Issues and Challenges

Do you look after your feet?

Wednesday, August 25th, 2010 by niknak30

Nursing is one of those professions that has you on your feet most of the time. Like waitresses, shop assistants, surgeons and pharmacists and people from many other professions, we often end the day with sore or tired feet.

What is it that you do to make sure you can get through your day whether it be a 4, 6, 8 or 12 hour shift without being unable to walk?

feet

I have always been a fan of buying good comfortable shoes. I don’t buy shoes that are designed specifically for nurses. Why is that you might ask?…. well basically it is because they look a bit ugly to me. Now, I realise that nursing is hardly a fashion career, but being that I have always had to wear a uniform, my choice of footwear is my only fashion choice I can make for myself.

So, what shoes do I wear? How do I choose them?

Well basically I just choose a shoe that fits my foot well, has a reasonable amount of support in the sole, that I like the look of and that feels comfortable when I try it on. I tend to go shoe shopping late in the day not first thing in the morning so that my feet are at their most tired and therefore I will get a better sense of what feels comfortable.

I tend to buy shoes every 12-18months and on the most part my shoes last that length of time quite well. Being that I just purchased a new pair of work shoes last week I thought it fitting to write about the ones I chose this year.

If I went with the packaging (which I didn’t) I would believe that I will have toned calf muscles, good posture, tightened abdominal muscles, improved circulation and will lose up to 5kg. They also came with a DVD telling me how to walk in them…. which I have yet to watch. Now, whilst that all sounds good, my aim from a work shoe is to not cause me foot pain after 12hrs. Thankfully, this purchase – my most expensive work shoe at $179 has provided me with comfortable shoes that lasted the distance at work.

I have a school friend who is a podiatrist and he agreed that whilst they are a good shoe (when you walk on them properly) the toning shoes as they are known are a fad. Again, that doesn’t really bother me, as long as comfort is maintained.

I would like to say that I also think a soak in the foot bath at the end of a long day does do my feet wonders, but that’s not when it counts. What counts is those last 2 hrs of the shift when you think your feet won’t hold you up any longer. That is when I most appreciate the investment in my feet and my comfortable shoes.

foot bath

How do you choose to look after your feet? Is it the shoes or do you have other ways of looking after your feet?

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Image credit: wombatunderground1, fljpg.

This post was brought to you by th NSW Nurses’ Association.

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A stressful occupation?

Friday, August 13th, 2010 by NU_admin

Nursing is a demanding profession.

The critical nature of the work has the potential for serious injury to others if a nurse is careless for even a moment.

nurse overwork

Nurses are short-handed, understaffed, and overworked.
We are only an accidental needle stick or body fluid splash injury away from exposure to deadly diseases.
We get aches and pains from lifting and tugging on people bigger than we are. We watch people die. We see families grieve.
Often we work double shifts to meet the needs when staffing is overstretched. We are tired.
Yet we love nursing — most days. But we need support and help to cope.”

(Turley, 2005b) Nursing Economics.

The physical and mental well being of nurses can be significantly impacted by these repeated challenges and can lead to stress, burnout, fatigue and even panic attacks.

The stress levels involved with the work can cause nurses to reduce hours, move to a less stressful part of nursing, or leave the health care industry all together.

What can be done to help our nurses deal with stress?
What are your thoughts? How do you cope?

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Image courtesy of Cristiana Care.

This post was brought to you by the NSW Nurses’ Association

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At Australia’s Federal Elections, what do nurses stand to gain or lose

Tuesday, August 10th, 2010 by NU_Editor

From time to time, we feature comments submitted by Nurse Uncut members to highlight what they have to say. Here’s one of these enlightening comments by Nearly Left on one of our past blog entries “The New Australia Health System – what’s in it for nurses?”

Gillard vs Abbott

Gillard vs Abbott

I’ve read all of the above. Given the dates, some of what has been said is now either obsolete or in the process of ‘political promise’, given the forthcoming Federal election.

Some of what has been stated in the previous comments seem to be a touch ‘ill-informed’. by this, I mean, you can’t just go up to your Local MP and start ranting away about the Health system. You can’t rock up to the NSW Labour Council, and demand to speak with a campaign manager, and you most certainly can’t turn up to an Area Health Service HR office, and start carrying on about how your Nursing career has deteriorated over the past twenty years or so. ( at least two of those options will cause you to be taken away to a ’safe environment’ for some psych. assessment !! )

We will see change in the next few months.

Post the Election, no matter which major party is elected, some major changes in Health will occur.

