It’s been a very busy few weeks. At work, I was added to a team and we are preparing to train for our new charting system. I have to say it has been rather exhausting. It’s a very different system and while I can understand that in the future there will be benefits to this system, in the now…it is a very frustrating one to work with.

On Monday I start training with a few of my co-workers. Over the next three weeks, we will be training over 400 nurses. Should be an interesting experience.

In other news, this last month has been fraught with worry. Starting a few days after 9/11, Australian news programs began discussing the rise in the terror level and the number of Australians that may be fighting against their own countrymen. A few days ago, there was a police raid in several Sydney suburbs. The government had incepted chatter about a possible terrorist attack. There was supposed to be a random beheading in Sydney…just a random citizen pulled from the street and beheaded for all the world to see.

These news broadcasts brought the feelings I had around 9/11 back in full force. I remember exactly where I was when I first heard the news. I’ve been more anxious if I don’t hear from my husband when I normally do, but I also need to focus on the now and move past these thoughts. The police and military here are well prepared for this and I know this.

Just my thoughts as I relax on my day off. Australia isn’t all rainbows and puppies, but I still love it here.

As I am all cuddled up in my very comfortable bed; with an excellent view of Sydney, I feel so at peace and so happy. My husband and I are celebrating 100 days married today. Whilst it is a silly little celebration, it reminds me of how thrilled and scared I was to come to Australia. I chose to leave the US behind and move to Australia to be with my husband. It was a hard decision because Australia is so far from everything. It’s a little joke that has frequently appeared in our relationship.

Not only is the flight long, the time change is exhausting. Currently, it is a 14 hour time change. If I plan to phone home, I have to get up at a decent time or make plans for Skype calls well in advance. Daylights Savings Time occurs here in less than a month and then it will be a 15 hour difference. Eventually when DST happens in the US, it will be 16 hours.

When we flew to Europe for our honeymoon, it was a LONG flight. We were in the air for 24 hours. Thank goodness for a stop Singapore. Australia is so far from everywhere, but it is so worth it.

My biggest fear wasn’t relocating to another country. Instead it was “how to be a nurse in a different country.” All of a sudden I was even more grateful for my experience as a travel nurse. If it weren’t for my travels back home, I might not be in the situation I am in today. It’s likely that I would have been far more stressed out and may not have been able to adjust to the differences.

I’m working at a Private Hospital in Sydney. The hospital has the same beds, monitors, IV pumps, and ventilators as I’ve used in the past. Those similarities made it easier to adjust, but what traveler hasn’t had to jump in with completely different equipment and just go for it after 12 hours of orientation. That was the easy part. The computer charting wasn’t difficult. Like most computer charting, it was just a matter of playing with it for a bit and remembering where to go to chart whatever needed charted.

The hardest thing has been and continues to be medications. There is not Tylenol here; Only Panadol (which is acetaminophen, but that is besides the point). If you ask for Tylenol, you’ll only get confused expressions. No Advil; The Ibuprofen is called Nurofen or Hedafen. You can buy Nurofen Plus over the counter and it contains codeine. If you want to buy medications at the Chemist, AKA Pharmacy, you will need to consult with the Chemist and he will decided what medication is best for you. I just go to Aldi and get Nurofen. Much easier.

I think the first few weeks I spent hours staring at medications and searching for them in the medication book only to find out that these are medications I’ve been giving for years and I have to say it was really frustrating. Dosing was a roadblock as well. Magnesium is administered in mmols instead of grams. So I administer 10 or 20 mmols. Just the little things that make you stop and think.

Lab values are yet another hurtle. Pathology was something I didn’t even consider. We keep our patient’s Blood Sugar Levels (BSL) between 5-10. It took months to not block that out.

But when I was working earlier this week, I realised how much I really love it here. I was with an agitated, intubated patient. We were planning to extubate which meant no propofol or sedation of any kind. It also meant frequent Inotrope tritration to maintain blood pressure parameters. Up and down on the Norad (Levophed) and SNP (Nipride). Back in the US, I would have had 2 intubated patients or 1 intubated patient and one easier patient (depending on the day and the Charge Nurse), but at my hospital; intubated patients are 1:1 no matter what. I felt very grateful to be working in this environment.

Our fresh open heart patients are 2:1 as is our large Neurosurgery cases for at least a few hours. In our Grade 5 AVMs, we’ll have one nurse just to titrate drips when they first arrive back because the blood pressure parameters are so tight.

