When it came time to apply for my new graduate year, I wanted something different from the standard programme and role. Everyone was focused on a new graduate program at a public hospital, which was typically a 3-4 rotation program of 12-week rotations from February to Christmas. You were not guaranteed work at the end of the programme, and you would be left hanging over the holiday period with no security for you at the end of the slog. This would also imply applying for a second-year program while the first one is still being completed. It didn’t sound like much fun already. There must be something else, something for me!
📚 Story Time – Fill in the gaps…
I was completely naive about nursing before I started. This is another story for the blog, but until my clinical placements, I had never been in a hospital or seen what nurses did. Prior to starting nursing school, I worked as a professional beach lifeguard. I had a fantastic, well-paying, and enjoyable job. But I wanted more, more in my professional role. I loved the clinical world of medicine, and I decided to pursue a career as a paramedic or doctor. After much deliberation and advice from the paramedics and doctors I had trained with in Aquatic Rescue, I decided to pursue my nursing training first. Fast forwards much further in the story, and there I was, nearing the end of my third year, with an awesome job at the beach and in a difficult situation.
🌊 Beach and Hospital
In addition to working at the beach, I was an undergraduate AIN at my local public hospital. It was interesting to see the hospital environment in a different light than clinical placements and to work in different areas and teams. I was fortunate to work in my local emergency department, where I fit in well due to my enthusiasm and pre-hospital rescue experience. When I first started nursing, I had no idea what I wanted to do!
🎯 Maximise The Chances
It was difficult to decide what I wanted to do for my graduate year, but when it came down to it, I decided that I would apply for every position in my local area and give them all my best shot! I wanted to put myself to the test and see what I was capable of. Plus, I didn’t want to limit myself by not submitting an application, which is so easy to do! I also promised myself that I would not enrol in a new graduate programme in a ward. It wasn’t for me, and I wasn’t willing to leave my fantastic job at the beach for something less (for me and what I was interested in and what I needed at the time).
👀 Look outside the box
When I looked beyond the standard that everyone talked about and that my university and placements had led me to, I discovered some amazing programmes and flexible employment opportunities in a variety of different areas, roles, and companies. Ramsay Healthcare was one of them in my neighbourhood, less than five minutes from my house. The Ramsay Hospital was a large private hospital near where I lived (and attended school). This one, like hospitals, expanded and expanded again. It received a large number of new graduate nurses, approximately eight to ten. There were four positions in the theatre and six on the ward. As I recall, you had to apply to the programme as a whole and then indicate what you wanted to do for your graduate year.
🤩 Something for me, something new and exciting!
I decided that I wanted to start a new graduate programme in theatre. I had only been to a theatre once before, and ever since then, I have wanted to start my career in theatre and experience the wonders of anaesthesia and the intensive care unit! I applied for the programme; it was my first application, and I was very excited about it! I then applied to every theatre programme in the area and beyond!
🤪 Some are better than others and others are better for you!
In preparation for my applications, I thoroughly researched the various programmes and what the various employers had to offer, and it was clear from the start that one was distinct from the others. Ramsay was the one. Ramsay provided a programme similar to what you would find in a public programme. Study days which included trips to Sydney (from Newcastle), conferences, free further study, a learning library, and access to professional journals were all available. But these two blew my mind! Because Ramsay’s network is not limited to a single state, you could transfer and gain experience all over Australia. The other is the chance to travel and work with Ramsay during my graduate studies! I was already sold!
😊 The Difference I felt!
I walked into the local Ramsay hospital, having completed none of my private placements, and was greeted by people who were smiling, happy, and friendly. I was treated with dignity, and it was a pleasant experience for my first time there in private, let alone for a recruitment process and interview. I sat for the interview in a small office with the three people who were interviewing me for the position. When we sat down, they asked general, friendly questions that relaxed me. They asked why I had applied in general, and before I knew it, we were halfway through the interview. It was completely different from the public hospital’s recruitment procedures. I was asked about myself, my skills, what I could bring to the table, and my future plans.
➡️ Aiming for Theatre
Two weeks later, this was the first position I went for, and through the preparations for applying for them all, I realised this was the one I wanted! I waited desperately on the phone, and it rang! I couldn’t believe it! I was over the moon!
✅ Going to Theatre!
My future NUM said to me, ‘Rory you interviewed very well. Well done. We would like to offer you a position with us. You were our preferred applicant overall and you can choose your program. Would you like theatre or wards? Scrub, Scout or Anaesthetics and PACU?’
🚀 Beyond
I spent 2.5 years having a lot of fun in Anaesthesia. This hospital had ICU and cardio-thoracic services and I was working closely with the cardiac ICU team in Anaesthesia. In the same year, this hospital opened the state’s first emergency department that was completely private. This was another great learning curve and opportunity to be involved with.
