I completed my first shift yesterday at an Australian hospital and boy was it a learning curve. I’m going to preface this blog with an apology to the non-medical readers who might be viewing this, cuz you may not find this interesting, but I’ll do my best
I got called to do a swing shift 3-9:30pm. They don’t do 12hr shifts here, so it’s basically 8 hour shifts and a 6hr swing. Anyways, I agree before I realize how far this hospital is (or rather, they don’t tell me how far it is)…AFTER, I’ve confirmed my shift, the agency gives me the directions which includes a 40min train ride. But to get to the train station I need to take a 15-20min tram into the city center….oh did I mention, after the train ride, I need to take a bus to the hospital? I left my place just before 1 and got to the unit at 2:45. I was lucky enough to not have any issues with the public transportation. I did have the same anxiety of going somewhere new plus dealing with trains and buses…I haven’t even mastered the trams yet! And of course there was a total bogon (aussie for…lack of a better word, white trash) sitting behind me (like back to back) on the train who was humming…and not humming a tune…humming like he was a kawasaki motorcycle. I was sitting kind of sideways-ish with my back to the window and facing the aisle reading and he decides to sit the same way but resting his head on the back of the chair…which means his head is very close to me and he can basically read The Game of Thrones along with me….while humming!!! The girls had warned me about trains and train stations, esp at night…this was broad daylight and it definitely seemed more dodgy.
I get to the unit just a bit early and begin to get report from the previous nurse…and I feel like I’m in nursing school again or a new grad nurse. Just trying to keep up with what she’s saying and figuring out what the abbreviations she’s saying. I tell her it’s my first shift at the hosp etc…and she slows down a bit, answers my questions. She gives me a quick tour and the codes for the med carts and is gone. I’m feeling a bit overwhelmed already…mainly cuz I got a shitty report. All the patients were stable, but she basically said “keep an eye on them, make sure their safe”…well no duh…of course that’s what I’m going to do. But I’d really like to know their history, how long they’ve been here, why he was in ICU, and what the plan of care is! Some stuff I was able to get from her, but it all went so quick, I wasn’t even able to register how much info she didn’t tell me till she left.
Luckily, I had great patients, 4 little old guys (all in one room)…who were so sweet and one went to surgery so I had 3 most of the shift. It was old school paper charting with flow charts and hand written MARs. Anyways, I’m just glad when I precepted at Torrance and did clinicals, we were using those, so it wasn’t too bad. I’m definitely getting use to writing the date backwards…day/month/year…I’ve been very cognizant of that since I’ve been here…even saying my date of birth..you don’t realize how unnatural it is to say it in a different order. I’ve been saying my date of birth the same way for 30+ years. Anyways, trying to find a good H&P was iffy…and then I had to scour the progress notes to figure out what was going on with the patient…all of this could have been avoided with a good hand off.
I didn’t realize the luxuries of Torrance or really all our hospitals in L.A. Here, I’m pretty sure they reused urinals, there was one thermometer for a cluster of rooms (each room had 4 patients)…the nurse laughed at me when I was trying to find the thermometer and he said check in your rooms…then I said “oh, is there one for every room?” he laughed out loud…and said you’ll be laughed at if you keep mentioning that. Hmmm….okay. Well then I needed to empty a JP drain and wanted a small graduated cup to measure…I couldn’t find one, and I asked the charge and she said to use the kidney basin because it’s graduated. Ok, well I did, but it was basically eyeballing it since the smallest measurement is 100cc. Harrumph…not an accurate measurement…but ok, going with the flow.
Also, the meds were mainly dispensed from bottles or blister packs…whereas at home, most of the meds are separated and each pill labeled in a package…here I had to get my med cup and dispense all the pills then bring it to the patient’s room. I didn’t like it…not having that final check with the MAR in the patients room…and what if they wanna refuse one…I tried to separate certain meds, like the narcotics or blood pressure med so I could check before I gave it to the patient…but I felt like it would be easy to make an error. They did have a for real mortar and pestle to crush meds though (which I really wanted to use for no reason). Another interesting sight was their sputum cups…it was literally a stack of styrofoam cups pre-labeled ‘sputum’ (think your small styrofoam coffee cups) and the lid was a lid for a drink cup…not sterile just stacked in the clean core. I totally missed getting pics of some of this stuff.
The names of some meds were different. I knew tylenol was panadol. But I forgot that the generic name is paracetamol. I asked the nurse what the other name for paracetamol was…I knew it was familiar to me but at the time I couldn’t remember. He said to me with a quizzical look…”paracetamol”….I said yes, what’s the other name again?…he said “paracetamol?”…dude…i’m not a dumb…I can read that the MAR says parcetamol but I can’t remember what the other name is…(now he’s making me doubt that there is another name)…finally he says “panadol”. Then I make the connection…I told him I’m use to tylenol and forgot…he said “that’s terrible” kind of smirking (not sure how to take that…same guy that made the thermometer comment)…ugh…was annoyed with him and it wasn’t even worth the explanation so I didn’t even want to go into this being my first shift, period, in Australia.
Overall, my shift went well. I didn’t have much to do except pass meds…I was actually bored for a bit…used that time to try and figure out what was going on with my patients. I did get to chat with my patients quite a bit…they were all so cute…and one of my patients wife liked my accent…haha. It was probably good it was a swing shift because I didn’t need to call any docs or carry out major orders. A good way to slowly introduce me into it…but there was no orientation at all. It was more like here are things and you’re on your own. The other staff was helpful when I had questions, but they were all pretty busy.
I was surprised by the differences in resources, it was by far not at all comparable to nursing in a 3rd world country, but more 3rd world-ish then I expected for Melbourne. But it could also be that hospital. Oh! I forgot to mention…the patients have to pay if they want to watch TV!! One of my patients said 2 weeks of TV cost him $80. This was a public hospital, but I think even in private hospitals it’s a thing…so when our patients get upset we don’t have HBO…just tell them that they’re lucky they don’t have to pay for network TV! Anyways, we’ll just have to see how the other hospitals compare…but I won’t be going back to that hospital…it was just too far. I had to walk to the bus stop, take a bus to the train station, train into the city, tram to my suburb, then walk the short block home…finally home 1 hour 45 minutes later.