Nursing Post - Issue 15: Theatre/Critical Care

theNursingPost www.nursingpost.com.au

The Career and Education magazine for Nurses and Health Professionals

In this issue

“Theatre & Critical Care Nursing�

8 August 2011 - Issue 15

Visit us online for the latest jobs and articles

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From the Editor...

Welcome to Issue 15

Inside this issue

We hope you enjoy our topic for this issues feature as we examine two closely related fields of nursing: Theatre and Critical Care. We take a look at what each specialisation entails and how to work towards these two exciting fields.

The “Front cover competition” winner for this issue goes out to Andrea Woods from West Coast Institute of Training in WA. According to Andrea, “Ramsay Health Care has created a scholarship for West Coast Nursing students”.

Issue Feature The three winnersNext in the photo are Jessica Kinder, Kiri Fonotia and Amanda Brown who will “each receive $2,000 cash and complete 2 stages of practical work placement at the 22nd Aug Issue 16 Ramsay Health Care owned Joondalup Health We look at Andrea the various pathways Campus“. Congratulations (and ladies) a community can diversify into and examine the for submitting thenurse winning photo for this issue

Theatre and Critical

Care Nursing

Mental Health

Next issue

issues facing health professionals in this field

Join us for our Mental Health feature in our next issue. We bring you a story from one of our readers and we discuss the latest issues in this Upcoming Features field of care.

5th Sept

Education

We hope you enjoy reading this issue. Take care 19th Sept CPD Quiz and Working Abroad readers and remember to look out for the next 3rd Oct Paediatrics / Child Health issue!

If you are interested in participating in any of the above publications either by advertising or editorial contributions, don’t hesitate to contact us on: (08) 9325 3917 or email: admin@nursingpost.com.au.

Advertisers Index

Nursecare Personnel . .......................................

Matching Staff ..................................................

Australian Recruiting Group ..............................

CCM International..............................................

Pulse.................................................................

WA Country Health Service (WACHS)..................

Continental Travel Nurse ...................................

Quick and Easy Finance ....................................

CQ Nurse...........................................................

Hays Healthcare.................................................

Ramsay Health..................................................

VNS Nursing Agency..........................................

Queensland Health.............................................

Mercy Health & Aged Care (QLD)........................

RAHC.................................................................

UHG...................................................................

Medacs.............................................................

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Inside Cover 1 3 4 5 6 7 8 9 10-11 12, 15, 18, 20 14 16 17 21 22 23

Mental Health

Mediserve Nurses Agency..................................

ENA Work UK.....................................................

Promesse ........................................................

Healthcare Australia . ........................................

24-25 27 36+37 Back Cover

ABN: 28 105 044 282 | PO BOX 6213, East Perth, WA, 6892 Ph: +(618) 9325 3917 | Fax: +(618) 9325 4037 E: admin@nursingpost.com.au | W: www.nursingpost.com.au Next Publication Details: Issue 16: 22 August 2011 Material Deadline: 15 August 2011 Editor: Kelvin Chong | For media-kits, deadlines or advertising queries, please contact Manish Shah | Printed by Westcare Pty Ltd

If you can see yourself working across

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THE BEST PEOPLE IN HEALTH AND SOCIAL CARE 5

WA Country Health Service Nursing Opportunities of a Lifetime Are you looking for a chance to travel, experience adventure and work in rural and remote Western Australia?

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Feature - Theatre/Critical Care Nursing

Theatre & Critical

Care Nursing What is critical care nursing?

Critical Care nursing focuses on the acute stages of injuries and illnesses. Critical care nurses attend to patients that are seriously ill and patients that depend on life-support equipment for their recovery.

Working closely with other medical professionals and often with families coping with what may potentially be the most traumatic period in their lives.

Critical Care nursing requires interaction with state of the art technology such as ventilators, monitors and dialysis machines. The critical care nurse must

encompass a team approach to care delivery as these nurses work closely in conjunction with all health colleagues.

Some of the responsibilities of a critical care nurse include: • Monitoring life-support devices • Be aware and respond to changes in the patient’s condition • Administering medications and monitoring effects • Performing basic nursing care functions • Provide advanced life-support measures within a team environment • Oversee both complex and simple wound dressings 13

Feature - Theatre/Critical Care Nursing

• Utilising, monitoring and verifying data on bedside computers

What does a Critical Care nurse do?

Critical Care nurses care for a range of patients, including those recovering from trauma, cardiac surgery, neurological surgery, organ transplantation and many other patients in a variety of settings such as coronary care, emergency, high dependency nursing areas and intensive care units.

