A new adventure awaits?

I think if you were to ask many people, whether they are nurses or not, if they could do with a nice holiday, you may get an overwhelming response saying yes! But, what nurses can do is take work in a far away country and take a very long holiday all at once and one additional bonus is you can put it all on a CV.

I met with a friend the other day who told me that she is off to australia for a few months. She has handed her notice in on the ward where she works and is jetting off to a new job down under with two other nurses. I would be lying if I said I wasn't jealous, but then I have thought that perhaps I should look into working abroad...what a tempting thought.

Sounds incredible and too good to be true. Better pay, better living and working conditions and a whole host of new adventures, but is it a case of the grass is always greener on the other side or is it same situation, different country? If it was that simple, wouldn't every nurse be doing it?

I guess it isn't that simple. There are countless adverts for nurses to leave the UK for sunny shores such as the middle east and Australia. My friend spoke particularly about the difficulty of obtaining registration in Australia. this alone seems to be no easy task. I also wonder how some nurses feel about uprooting their entire lives and taking themselves away from family and friendships on the promise of a quick buck and a sunny beach.

I wonder if it is easier for young nurses with no children, partners or mortgages to pack up and head off to another country, I have to confess that I am often very keen to take advantage of what appears to be on offer, but what is actually waiting when I get there? Or put another way, what is stopping me?

When I think about going to work abroad, I also think about the cultural change, for example in the middle east...I am however assured by one international agency that I am not required to learn arabic and that most of the staff and patients understand and speak english. I guess the shortage of nurses worldwide is such that countries are prepared to overlook some things to better the situation.

I have also tried to look at it from another angle, more specifically all the nurses who have come from Africa and the Philippines to work here in the UK. I have no doubt, that without their being here, the situation in healthcare would be dire, but I often wonder how hard it has been for some of them to leave people behind, in a country where actually obtaining work in the Philippines as a nurse is difficult and in some cases, leaving their children behind to support a foreign healthcare system...all to make a bit more money.

Are nurses also leaving one set of politics and problems, to go to another country and find another? If one country is terribly short of nurses, surely that would set a nurse to think why, as they say...there is no smoke without fire? this piece of writing may sound depressingly negative, but I do wonder what awaits nurses in the land far far away.

I guess thats half of the adventure though...the not knowing what you will find, I did contact one of the agencies to find out more. I'm keen to see what opportunities are out there. who knows, you will never know unless you get out there and try it. I wish my friend the very best of luck in Australia and selfishly, I hope she doesn't enjoy it so much she decides to stay. Can't wait to see it for myself someday. regardless of if you are a nurse, I am a firm believer that travelling makes for well-rounded people in society with a lot of stories to tell

A partnership of Equals?

Looking back, I have been tempted to write about the current situation in nursing, specifically the rise in registration fees for nurses. Having attended the meeting at the NMC offices and thought at length about the situation and voiced my own opinion in the nursing standard, I have decided that its is an issue that goes far beyond my own reflections. I will leave every nurse to voice their own opinion...enough said. Instead I opted for another issue close to me, inter-professional equality.

Outside of attending NMC meetings, writing this blog and having my fingers in other proverbial pies, I still have time to work full time as registered nurse in an acute hospital. My day to day practice  consists of two parts, I have a permanent role as a scrub practitioner at the trust, but I also enjoy maintaining my skills in ward and specialist based practice through a staff bank (given most nurses current situation, I dare say not many don't!). Nonetheless, it is important to me to widen my professional horizons as well as pick up a few extra pounds.

This particular issue arose out of my practice in the operating theatre. The trust I work for have recently reviewed the swab, sharps and instruments policy. Any nurse practicing in the peri-operative environment will be fully aware of such a policy and every hospital trust that carries out invasive surgical and/or diagnostic procedures will have such a policy in place. For those of you who don't work in such an area, it is essentially the policy that stipulates responsibility for swab, sharps and instruments checks and counts during a procedure and responsibilities (among other more specific duties) of each profession in order to facilitate safe surgery.

Due to some issues with clarity in areas of responsibility the trust took the liberty of reviewing the policy and thankfully decided to be highly specific about who takes responsibility for what and when. This is where the issue of multidisciplinary equality began. As part of our checks that are undertaken as a "team", we religiously perform the stages in a WHO surgical safety checklist...without fail I might add. All of the above is necessary to ensure we get everything right the first time, when getting it right is of high importance.

As a team we share the responsibility of performing the necessary checks and supporting each other to fulfil our duties. One benefit of working in such an environment is based upon trust and spending a large quantity of time in one room together. However, the revised version of said policy states that it is the responsibility of a surgeon and anaesthetist to ensure that the WHO surgical safety checklist is completed and documented appropriately. One anaesthetist pointed out two interesting points, one; ensuring this new responsibility is communicated to them and secondly and just as importantly, that does this newly delegated responsibility undermine the "team" approach in carrying out this work and reinforce the concept of a hierarchy in the health care professions?

I remember in my first year of nursing school, undertaking a module in multi-professional team working, whereby students of each discipline worked together to solve a problem in patient care and role play solving this problem as a team. The aim of the module is partly to ensure each profession contributes equally and is left feeling empowered in patient care. I was in some respects, in for a rude awakening when I qualified however. In many situations on the ward, nurses can be made to feel insignificant, that doctors/surgeons make the final decision and there is no room for debate. Sadly on more than one occasion I have felt belittled by the fact my reasons for doing something were not considered as important. I have worked bank shifts on wards where the communication between the professions is poor and in some cases some professions do not believe it necessary to communicate with other professions despite it causing friction. Not to mention the lack of understanding of role or knowledge base. I believe this has a huge impact on respect for each other. This is not when multi-professional comes into its own, and why operating theatre work does encompasses everything that multi-professional work is supposed to.

Lets face it, we don't work as hard as we do for our health? I'm sure we would all love an environment where we all communicate properly and that patients are then right back where they should be. In the centre of the care! I would encourage anyone to challenge the hierarchy in multi-disciplinary working otherwise we will always be left with professions feeling demoralised, undervalued and disrespected much to the contrary of what we should be working towards. I can certainly tell you that I resent having  other professions talk to me or treat me without respect as a person let alone as a nurse.

I hope to be senior nurse one day and multi-professional team working is a passion that I will promote enthusiastically, I cannot tolerate the hierarchy when it goes against everything I have learnt from tutors, professional colleagues and other nurses. I have a great deal more respect for professions that don't work on a culture of fear but instead makes other people feel respected and valued and that their contributions are equally important. one fantastic example of this is the comments from Dan Poulter in this week's Nursing Standard. I commend his thought into the role of nurses, not necessarily his full opinion. There is a doctor who understands professional empowerment.

If nothing else, it is nice to see changes. Comparing stories that colleagues describe, we have made changes in the right direction in equal working. There is still work to be done but, it is a step in the right direction. It is just disheartening when you read new policies that don't reflect the hard work of all professions. Perhaps, it is the hospital trusts that need a lesson in multi-professional team working and not the health care professionals?