As you know, if you have been keeping up with the ‘promises’, both the major Parties are planning big promises for Health. Not only Public Hospitals, but Aged Care, Private GP Practises, and aspects of funding and rebates etc.

Now, down to a little ‘ nitty-gritty’……

Labour ( PM Julia Gillard’s team ) have spoken about NURSES – numbers, workplace conditions, training, and funding.

Tony Abbott ( Liberal Opposition Leader ) has claimed, he will throw over $900M into Aged Care. Sadly, he couldn’t seem to think of using the word ‘Nurses’.

In his ‘infamous’ policy speech, he promised the world….. but didn’t promise anything to NURSES. No funding. No training. No wage rise. No workplace conditions improvement. It was all about spending on infrastructure and funding resources that will produce better facilities….. for PRIVATE providers. That is, he will fund bigger and better Nursing Homes, that will make more profit for those who ONLY exist to profit from the lives of our esteemed elderly in their final years of life.

Sadly, Mr. Abbott didn’t think that it’s the NURSES who actually care for the residents on a day-to-day basis.

It’s the NURSES in Aged Care who are paid up to $5. an hour LESS than Public Hospital Nurses ( No argument with Public Hospital Nurses intended here – of course you deserve your rate of pay ).

Mr. Abbott has not addressed this wage gap in any aspect of his Policy on Aged Care.

By contrast, Ms. Gillard has in fact acknowledged NURSES.

She will honour the former Rudd Administration promise to inject millions of dollars into TRAINING for NURSES. We will see improvements in Agreement negotiations ( replacing the former Awards ), and she knows who and what NURSES stand for.

Ms. Gillard received a standing ovation after her speech to the NSW Nurses Association Annual Conference of Delegates (on the Wednesday of the Delegates Conference, not the Friday general Professional Day ). She spoke of her recognition of the Nursing Profession. She encouraged all Nurses to continue the fight for recognition of our worth in our communities, and she vowed to continue the push for greater expansion of the Services provided by our more highly trained Nurses in areas such as GP Practises; Nurse Practitioners, and general workplace condition improvements.

However, it is the potential Abbott Govt. that poses the greatest risk to our Profession ( and many others )……. the spectre of WORKCHOICES.

Whatever the name – Never again !!

Mr. Abbott says he wouldn’t call it WorkChoices, but then Mr. Abbott has said a lot of things lately…….

On Saturday 21st. August 2010, think of what YOU stand to gain….. and what YOU stand to lose.

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Image credit: The Age

This post was brought to you by NSW Nurses Association

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A Reaction to the Red Cross Ban on Gay men donating blood

Monday, July 19th, 2010 by NU_Editor

From time to time, we feature comments from our members on articles we publish on our blog if we think their opinion or feedback is worth highlighting for others to read as well.

In April we publish a blog post here by another nurse regarding a review that the Red Cross is doing on a ban against gay men donating blood. This article received quite a number of comments from our members.

Here’s one from Bory_88 we’d like to highlight. Bory_88 is a nurse at the Clarence Street Blood Bank Mobile Unit

Red-Cross-Blood-Box-Poster

Okay, I’m going to wade into this. I am currently a Nurse with the Large Mobile Unit of the Clarence Street Blood Bank.

I’m going to put a facts out here that a lot in general seem to be missing.

We ask One question, which has just been change:

Have you had Male to Male Sex, Oral or Anal, with or without a condom, in the last 12 months.

That’s it. I’ve deferred people for it many times, never once did anyone have go at me or cause a scene.

We also defer you for six months for many lifestyle choices, such as:

  • Intercourse with a sex worker in the last 12 months,
  • being a sex worker in the same time frame,
  • intercourse with a person who lived in a HIV n the last 10 years, male or female, with or without a condom,
  • injecting drugs not prescribed by a Medical practitioner
  • A Tattoo within the last 6 Months (Used to be 12, changed this week to 6)

then ones not related to life choices,

  • If you suspect your parter has done any of the above
  • Treatment with clotting factors VIII or XI
  • Being in prison for more the 72 hours

But that is a mere fraction of what we deffer for. Anyone who lived in the UK from 1980-1996 is permanently deferred. If you’ve had a stroke or heart attack, if your epileptic, all permanent deferrals.

And my final point. A warning to any who intends on lying on this document. The Human Tissue Act (NSW) states, you could face penalties of between a $5,500 fine to 12 months in prison for lying on the form. It is a legal document.

I’m not taking sides, I’m just stating the facts. These policies go way above the heads of the nursing staff who do the interviews. Our guidelines need approval from the T.G.A.