The critical care nurse working in the intensive care or high dependency unit basically provides care for a patient and the patient’s family. When a patient

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enters a hospitals intensive care unit, a critical care nurse will manage that patient’s care and will work towards the patient’s recovery so they can be discharged from the ICU. An emergency nurse is considered ‘multi skilled’ in the nursing profession. The work is often challenging but offers the ultimate in variety and fulfilment. Emergency nurses work in the accident and emergency department of a hospital and act as the ‘first line’ in the treatment for patients involved in major or minor trauma, patients with medical and surgical conditions and patients with orthopaedic (bone) injuries. If you like adventure, variety, an ‘adrenaline rush’, sore feet, short tea breaks, ‘quirky’ humour, hard work, satisfaction, and being part of a great team, then emergency nursing is for you.

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We’re growing.

Join us.

Advance your intensive care nursing career with Queensland Health Have it all — leading rates of pay and professional development, unprecedented career opportunities and the famed Queensland lifestyle from coast to country.

!

Recruiting nowowns,

Search for jobs or submit your online Expression of Interest and CV at

www.health.qld.gov.au/nursing 16

NM080811

rling D Gold Coast, Da sland, Central Queen West, Mackay, South Cairns.

Feature - Theatre/Critical Care Nursing

The Mater Misericordiae Hospital in Bundaberg is seeking Registered Nurses in this rapidly growing area of Queensland. Bundaberg offers a relaxed regional lifestyle close to the coast with beautiful landscapes and excellent educational, sporting and cultural opportunities.

RN - Orthopaedic Scrub Terms: Part-time position, 64 hours per fortnight that attracts a base hourly rate range of $27.51 to $35.35 dependant on comparable prior service + superannuation and penalties.

Registered Nurse – Scrub

Terms: Part-time position, 40 hours per fortnight that attracts a base hourly rate range of $27.51 to $35.35 dependant on comparable prior service + superannuation and penalties.

How do I become a Critical Care nurse?

There are no other mandatory or licensing requirements for nurses to practice in Australian critical care environments. Whilst not mandatory for practice, many local critical care nurses do undertake postgraduate specialist training via a collaborative hospital or through a university program.

After gaining experience in a general hospital environment, a registered nurse can apply for a position in critical care. Depending on the unit and the hospital, graduate nurses may gain employment straight from university. Most hospitals however prefer nurses to have 12 months’ postgraduate experience. Registered nurses can then further their academic standing by enrolling in the Graduate Diploma or Masters of Critical Care programs.

For further information on critical care nursing, please visit the Australian College of Critical Care Nurses website: www.acccn.com.au

The Orthopaedic Scrub and General Scrub, will deliver direct clinical care to surgical patients in collaboration with the Nurse Unit Manager and other treating health professionals in accordance with the Australian Nursing and Midwifery Council and within the scope of practice that the nurse is qualified, competent and registered to perform.

Enquiries:

Apply and/or gain more information about these positions at www.mercycq.com/jobs where the position is listed under Mater Bundaberg vacancies. Alternatively contact James Turner, Nurse Unit Manager, on (07) 4153 9461 during business hours or email jturner@mercycq.com

“we are an equal opportunity employer”

What is Theatre nursing?

Theatre Nurses (more formally known as perioperative nurses) are nurses whose primary focus is on operations and patient care before, during, and after surgery. The theatre nurse works closely with the operating team and thus the nature of the theatre nurse’s job is complex at most times.

A theatre nurse may also tend to anaesthetic duties. It is more common for theatre nurses to take on an out-patient, recovery, or ward role where the main responsibility is caring for the well-being of the surgical patient.

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Feature - Theatre/Critical Care Nursing

It is also their duty that all further treatments needed for the full recovery of the patient are carried out. They can also be trained to provide post-operative consultation because they will be the one who will maintain close contact with the patient during recovery.

Some theatre nurses even become highly sought after members of surgical teams, especially experienced nurses who are familiar with a wide range of procedures. A theatre nurse can move up and become a Senior Theatre Nurse and may be asked to train, teach, and supervise new staff.

Being a theatre nurse is hard work, as these nurses can work long hours in the operating room and they may be asked to assist on emergency surgeries in the middle of the night.

This career can be very demanding, but also quite rewarding. Demand for theatre nurses is constantly rising due to the important role these vital medical professionals play.

“

Being a theatre nurse is hard work, as these nurses can work long hours in the operating room and they may be asked to assist on emergency surgeries in the middle of the night.

