Four weeks out west

I have been incredibly busy on a nursing placement in Central NSW! So far it has been absolutely incredible; the nursing staff are supportive, welcome and lovely, the hospital* I'm at has only opened in recent years and is well designed and equipped, aaaand I have finally had a chance to get in to the operating theatre and LOVED it!

During placement, I am sharing a house with three other students. It is a huge and beautiful house, though the living arrangements have proven a little stressful for me. Then add demanding assessments on top, a rotating roster and a sprinkle of sleep deprivation and you got one reeeeally tested nursing student.

Daffodils grow everywhere here!

The massive house

Ice on the first morning

Gorgeous sunrise

The neighbour's cat loves us

However, I can't complain about the rotating roster; this placement has been absolutely incredible. We do not have a university facilitator with us so the onus falls on the hospital's onsite facilitator who has been amazing! She has organised for each student to be on a different ward and shift each week which I've never experienced on any other placement. It makes sense though, especially when I want to experience as much as I can during this four weeks!

Last week I was working on an extended day surgery unit and learnt a lot about pre-operative and post-operative patients. The staff were fantastic and for the first time ever I felt a part of the team and was even called by my name, rather than "the student"! It was fairly busy and has a high turnover of patients, but all of my questions were answered and I was able to do so much; there were many opportunities to practice IV fluids and medications, wound dressings, and I even took out belovac drains for the first time.

During my time on the extended day surgery unit I fulfilled many objectives:

• admitting patients from recovery and remembering to do half-hourly observations
• getting patients ready for theatre: pre-operative checklists, anaesthetic checklists, ensuring they have two ID bands and a correctly coloured cap, etc.
• practicing drug administration, particularly IV medications
• getting in to theatre!
• learning as much as I can and being able to educate patients, for example teaching post-operative deep breathing and coughing exercises, and explaining the rationale and technique for self-administered clexane injections
• getting to know patients and establishing a relationship through effective communication strategies

SCRUBS!

Getting in to theatre was most definitely the highlight of last week. I got to see a cesarean and watch a baby be born which is something I will never forget. I also got to see urology procedures; transurethral lithotripsies, one via flexible and the other a rigid ureteroscopy. These procedures involved passing a camera up the urethra and shooting laser beams at kidney stones which really just looked like I was watching someone play Call of Duty. Being in theatre also allowed me to learn about the roles of people in the OT, anaesthetic agents used, and rationales for patient positioning. I even had a surgeon take a few minutes to educate me on anatomy via a CT scan and locate the kidney stones.

Heading back out west after spending the week in Sydney

This week I have been working afternoon shift on a surgical ward. It's been a great opportunity to consolidate more clinical skills and I got to administer an IM injection for the first time. Totally not as hard as I thought it would be. I've also learnt a little about how traction works as I had never seen it in practice before. Yesterday I was lucky enough to get in to theatre again for the whole day, and saw a few orthopaedic operations and three colonscopies. It is all fascinating!

I am extremely proud of myself so far so diving in and giving everything a go. I've tried really hard to not let myself get overwhelmed and have been open to new clinical situations. I cannot wait for the next two weeks; ICU and CCU!


*I shall keep details as anonymous as possible - my intention is to merely reflect on my experiences.

Progress notes

I cannot believe that tomorrow marks week 4 of semester already! Time has been flying, yet passing so slowly at the same time :\ I haven't got much time to spend blogging but here is what has been happening...

I had my New Grad interview on Monday (12th Aug)! I'm not feeling 100% confident but it's over! My questions weren't too hard; I just found that I had a complete thought block and I put that down to how nervous I was :( Hopefully the panel take nerves into consideration! My questions were about: skills and role of an RN; a scenario; the multidisciplinary team; social media; CORE values; and infection control. Unfortunately now the long wait continues until early October when we get the result - offer, or no offer. I have also applied for a New Graduate Program within the private sector to increase my chances of getting something.

I'm yet to really get on top of any of my assessments - yes, partially my fault, but many thanks to factors out of my control. Last week a burst water main affected a few of the university buildings, and a result our online library was offline. That meant no access to databases, journal articles, etc. This proved frustrating on one hand because I was unable to access academic sources of information. However, on the other hand, I didn't feel guilty continuing my procrastination and even allowed myself a few sneaky wines! As of this afternoon, all systems are back in action; eeeeek, deadlines are looming! I am a little worried about having all the work done in time, especially because placement begins soon (read on!).

Lastly, placement begins soon! My four-week placement starts on August 26 and for that time I have AM shift. I'm surprisingly feeling good about placement (which is rare - I only ever associate really negative words with placements!) and am not only looking forward to consolidating my clinical skills, but also getting my head around AM shift and giving everything a good go. Up until last semester I'd never had an AM shift before. EVER! And it sucked, but that's another story. There are four of us that are renting a house in Orange and I am able to take my gym membership with me which is fantastic! My man plans on driving out to visit on the weekend too!

Besides university and work, I've been trying to keep myself sane and get back into some kind of routine! Before uni went back, I went camping for a weekend in Karuah National Park. Absolutely beautiful there and our campsite had a great view of the river. The following weekend, made it to Awaba State Forest for a 4WD which was good fun and resulted in another part of the 4WD giving in. Yay for repairs...

And last Friday, most of the Wolfpack reunited for a Thai dinner in the city! It was amazing to catch up with everyone and see what people have been up to since Thailand.

Aaaaanyway, I best be off to prepare for class tomorrow and get my bag packed. I hope to post more regularly but I'm sure you understand how hard it is. I just keep reminding myself that there is finally light at the end of the tunnel!