Image courtesy of Australia Red Cross

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Finally a paid parental leave scheme for working mums in Australia

Tuesday, June 29th, 2010 by niknak30

In December last year, Shirley wrote a piece on why Australia is lagging behind other countries when it comes to paid maternity leave. Imagine my surprise when I heard that the Australian Government had passed the Paid Parental Leave Scheme.

breastfeeding

breastfeeding

What a wonderful result for the women and families in Australia!!

With rising child care costs and often the inability to find places for our children, it will hopefully mean we are able to spend more time at home with our babies without causing unneccessary financial stress.

As a public hospital nurse, we have long been fortunate enough to receive paid maternity leave of 14 weeks a our base rate pay and I know we all appreciate that our union worked hard for us to have this.

What I wonder now is what exactly our entitlement will be? I have read a few articles on this and none have given me a definite answer on exactly what I would be entitled. Is it that we get the 18 weeks minimum wage and then the 14 weeks from our place of employment?

Do we get our 14 weeks stretched out to the 18 weeks but only at the national minimum wage or is it all paid at our base rate nursing wage ?  Do we get a similar deal to the non working mothers which continue to receive the means tested baby bonus and then our 14 weeks provided by the hospital?

Whilst I am happy to receive whatever I may be entitled to, it seems unclear and somewhat confusing. Am I the only one that feels this way? Will you decision to expand your family be reliant on this information?

Photo credit: RubyJi on Flickr

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HIV/Hepatitis Scare

Wednesday, June 16th, 2010 by ara-c2009

Recent reports suggest patients have been infected with HIV after having had an endoscopy as a common denominator combined with the use of unhygienic instruments, I find the fact that patients have been exposed to such a great health risk like HIV or hepatitis totally irresponsible. 

 spear-nurseWhy do we have problems like this which we all know are preventable??  If only people followed the infection control protocol on how to udisinfect and sterilize equipment used in invasive procedures like endoscopy. 

In the clinical setting I don’t know how a HIV positive patient can be ‘handed over’.  In the UK where I worked previously, it is permitted to write in the handover sheet “High Risk” which means that the patient is HIV positive.  The actual word HIV is not written in case somebody misplaces their handover sheet due to confidentiality issues.  Here in Australia I don’t know if it is usual practice to record in the handover sheet that the patient is HIV positive or not?

  • Do you have anyway of communicating when there is a risk of blood exposure from a HIV positive patient in your place of work?  
  • Do you think there is a risk of not recording anything on the handover sheet to warn us in case we need to take their blood or do cannulation for the patient? 
  • Do you think its fair that while preserving patient’s confidentiality our own safety is compromised?
  • What can we do to protect ourselves and other allied health professionals from such a risk?

It’s good if we are working in the same unit and know from the start that a patient has HIV or Hepatitis but what if we don’t know and the person who handed the patient over forgets or did not know as well?

Don’t you think a simple warning like ‘high risk’ or ‘blood prick precaution’ or simply putting a ‘yellow’ word in the handover sheet instead of infectious will be enough to protect our health and those of others who are not yet infected?  

What do you think? Any suggestions from the Department of Health?

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We need less Nurse Chiefs and more Nurse Indians!

Wednesday, May 26th, 2010 by NU_Editor

We have a lot of passion members of Nurse Uncut. One of the topics close to their hearts is the Australian Health System and the changes about to or have been implemented.

indian and chief nurses

Let’s “hear” it from jessjack86:

This is an opinion that is not ” Mouthing off” or a “Whinging session” but here goes…

How about we get the top notch politician’s and ministers that throw the money around, and choose where it goes to work the public hospitals in rural and remote areas and do everything that nurses do??

For instance, bed pans, IV lines, Feeds, routine medication rounds, routine observation rounds repetative paperwork, etc. Let them deal with the abuse and aggression from patients, doctors and managers because of something that really had nothing to do with the frontline workers.

How about we let them experience the real restrictions of living in smaller communities, having limited resources, and if ya get really sick, being transferred to a tertiary hospital that is 100’s of kms away from home and family??

This may seem completely off the track of the subject but there is a point…

When the health system is re-shuffled because it is in crisis generally it becomes more critical than before. Rural hospital get the short end of the stick with further budgeting and staffing cuts.

Some of the issues with budgeting pressures are due to the lack of permanent staff spending more money on agency staffing, (getting the money that all nurses deserve), however it takes away money for other needs.

There is a stigma out there to further “learning and development”, keeping up with ‘evidence based practice’ and ensuring that our knowledge is up-to-date, to provide the best care for our patients.