“

A patient who has undergone surgery have different needs to an ordinary patient, which is why a theatre nurses are concerned with patients who have just undergone surgery and to ensure that the patient is doing well.

What does a theatre nurse do?

Theatre nurses are needed anywhere surgery is performed, such as clinics, day surgery units, all sized hospitals, overseas aid programs and rural & remote practices. Various positions also exists in orthopaedics, ophthalmology, obstetrics, cosmetic and other fields that require operations and surgeries.

A Scrub nurse is fully “scrubbed in” for the surgery. The nurse hands instruments to the surgeon and helps to keep an eye on the patient’s condition. They should be very knowledgeable about every single piece of equipment and should never mistake one for another. Though they would not be using the equipment themselves, theatre nurses should also know the uses of each piece of equipment, which will help them respond calmly and immediately to the surgeon’s request.

Scrub nurses are extremely valuable members of the surgical team, providing support in the operating room and patient care outside of it as well. Surgeons may do the cutting, but a scrub nurse is every bit as important.

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Feature - Theatre/Critical Care Nursing

A Circulating nurse, another type of theatre nurse, works on the perimeter of the operating room, monitoring patient care, ensuring that the room stays sterile, and keeping track of instruments and sponges. The circulating nurse should make sure that the operating room is not contaminated in any way.

Other roles played by theatre nurses include the Holding bay nurse who oversees patient admission and care before an operation, the Anaesthetic nurse who specialises in providing support to patients/anaesthetist before and after surgery and the Instrument nurse who primarily focuses on the supplies used in the operating room whilst anticipating the needs of the surgical team.

How do I become a theatre nurse?

Training to become a theatre nurse is similar to the requirements of a critical care nurse. Typically attending nursing school and receiving certification as a registered nurse is required before pursuing training in operating room work. Those who are interested should also try contacting Nurse managers for information.

For further information on theatre nursing, please visit the Australian College of Operating Room Nurses (ACORN) website: www.acorn.org.au

www.ramsayjobs.com.au 20

Independent Contract Nurses Required!

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For general enquiries, please phone Jessica on (03) 9692 7049 A division of UHG : www.uhg.com.au

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PERTH: (08) 9325 1332 - perth@mediserve.com.au MELBOURNE: (03) 9629 3780 - melbourne@mediserve.com.au SYDNEY: (02) 9290 2700 - sydney@mediserve.com.au

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The employment experts for Nurses around Australia Specialising in a range of permanent and temporary roles for Registered Nurses in Australia and across the world

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Nursing in Australia its never been easier

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CITY SHIFTS

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MyRAHCExperience Pauline Rubin | Registered Nurse Like many registered nurses nearing retirement, Queenslander Pauline Rubin was in search of a balance between her work schedule and changing lifestyle. Through RAHC’s short term placements Polly is able to continue her career and contribute her skills and experience into health centres in remote Indigenous communities across the Northern Territory.

“I was experienced in both nursing and in life, less restricted by family commitments and free to work short term contracts,” Polly said. Polly contacted RAHC and was then placed in a nursing position in Alice Springs.

Sitting in the centre of a vast red desert with majestic mountain ranges of spiritual significance, Polly says, “I am in awe of this ancient land. I do feel I am making a difference as an experienced professional and helping to ‘close the gap’. I am now on my third placement, working in the red centre of Australia, and enjoying the best days of my career with generous pay and work conditions. Perhaps it is true we save the best for last!”

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Next Issue Feature

Mental Health 22nd Aug

Issue 16

We look at the various pathways a community nurse can diversify into and examine the issues facing health professionals in this field

Upcoming Features 5th Sept Education 19th Sept CPD Quiz and Working Abroad 3rd Oct Paediatrics / Child Health If you are interested in participating in any of the above publications either by advertising or editorial contributions, don’t hesitate to contact us on: (08) 9325 3917 or email: admin@nursingpost.com.au.

Visit us Online!

Go to nursingpost.com.au for the latest healthcare jobs, feature articles and stories!

