REBECCA LANIGAN

“I think as nurses, often we focus primarily on our jobs and patients, but it’s also important to spend time on ourselves, our self-development and career satisfaction.”

I am a Registered Nurse, working in a Level 1 Emergency and Trauma centre in Melbourne.

Prior to doing my VCE in Mildura, I went on a cultural exchange trip to Indonesia. I lived with a host family in Yogyakarta, going to school and sharing their lifestyle. The second time I visited, I actually ended up being a patient in their healthcare system. That was the first time I was in a hospital – home or overseas.

When comparing the lifestyle I experienced there to my own, I was especially struck by the difference in healthcare – not just the resources, but even in the basic access people have to knowledge and health education. These experiences inspired my passion for community healthcare and education. My plan is eventually to return to Indonesia and work in healthcare there.

I chose nursing specifically because I wanted a career that was going to be challenging and offer something different everyday.

Because of my dream of working in Indonesia, I was specifically interested in regional nursing.

I did my degree in Bendigo, so most of my placements were in the Mallee region of Victoria. Once I got my registration, I decided to do my graduate year in a metro hospital, to expand my skills and knowledge.

There’s a big difference between city and regional hospitals, even in a first world country like Australia.

Regional departments often operate with very limited facilities, often there is not a doctor onsite all the time. As a nurse, you have more autonomy, but also less resources.

A common scenario is that the local GP is the doctor that does the morning rounds on the wards. In emergencies, we frequently relied on paramedic staff and flying doctor services to transport people to larger centres.

Another thing I had to learn in a metro hospital was the hierarchies of the doctors – from the interns to consultants, plus all the allied health care professionals we work with, like physios and occupational therapists.

My first six month rotation was in the Renal, Endocrine and Rheumatology department.

This is where we looked after patients with kidney disease; people who were getting kidney transplants or were on haemodialysis. Haemodialysis is a treatment that replicates what the kidneys do for your body – that is, to get rid it of toxins. So patients whose kidneys can no longer perform that function have machines that do it for them.

Most of the work I did involved ward nursing. I would be allocated 4-5 patients daily, though those who were on dialysis would be not be around for half my shift, as they were next door getting their treatment. My job was to prepare the patients for treatment, make them comfortable, and do general observations on them.

Working in that department gave me a huge appreciation of what our kidneys do for us, the fatality of kidney disease and the importance of looking after them.

The knowledge I gained on the renal ward has served me well in Emergency, where I work now, in being able to identify kidney-related illness and knowing the steps to take to deal with urgent cases suffering from it.

I applied to Emergency for my second rotation because I was attracted by its fast paced and challenging nature.

What I really like about it is the variety; something different happens everyday.

You get a section of each medical speciality, and grow your knowledge to include a bit of every clinical area. People present with every possible condition – heart problems, organ failures, infections.

It’s a very unpredictable environment. Things often happen to throw everything out of schedule, so you must adapt to the emergency at hand.

There are two different areas within the emergency department I work at. There is the trauma centre, which receives major trauma cases. You need your post-graduate certificate in critical care to work there, which I plan on getting soon.

I work within the Emergency centre where individuals often arrive by ambulance or self-present.

They come to emergency and are assessed by the triage nurse who assess their category of acuteness. Then they are sent to their allocated area to either be assessed immediately, or wait for further assessment – depending on their condition.

My job is the primary and second assessment upon presentation to our unit. I assess the condition in more detail, ask about their past medical history, allergies. I’ll check their blood pressure, respiratory rate, as well as skin integrity and the whole body.

Then alongside the doctor, we’ll look at the most appropriate interventions: do bloods need to be taken, do they need a cannula for fluids or medications. They may also need radiology or special monitoring.

Within my specific department, once that initial assessment is done, they may be transported to another area of emergency, and then ideally we like to know what the plan for them is within 4 hours. So within that time, based on the results of all the assessments and tests, we evaluate if they can go back into the community or if they need to stay within the hospital, and which department.

Sometimes a patient can rapidly deteriorate.

When that does happens, we may transport patients within the emergency department, to our resuscitation area or a more visible room. I don’t work in Resus because that’s where you require your critical care post grad certificate, which I haven’t done yet.

Looking forward, I’d like to continue with my emergency specialization, and to do my critical care post grad that will allow me to work in ICU and trauma.

