Another reason we continue to celebrate nurses on May 12th

Each year on May 12th as I celebrate International Nurses’ Day I’m reminded of Florence Nightingale’s legacy.

All of us in society, whether we are nurses, patients or family, share a debt of gratitude to Nightingale for laying the foundations of nursing and establishing many of its principles we value today.Florence_Nightingale_monument_London_closeup_607

I was reminded of this recently when I visited the Nightingale Museum housed in the Selimiye Barracks at Scutari, Istanbul. It contains many relics from the Crimean War between Russia and the combined forces of Britain, France and Turkey. This war is remembered not only for the Charge of the Light Brigade but also for the terrible troop losses from disease which led to a Royal Commission into Military Hospitals. Florence Nightingale’s association with the Crimean War is also justly famous because of her attention to the nutritional and hygiene needs of the sick and wounded troops. She fought authority wherever she found it to be misguided. She made a difference.

I was able to visit this most historic museum when I travelled to Greece and Turkey to commemorate Australian and New Zealand nurses’ achievements during WWI. Like Nightingale half a century before them, the nurses of WWI skilfully cared for the physical and emotional needs of our wounded soldiers, and improved their survival rates so that many of these young men could return home and contribute to our growing society. In recent months, I’ve written more about this trip in the Journal of Perioperative Nursing in Australia and I’ve posted some photos on the NSWNMA Blog Nurse Uncut.

So this year, let’s all remember our debt of gratitude to Florence Nightingale for establishing what we know today as the profession of nursing and consider the many ways that nurses contribute to our society.

Would love to read your comments here about how you celebrate International Nurses’ Day – thanks for reading, Sally.

From Postie to PEPEN: A Water cooler conversation

We were delighted to receive these words from Mark Quealy recently in response to “Where are they now?” on our Water Cooler page.

POSTIE TO PEPEN

It’s never too late to take up nursing. At 46 years old & a postman in Kahibah NSW, I was encouraged by several nurses on my run (identified by their LAMP subscriptions I was delivering) to consider nursing. An inspiring Trainee Enrolled Nurse (TEN) program closely followed by the very supportive 12 month Perioperative Education Program for Enrolled Nurses (PEPEN) based at Prince of Wales Hospital in July 2005. I never would have believed that I was capable of working in theatres if it wasn’t for the multitude of mentors on the way. I have since completed my Bachelor of Nursing, thanks in part for the persuasion from preceptor Beth Mangelsdorf but mostly my wife who had more confidence in my aptitude than I was capable of. I am very happy working in the many & varied specialties at Randwick Campus Operating Suite with a truly inspiring bunch of colleagues. I hope I can encourage others to aim for what seems impossible initially.

Mark Quealy

What a great journey and thanks for sharing this on our website Mark! It’s an inspiring story about the empowerment of education and influence of mentors (and wives!).

Menna and I have known Mark since 2005 when he was selected for a place in PEPEN No.1.

But I’m getting ahead of myself!

Ms Deb Thoms presenting Certificates to PEPEN graduates 2003

Ms Deb Thoms presenting Certificates to PEPEN graduates 2003

PEPEN No.1 and Mark’s group followed the successful PEPEN pilot in 2003, which produced seven graduates and was a catalyst in establishing an advanced practice role for the Enrolled Nurse instrument nurse in New South Wales.

These photos from the Pilot graduation in 2003 show Ms Debra Thoms (then Area Director Of Nursing for South East Health) as well as Amanda Gore (Pilot Project Officer) with Invited Speakers Rebecca Roseby (then ENPA Representative) and Menna (then NSW OTA President) with me tucked in the middle – feeling very proud of the graduates and the large team of educators and managers who worked with Amanda and me to facilitate this area-wide project.

PEPEN Pilot key personnel and guest speakers with Graduates

PEPEN Pilot Graduation 2003

Two years later following changes to Enrolled Nurse education in New South Wales, the PEPEN no. 1 cohort in 2005 were all – like Mark Quealy – newly qualified medication-endorsed ENs, and keen to embark on a career in the operating suite.

This pic (below right) shows Mark during a PEPEN clinical teaching session facilitated by Graham Hextell (PEPEN Project Officer 2005-2008) at Prince of Wales Hospital.

