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.