I think you know enough about me to figure the rest out! 😜
After many years with other private health services and NSW Health, I have returned to work with Ramsay this year, as a Clinical Nurse Educator.
🚨 Graduate Fellowship Program with Ramsay 💥
I chose Ramsay Healthcare because I could go straight to the operating theatre in a major private hospital. This suited me and my interests as well as my goals for the first couple of years of my career. The hidden benefits I had was Monday to Friday work, no on-call and no weekend work. I had 6-month rotations to really learn the clinical area and decide if it was for me.
There are many opportunities to work with Ramsay!
So if you haven’t already considered or applied for a position at Ramsay…
Apply for next year today!
Check out this blog to read about the 2023 program👇🏼
It’s time to apply for all of the programs available to new graduate nurses for 2023.
There is a great program opportunity that closes THIS WEEKEND!
Read on 🤓
Ok, you have decided you would like to pursue a new graduate position in a hospital, commencing your career as a hospital nurse while developing yourself as a clinician 👩🏼⚕️👨⚕️
You have applied for your state or territory health areas, such as NSW Health for everyone in NSW and so on. This is one of the many options available to grads seeking to commence their career in the hospital setting.
Many do not realise, that Ramsay is the biggest private hospital provider in Australia AND is one of the most popular and prestigious healthcare providers internationally. They have hospitals in every state and territory of Australia as well as internationally in countries including the UK, Singapore, Italy and even France!
🤩 Graduate Fellowship Program with Ramsay
📅 Applications Close August 14th!
Dont miss out!
There are many reasons to consider an alternate hospital new graduate program such as Ramsay Healthcare. Ramsay offers a new graduate program they now refer to as a fellowship program. This is a great alternative for you to look at! Let’s have a look at a couple of advantages:
The fellowship runs over 24 months and you are able to work full or part-time depending on what works for you.
At the end of the 24-month period, you are offered a position with the organisation based on your performance.
Opportunity to complete rotations in the general ward, theatres, critical care (ED and ICU) and specialised services such as oncology and many others.
Opportunity to gain experience all over Australia
Opportunity to travel and work internationally, on another continent such as Alaska or somewhere like Singapore, Italy, the UK or even France!
Think about what you are interested in and what will fuel you to turn up, learn and do your best, each and every day.
Have you thought about it?
Have a think and if you are aiming for a hospital new graduate role, consider Ramsay Health.
After all, I completed a Theatres New Graduate Position and loved every moment 😜
Today’s blog is for new graduates and new nurses who have landed a position in peri-anaesthesia, or you are a nurse who is interested to give this fantastic clinical area a go. As many of you know, I am not only a peri-anaesthesia nurse specialist; I also completed my new graduate year in anaesthetics and recovery! This blog post is sure to provide you with plenty of value as you learn the clinical specifics and progress with your journey in peri-anaesthesia nursing.
I wanted to share the key areas in peri-anaesthesia nursing with you and what I found helpful to learn as I progressed in the area. We will look at what I found helpful starting as a grad, including the knowledge, skills, hints, tips and more!
Let’s have a look!
Important Aspects of Peri-Anaesthesia Nursing
A breakdown of the important aspects of peri-anaesthesia nursing for new nurses – a FREE guide for YOU!
The Role of the Peri-anaesthesia Nurse
Anaesthesia Nurse
The anaesthetic nurse is the assistant to the anaesthetist. They:
prepare the environment and equipment for the patient
prepare equipment for administering the anaesthetic
receive the patient into the operating room, establish rapport by asking and answering any questions, and check identification and consent
communicate relevant patient information to the other members of the intra-operative team, both nurses and doctors
assist with intra-operative patient monitoring and ensure the patient’s safety, comfort and warmth
assist the anaesthetist at the end of the procedure as the patient emerges from the effects of anaesthesia.
Position statement on the assistant for the anaesthetist – CLICK HERE
Knowledge and skills
The anaesthetic nurse requires:
good assessment skills
a knowledge of anaesthetic methods, anaesthetic agents and equipment
an understanding of fluid balance and respiratory monitoring, cardiac monitoring and haemodynamic monitoring, and the ability to identify any changes that may have impact on the patient
knowledge of airway anatomy and physiology, airway management strategies and anaesthetic complications.
Becoming an Anaesthesia Nurse – Education pathway
This role is suitable for both registered and enrolled nurses. Registered nurses need to complete a Bachelor of Nursing degree and a postgraduate degree that focuses on anaesthetic nursing. Enrolled nurses need to complete a Diploma of Nursing that includes medication administration and a Diploma of Anaesthetic Technology.