Mark Quealy with Lily Peng and Hazel Poon and other students of PEPEN No 1 in 2005.

Mark Quealy with Lily Peng and Hazel Poon and other students of PEPEN No 1 in 2005.

He’s with PEPEN colleagues Anne Faulkner (left), Lily Peng and Hazel Poon (right), whose perioperative nursing careers have also thrived under the supportive team at the Randwick Campus Operating Suite, where until recently Menna has been the CNC.

In the decade since PEPEN, Mark has also found time time to be a local representative for NSW Nurses’ Association in his workplace. What a varied and satisfying career path!

As Mark says “I hope I can encourage others to aim for what seems impossible initially”.

If you’ve got an interesting story to tell about your career path or you’ve worked with us in the past, we’d love to hear from you again! Get in contact with us and we’ll post your story (and pics) too.

Bye for now and very best wishes for the festive season, Sally.

Times Past – Future Views

During my trip to UK, I visited the Old Operating Theatre of St Thomas’ Hospital which is tucked away on the top floor of an English Baroque church near London Bridge (Southwark, London) and adjacent to the famous teaching hospital Guy’s (St Thomas’ Hospital having moved to a new location in Westminster). I had seen photos of this operating theatre and although I was brought up in London, had never had the opportunity of seeing it first hand.OR at St Thomas' Hospital

The operating theatre is the oldest surviving theatre in Europe, dating back to 1822 and was used until 1860. Its location is rather odd, being on top of a church, but the wards of the old St Thomas’ Hospital were built adjacent to the church. The theatre was only rediscovered in 1956 and underwent an extensive refurbishment allowing it to be opened as a museum exhibiting a number of surgical artefacts and pharmacological potions. Whilst viewing the exhibition, it struck me that although we are nearly two hundred years down the track, many of the instruments on show looked remarkably familiar – a sigmoidoscope, Sims speculum, birthing forceps, assorted other surgical instruments. The operating theatre itself is of course drastically different, as you can see it is set up with a viewing gallery to accommodate the budding surgeons of the day, all jockeying to get the best view of the latest surgical techniques – hence the term ‘theatre’. But unlike today’s modern surroundings this theatre has a crude wooden table with a tray of sawdust underneath ready to catch the blood. Blood stained aprons hung near the door with a mirror so the surgeon could clean himself of blood spatters. The bowl was available for the surgeon to wash his hands after surgery rather than before! Anaesthesia and antisepsis were still some years away, therefore the procedures undertaken were very limited. Amputation was one of the most common procedures performed and surgeons vied for the reputation of being the quickest – often asking a member of the audience to time them. One such surgeon was Robert Liston who in the mid 1800s, it is claimed, carried out an amputation of the leg in 25 seconds! He also, so the story goes, accidently sliced off the poor patient’s testicles too!

In a hundred years time, will someone stand looking at our current operating theatres and wonder how we worked in such conditions? What will the operating theatre of 2114 look like and how will surgery be different?

Our operating theatres may cease to exist in their current configuration and may look more like high tech radiology suites. We will see more minimally invasive surgery using technologies such as those currently being trialled eg High-Intensity Focused Ultrasound (HIFU) and Magnetic Resonance guided Focused Ultrasound Surgery (MRgFUS). These technologies can be used for a variety of procedures including treatment of uterine fibroids, metastatic bone tumours, Parkinson’s disease with patients likely to be walk in/walk out same day surgery. Surgery may be undertaken by robots operated by surgeons located remotely. 3D printing is already being used in innovative ways and I am sure in the future we will see prostheses being made to measure within the operating theatre! I came across this information in an interesting blog on the ACA Research website describing the modular operating room at QEII Jubilee Hospital, Brisbane – The Operating Room of the Future OR at John Flynn Hospital

Where does this view into the future leave perioperative nurses?   Will we survive this technological revolution? We will need to reinvent ourselves using new skills and knowledge to care for patients in this brave new world. With National Perioperative Nurses Day fast approaching on 12 October, it is a perfect opportunity to consider our current and future roles. Many of us won’t be around to see the new technologies and innovations, but we can think of ways in which we can lay the foundations for the next generation of perioperative nurses to meet the challenges of the future.

