I should post more often…

Yamaha TDM900 (2009)

It is not the first time, nor probably the last time where I have said, ‘I should post more’.

It is now April 2019 which is almost 12 months since being in a road accident that nobody else was injured, including myself. Sounds strange I know, but that was my experience. However I did without warning collapse inside my car whilst driving to work early in the morning. I think because it was a cold winters morning with fog and frost around kept most people indoors compared to the warmer climates. Unfortunately my 1964 Chrysler Valiant (AP5) sedan was written off as I was driving that at the time. I was taken via Ambulance to the ED and eventually was fitted with a pacemaker after undergoing quite a few tests. I have a history of cardiac health issues, so having the pacemaker inserted was on advice from my cardiologist.

One of the restrictions of having a pacemaker is that you can’t use a welder nor any heavy electrical tools as they can interfere with the pacemaker circuitry. That being the case my years of restoring cars has ended, so from now it is doing things differently.

Later on I will purchase a ute of some sort which would be handy for my needs. Until then I have decided to ride two wheels for a change which I enjoy just as much. Initially I was looking for a motorcycle around the 750cc range until I spotted a Yamaha TDM900 twin (2009) for under ($5000 Aus Dollars) at a motorcycle dealer shop. I checked the bike over and test rode it and felt it was value for money for its age. The previous owner had kept it in good condition as it looked almost brand new on the floor. I added the Givi top box, and panniers after buying the bike. I also have installed HotGrips by Oxford that heat up the handle grips during cold weather. One of the items I am working on at present is fitting led tail, stop, indicator lights to my Givi top box. This will provide better visibility on the road for safety.

Talk soon 🙂

AIN to RN to Bus Operator

by P Stevenson

The amount of energy, budget, and time commitment whilst completing the Bachelor of Nursing has not ended in turmoil or tragedy for my situation given I am employed as a bus operator.  I thought I should point that out as when attending many nursing tutorial sessions some comments were made that not all nursing students will gain employment as a Registered Nurses.

I first ventured into nursing (Aged Care) as an Assistant in Nursing (AIN) in April 2002 which I completed the Certificate 3 in Aged Care by late 2003. I spent around 14 years nursing in aged care which consisted of full-time, part-time, and casual working hours whilst completing my nursing degree.

From time to time aged care gets a mention in the mainstream media which it did today on the Today Show on the Nine Network. The presenter of the Today Show was discussing whether nursing ratios would improve the situation in aged care around Australia with the Minister for Ageing. The interview was rather short and nothing much came from it which seems to be the case for most media sessions relating to aged care.

In my experience, aged care nursing is unpredictable on most days especially in high care wards where providing nursing care can differ from day to day. It is not like attending to mechanical needs of an old car where you can service something that needs attention when the budget allows you to. For example, my 1964 Chrysler Valiant Sedan (AP5) had an unfortunate electrical short in the left side indicator switch. Due to the age of the vehicle I could not replace the faulty wiring which meant I had to install a toggle switch until I could find the part and replace it. With aged care people you must apply nursing care to meet their needs at the time of providing care.

Here is an example from my experience…Mrs Fluropen in her eighties complains she has soiled her pad after we had only showered her and dressed her just in the last hour. We still have five more residents to attend to that have not been seen to yet. Available nurses to assist is zero given we work in aged care and not a mainstream hospital. The RN’s are busy with their medication rounds and associated medical interventions, which means the AIN’s have to deal with Mrs Fluropen situation. We kindly suggest to Mrs Fluropen that we will come back shortly to assist her, but she becomes agitated and demands to be changed now. So, we decide to quickly assist Mrs Furopen to ease her agitation. Unfortunately, due the medications Mrs Fluropen receives has made her faeces loose therefore requiring her to be washed as the faeces has invaded her vaginal areas and buttock.
The above is a classic example of where time can be lost on one resident that is not catered for in the normality of nursing care. Then once you attend to the remaining residents in some cases their family members have arrived who then criticise you at your lack of ability in caring for their loved ones. As normal you just have to suck it up and get on with it.

After graduating with the Bachelor of Nursing in 2014 I was offered an aged care grad program, but I declined after giving it some consideration.

Much has to change in aged care to really improve how care is provided without cutting back on resources. There are a lot of experts who are happy to share their opinions and ideas but would stumble if they had to endure what aged care nurses do hour by hour 24/7 on limited incomes.

So, I have progressed to Bus Operator and have achieved qualifications in that field of work. I am now licenced to drive heavy rigid vehicles such as artic buses, and steer-tag buses anywhere in Australia. I am earning just as much as an RN or more so from that aspect I am quite happy in my new role as a bus operator. My role as an ex-nurse has not be in vain as even in bus driving there are times where I can use my past nursing experience towards various passengers whether they be elderly, disabled, or have hearing or vision impairments.