Cheers to a productive day today!

Elephants bring good luck, especially when the trunks are up

I'm sitting in my home in Sydney, where the weather is 16.9 degrees, a drop of 15 degrees from what it is currently in Bangkok. It's been almost 2 weeks since I arrived home, and the trip now feels like a dream. I flick through my photos and think about what I experienced... and it all seems like a million worlds away. The most trippy part for me is wrapping my head around the fact that I finally made it overseas for the first time!

When I think back to arriving in Bangkok and venturing out for the first time I can't help but laugh. I had these horrible ideas in my head of being followed or pick-pocketed, yet I felt so safe and accepted. I remember worrying about what I'd be eating and feared getting sick, yet I ate fresh fruit, drank iced drinks and brushed my teeth with tap water! But most importantly, I kept my mind open to what lay ahead of me and what I would be experiencing as part of the Experiential Nursing Program. I knew before the trip that barriers in verbal and non-verbal communication would exist, and these barriers required me to be flexible and adaptable when interacting with people. Learning a few words in Thai definitely helped and it is evident that a smile can mean a lot. Also, being immersed in an unfamiliar culture compelled me to be aware of my own beliefs and customs and I remained open-minded to new and differing scenarios, always conducting myself in a culturally safe and appropriate manner.

I struggle to think of anything that would have enriched my life or influenced my personal or professional development to the extent that this trip has. I can say that without a doubt, I returned home with a greater appreciation of the health care available in Australia and a greater understanding of socioeconomic issues and their impact on health in developing countries. Where do I begin describing what I witnessed? Diseased and injured organs and limbs. Forensic photographs of horrific accidents. Babies born with lethal abnormalities. Women swaying around poles atop bars, expressionless. The sad result of sex tourism and children left in orphanages. Rubbish dumped in streets. A homeless man and his dog sleeping underneath the train station. Unprotected motorcycle and scooter riders transported 2, 3 or 4 passengers. Polluted waterways filled with rubbish and dead fish. Exquisite temples standing between rundown apartments and tall commercial towers. Markets selling medications that would require a prescription if sold in Australia. Women begging for money with children asleep in their laps. Private hospitals filled with international clients. People living with HIV socially isolated and forgotten about.

All of this just emphasises the fact that health care should be a right, not just something that exists to those who can afford it. The focus of health in Thailand needs to change from elective and cosmetic, to prevention of illness and promotion of health; through increasing education, eliminating stigma, and reducing social inequalities. Our visits during the program also highlighted the need for better equipped rural and remote facilities and recognition of their importance in the health care system for reaching disadvantaged populations.

Overall, this experience confirms my choice of career: Nursing, the art of care and healing that translates universally regardless of language, country, and culture. I know that I am destined to do more than work on a general ward; I want to be working to help the disadvantaged, I want to work in rural Australia, I want to travel overseas and see where nursing can take me, and I want to contribute to changing the culture of nursing in Australia.


Things I'll miss about Thailand:

• Living in a completely unfamiliar environment and culture
• Walking through the city and exchanging smiles with strangers
• Meaningfully relating to people non-verbally
• Venturing out in to the city not knowing what to expect
• Seeing squirrels scurry along power lines
• Playing with gorgeous and happy children
• Sleeping less than 6 hours a night and dreaming about the buffet breakfast I'll wake up to
• The buffet breakfast
• The street vendors and fresh produce
• Being able to afford to eat prawns in every meal
• Conversing in a new language (Sawaadee-ka!)

I will even miss:

• Waking up so early to allow copious amounts of time for traffic
• Eating too much food because it is too delicious not to consume
• The heat and the interesting smells
• Sitting on a bus for hours being able to absorb the views of changing landscapes
• Blowing my nose every 30 seconds while eating the spiciest meals

What I'll remember for the rest of my life:

• Being so welcomed into an entirely different environment and culture
• Discovering an absolute love and passion for travel
• Participating in a rich learning experience and further discovering my interest in health care
• Pushing myself beyond my comfort zone and surviving
• Immersing myself in the experience and making the most of every moment!

But for now, reality beckons. A few days ago I received my subject results for last semester; 3 Distinctions and a High Distinction - absolutely stoked! On Monday, I'm back at university for the last 6 months of my degree! It's all starting to feel a little more real, especially with my New Graduate Interview date fast approaching. I also have an upcoming placement in Orange (Western NSW) which will give me a perspective of rural nursing and I cannot wait!

ISBAR

Well, welcome to the inner-most thoughts of a passionate nursing student! This blog is intended to be a space where I can share and reflect on clinical experiences and whatever else may cross my mind, or to merely entertain the occasional visitor.


I am currently completing the last few months of a Bachelor of Nursing, with the deadline of New Graduate applications looming (eeeeek!). This journey of becoming a Registered Nurse has been challenging, albeit empowering. The last three-and-a-half years have consisted of deadlines, essays, tears, happiness, clinical experiences, long hours, new friends, exams, triumphs, learning curves, medications, COFFEE... the list really could go on.


So, I have started blogging now for a few reasons:


Firstly, a normal day for me involves having a million and one thoughts trapped in my head. I'm not one to write down thoughts on paper, so here I am. 

Secondly, I question a lot of things about the health industry and my own practice, and this will be a fantastic forum for reflection.

Lastly, I incredibly got offered one of twenty scholarships through my university; for an experiential nursing learning program. Titled 'Health for Wealth: Nursing in Developing Economies', the program will take place from 30 June to 12 July 2013, and I plan on documenting every single exciting detail about this amazing experience!

In the days to come I will explain a little more about this program and why I chose nursing as my future career. Watch this space.