I’m sitting in bed,on this beautiful Sunday morning, feeling blessed beyond belief.

It’s a beautiful day here in Sydney.

I spent my arvo hanging out at our rooftop pool. 

On 1 September, it was the first day of Spring and this is such a lovely day!

I may have been here for nearly two years, but I have yet to get used to pronunciation of certain words. Medications are pronounced differently; names are pronounced differently, and most of all, letters have different sounds. 

When discussing the letter “Z”, it’s called Zed. If you say the “H”, it is pronounced. “aitch”. That is just the tip of the iceberg. I’m very happy that I arrived months before I started my job. While I still say say huh quite often, I understand much more. 

Phrasing is so different as well.

If discussing is about the season finale of a show on television or telly, it will be the season Final. If a show is on next Monday, it’s on Monday week. 

We’re going to Hospital instead of going to the hospital. Crook equals sick. Chock is chicken. And an Esky is a cooler. 

Whilst it might take a while to get used to the sayings or pronunciations, it’s fun to learn new ways of saying things and it’s even more fun to argue with my husband about the proper way to say it and pash after play flighting. 

Two years ago, most of these statements would thrown me for a loop, but I’m finally getting the hang of it.

 

MUH is hiring. I’m so excited that MUH is willing to looking at overseas applications as the Nursing Unit Manager has posted job listings. We are expecting a Nurse from England to add to our very diverse workforce. So if you are an ICU nurse and have started the AHPRA application process, you should come to Sydney. 🙂

 

Today is the first day of spring and the first day it hasn’t rained in a few weeks. It is gorgeous!

Today is the first day of spring and the first day it hasn’t rained in a few weeks. It is gorgeous!

The cost of living is high in Australia. Rent is weekly and I pay as much in one week as I did for an entire month in Miami. Base pay for nursing is about the same as in the US. However, I work at a private hospital so I get paid “penalties”. These are benefits to the nurse, but penalties against the hospital. If I work night shift, I get paid 15% more an hour than when I work day shift. If I work Sunday, I get paid 50% more and get extra time off. 

Cars are very expensive. When I was living back home, I had a Kia Soul which I purchased for around $15,000. The same car here in Australia is $38,000. I bought a 2004 car for $5,000. 

My biggest suggestion is if you want to come to Australia; grow a BIG nest egg. 

Nearly everything costs more.

Coming to Australia as a nurse was a dream come true. I love my job and I adore the people I work with. Eventually, I want an Educator position, but until after my Mum visits, I’m happy to stay at the bedside. 

Not only to I love my job, but I got to get married in one of the most beautiful locations in the world. If these isn’t enough reason to visit and stay in this beautiful country, I don’t know what is.

I’m very lucky to work in a hospital with computerised charting and Physician Order Entry. I have to say that it has taken time to adjust to medication administration. Firstly, many of the medications have different names. Some have the same generic names, but different brand names. Others have completely different names and after quite a bit of searching, I have been able to find the American name for the medication. I’ve caught myself smacking my own forehead when I finally put 2 and 2 together and realised that this is a medication, I’ve been administering for years.

Examples:

Levophed = Noradrenaline

Nitroglycerin = GTN or glyceryl trinitrate

Metoprolol = Metoprolol (Thanks Goodness this one is the same)

Insulin = Actrapid

Tylenol = Panadol

Advil = Nurofen

Phenergan is the same, but pronounced fe –NER- gan

Secondly, medications are often delivered by the pharmacist to the patient’s room. Each patient, in my hospital, has a locked drawer in their room. Their everyday medications are kept in this drawer. Although some stock is kept in the medication room, it’s not all inclusive of the meds you would administer on a given day.

I haven’t seen nor heard of a Pyxis since I’ve been here. Man, do I miss the Pyxis. Heck, I’d even take an Omnicell at this point. Narcotics, known as S8 and S4 medications are in a safe behind locked doors. To sign out these medications, two nurses are needed because two signatures are required. We count the S8 drugs at 0700 and 1900 in the Intensive Care Unit.

Thirdly, the frequencies are different, but just different enough to make it difficult to remember.

BID = BD

Every Morning = Mane

They write medications as 4^th hourly instead of q4.

It truly is the little things that can add stress, but it is stress that is easily overcome.