Chrysler Valiant update…

A lot has happened over the last 12 months which I have not posted anything on Word Press. The good news is that last December 2016 I was at long last able to register my Valiant. Since then I have renewed all shock absorbers which has improved the ride given the older ones have been on for years. The next project I am working on is to replace the clutch as it also has been on the car prior to purchasing it off my younger brother back in late 1997.

One of the problems the Valiant has had was losing oil which I assumed was from leaking through worn out engine gaskets. To my surprise a mechanic noticed that the oil sender pressure switch had a small crack in it which when the engine was under pressure was spraying oil every where. As a result I feel some of the oil has come into contact with the clutch system as the clutch has been slipping for sometime. The positive outcome is that the engine oil is not being lost as it once was and dip stick level is retaining the correct level.

I am in the process of waiting for my new clutch kit to arrive which should make an in-vast improvement to how the clutch works once installed.

Valiant Dec 2016

1964 Chrysler Valiant Sedan (AP5)

The other areas I have repaired have been;

  • Replaced front and rear windscreen rubbers
  • Replaced old carpet and underlay
  • Installed rear window demister
  • Modified internal car heating system (still being worked on)

 

The Valiant drives well…but will be much better when the new clutch is installed.

Pete.

 

Chrysler Valiant Sedan 1964 (AP5) update

Campmark ARC/MIG Welder

Campmark ARC/MIG Welder

Speco Centreshift installed

Speco Centreshift installed

It has been some while since I last posted something on my Word Press site…so today is that day.

One of my ongoing projects outside of nursing is to restore my 1964 Chrysler Valiant (AP5) sedan so I can have it passed for registration. Over the last 12 to 14 months I have been working on various items on the Valiant and have had success so far in what I have tackled. The list of repairs I have done during that time would relate to…

  • Modifying the electrical fuse box.
  • Replacing the left rear wheel bearing.
    Replaced both front wheel brake cylinders.
    Flushed out Brake Fluid and renewed.
  • New engine oil.
  • Replaced Oil filter and Air Filter.
  • Flushed radiator & replaced Coolant.
  • Replaced heater cable.
  • Replaced rear boot seal.
  • Replaced fuel pump.
  • Replaced spark plugs.
  • Installed new Speco Gear Centreshift.
As you can see there has been quite a few items that have been attended to over the last 12 to 14 months. Just recently I purchased a new Campmark arc/mig welder which is a dual welder as I can use it as a standard arc welder or a mig welder. Initially I was just going to purchase a mig welder as I need to do some minor welding on the Valiant where I installed the speco centreshift unit. However I spotted the Campmark welder on EBay and decided to purchase that one as I would have paid the same price for one elsewhere but with less features and qualities. The welder arrived the other day and is much quieter from a previous arc welder I owned some years back. I have tried the arc welding side of my new welder and it works fine. I have to buy a reel of gasless welding flux core wire before I can try out the mig welding side but have tested out the wire feed mechanism which works fine on the new welder.

My next plan is to do some practice mig welding on thin sheet metal before tackling the Valiant. Once I am confident I will do the minor welding on the Valiant before the end of this year and hope to have the Valiant inspected for registration in early 2016.

Catch up soon,

Pete.

My Valiant

My Valiant

My Nursing Experience at Morling Lodge Aged Care

Morling Lodge Aged Care

Morling Lodge Aged Care now decommissioned (last week) is located at Red Hill in the Australia Capital Territory (ACT) which is managed by BaptistCare (NSW & ACT) formerly known as Baptist Community Services NSW & ACT). I felt somewhat compelled to write some of my views about Morling Lodge due to hearing it is now decommissioned.

It was here that I first ventured into nursing in April 2002 working my first shift in Chaffer Wing that catered for high care residents. I remember applying for the position of Assistant in Nursing (AIN) at Morling Lodge which stipulated that applicants must have experience in order to apply. At the time I had no experience at all in nursing as my previous occupations were not in anyway slightly related to nursing. In fact my previous occupation was maintenance manager of a hotel-motel which had a limited future. After applying for a number of positions when I was working in maintenance and not getting anywhere I thought out of curiosity why not try nursing even though I had no experience. The worst thing that could happen is they send back a reply to say I’m not suited which wouldn’t matter as most other employment applications I tried were coming back negative anyway.