But how are we supposed to do this when there is no available staff to cover us? As well as having to fight with management to be released for the internal or external courses that we are required to do.

Where are the extended resources going to go? Bet they won’t go to rural communities!

All these extra beds they are opening, how are they going to staff them or will the current staff have to have an increased workload?

All these questions need to be answered before they think about the big management re-shuffle. Why not ASK the FRONTLINE workers???

Why is it when the frontline nurses score themselves a managerial role, that they always forget what it was like to be a NURSE ON THE FLOOR??

Why not sack all the managers and make them reapply for the position and prove themselves to be worthy of the position?

I don’t normally get into all this political whoo-haa but lately I have endured a few politically incorrect moments that have opened my eyes to the causative agents related to a deteriorating health system.

Let’s all stick together, us nurses, strike at the same time for an entire week and see who will run to the frontline and care for the patients, or will it be a fight for who will be the leader all over again?????

We need LESS CHIEFS AND A LOT MORE INDIANS for this health system to be repaired!

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Image credit: sxc.hu

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I am a Mother, a Daughter and a Nurse

Monday, May 24th, 2010 by niknak30

I am a mother, I am a daughter and I am a nurse and these three titles are ones that are forever merged.

mother and child

mother and child

Since becoming a single parent ten years ago, I relied heavily on my mother for childcare, advice and support.  I was fortunate that I was able to move in with my parents and they helped me so much that I was able to get myself back on my feet.  I used formal childcare on the weekdays but on weekends I had no option for a child care centre and yet because I worked a rotating roster I had no choice but to do my share of weekend shifts.  Also, by working the weekends I was able to work less than full time…. I was very fortunate and I realise that not all people have that level of support from parents who were well into their sixties.  Living an hour away from my job, I also had the issue that I had to leave home before the child care centre opened and with night shifts there was no other option in terms of care.

I studied hard and was proud of being a nurse so to not continue doing that when I became a mother was not an option.  I have always loved my work with children and it mattered to me to continue what I started.  My parents encouraged me to do further study when I wanted, to go out and meet people and socialise on my days off and in the evenings and to continue the life of a 28 year old.  They never expected me to sit at home with my two year old and lose all of my independence just because I was now no longer a wife.

I am very grateful that they gave me those opportunities, as now in 2010 I am no longer single and my son has the influence of a man who treats him as a son.  I have a wonderful relationship with my son who is loved and nurtured by not only his mother but also his Nan Nan and Pa and my relationship with my parents is better than ever.  I read in the papers often of the increasing role that grandparents have in the lives of their grandchildren and I think it is wonderful.  My son is an only grandchild and I am very aware that this also impacts the amount of care he has been able to get from his grandparents.

In an ideal world my situation would not have been that I became so heavily dependant on my parents.  In an ideal world my finances would not require me to leave my son and put him in care.  In an ideal world, I would have had the support of my son’s father.  In an ideal world, I would have had set shifts in my job that fitted into my life.

Let’s be real though….. this world is far from ideal, but I am happy to say I have made the best of it, I have never compromised my beliefs in how I wanted my son to be raised and our family (all be it extended) has loved and supported each other.

So on this mother’s day, remember that we may not do it perfectly, we may feel guilt along the way and we may take a road we never imagined but all in all, the majority of mothers do the best they can!  And that is something to be celebrated!!

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Nurses, are We confusing Dementia with Hearing Deficits?

Thursday, May 20th, 2010 by shoils

For the past month I have been trying to organise one of our residents to attend hydrotherapy with a private physio company. Mr X got approval from DVA (Department of Veteran Affairs) and was considered a good candidate for such hearing aidtherapy. This decision was made by the practice manager over the phone after I had spoken with her at length about Mr X. I finally got him an appointment for an assessment at the hydrotherapy place, sent him off, and after an hour he was sent back.

I then received a phone call from one of the physio therapists, in a very distressed and angry tone she proceeded to tell me how Mr X was not a candidate for hydrotherapy. He was demented, confused and didn’t answer any of the questions she had asked him. She couldn’t see how we thought he was a suitable candidate, he had arrived in a wheelchair and was unable to get up on his own. I let the physio have her say and then calmly told her that Mr X in fact was not demented or confused, he is able weight bare and walk with assistance from 1 staff and a frame. This in itself makes him a candidate for hydrotherapy….. no?

When thinking back later that day it dawned on me that the reason she must have thought he was demented and couldn’t answer her was probably because he couldn’t hear her properly. This confusion happens more than we care to think about. Many residents are branded as demented, confused, depressed, and as having behavioural problems simply because they cannot hear properly.