Post-Anaesthesia Care Nurse
The Post Anaesthesia Care Unit (PACU) nurse receives the patient into the PACU (also known as the recovery unit). They:
undertake respiratory, cardiovascular and neurological assessment and monitoring as the patient recovers from the effects of anaesthesia and surgery
monitor emergence from anaesthesia, dressings, intravenous lines and drainage tubes
implement and document post-operative treatment regimes including pain management.
Knowledge and skills
The PACU nurse requires:
strong knowledge of and ability to manage post-operative complications and respond to patient deterioration quickly and efficiently
advanced airway management skills
the ability to quickly recognise respiratory compromise and take necessary action
excellent assessment skills
strong knowledge of pain management methods and medications
excellent communication skills
the ability to work as an effective member of a multidisciplinary team.
Becoming a Recovery or Post-Anaesthesia Care Nurse – Education pathway
This role is suitable for registered nurses who have completed a Bachelor of Nursing degree and a postgraduate degree that focuses on post-anaesthetic care.
Enrolled nurses who have completed a Diploma of Nursing that includes medication administration may work in second-level recovery care where patients require a period of supervised monitoring, privacy for the discussion of procedural outcomes and discharge instructions, bathroom facilities and provision of food and fluids. Criteria for discharge from second stage recovery include pain and nausea control manageable with oral medications, return of cognition to pre-procedure levels, and the ability to be mobile safely.
Pharmacology (including GA + Muscle Relaxants & Reversal) used in Anaesthesia & Post-Anaesthesia Care
Different types of anaesthesia – General, sedation, local, regional, combination
Main anaesthesia medications
Muscle relaxants – depolarising and non-depolarising
Caring for the Patient having Regional Anaesthesia
What are they?
Why are they used?
What are the benefits?
How do they differ from GA & sedation?
Can you have a GA &/or sedation with regional anaesthesia?
What are the differences between these types of regional anaesthesia?
Epidural
Spinal
Major joint
Extremity
Study Guide for your Journey in Peri-Anaesthesia
Knowledge Areas
Foundational knowledge to brush up on prior to starting or to reflect upon along the journey within the first few weeks to build confidence and nail your skills!
Specific Roles of the anaesthetic and post anaesthetic care unit nurse
Pharmacology utilised for general anaesthesia, sedation, local and regional blocks
Monitoring a patient before, during and after anaesthesia
Respiratory complications
Airway anatomy + physiology
Airway assessment + management
Acute pain management
Peri-operative emergencies
Patient Assessment
Caring for patients who have had regional anaesthesia
Devices and equipment utilised in peri-operative and peri-anaesthesia clinical practice
You will be exposed to, practice and develop advanced nursing skills surrounding airway, breathing, circulation, disability, pain and exposure. Familiarise yourself with these clinical skills in peri-anaesthesia and identify your roles as an anaesthetic or recovery nurse.
Non-invasive airway management devices – oropharyngeal and nasopharyngeal airways
Differences with Adults vs children & infants
Airway Management
Suctioning
Airway cart and equipment
Suction airway
Assist ETT Intubation with manual and video laryngoscopes
Cricoid pressure
Verification of ETT placement: CO2 detector, auscultation, CXR
Use of bag-valve-mask
Assist with tapes
Insertion LMA
Clinical Competencies
The required clinical competencies ranges and depends on the specific clinical area you are in and the type of peri-operative services the hospital provides.
Common competencies include:
Anaesthesia & Post Anaesthesia Care Nurses:
Patient Assessment
Patient Monitoring
Management of the unconscious and semi-conscious patient
Airway management including the removal of LMA upon the emergence of GA
Assisting anaesthetists
A-G patient assessment
Manage pain and primary assessment complications in the immediate post-operative stage
Manage the thermic state of the patient
Use various pieces of equipment for the care of the patient including:
Use of doppler
PCA
Transducers
Chest drains
Non Clinical Skills
Communication Teamwork Time Management
Resources for the Anaesthetic Nurse
Emergency Department Notes
Handover from Emergency Team
Pre-operative Assessment
Progress Notes
The patient
Resources for the PACU Nurse
All of the above
The patient (sometimes)
Anaesthetic Record
Anaesthetic Handover
Scrub Nurse Handover
Getting prepared
I was always searching for the best and up to date information. Along the journey, I found and developed some great resources. I decided to collate them all together here in one place for us all to enjoy!
I was a New Graduate in Peri-anaesthesia straight out of University. Now, I am a Clinical Nurse Specialist & Clinical Nurse Educator. I have previously worked as a peri-operative Clinical Nurse Educator.
CLICK HERE to hear about my journey, from a University Student Registered Nurse to New Graduate Registered Nurse.
