Nurse In Australia

7 Tips to Survive a Late Night Hospital Shift

Ross — Thu, 12 Nov 2009 00:41:15 +0000

Guest post by Mary Ward

Perhaps you are new to working at a hospital or just feeling out of sorts and just plain lousy. Working the late night shift at the hospital is incredibly challenging to many people in the medical profession.

All adult human beings require seven to eight hours of quality sleep each night. Sleeping during the day is not as restorative as night sleep. Medical professionals that work the late night shift rarely get the seven to eight hours of sleep that they need. Not getting enough sleep can cause problems with mood, concentration and memory. In addition, missing out on quality z’s can lead to chronic diseases such as heart disease, diabetes and obesity.

Until a time when hospital patients no longer have to spend overnight stays in the hospital, medical professionals are not likely to stop working the late night shift any time soon. Therefore, it is critical that individuals in the medical field develop and practice healthy sleeping habits. Here are some tips to help you survive a late night hospital shift:

If you are having trouble getting any quality sleep, you should start a sleep journal. Write in your journal every day for a minimum of two weeks. Make an appointment with your doctor in order to determine which treatment is best for your situation. Take your sleep journal with you to your appointment.
Try wearing your sunglasses on the way home from work if it is light out when your shift is over. This will signal to your body that it is time to go to sleep. When you get home, draw the shades and climb in bed for a good day’s sleep.
If you are stuck working the late night shift at the hospital, try to take a nap during your lunch break. Studies indicate that just twenty to thirty minutes of sleep can make you more alert and ready to get back to work to finish your shift.
Limit your caffeine intake to no more than 500 mg per day. In addition, only consume caffeine in the first four hours that you are awake. Consuming caffeine to late into the day or night can disrupt sleep.
In order to help your body adjust to working the late night shift at the hospital, keep up with the routine. Wake up and go to sleep at the same time of day or night whether you are working or not.
Make sure that your family, friends and neighbors know you are working the late night shift. Let them know when it is okay for them to call or come by and when you will be catching up on sleep. You may also want to ask your neighbors to keep the noise to a minimum when you are resting.
Do not expect to function fully during the day just because you work the late night shift. Avoid planning any additional responsibilities during the time you should be sleeping. If you do not respect your body’s need for sleep, you will not be able to function at work or enjoy the time you spend with your family and friends.

* Mary Ward writes about how to choose among online diagnostic medical sonography degrees.

Job security luring more students into nursing

Ross — Wed, 04 Nov 2009 15:48:08 +0000

credit: Shermeee

Job security has always been a great factor of nursing. In my experiences on the job, it’s pretty rare that a nurse gets fired – you basically have to be grossly incompetent, breach some serious code of conduct or be solely responsible for some dire situation that occurred.

This is not to say that nurses take registration lightly, or become sloppy because of the knowledge that their job is pretty secure.

On the contrary, I think most people are very aware that the threat of litigation and the need to be deemed competent underlies every shift we work, and generally speaking nurses are really very careful with things like medication checks, following protocols and working hard within their level of expertise. They are also very aware that any given situation could potentially end up in court, maybe with no fault at all on their behalf, leaving the nurse to defend or clarify their actions, involvement and/or documentation for a particular situation.

One of the stories that came out of the Sunday Telegraph last month titled Nursing’s a healthy option for students has highlighted what I’ve always felt about nursing – it’s a pretty secure profession. After all, even in times of economic downturn, people want good education and good health care. You can’t really say “well, lets cull a few hundred nurses because they’re costing too much.”

From the article:

“Job security is luring more students into nursing and teaching careers.
University chiefs believe the global financial crisis – and generous new HECS subsidies – have led more students to pursue stable career options.

Applications for a nursing degree at the Australian Catholic University in 2010 are up 44 per cent on last year, while education applications have risen 38 per cent.

The University of Technology, Sydney, has recorded similar increases.

An extra 375 students have applied to study the popular nursing program next year, with an additional 99 applying for the teaching degree.

Applications for the two degrees have doubled at the University of Notre Dame.

University pro-vice chancellor and executive dean of nursing Margot Kearns said the global financial crisis seemed to be influencing students’ subject choices.

