US Nursing Student seeking help with Global Health Project

talaxandra · Mar 23, 2010

I've been registered for almost two decades, so I can't answer on my own behalf but I have one of last year's grads beside me :)

1. After school, what steps do you have to take to attain a license? (i.e. NCLEX)

Apply for registration with the appropriate state board - the assignments and exams taken as part of hte nursing degree, combined with clinical esxperience and reviews is sufficient to meet registration requirements (in addition to a police check, which is done before clinical placements

2. Do you have a choice about what field you begin working in?

Final year students are computer matched to graduate nurse positions. We had some say in where we wanted to go (eg which hospital) and what specialties we were interested in. Some hospitals have two six-month rotations, some three four-month options, and one has a twelve-month placement. My first preference was the ward I did my final pre-match placement on. Once I was matched I was interviewed by that hospital, and happily was accepted into their graduate nurse program, on my first preference ward.

3. What does your school do to aid you in attaining a job?

Advice on computer matching.

4. Do you feel adequately prepared to begin working independently?

The first day was really scary but it helped that I knew some of the staff from my student placement. I felt happy with the amount of support I was offered to transition.

5. How long does orientation generally last for your first job? Are there new graduate programs?

I had two days of orientation (one general to the hospital, half on BACPRA and other safety aspects, half being oriented tot eh ward itself), before starting on the ward. We were allocated one preceptor to two graduates - after three days of us working with her and being supernumerary, we took a patient load eacha nd she was supernumerary (no load) for five weeks.

We had several paid study days throughout the year, as well as weekly to fortnightly sessions with graduate support educators and our preceptor.

6. Can you explain a little about what the role of an RN in your country encompasses? (leadership? team member? just do certain skills? collaborate with other members of the HC team)

My ward combines primary and team nursing; I'm still too junior to be a primary nurse but have taken on associate roles with support a frew times. We allocate geographically, with eight patients divided between two nurses. We do not routinely use PCA/CNAs.

Yesterday morning was fairly typical of my AMs. The shift began with area handover from the outgoing nurse - we heard about our eight patients, went through the charts and asked questions. My buddy and I then completed the morning plan, filling in when meds/obs/other interventions were due, and noting things to follow up with other members of the team (eg drug chart to be rewritten, new IV orders, dietary modification). We then went around to the patients, introducing ourselves while doing a safety check of the emergency equipment, before checking obs and BSLs, and getting morning meds ready. Breakfast arrives around 8AM, so there's usually time to give time sensitive pre-prandial medications (like phosphate binders and diabetic meds) before the trays arrive. That's usually the first priority, unless night staff haven't got a dialysis patient ready.

The rest of the morning included a team meeting with the stroke unit (attended by all AH, the unit manager, the stroke team including consultant, and nurses caring for the patients, who come in for their patients and then leave), a round with infectious diseases, a rehab assessment visit, two OT shower assessments, and the physios getting a patient up for the first time.

In between that we had a heap of anti's due, a dressing, one patient in full (?H1N1) isolation, a post op patient waiting for surgical review, and two discharges. I went to tea a little late, but feasted on sandwiches from one of the team meetings.

By quarter to one all the patients were washed and had their meds and obs up to date. AM to PM handover is usually at 1 but there was an inservice - all the PM staff attended, while we started care plans, notes and electronic referrals. We also took handover on one of the new patients coming in - he was another isolation patient so we got the room ready: specific isolation signs, a trolley with gowns and gloves, and made sure the mask box was fully stocked.

During my shift yesterday I spoke to the ward pharmacist about how to give a med new to me, contacted the pharmacy tech about imprest stock, consulted and was consulted by a number of AH staff (OT, dietician, PT, diabetes ed) and the palliative care and continence nurses, and spoke with members of four of our home medical teams plus one surgical team and an anesthetist. One of my patients had a routine post-ICU review, so I also spoke ot the ICU liaison nurse.

7. What do you feel will be your biggest challenge going into your first job?

I'm a year out, so this is retrospective - transitioning from being a student to being a nurse. It was a combination of mind set and getting a bigger picture of the ward, my patients and my role. Plus adjusting to shift work was harder than I thought it would be.

8. Is horizontal hostility an issue in the hospitals in your country?

Not on my ward but a friend from uni was bullied at work. She spoke to her NUM about it and apparently things were resolved.

9. What is a typical yearly income for a new graduate in your country?

It varies between states and on what shifts you do - there are penalty rates for working PMs, nights, weekends and public holidays. Last year I worked one weekend in three, ten weeks of nights, and roughly equal numbers of morning and afternoon shifts, and earned about $52,000 before tax.

10. Do the hospitals in your country provide their employees with a good benefits package?

I have access to salary packaging, which is a way of reducing my pre-tax income. Australia has universal health care, so I don't need access to an employer-based insurance program. I'm a member of the nurses' union and have $2M indemnity insurance through them

11. Do you feel that you will be respected as a new graduate in your first job, or is that something that must be earned? I was treated well from my first day, but certainly feel I've now earned respect for my skills and abilities.

agraves01 · Mar 23, 2010

Thank you so much! That is all very helpful.

talaxandra · Mar 23, 2010

Glad we could help :) I'm on leave now but can ask some of this years' grads if they're interested in participating, too. I'd be interested in hearing what differences and similarities you uncover - good luck!

agraves01 · Mar 24, 2010

I would really appreciate that, thank you!!!