How many times have we seen a diagnosis of dementia on a discharge summery yet there are no tests to substantiate this diagnosis? They arrive to the nursing home, we do our assessments, pick up the fact that they can’t hear properly, get an audiologist visit, arrange for hearing aids and all of a sudden the resident is a different person.

It makes me angry to think that people like this physio are so quick to judge elderly people. They don’t take the time to stop and think that maybe there is something else causing this communication barrier other than dementia. Elderly people are misdiagnosed all too often and it is because people cannot be bothered to look at the whole picture. The rate of elderly people being diagnosed with depression is unbelievably high. GP’s start them on anti-depressants and then staff wonder why the medications aren’t working.

Did it ever occur to anyone that maybe the resident is not depressed?

Did the GP bother to check the resident’s ears?

Could it be that there is a wax build up in the ears? Or the resident requires hearing aids?

What has happened to the concept of holistic care and comprehensive assessments of our patients? Or is it that the elderly don’t deserve our time.

The statement of “I just don’t have the time” just doesn’t cut it, we are all pressed for time these days but if we just spend that little bit of time assessing the elderly properly then we will save time and money in the long run.

Have you experienced an incident like this?

Have you suffered the same frustrations where one of your patients has been misdiagnosed purely because someone was quick to assume or didn’t have the “time” to find out what really is going on?

Tell us your story, and maybe, just maybe, we might change the culture of medical/allied health staff dismissing the simpler things that make all the difference to our treasured elderly people.

Photo source (http://www.fotosearch.com/photos-images/hearing-aid.html)

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I feel unprepared says Graduating Student Nurse

Monday, May 10th, 2010 by NU_Editor

I think most young people who are about to graduate from University or any certification or course go through stages of “feeling unprepared” or overwhelmed by the task ahead of them after graduation.

student nurse

student nurse

It is no wonder that one of our Nurse Uncut members, Jess feels this way.

Here’s an excerpt of her thoughts when asked the question:

Do you feel your training equips you for the transition from student to RN? Do the ward RNs help or hinder?

I am in my final year as a student nurse and only have a few months before I graduate.

To say I’m nervous is an understatement though it stems from feeling wholly unprepared. Personally I learn alot from my practical experiences, though I will admit that I have spent many of them doing basics (many showers, manual handling etc…).

All the things I do has a paid AIN.

I’ve found that some of the best RNs are the 1st,2nd and 3rd years out who still remember what it was like to be a student wanting to get in and do “clinical”, are still learning themselves and are therefore very accepting if you want to look something up.

*** RNs – as students we want to feel like we actually have a career ahead of us, throwing us into a 4 bed room and telling us to shower everyone while you go and do ECGs, medications, talk to the doctors etc doesn’t inspire us. I’ve found that some doctors are willing to teach more than some RNs.

I once did a rotation in theatres and had the Anaesthetist pull me aside in the middle of surgery and explain what was happening, what he does, what each drug was for, how to measure different aspects in the unconscious patient.

It was very enlightening and I went home that night and studied up all I could for what I have learnt. Unfortunately not every prac is like that and I will admit I have had more bad than good pracs.

At my uni, I have found that last year consisted of information overload with extremely long semesters that started in Jan and finished in Dec.

This year though, we have 2 semesters consisting of; 3 weeks of “intensive” lectures/tutorials, though this was only 3 days a week and was quite disorganised.

After this we have 6 weeks of prac (which is good but it is a long time to not be able to work and earn money to pay for the fact that 95% of us have to travel for prac as it is only a small area and not many hospitals. Last I looked, temporary travel, accommodation and food costs alot of money and many still have to pay for their permanent accommodation on top).

For those students such as myself who had yet to complete mental health, I spent 6 weeks away from the hospital and the location was such that I was away from my family.

On top of this I had 3×3000 word essays due the week we got back and a few weeks later we have exams. By the end of this semester I didn’t feel I learnt anything except what my assignments were about and a few little things on prac.

I’m hoping to get a hospital placement for my final prac (6 weeks again) and even if I do it would have been 12 months since I last did anything clinical (aside from the very rare wound or vaccination).

Does this make me feel unprepared? – absolutely.

I’ve been told that despite feeling unprepared, the new grad year is a godsend and after a few weeks alot of things come back to you. Not to mention the fact that you can ask for help and not fail because you don’t know the answer.

This alone is the “light at the end of the dark tunnel”. Anyone else have advice on how to survive the final 6 months of training and then the transition from student to professional?

Jess

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