Well the first week is over and I survived it! 40 degree temperatures, and aircon that is, to put it nicely, "ineffective." Although, in this heatwave, I don't think there are many aircons that are going to work well!

The frustration with registration continues - I am still not registered and therefore still not able to receive the RN wage, plus I can only work within the scope of an AiN. Which means that everything I do, I have to stop and think "am I allowed to do this?" In many cases, the answer is no, and I am finding it difficult to be a part of the team when I am constantly second-guessing myself in this way. The team here is fantastic - all helpful and accommodating, and it's very lucky I am supernumerary at present otherwise they might all be feeling as annoyed as I am! The scope of practice for an RN is very different here, when compared to a tertiary or referral hospital, and I am really keen to get in there and start doing things. Aaaargh! I did everything asked by the new Board - I sent in my pre-registration in November, they charged my credit card in mid-December, and emailed me a couple of weeks ago to tell me my registration was being processed - but still nothing. So they'll gladly take your money but not provide the service. Typical. Imagine what it will be like in May when everyone Australia-wide (including us new grads!) renews their registration! Yikes. There is another nurse here who sent in her renewal in December and is also still waiting.

 In other news......this week also included some testing moments for me. The week closed with my first death in this facility. Having worked in aged care, deaths are not new to me, plus I experienced plenty on my placements. This was a new experience though, as being a country town, everybody knows everybody. As it's a team nursing environment, all the nurses were involved, and the support given to the family was fantastic. I think there were more nurses than family in the room for a while! Things are not so fast-paced, so you have the time to give people attention, and when you have a death, or the patient is close to it, no matter where, you go from caring for one patient to caring for a patient PLUS a family, and it's never easy. It's probably the hardest part of the job. To complicate this one, down in the other end of the ward were two patients who were neighbours of the patient who passed, and kept asking about him. Naturally confidentiality does not allow staff to discuss other patients, but it was tricky trying to keep them from running up to see what was going on.

It made me think about the small town issue though. I imagine there will be times when nurses here will have to care for their own acquaintances and perhaps family to some extent, and probably care for them when they pass. It's not as simple as in a big hospital where you tell the NUM you know someone and they just assign you elsewhere. Obviously with team nursing you can avoid them as much as possible, but the patient or their family is going to seek out that familiar face and there will be a time they will find you.........what to do then? And out in the community, people will know you're a nurse and ask for advice. An interesting year awaits me for sure!

I've also never encountered the bedside handover before. I'm still in two minds about it. I like the idea of including the patient, but I worry about the confidentiality issues it brings up. I think it is easier to give a proper handover when you are standing there, as you have the patient there to jog your memory of what occurred on that shift, rather than just a sheet of paper with their name. But you also have another patient in the next bed listening to every word you say...........and I don't think I'd like people discussing something embarrassing for all to hear! There may also be visitors present, so you may have half a dozen people listening to how your haemorrhoids were treated today! Hmmm. The curtain is not a wall, although we often think that it is. I've noticed that some of the nurses here are less than fastidious about patient privacy - which was one of the only things picked up on in my final assessment, so remains something I am rather picky about. But being the new kid on the block, it is not the time for me to jump in and tell people that I don't like how they do things - all that would achieve would be alienation and a tough year for me. But I can remember, and reflect on things, and improve my own practice - because the only person who will protect my registration is me.

The culture shock hasn't been too bad though, not yet anyway, and everyone has made me feel welcome and helped me out immensely when I was a bit lost. I have another week of supernumerary time, and competency assessments, and then I am on my own, but with a great team to support and teach me along the way.