“In this economic climate, people are looking for a more structured career path,” she said. “With education and nursing, they’re actually professional degrees and vocational degrees.”

“If you do a Bachelor of Nursing, you become a nurse; whereas with some other generic degrees, the actual career paths are not as well-defined.”

Perhaps this is partly a reflection on the current economic situation. Maybe more people are thinking about job security and long term career paths, rather than pursuing other lines of study they may also be interested in. I know that for me personally, I had several interests at the end of high school, and ended up studying a completely different field before my transition to nursing. When it comes to job security, I’m glad I made the move.

Professions like nursing and teaching certainly have the advantage of leaving you with a clear idea of what your job entails. What are your experiences – is job security a factor when considering career choices?

If you’re not sure what nursing is all about, maybe have a read of Should I Be A Nurse? and Good Things About Nursing.

For those interested in nursing, or not sure where to start, I’d also recommend that you check out Nursing in the Australian Health Service.

For Travel and Overseas nurses, don’t even think about coming to Australia without grabbing a copy of Nursing in Australia: A Guide to Working and Living as a Nurse Down Under.

Should nurses light patient’s smokes?

Ross — Wed, 28 Oct 2009 11:35:54 +0000

An interesting situation regarding smoking and patient’s rights has developed in Tasmania this month, opening up a whole new world of questions on nurses obligations, rights and rules at work.

The heart of the issue is that A wheelchair bound, tobacco addicted MS sufferer has had his smoking privileges canned, after nursing staff have been prohibited from lighting his cigarettes.

From The Mercury:

“A Tobacco-addicted patient and his nursing home are at odds over regulations that stop staff helping him to smoke.

Brendan Nutting, who is paralysed from the neck down and has lived at the home for 2 1/2 years, received help from staff when the Tasmanian Health and Community Service was owned by the Tasman Council.

But, in February the Hobart District Nurses took over the home, and from next month will enforce a policy that prohibits staff from lighting Mr Nutting’s cigarettes, which are held in a robotic arm attached to his wheelchair.

The home’s managers say their hands are tied by strict occupational health and safety regulations but Advocacy Tasmania and the Multiple-Sclerosis Society say bureaucracy is prevailing over common sense.”

And the response from Hobart District Nurses Chief executive is that there is potential for further legal action if the practice were to be allowed, as well as endangering the health of employees.

“We have a world that is more than aware of the health dangers of passive smoking and as an employer we have to provide a safe workplace,” chief executive Kim Macgowan responded.

Mrs Macgowan suggested that the family were still able to help him smoke, and the nursing home would provide nicotine patches if desired.

“We haven’t stopped anyone from smoking, we simply said staff couldn’t assist people to smoke,” she said.

What’s interesting is that a lot of the decisions that have been made appear to be in order to reduce the risk of litigation in years to come.

“I go back to the asbestos incident and what that tells us is this will expose us to the risk that 20 years down the track people will be knocking on our door and saying I have cancer and this workplace contributed to it. I simply can’t allow for that.” Mrs Macgowan added.

The patient also had a bit to say on the topic:

“I’m stuck in here — I’m too young to be in a nursing home. Now I can’t even have a fag.”

“This is supposed to be my home. I’m supposed to have rights. The staff are happy to help me but it’s just the ridiculous system — there is no common sense.”

“It is a prick of a disease, I have to rely on everyone else to do everything for me,” he said.

What do you think? Is this an act of common sense, or politics gone wrong?

Are nurses injecting incorrectly?

Ross — Tue, 20 Oct 2009 05:17:27 +0000

This week’s interesting video comes from Western Polytech Hospital in America, where hundreds of people recently lined up for flu vaccinations in a makeshift clinic.

What’s interesting about it is that a news story on the clinic sparked some calls from nurse viewers, who were concerned about the injection techniques displayed & queried whether or not in some cases the correct vaccine dose was even being administered.

Watch the video below:

Click to view video if unable to view correctly.

Performing injections correctly takes a bit of practice, and clearly the video shows some pretty sloppy injection techniques. A spokesperson for the clinic stated the injections were performed by RN’s, LPN’s and Physicians.

