“They don’t see perioperative nursing as glamorous as maybe critical care, or midwifery.”
I’m a registered nurse, currently working as a Clinical Services Manager in a day surgery.
I went straight into nursing after high school in the 70’s. I thought it would be a job that I would enjoy – and I always have, actually. I did my general training in Dublin, at the Meade hospital, which is gone now.
As a general nurse, you’re looking after patients who are in hospital, in the wards: it’s general duties. From there you can specialize – you can go intensive care, midwifery, acute care, many other specializations.
There’s huge scope for specialization within nursing, there’s so much to do – you’re never bored.
Initially, I worked as a midwife for a couple of years, but then I moved to St Vincent’s and did my post-grad in perioperative nursing, specializing in operation theatre work. St Vincent’s was a very busy public hospital, we did a lot of trauma, emergency operations.
I found I really enjoyed working in operation theatres, and I’ve stayed there ever since.
In operation theatres, patients come in for a surgery. The nurses admit them, go through their medical history; we prepare them for operation, take them to the theatre for the procedure.
We maintain sterilization, there’s a lot of criteria that’s required to be reached for theatres, infection control, national standards we have to maintain, preparation and maintaining theatre equipment – and there’s a lot of equipment!
Even within periop, there is a lot of nurse specializations: there are pre-op nurses who prepare people for surgery, anaesthetic nurses who maintain the drugs and monitor airwaves, scrub nurses who assist the surgeon; then there’s recovery staff.
In the late 80’s we moved to Australia.
At that stage the economy in Dublin was going through a big slump, while there were huge shortages in nursing here, so there were a lot of people recruiting in the UK for Australian hospitals. A lot of nurses came over in that period.
We moved in January 1987. We came with the intention of staying for two years, as many do, and then we really liked it and stayed. I’m an Australian citizen now.
My husband was in IT, so he didn’t have any problems finding work either. I had just had my first baby, so was only after part time work. But as I’d had 10 years experience in nursing by that time already, I found work easily.
I just got on the phone and rang all the hospitals within a 5 mile radius and had a job within 24 hours!
Theatre is actually really good for working-mother nurses because there’s still a huge shortage of op theatre nurses, and you’re always in demand – I could pick my days and hours.
That first job in Melbourne was in a general surgery of a hospital. There wasn’t really much difference between working here and in the UK, everything was the same – I suppose the standards are pretty much across the board in first world countries.
After I had my second baby I went back to work for an orthopaedics department, which deals with surgeries like hip and joint replacements, knee and shoulder surgeries, a lot of fractures and bone repairs.
I ended up scrubbing in orthopaedics for close to 15 years.
Then I got offered a position in a day surgery centre as a casual nurse, on top of my job at the hospital – I started out doing a day here and there.
The majority of surgeries performed in Australia today are day surgeries. For more major surgeries, the patients go to hospital where they can stay overnight or several nights.
But for minor surgery, there are day surgery centres, many of which are independent and are not attached to a hospital. Patients are sent home the next day. There are many various surgeries done here, most common being things like lesions, eye surgery, ocular plastics, retinal surgery.
Once the patient comes out of surgery and stabilizes, they are sent home.
Eventually, through my experience, I took over the management role at the day surgery, which I did for the next 10 years. That led me into nursing management and my current position as a Clinical Services Manager.
My job now is incredibly varied, from HR duties to practical duties to the corporate side of things.
On the HR side, I am in charge of employment, staff management, training. I manage staff across five theatres, I run the schedules, book the surgeons and anaesthetists, fill in last minute absentees by calling temp agencies.
I still do time in the theatre myself, almost everyday: doing relief work to scrub where needed and letting people have a break or time off.
I think you have to keep in touch with that: you can’t see what’s happening on the ground unless you’re on the ground yourself!
I organize the staff training and education. As a registered nurse you must have a minimum 20 hours of education a year, regardless of experience. So I organize all the in-services courses, conferences and classes.