What are your thoughts on the future of surgery, operating theatres and of course perioperative nurses? Get in touch and tell us what you think.

Back to Australia next week, so til then….
Menna

24 Hours in Emergency

One program that I try to catch each week is the fly on the wall documentary – ‘24 Hours in Emergency’, shown on SBS TV. The main reason that I enjoy it, is that it is filmed at King’s College Hospital, Camberwell, South London which was my training hospital and I love to see the panoramic shots around the local area, spotting haunts that I know so well. Not only did I train at King’s, I grew up just around the corner, so it holds a very special place for me. Plus I love hearing those South London accents belonging to the salt of the earth people who inhabit the surrounding suburbs and were once my neighbours. The program follows the patients who come through the Emergency Department doors in a 24 hour period. King’s is one of the busiest Emergency Departments in the world and has certainly undergone an amazing refurbishment in the years since I was a terrified student nurse working there – not my favourite placement!

The focus of most days is the red phone bringing news of the latest trauma victim which sees the team swing into action – teamwork at its best – everyone assigned their roles by the Team Leader working seamlessly to stabilise and treat their patients. What sets this program apart from other fly on the wall medical documentaries, is the emotional impact of the face to camera interviews with the medical and nursing team – they reveal a lot about their thoughts and feelings as they treat the patients, the responsibility that weighs heavily on their shoulders – something that in the hustle and bustle of a busy department goes unnoticed. There have been many lump in the throat moments whilst I have watched this program. The individual patients and their relatives are followed through their treatment – mostly the outcomes are good and you see the patients many weeks after they have recovered. They provide an interesting insight about what it was like being the patient or a relative coping with the shock of seeing a loved one sometimes at death’s door.

In a recent episode one of the RNs, the night supervisor, found himself admitted as a patient. A casual comment by one of the RNs that his eye looked very bloodshot and he should get himself checked out, led to a colleague taking his blood pressure – 180/110. A barrage of tests followed and revealed he had lung cancer! Surgery and ongoing treatment has seen him back at work and optimistic about the future. All that simply after a casual remark.

Amidst those requiring immediate life saving treatment are the usual collection of chair warmers with minor complaints which could have been treated by a GP. They often, unintentionally, provide the amusing entertainment element of the program!

If you haven’t seen it, it is worth a look from a professional and human interest perspective.

Cheers  Menna

ANZAC Girls – Wartime Soap?

If you prefer to listen to this on audio click here.

I wonder how many of you have been following this ABC series on a Sunday night. As part of the year long commemoration of WWI leading up to the centenary of Gallipoli landings, it was with great anticipation that we both tuned into the first episode a couple of weeks ago. Though there were some good moments looking at how the nurses coped with their first experience of the casualties arriving in huge numbers to a Cairo military hospital, overall we both came away with the feeling we’d been watching a bit of a ‘soapy’!

There was great emphasis put on romance/social side which whilst I am sure happened (and you’d need something to take your mind off the war), took away from what we both thought would be the focus of the story – how did nurses transplanted from the relative comfort of Australian hospitals cope in a tough wartime environment. In fact Sally thought she might give the rest of the series a miss, so disappointed was she at the direction the series seemed to be taking. Sally has done a great deal of reading on the nurses in wartime, particularly WWI, so was much less forgiving of the portrayal. I, on the other hand, was prepared to tune in again last Sunday and give it one more chance. The scene setting, tours around the pyramids and building of the first episode had given way to a much more gritty picture with a group of nurses being sent to the island of Lemnos (piped up the beach with bagpipes – where else would you see that!) where they had to set up a hospital virtually from scratch and receive overwhelming numbers of wounded soldiers; having to fight for the provision of water and the basics of first aid equipment. The tearing off of their petticoats to make bandages showed the nurses to be resourceful and they also showed the risks to their own health from dysentery and other tropical diseases, which actually took the life of one of their group.

Despite the war time environment, there was no escape from some of the arcane cultural mores that the English nurses brought with them – one of them snootily commenting that as the Australian nurses were only army reservists, not ‘proper’ army, they were not really entitled to wear the red cape! You would think there would be other things to think about! But interesting nonetheless to chuckle at such customs!

So let’s see where it takes us over the next few weeks……. What do you think of the series so far??

Cheers Menna