Having been fairly closely involved with Australian nursing students over the years, personally I’d have to say that their injection techniques in general are of a fairly consistently high standard. Which begs the question – why are the people in the video slackening off? Are they simply not well trained, or is it the repetition of mass injections causing people to slacken off by the time they perform hundreds of injections back to back? Would we expect to see a certain percentage of sloppy injection techniques like this in our mass vaccination clinics also?

Damning Hospital Reports, Government Takeovers… and all that jazz

Ross — Thu, 15 Oct 2009 13:55:35 +0000

credit: EMS_EMT

Who should run our hospitals? Are our standards still comparatively high, or slipping further into embarrassing depths?

Back in 2007 (before winning the poll, interestingly enough) PM Kevin Rudd vowed to fix the Australian health system by mid 2009, or else a move would be made to take control of public hospitals.

In May ‘09 we were given an indication of the government’s intention to renege on this issue, when we heard that “the Rudd Government is expected to stop short of a financial takeover of public hospitals and instead seek control of other health areas including outpatient care and community health services.”

According to The Australian, a final decision on a takeover move has now been delayed until early 2010, to “allow for further consultation on the National Health and Hospitals Reform Commission’s final report, released in July.”

Responses to the Government’s Stance

The backlash over this move has made Kevin Rudd an easy target, and probably rightly so.

Family First leader Steve Fielding has recently stated “The health system is still stuffed and the Rudd Government has reneged on its promise to the Australian people.”

Opposition Leader Malcolm Turnbull has responded with “The critical thing is that Mr Rudd be held to account for his promise. Let’s be quite clear about this. In 2007, Mr Rudd said to the Australian people he would fix the public hospital system by 30 June this year or he would take it over. And he has done neither. He hasn’t fixed it. Things have gone backwards and he hasn’t taken it over.”

Are they right? Let’s see what the Australian Medical Association (AMA) has to say on our current standards or health care.

AMA 2009 report: Another year of overall decline

Pressure is now increasing on the Rudd government to make good on their promises as the Australian Medical Association’s 2009 report on public hospitals shows “another year of overall decline in emergency department performance and increasing elective surgery waiting times.”

According to AMA president Dr Andrew Pesce, extra funding by the Rudd government is yet to bring any improvement in Australia’s public hospitals.

“Our report card shows objectively, slowly, things are deteriorating, access in emergency departments is worse, waiting times in emergency departments is worse, on all measures our public hospitals are gradually getting worse,” Dr Pesce told reporters this week.

“Where has that money gone? Why are things still getting worse? The current funding for the public hospital system is dysfunctional to the point that extra funds don’t deliver results.”

Interestingly enough, it appears that the situation might be even worse as the report also stated that hospital data can be “manipulated to cast a better light on achievement of benchmarks for political purposes”.

Mr Rudd responded by stating he would take a ‘very dim view’ of any state-based attempt to be ‘cute’ in reporting what was going on in public hospitals. “I basically agree with them, there is a real problem out there,” Mr Rudd stated to reporters. “And therefore, the Australian government, rather than simply pushing this problem under the carpet, believe it’s time we have a fully fledged national debate about how we fix this system for the long term.”

Changing our Health Care System

The situation is extremely complex. I don’t believe on any level that it’s as simple as throwing more money around in the hope that our waiting times improve, our ambulance ramping problems stop and our hospitals can function more efficiently.

I can tell you with absolute certainty that when wards are full, admitted patients occupy acute ED beds. And this is not a great thing.

On the surface, comments like “build more wards” and “get more staff” would appear to fix the problem. However, “more wards” soon fill up, leaving us with the same problem – emergency beds are filled with admitted patients who are stable, or at least have a provisional diagnosis and plan of care. The incoming patients en-route to hospital, those ramped in corridors and sitting in the waiting room, do not.

So what else do you do to fix the problem? Fast track patients who are likely to go home from emergency rather than being admitted? Put on more emergency doctor’s and nurses, and build more spaces to see people? Implement strategies for early intervention when the capacity to deal with a trauma situation is diminished? Sure, all these things and more.

Ultimately however, I believe there needs to be a complete restructure and change in our health care system. Meaning, high occupancy levels, ridiculously long emergency wait times and corridored patient’s being a daily feature is just not on. Whether or not a government takeover would ultimately improve these key areas remains to be seen.

