US RN needs advice on working in QLD!!!

Hi allnurses!

This is my first time posting to this website and I am hoping to get answers to several questions I have! Just a quick background about myself to help paint a better picture - I graduated May 2009 with a BSN. I have now been working as a RN for just over a year on an obstetrical unit in a major hospital in FL. I am married to an Australian and we actually used to live in QLD for several years (I have permanent residency). My husband and I however have been back in the States for about three years now, during which time I acquired my nursing degree. We plan on moving back to Oz around this time next year at which time I'll have just over two years nursing experience under my belt. My goal is to eventually go back to Uni in QLD for midwifery. In the meantime I am nervous about working as a nurse in Australia as I still feel very new in my nursing practice. My questions are as follow:

1. In looking for jobs online what is the difference between a position for a "Registered Nurse" vs "Clinical Nurse" or rather nursing grade 5 or 6? Are enrolled nurses essentially like our LPN's? What job postings should I looking at on the jobs.qld.gov website for example?

We have different grades of Registered Nurses. Some states use grades 1 - 7 I think it is, others use levels. For example I am a Level 1, year 2 (2nd year) RN, thus I put myself down as L1.2. RN years go from 1 - 9 years, then you would have to study to become a Clinical Nurse. It depends on the state you are in re grades, the nurses board website for the state you are interested in should have details on it or contact any nursing agency.

A Grade 2 nurse would be a Clinical Nurse - they are higher than RNs and have a specialty under their belt. Clinical Nurse Specialists (CNSs) or in some states they are called Clinical Nurse Consultants (CNCs) are Grade 3 nurses and are specialists in their own right. They usually are the head of a unit or team. Nursing Unit Managers (NUMs) I think are Grade 4s or higher and head their own unit - depends on the state you are in I think.

An LPNs I think is the same as our Enrolled Nurses (ENs) or Endorsed Enrolled Nurses (EENs) - depends on the state re the title. They are lower than RNs but can be medication competent.

You should look for Registered Nurse job postings L1.2 to start with.

2. Are all OB jobs in Oz limited to midwives? Are there any OB related positions available to simply RN's with a strong background in antepartum/postpartum?

Yes you can get jobs just for OBs that I have seen. Midwifery is a specific job here with separate registration. All ENs, RNs, Midwives, CNs etc have different registrations, and you can only practice as one particular specialty, for example a RN can't work as an EN.

3. What are the average nurse to patient ratio's for a typical med/surg unit?

Usually in my experience one RN to 4-6 patients.

4. Are there any courses or training programs available through the public hospitals themselves to help "orient" an international nurse to working in Australia. For example I am a little nervous about learning new names for meds or learning slight differences in procedures between the US and Australia.

You would have to Google all the QLD hospitals and email them. I don't know if the QLD universities might have some sort of bridging programme - go to Hotcourses.com.au which lists 92,594 courses from 1,377 colleges and universities in Australia. Also try http://www.qtac.edu.au/Courses/courses/guide2010 - this website gives comprehensive and very detailed info re QLD university courses.

6. Have Australian hospitals converted completely to an EMR or is paper-charting still the common practice?

Paper charting is still common here. What is EMR?

7. Where should I look for jobs? Should I go through a recruiting agency? I obviously don't need any assistance with immigration however not having any experience with searching for nursing jobs in Oz would an agency ease my transition?

They could but agency work can be unreliable - it is all casual and shifts quite often get cancelled. In WA agencies are not independent of the government - a body called NurseWest runs the public hospitals and decides who works in them though private hospitals are independent of NurseWest. Over east (SA, VIC, etc) it is different. You can try these websites: careerone.com.au; seek.com.au; http://employment.byron.com.au/; http://www.health.qld.gov.au/nursing/default.asp. I don't know what nursing agencies they have specifically for QLD but the big ones are Mediserve (www.mediserve.com.au/); randstad (randstad.com.au) and ramsay health care (they run private hospitals & aged care) www.ramsayhealth.com. This is only a very few - QLD will have its own specific nursing agencies I reckon.

8. Everywhere I look I've read that Australian nurses work 8 hour shifts? I love working my 12 hour shifts! Is the 12 hour shift very common is Oz?

