I agree to a point but question wether a deeper knowledge and understanding would be more beneficial in the long term than "protocol driven" knowledge, ie; understanding why something is done not just doing it because the protocols say so. I knew that this thread would have as many viewpoints as posters, it is very interesting to see differing views on this subject and how people come by their views. I was a medic for many years and only after learning pathophysiology, (deeper) anatomy and physiology and pharmacology during my nursing degree did I understand why some things "were".

This is the point I was trying to make, there are a lot of instances where medics are treating the civilian population. I know of a senior Army medic, (Australian) who was handed a Dying infant while on deployment and apart from the very basics had little idea how to help. Without exposure/training the medic is not going to know the baseline for small children or how quick they can deteriorate, add a language barrier and I believe that an unhappy situation could easily develop. I have toured the USS Mercy and am aware that her mission is often purely humanitarian in third world countries and wonder at the pre-deployment training with civilian casualties. If the training is similar to ours then couldn't the medics be compromised? ie: feelings of guilt for not being able to help someone. I conceed that the Commisioned officers, Nurses and MO's get hospital training yet how often do they "refresh" their skills and practice outside of the Military. I have seen here in Australia both Medical and Nursing Officers working in Hospital settings on their "days off" just to keep their hand in. In our system there is an Ad Hoc arrangement with some hospitals for medics to have placements with little chance to use or practice most skills due to discrepancies between Military and Civilian qualifications. A good example of this is that as a Registered Nurse I could not cannulate until I had done the hospitals' education package, my qualifications and years of experience as an Army medic did not count in the "Real World".

Reading another thread I was reminded about the differences between Military medicine for want of another term and the Civilian world. In the Military we have a demographic of younger, fitter people with a lack of chronic illness giving us a narrow spectrum of experience. For example, I never had trouble throwing in an IV until I started in a hospital setting trying to cannulate little old ladies, the morbidly obese, IV drug users with no (usefull) veins or the vascularly compromised. My thought is that Military Nurses and medics should spend time working in a civilian medical facility, either in a block of time that is repeated at intervals or as a part of the normal working week. As an extension of this idea is that military qualifications (more so for medics/corpsmen) are brought into the mainstream, ie: this type of medic receives the equivalent of the Paramedical Science Degree, this type of Corpsman receives qualifications as a Registered Nurse. It would require an extension of training over a number of years but to my way of thinking this extension of training would give them more knowledge to do their job better and would reward those who stay in for longer with usefull qualifications, (without the debt). Don't get me wrong, I know that there is a lot of things that Military Medicine does that is not covered anywhere else but how often could a military medic be asked to provide humanitarian assistance or happen upon civilians while on operations that require help? Any thoughts?

Lamazeteacher you have come up with a great idea. I have often thought that having serving Military medics/corpsmen working part of their work week in a civilian hospital would provide a great experience that cannot be taught. I knew very little about chronic illness, peadiatrics or gerontology until becoming a nurse, yet if the situation arose as a medic I was expected to treat conditions/populations that by training I was unfamiliar with. We don't have a VA system in Oz but I can see the benefits you propose.

I am sorry fins but that is so soft, I can't understand why.

I have become more assertive but also less aggressive. With my size, I have to be carefull not to intimidate my Pt's and found that I have learned to "use my words". It is amazing that I have found that a few choice words in a quiet tone get me further than an aggressive manner. I must admit that I am widely read and have a great vocabulary to describe my displeasure. My assertiveness upsets the Minister of War and Finance because when I get busy with something and she helps I go into what she calls "Nurse Mode", short clinical instructions, I need....., Pass the......, etc. In a shop I am different, I vote with my feet. There is an old truism "A happy customer tells 6 people about their service, an unhappy customer tells 20". I tell everybody and in a small town, 120, 000 people, it doesn't take long for word to get around.

If this is the case I have lost all respect for the President. Maybe someone pointed out that his re-election would suffer? While I am not American I felt a kick in the guts when I read the article, one group that I believe should be held high in respect are Veterans, WIA's should be not only looked after but compensated and retrained for another career. When this type of thing happens I can see it hurting not only the Veterans but society as a whole.

I can't handle throat swabs, if I had to do it myself I would chicken out and just swab my cheek. Last time I had a throat swab they hit my gag reflex and I vomited everywhere. Use the back end of a needle, the hollow bore helps drain the heamatoma quicker, and if there is enough pressure it makes a pretty fountain.