The great thing about nursing is that it changes all the time, there are always new things to learn, and there are always opportunities for further education .
There is a lot of admin work: : I’ll update policies, go to meetings with the medical board, review different standards.
The government are always pulling out new standards, so I have to review those, introduce them to our staff and ensure they are being applied across our facilities.
It can be tricky sometimes; there’s some standards that come across quite bureaucratic, and are extremely hard to apply in real life, to real patients. But it’s my job to enforce them, to be positive about them and to ensure things get done properly.
Then there’s is hospital accreditation. It’s my job to keep up to date and apply all the compliance requirements for the hospital. Accreditation is a big thing: all hospitals must be accredited and reach the standards set by the accreditation bodies. There’s a lot of paperwork! A lot of policy reading, writing and implementing.
Management, as opposed to just nursing is certainly quite different; for me it’s more challenging, you have to deal with many more people and personalities, you have to use your diplomacy and management skills to manage other people.
Hospitals are an area where the teams must get on with each other – for obvious reasons.
It’s a close knit environment, and teams must work very closely together. As a sort of HR manager, it’s a big part of my job to ensure that happens, which can be stressful at times.
Another part of my job is to entice the new graduates into the operation theatre. A lot of nurses, once they get their general qualification and are looking at specialization, don’t consider the area of perioperative.
They don’t see it as glamorous as maybe critical care, or midwifery.
It may seem like there is less patient interaction, as the patients are largely unconscious, so there isn’t that care and connection factor that you have on the ward.
But once people try it, a lot find it really interesting and really enjoy it.
Yes, it’s quite technical. It’s technical to put a patient asleep and keep them asleep. There’s a lot of instrumentation, technology that you have to learn and know.
But you do have a great rapport with your colleagues, the other nurses, the surgeons and the anaesthetists – it’s a really great team environment.
And a lot of patients coming in for an operations are very nervous. As an admittance/ anaesthetic nurse, you need to really care for them, calm them. It’s your responsibility to make the patient comfortable, relieve their anxieties.
The recovery stage is also a very vulnerable time for the patients, so as the recovery nurse you need to see them through it and ensure they are comfortable and calm.
A theatre is a very controlled environment.
It’s extremely rare that things really go wrong – not like they do in the TV shows. Of course with every patient going in, it’s in their mind: they’re thinking ‘what if it goes wrong, what if it goes wrong’. It so very rarely does.
Everything is very controlled. We are all trained that if something does happen, we can manage it – but again, that’s not common. Maybe an airway gets blocked, something like that – we all know what to do about things like that.
In the majority of cases, the worst case scenario is if a day surgery patient has to be transferred to an overnight facility.
That’s seen as a bad outcome, as rare as it is. And it is mainly bad because it’s a mental stress on the patient, more than anything else – a change in expectations during a vulnerable moment.
That’s why we do a lot of pre-op screening in our patients, accessing them for day surgery suitability.
My favourite part of my job is the people part. I am a social person, I like interacting with people.
For me, the greatest satisfaction at work comes when we reach the end of the day and all the staff are happy and feeling like they’ve done a great job – which is what most nurses typically want to feel, that’s what they strive for. We want to feel like we’ve done the absolute best for our patients and achieved good outcomes – that’s a good day.
There are so many pathways in nursing.
You can do perioperative, intensive care, emergency, midwifery. And then within those larger specializations, there are further niches. You can go into education, management, corporate, financial. You can do government work like department of health or medical research – so many areas open up to you. It’s an extremely diverse career.
I have been in my current role for 5 years now and I’m happy where I am. I enjoy the challenge of it, there are still things to learn all the time.
Truly, I believe I’m extremely lucky. I’ve always enjoyed what I’ve done, always had opportunities to move on and do something different, learn and diversify.
My daughter has also become a nurse and I’m so proud of her. My best advice to her is that you must be happy with what you do first of all: work hard and try and be the best person that you can be – both to your clients and your team, and you will always come home feeling good about yourself.