No not really. We usually work 6 - 8 hour shifts, and 10 hour nightshifts but depending on the shift you would work more days. Why do you love working 12 hours?

9. Lastly I know this is a fairly broad question and obviously varies between a rural hospital and one like RBH, but how does the scope of practice differ between nurses in the US vs nurses in Australia? I know both do IV's, wound dressings, etc. Reason I ask is because before we moved to the US many nurses I met in Australia were saying that American nurses are allowed to do so much more. Is this true?

Yes it seems that way. Many RNs including myself would never be allowed to site an IV or example; only specially trained RNs or emergency room nurses do that. Also I don't take blood on shifts - there is usually a phlebotomy RN that does that. However you can do training courses through many hospitals and some agencies pay for you to do these courses, or help you out with the cost. Many of these costs are also tax deductible.

Whew, that was a lot of questions but any answers would be greatly appreciated! My husband thinks I stress myself out terribly about what it will be like working in Australia. I just blame it on the fact that I take a lot of pride in my job and I want to feel confident that I am doing a good job no matter where I am working in the world!!

Thanks for reading!

You'll be right mate. I have been told US RNs are great at their job. I have worked with Canadian nurses who were great too. You will just have to get used to having a few drinks by the barbie in the sweltering summer up in Brizzy, spending hazy long days at the beach watching beach bums, and saying to your patients and yourself "No worries!" and you'll be OK. You'll be Ocka in no time at all!! :)

Plenty of RNs take bloods and insert IV lines outside of the ER myself included. However most don't insert foleys into men without extra training.

Here in Oz as well you can initate some medications without a doctors order on a once off bases such as lactulose, coloxyl and senna, microlax, mylanta, paracetomol.

You could also look into bridging programmes if you are very anxious but these are usually a year long and VERY expensive. The AHPRA may require you to take some kind of program when you register, I'm not sure it is on a case by case basis I think. Most wards don't have the looooooooong orientations that American hospitals seem to give. Mine was 2 days supernumerary following another RN but I was itching half way through the first day to get in and get my hands dirty!!

Best of luck.

Plenty of RNs take bloods and insert IV lines outside of the ER myself included. However most don't insert foleys into men without extra training.

Here in Oz as well you can initate some medications without a doctors order on a once off bases such as lactulose, coloxyl and senna, microlax, mylanta, paracetomol.

You could also look into bridging programmes if you are very anxious but these are usually a year long and VERY expensive. The AHPRA may require you to take some kind of program when you register, I'm not sure it is on a case by case basis I think. Most wards don't have the looooooooong orientations that American hospitals seem to give. Mine was 2 days supernumerary following another RN but I was itching half way through the first day to get in and get my hands dirty!!

Best of luck.

That is good info, I didn't know RNs put IVs in without special training - I stand corrected :)

No worries mate!

No worries mate!

Karenmaire, did you have to do special training to do IVs etc? I have always been told you need to be accredited to start IVs and do blood, or maybe it's just because I am a new RN?

I didn't have to because I was out bush and had to do them :) It was that or the pt didn't get IV's!

For cannulation at my hospital it is a 2 hr "course" and 5 supervised insertions. Drawing bloods doesn't require any further education where I work.

I did over 20 years ago...what you are trying to do now. It is near impossible to get a job in OB without being a midwife. However, NICU is open to non-midwives. For jobs...check out www.ncah.com.au

Thanks for the feedback, I know it'll work out but I do think it is going to be a big adjustment. I was actually thinking about NICU as a matter of fact. I hope they give more than a 2 day orientation. We usually get 6 or so weeks when you are hired onto a unit. Some specialty units like NICU and ICU give a 6 month orientation. I guess I just need to get busy and start contacting hospitals. Thanks again!

I think you will be OK. Just ask the various hospitals what they require and start applying. Also another tip, try to contact the Nursing Unit Managers directly as they will have more info than just HR - that way you can get answers to more direct nursing questions and introduce yourself. Also offer to fax through an appication/CV to the NUM to show you are keen.

From what I've been told Aussies and Americans aren't too different, and your hubby is an Aussie so you should be right.

I'm planning to go up there next year (gotta get some more experience under my belt and save, save, save) as the winters now down south and over west are really starting to affect my joints. (sigh) I'm getting old!

Let us know how you get on anyway.