To the Pt being monitored "Just in Case" waiting for a second Troponin with gastric reflux, (New Dr decided to go cardiac pathway). "Hold your breath for 20 seconds and your Dr will come and see you." Oh yes, I did say that... his Dr and half of the floor staff visited him at a fast pace! (No they still don't know that I initiated this, the Pt had a feeling it was better to not "dob me in".)

My contract expires at the end of next month, so far I have recieved letters and phone calls almost begging me to apply for a new contract. The facility I work at is constantly in bed-block or close to it. We are opening "temporary" wards at times but are low on staff. The NRC's are in a constant fight to provide enough staff to safely fill requirements. We have a programme where foreign nurses are trained to our standards in an accelerated manner to fill our vacancies. I am not bragging, just stating what is happening here. It is not all beer and skittles, but nurses have no worries getting work here.

I worked as a commercial cleaner, exposed to chemicals, lifting and carrying equipment up and down stairs, working shift work (because the workers in the offices, industrial site, commercial enterprise didn't want to be bothered moving out of the way or be subjected to the chemicals.) and then silly me, I became the operational superviser for the region, so I had all of the above on top of doing quotes, "special cleans" and the worst part of all human resources. Try firing someone with a family after working 18 hours straight and knowing you have to find someone to do their shift...or do it yourself. And it paid less than nursing.

As an Aussie, my biggest blunder of this type is calling every male Pt "Mate". I am not the type that can get away with Honey, Sweety or the like. I did have an elderly gentleman I was looking after who I addressed as "Uncle" but that was for semi-cultural reasons and was more appreciated than Sir. Generally I try to use the Pt's name or a nickname I make up on the spot such as "My favourite malingerer.".........yes, you can relax, it was a joke.

I dont think you struggled at all, I think you nailed it.

Maybe we should link this thread with the "No Bra" thread from a couple of months ago....just to make it even funnier. Just reading the posts on this and other threads it is easy to make up ones mind (with a lot of assumptions) about other posters. Without descriptions or photos just their words and thoughts some posters show a "sexiness" that mere physical attributes can never amount to. "Sexy" is a state of mind that is expressed by attitude, confidence and outlook.

I sometimes wonder about the "art" of nursing. On entering a Pt's room and saying hello a good nurse can assess: response, ABC's, pain, WOB in addition to a range of other assessments. Would a non-caring nurse take the time to "learn" this skill. If a non-caring nurse couldn't do this would that make them unknowledgable? A nursing student on their first placement has little practical knowledge yet should be able to state the normal range of Pt observations and recognise paterns indicating the need for an intervention: if they didn't care they wouldn't tell someone so to my way of thinking that both are as important as the other.

Try whistling that tune from Kill Bill, the assasin nurse............

That in itself is sexy! Women are as bad as men, if not far worse! If the average man could hear the conversations I hear at work...........

I think that rather than another piece of paperwork for the nurse at the bedside, a different approach would be to ask community leaders of the various cultural groups to provide a broad outline of their cultural practices. This when put into a database would provide the information to provide a broadly ethnocentric careplan for an individual Pt. Trying to please everyone would be a huge waste of time and resources, not every Jewish person follows the same rules, as stated earlier. An example, as an Australian would you guys think that apart from my lack of an accent I would be different from a Caucasion American? Would a Native American from Texas have different customs to a Native American from Oklahoma, (are there Native Americans in Oklahoma?) In Australia we have the Aboriginal people, people from as close as 100 miles often speak different languages and have surprising different aspects to their culture, even though the basics are very similar. I think to provide a culturally apropriate care for our Pt's we need to look inside ourselves at our own culture and try to understand that. I will leave you with a little story that I heard years ago.........A tourist was in South East Asia on holiday and watched a monk place a bowl of food at his ancesters shrine, "How can your ancesters eat the food you put there, thats stupid." The monk turned to the tourist and asked, "When you place flowers at a loved ones grave, do they come up and smell them?"

Experience is different for every nurse from their first clinical placement to their retirement. Saying that someone has 1 year or 2 years experience is in my opinion worthless. State what sort of experience you have when applying for a job and illustrate this by what skills you have learnt. I had a classmate who we called the "Gucci Catcher", she caught all of the "Gucci" skills while the rest of us never got a chance to even see a Pt who required the interventions that she had learn't. In my first year placement I was allowed to conduct "complicated dressings" and suction dressings under supervision, there were students from my cohort who graduated without seeing a suction dressing, because they worked different floors. Even after working for a while, I have seen things that are unique to my learning experience and not known by many nurses very senior to me, vice versa, they have seen things and done things that I may never experience. You just need to state your experience and let the decision be made, then work within what you are given. Good Luck.