I think a good four weeks had passed and I just came to the conclusion that my nursing application to Morling Lodge was also going to be a negative outcome. I was at the point of dismissing the idea of being a nurse till I received a voice mail wanting to know if I would be interested in having an interview at Morling Lodge and if so to contact them. The next day I phoned back and a week later had the interview and started working a week after that.

I remember my first shifts in aged care nursing at Morling Lodge (Chaffer Wing) which were quite educational as I had never really seen aged residents in their late 80s and 90s requiring full on care before. It became apparent to me that quite a lot of aged people in nursing homes become the forgotten members of society as some hardly had many family visits except at Easter, Christmas or their birthdays. The care staff for most residents to some degree become their second family as there is that connection as staff and residents develop therapeutic relationships. Most of the AINs I worked with in Chaffer Wing had great skills in manoeuvring lifters when transferring residents as the rooms were quite small and were built when lifting was all done manually by care staff. All the showering and toileting was done in various bathrooms external to the residents room which meant you had to transfer them to the bathrooms which some residents didn’t enjoy as the corridor and bathroom air temperature was different to their bedroom especially on the cold Canberra mornings. I also did some nursing shifts in McMaster Wing (low-care) and the Dementia Unit at Morling Lodge but most of my work was in Chaffer Wing.

As time progressed I commenced a trainee-ship which would provide me with more skills and knowledge by gaining the Certificate III in Aged Care at the end of 2003. This inspired me to learn more and I eventually ended up at University completing the Bachelor of Nursing.  I think it’s safe to say now I have gained my nursing experience 🙂

Note… the new aged care facility that replaced Morling Lodge is now in the Canberra suburb of Griffith in the ACT located in Stuart Street which looks quite modern and no doubt a place of comfort for the residents.

Pete.

Are Australian Registered Nurses a vital necessity in aged care homes?

Ageing graphic

Ageing graphic

Health editor at the Sydney Morning Herald (SMH) Amy Corderoy featured an article called “Plan to remove nurses from nursing homes” on May 21 2015 (Corderoy, 2015). The term nurses in the headline relates to Registered Nurses (RNs) as can be seen when reading the whole article (Corderoy, 2015).

According to Brett Holmes the NSW Nurses and Midwives Association general secretary said;

Extract… “the problem had emerged after federal changes to the way nursing homes are funded last year essentially abolished the distinction between “high care” and “low care” homes, and instead directed funding towards individuals. This meant that NSW legislation that mandated all high-care facilities had registered nurses essentially became invalid” (Corderoy, 2015).

This issue has raised concerns from many health professionals including RNs who worked in aged care as can be seen in the featured article by Amy Corderoy. If I were participating on an imaginary television show and had to argue the affirmative or the negative on the question “are Registered Nurses a vital necessity in aged care homes?” I would have to argue for the affirmative. Some who are not involved with health may think that I have taken that stance based on the fact that I am Registered Nurse (RN) and are out to protect nursing positions. Nothing could be further from the truth as there is much more to nursing in aged care than most people would realise.

Having worked in aged care as an Assistant in Nurse (AIN) since 2002 prior to graduating as an RN I have seen many instances of how important the RNs are in their role in aged care facilities. Having nursed high care residents for a two year period and then moving to nursing dementia residents for another two years provides one with a real insight into what aged care nursing consists of. Some of the high care residents I nursed were fully dependent on having all their daily activities done for them. This relates to toileting, showering, dressing, feeding them, transferring them with lifters due to their impaired mobility and the list goes on. When residents at this stage of their life become ill it really requires trained interventions to manage their condition which the RNs are qualified to provide. The topic of gerontology is quite in depth and not something that can be learned over night or in a few months as it requires years of research and practice to provide holistic person centred care (Eliopoulos, 1997). Touhy & Jett, (2010) state from their research that a gerontological nurse may be a generalist or specialist type of nurse which in Australia would relate to general Registered Nurses or Nurse Practitioners who have undergone specific training in their chosen field of nursing. Gosney, Harper, Conroy, (2012) support the concept that aged care people with complex health issues require a special set of skills and attitudes by health professionals to ensure optimal medical care is provided.

Some of the physical challenges aged people have to contend with can relate to their skin integrity, sensory awareness, musculoskeletal issues, cardiovascular problems, respiratory issues, gastrointestinal problems, genitourinary and endocrine issues which almost relates to all the human body systems (Levett-Jones, & Bellchambers, 2011). Of course not all residents’ health remains intact all the time as over time they age and their bodies will decline and start to shut down which then brings us onto the topic of palliative care that aged care facilities cater for. Palliative care is ongoing and requires a thorough understanding of interventions and management for the resident and family members that Registered Nurses are clinically trained to implement (Palliative Care Nurses Australia, 2015). I certainly know that when I was an AIN I would have been out of my comfort zone trying to care for someone requiring palliative care without supervision from the RNs on duty.