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Educational Courses, Conferences & Events

Educational Courses, Conferences & Events Article: Professional Boundaries: Black & White or Shades of Grey? 30-31 Ausmed Publications................................................................................31 Oceania University of Medicine.................................................................32 National Allied Health Conference.............................................................32 ANZICS / ACCN Annual Scientific Meeting.................................................33

AUGUST Sydney CAREX 2011

11th Palliative Care Conference

“Australia’s premier health & aged care expo” Provider: Total Aged Services 10-11 August 2011 Rosehill Racecourse, Sydney, NSW. www.totalagedservices.com.au/carex.asp

Together in discovery and care Provider: Palliative Care Queensland 30 August - 2 September 2011 Cairns Convention Centre, Qld www.palliativecareqld.org.au/events/

12th International Mental Health Conference

ADS-ADEA Annual Conference 2011

Personality Disorders: Out of the Darkness Provider: Australian & New Zealand Mental Health Association 24-26 August 2011 Radisson Resort, Gold Coast, QLD www.anzmh.asn.au/conference2011/

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Provider: Australian Diabetes Society and

Australian Diabetes Educators Association 31 August-2 September 2011 Perth Convention Centre, WA www.ads-adea.org.au

September International Symposium

Aged Care Nurse Managers Conference “Clinician, Colleague, Carer & In Charge” Provider: Total Aged Services 21-22 September 2011 Caulfield Racecourse, Melbourne www.totalagedservices.com.au

21st Annual TheMHS Conference

Breast-feeding Seminar (Sydney)

”Resilience in Change” Provider: TheMHS Conference 6-9 September 2011 Adelaide Convention Centre, SA www.themhs.org/2011-conference

“A changing paradigm” 24 September 2011 Citigate Hotel, Haymarket, NSW www.breastfeedingconferences.com.au

15th Annual NT Chronic Diseases Network Conference “Out of the shadows, into the spotlight chronic diseases, mental health” Provider: Chronic Diseases Network 8-9 September 2011 Darwin Convention Centre, NT www.cdnconference.com.au/

CATSIN Annual Conference “Are we there yet?”

Provider: Congress of Aboriginal and Torres Strait Islander Nurses 21-23 September 2011 Mecure Hotel, Brisbane Qld www.indiginet.com.au/catsin/

2011 Australasian Sexual Health Conference “Sex in the Capital City” Provider: The RACP 28-30 September 2011 National Convention Centre, Canberra, www.sexualhealthconference.com.au/

(PNAQ) Annual Conference 2011 “Standing on the Shoulder of Giants” Provider: Perioperative Nurses Association of Queensland Inc 29 September - 1 October 2011 Royal Pines Resort, Gold Coast www.pnaqconference.net.au

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Educational Courses, Conferences & Events

“Advanced Tracheostomy Care and Prolonged Mechanical Ventilation” Provider: (Various groups from) Austin Health 1-2 September 2011 Hilton on the Park, Melbourne, www.tracheostomyteam.org

Professional Boundaries: Black & White or Shades of Grey?

Educational Courses, Conferences & Events

A

s health professionals we all work under a set of ethical guidelines laid down for us through our professional body, such as the Nursing and Midwifery Board of Australia, and through the unstated expectations of the public. While boundaries are in place to protect both health professionals and patients, they are not always as clear-cut as they may first seem. No nurse begins her career thinking that she is going to cross or violate professional boundaries, and yet this is what happens, through a sense of familiarity and trust that has been built up with a patient, the seductiveness of the helping role, or simply a general lack of understanding of relevant boundaries. Let’s take a closer look at boundaries, followed by a few examples of how professional boundaries can be violated.

Boundary crossings and boundary violations

Just as a garden fence defines the boundary of a person’s backyard, boundaries define the parameters of a professional relationship, creating a safe relational space. They “define the helping pathway – for both clients and professionals – and as such are integral to professional effectiveness”.

Literature indicates that professional boundaries can be either crossed or violated. A boundary crossing is seen as “a deviation from classical therapeutic activity that is harmless, nonexploitive and possibly supportive of the therapy itself.” In contrast a boundary violation “is harmful (or potentially harmful) to the patient and therapy alike because it constitutes exploitation of the patient, using the therapist-patient relationship as its vehicle”, for example conducting a sexual relationship with a patient, or stealing their belongings. Although boundary crossings may be viewed as trivial, they have the potential to progress to a boundary violation if there is an increase in the frequency and severity of the crossings. Do you think you have ever crossed or violated a professional boundary?

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Case Study 1

Sandra is a clinical needs assessor, visiting clients in their homes to assess what home help they might need. She generally visits clients a few times, and always phones beforehand to confirm her appointment. Sandra has already visited Mrs A, an elderly widow, two times and found her to be friendly, although lacking in familial support.

Upon phoning to confirm her visit, Mrs A asks Sandra to pick her up some milk so they can have a cup of tea together, promising that she has the money to repay her upon her arrival. Sandra is happy to comply with this simple request.