I have worked in emergency for almost two years now. Coming from the kidney ward, where you get to build relationships with patients over months, I didn’t think I’d get the opportunity to make close personal connections with patients here. And while it’s true you don’t get those long-term relationships with people, I still really enjoy meeting and connecting with the patients, building rapport with them and helping them through their ordeals.

I also really enjoy the team I work with. It is nothing like what I thought, any question I have someone will always ensure I know how to find the answer. Coming from a regional town often people won’t move to metro hospitals considering the larger numbers and myths about city hospitals: am I going to just feel like a number?

But everyone is really caring, and helpful.

Finding employment at a metro hospital has been a fantastic experience and has allowed me to gain a good understanding of the healthcare system and develop a diverse range of skills.

I love seeing people who come in very sick, leaving well and healthy.

In emergency, we often don’t see the end of the journey for people who come in, but a lot of the time you might see them again on the hospital grounds, and I enjoy seeing their improvements.

It’s also really rewarding when you can make a difference to the patient’s family, make it a bit easier for them, and it’s rewarding when they come back and thank you and remember you.

I really like patients who take initiative in their care, those who ask “Well, why are we doing this, why am I taking this?” I feel like I’m helping to empower them in their own health journey through explaining and educating them.

I believe understanding the role you play in your own health is the most important part.

Once a patient understands what’s happening, they are likely to be compliant with the health plans we give them, than if they don’t get it.

That’s probably my favourite aspect of the job, and ties in with my plans to work in community health education in the future. I recently started working with the Heart Foundation, doing their Community Speakers program, focusing on engaging community groups talking about heart health. Again, it’s all about that preventative health, educating people how to prevent heart disease, see the early symptoms.

Shift work can be quite difficult.

Night shifts are hard, but that’s the environment of the hospital settings, that’s the reality. I’m lucky I can request my shifts, and often get what I want. My roster comes out a month in advance, so you can plan your life. The upside is getting up to nine days off in a row, like I recently did after doing 8 days straight.

It’s hard to get both Xmas and New Year off; I count myself lucky to get New Year off this year, but I am doing Xmas. I did New Year last year, and it was nice – we got into our Xmas scrubs, and there was a nice spirit to it.

What amazes me is the sheer scope of nursing professions and specializations our there.

It’s really up to you where you are going, and how far. Something that’s really helped me get an insight into the depth of the profession has been the volunteer work I’ve done over the years.

When I was in my undergrad, I volunteered with National Rural Health Student’s Network (NRHSN), which I got onto by volunteering with my local university health club.

I represented nursing and midwifery students in Australia. We worked to advocate for nursing students and to help them with getting into rural and remote careers.

We did things like high school visits, educating kids on what various health care professionals do.

Like what’s the difference between an occupational therapist and a physiotherapist, what’s the difference between a nurse and a midwife? I was involved in organizing these talks, engaging the relevant students to give the talks, and gave some myself.

Through that, I got the opportunity to attend various conferences all over Australia, networking and engaging with senior people in the health profession, learning from them about their specializations and career paths.

I am now involved with ASANNA, which is an organization that represents nursing students and novice nurses.

I have been involved with ASANNA since its existence. I started as a representative for my university, and for the past few years I’ve been the state rep for Victoria.

Now I represent novice nurses, working alongside the student representative. We educate and assist nurses with their career options, giving talks at various universities, utilising our social platforms to engage with young people, let them know about different graduate programs both in Victoria and interstate and nursing events and opportunities.

Again, through ASANNA, I benefit from a lot of networking at conferences and events, where I get to meet people and keep learning about the profession.

I think as nurses, often we focus primarily on our jobs and patients, but it’s also important to spend time on ourselves, our self-development and career satisfaction.

Aside from that though, I am all about helping people, and as nurses I believe in supporting and empowering one another, that’s something I’m really passionate about.

Long term, once I get the experience in emergency and expand my skills and knowledge working here and overseas, I think I will pursue a more educational and leadership career path. I want to focus on preventative and educational health care, community outreach programs that have a really wide impact.

I don’t know exactly what I’m set on just yet, and I don’t want to get stuck in a speciality too early – there’s so much to nursing, and even with everything I’ve learnt so far, I feel like I’ve only seen the tip of the iceberg! I’ve still got time to explore and try different things, and it’s something I’m really looking forward to.