As we know from research a lot of elderly people take medications which according to the Australian Bureau of Statistics (ABS) in 2010 relates to 13.5 per cent of the Australian population (Broyles, Reiss, Evans, McKenzie, Pleunik, Page, 2013). When you have a resident taking over eight medications daily this is referred to polypharmacy which is quite evident in nursing homes from my personal experience as an AIN working in aged care (Broyles, et al., 2013). The topic of pharmacology is quite extensive and even now as a new graduate Registered Nurse I am still learning about medications every day which applies to most nurses at all levels of experience.

The Australian Bureau of Statistics (ABS) in 2014 released a report called “3101.0 – Australian Demographic Statistics, Jun 2014” which verifies that the elderly population over 65 years of age in Australia has increased from 11. 8 per cent to 14.7 percent over the last 20 years between 1994 to 2014 (ABS, 2014). The ABS, 2014 also states; “the number of persons aged 85 years and over increased by 153%, compared with a total population growth of 32% over the same period”. What this indicates is aged care homes will have to cater for this increase of elderly people in Australia known as the baby boomer period which RNs will be more sort after with the ongoing medical interventions required. A qualitative study by Chuang, Abbey, Yueh-Chen Yeh, Tseng, Liu, (2013) found that most residents felt secure knowing their care was provided by skilled health care professionals which Registered Nurses would be in that mix and felt comforted in having the correct information being relayed to them about their condition.

In conclusion I have looked at a range of reputable resources to ensure that my research is valid and not based on unsound judgement or views. The future population trends in aged care in Australia have been mentioned indicating that there will be an increase of aged people entering nursing homes as people are living longer due to modern medicine. The clinical issues affecting elderly people have also been addressed as when people age their health status will decline requiring ongoing best practice outcomes which Registered Nurses are trained to provide. Pharmacology was also factored in as elderly people require a combination of medications as they age which will need proper supervision and management by trained Registered Nurses. I feel there is merit from my research to support my argument in the affirmative that Registered Nurses are a vital necessity in aged care homes.

References

  • Australian Bureau of Statistics, (2014). Population by age and sex, Australia, States and Territories, 3101.0 – Australian Demographic Statistics, Retrieved from http://www.abs.gov.au/ausstats/abs@.nsf/0/1CD2B1952AFC5E7ACA257298000F2E76
  • Broyles, B., Reiss, B., Evans, M., McKenzie, G., Pleunik, S., Page, R., (2013). Medication for  aged care clients. Australian and New Zealand Edition Pharmacology in Nursing, (1st Ed.), p. 91. Cengage Learning Austalia Pty Limited, Sydney, Australia.
  • Chuang, Y., Abbey, J., Yueh-Chen Yeh., Tseng, I., Liu, M., (2013). As they see it: A qualitative study of how older residents in nursing homes perceive their care needs. Collegian: The Australian Journal of Nursing Practice, Scholarship and Research, vol 22, Issue 1, 2015, pp. 43-51. Elsevier Australia.
  • Corderoy, A., (2015). Plan to remove nurses from nursing homes. Sydney Moring Herald (SMH).Retrieved from http://www.smh.com.au/nsw/plan-to-remove-nurses-from-nursing-homes-20150521-gh6f1o.html
  • Eliopoulos, C., (1997). Gerontological Nursing, (4th Ed.), pp. 7-8. Lippincott Williams & Wilkins, East Washington Square, Philadelpha, USA.
  • Gosney, M., Harper, A., Conroy, S., (2012). What makes geriatric medicine different?, Oxford Desk Reference Geriatric Medicine, p. 13. Oxford University Press, Oxford, United Kingdom.
  • Levett-Jones, T., & Bellchambers, H. (2011).Medical-Surgical Nursing. In P. Lemone, K. Burke, T. Dwyer, T. Levett-Jones, L. Moxham, K. Read-Searl, K. Berry, K. Carville, M. Hales, N. Knox, Y Luxford, D. Raymond (Eds.) Medical-Surgical Nursing: Critical Thinking in Client Care, Vol 1. p. 30, Pearson Australia, Frenchs Forrest, New South Wales.
  • Palliative Care Nurses Australia (PCNA), (2015). Palliative Care Nursing. Retrieved from http://www.pcna.org.au/what-we-do/palliative-care-nursing
  • Touhy, T., Jett, K., (2010). Foundations of Health Aging, Erbersole and Hess’ Gerontological Nursing Healthy Aging, (3rd Ed.), p.16. Mosby Elsevier, St Louis, Missouri.