• Has Sandra crossed a professional boundary in buying milk for Mrs A? Some time passes and Sandra finds that Mrs A has started to ring her frequently, sometimes to discuss her nursing needs, and sometimes to ask her to run to the supermarket to pick her up a few essentials, as “she has no family to help her and Sandra means so much to her”.

• If Sandra complies, will this be a boundary crossing or violation?

• How could Sandra have refused the initial request, while maintaining a friendly, professional relationship?

• Should Sandra tell her supervisor about this relationship?

Case Study 2

Mark is a mental health nurse who loves reading.

One of his patients, Mr B, is also an avid reader, and they often discuss authors they enjoy and books they are reading. Mr B offers to lend Mark a couple of books and Mark eagerly takes him up on the offer.

• Has Mark crossed a professional boundary?

Upon returning the books, Mark is offered to visit Mr B’s house to see his collection and borrow whatever he would like. He is also invited to attend Mr B’s book club.

• Is visiting Mr B’s house a boundary crossing or violation?

• Is joining the same book club a boundary crossing or violation?

Case Study 3

As can be seen, often boundary violations are a process, rather than simply crossing a well defined line. Health professionals may act in a well-intended manner, yet end up crossing or even violating a boundary. As a nurse it is

important to use discretionary judgement in all circumstances, instead of merely trying to follow instructions.

If you would like to further review professional boundaries, the Nursing and Midwifery Board of Australia have all of the relevant codes and guidelines online: www. nursingmidwiferyboard.gov.au/Codes-andGuidelines.aspx#professionalboundaries

Continued Professional Development provided by

Comment on this clinical article at: www.ausmedonline.com/nursing-blog.html Sources: Peternelj-Taylor, C. & Younge O. (2003).

Exploring Boundaries in the Nurse-Client Relationship: Professional Roles and Responsibilities. Perspectives in Psychiatric Care, 39 (2).

Baca, M. (2011). Professional Boundaries and Dual Relationships in Clinical Practice. The Journal for Nurse Practitioners, 7 (3).

Cameron, M. (1997). Professional Boundaries in Nursing. Journal of Professional Nursing, 13 (3).

Clinical Nursing

Assessment Skills 2011 Dates Adelaide: Brisbane: Melbourne: Sydney: Perth:

26 - 27 September 12 - 13 September 13 - 14 October 21 - 22 November 7 - 8 December

Learn more at:

www.ausmed.com.au 31

Educational Courses, Conferences & Events

Ella works in a busy outpatient department that treats patients on a daily basis. Mr C has been coming daily for 3 weeks and they have formed a fast friendship. When Mr C finishes treatment he gives the whole team a box of chocolates but also brings Ella a necklace.

• Is it a boundary crossing or violation for Ella to accept the necklace?

• Is it a boundary crossing or violation for the team to accept the chocolates?

Mr C then starts to visit the department frequently, ostensibly to see his treatment team, but he always asks about, or tries to see Ella.

• Is it a boundary crossing or violation for Ella to continue the friendship?

Mr C invites Ella out for a coffee, “simply to say thank you for helping me during my treatment”.

• Is it a boundary crossing or violation for Ella to go?

• Should Ella tell anyone about this request?

RN to MBBS Earn your MBBS at Oceania University of Medicine ~ Samoa

– OUM-NP RNtoMBBS01/11col

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33

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Golden career opportunities abound in the Arabian Gulf

experts on the gulf 36

Many expat nurses share the Arabian woman’s love of gold jewellery and are well served by talented craftsmen and famous gold souks in major cities

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*Terms & Conditions: Authorised under NSW Permit No. LTPS/11/06190, ACT Permit No. TP 11/02716.1 Healthcare Australia Promotion / Healthcare Australia Pty Ltd, VIC Permit No. 11/1380, & SA Permit No. T11/1422. The promoter is Healthcare Australia, ABN 95 108 180 589, L30, 477 Pitt St, Sydney NSW 2000.

Promotion starts 01-08-2011 & concludes 01-12-2011. To enter, entrants must either be an existing or register as a new employee (nursing agency contractor) with Healthcare Australia & work 5 shifts to receive 1 entry. Every subsequent 5 shifts worked gains another entry. Entries are logged automatically.

Prize winner drawn 09-12-2011 at 12:00 Midday (AEST) at Healthcare Australia, L30, 477 Pitt St, Sydney NSW 2000. Winner will receive 2 around the world business class airline tickets. Total value up to $20,000.00. Winner published in The Australian on 16-12-2011. Full terms & conditions at www.healthcareaustralia.com.au