After all, I would suggest that most Australian’s rank having high standards of health care to be very important, am I right?

Congrats!

Ross — Thu, 08 Oct 2009 04:33:44 +0000

This month Nurse In Australia gave away some cash simply for getting involved in the new Australian Nursing Forums.

We’re pleased to announce that we have a winner – Meggles from Western Australia took home $50 cash just for posting on the forums – well done!

If you have something to say (doesn’t everyone?) and you want to make your voice heard – head over to the registration page and set yourself up with a username, it only takes a few seconds and you can post anonymously if you wish. It’s the best place to share a story, ask a question, or tell us what makes you sad/happy/angry about nursing!

Piña colada for the patient, please?

Ross — Sun, 04 Oct 2009 10:16:53 +0000

credit: Kenny Hindgren

People always ask me about what goes on behind closed doors in hospitals, so today I thought I’d give you a bit of an insiders view into emergency departments.
Just to mix things up a bit, today’s article comes with a twist of lime – I’m turning the tables and commenting on something that is widely known amongst nurses but probably not openly discussed, at least not in public

In my years of nursing I’ve come across a rather interesting phenomenon that many other health care workers have also experienced at some time or other. It really is quite a crazy concept that really defies logic, yet inexplicably it continues to occur in both the public and private sectors.

“What is this crazy phenomenon?”, you ask.

Ok here goes. And before you start throwing mouldy fruit at me, please understand the spirit of where I am coming from. Patient’s are great, and nurses are here for the patients. If we didn’t have some degree of empathy we couldn’t really function at all in the job. Honest!

However……

There are a certain portion of the population that actually seem to declare “Here I am, I’m on holiday!” upon arriving at the hospital.

If you’re picturing scenes of a family of 5 bursting into a hotel foyer with bags-a-plenty in tow, excitedly clutching at tickets and dropping bits and pieces of food as they make their way to the front counter, you’re probably not far off.

Strange but true, I’d love to give you some real life examples to back up my allegations. (Addit: for die hard nurses let me make a differentiation here between this kind of ‘holiday’ patient and another frequent flyer, the ‘dying swan’ patient, who can’t possibly push themselves back up the bed. I’ll save that discussion for another day…)

Anyway, here are some of the “yay, I’m on holiday!” type behavioural patterns I have personally been witness to over the years:

Many patient’s lie down on a bed and decide thank you very much, I am here to stay! Under no circumstances could they possibly get up off that bed, despite the fact that yes, their headache is feeling much better – and “can I have a bedpan, please?”
One man (relative of a patient) asked me if he could have some food as his wife was being unloaded off the ambulance trolley!? Say what?
More pillows, less pillows, more blanket, less blanket, foot rub, hair washed etc etc – quite fine if you’re in hospital with a broken hip after a high speed MVA. Quite not fine if you are in hospital because you drank too much last night!
Several people have asked me for a food menu to make their lunch or dinner choices while they’re in the Emergency Department. The “Emergency Department”. Not the Emergency A-la-Carte designer luncheon lounge!
Some people reach an emergency cubicle and begin to unpack – photo’s, blankets, flowers, reading material, portable DVD, games, lollies, can of coke, music – “ahhhh, here I am – does anyone know what time bingo starts?”
And the pièce de résistance: Once a girl in her 20’s came into emergency with a fairly minor complaint. From memory, it was some kind of ankle injury that ended up being soft tissue damage. She was discharged and ready to go home, and my colleague helped her to the toilets prior to departure. Minutes later a voice calls out from inside the toilets:
“Can you wipe for me please?”
My colleague: “Errr.. who wipes for you at home? Aren’t you about to go home?”
Disillusioned patient: “Yes, but don’t nurses like, help out and stuff?”
Frustrated nurse: “Errr no, you’re quite capable of wiping your own bot-bot actually”. *sigh*
As we discussed this incident later, dumbfounded, we wondered if someone was giving tickets out at triage – “one free bottom wipe with each presentation!”

Does any of this sound familiar to anyone?

Oh, and could someone fetch a Piña colada for the patient in cube 9 please? Don’t forget the little umbrella…..