IND Mini Series: Sarah B - The International Nurse

Our final episode on this special, poignantly being released on the 12th of May (International Nurses Day) is about Sarah, who began her paediatric nursing career in the UK.

In Australia 33% of our nursing workforce are born overseas, and with them they bring a wealth of knowledge and skills that can be applied here to improve the quality of nursing care.

Sarah speaks about her experience training in the UK and working in a busy London PICU before relocating to Melbourne and transferring her skills across. Many things are consistent with our nursing practices across different countries, but many things differ as well. We discuss this in this episode, along with placement poverty, a real issue being faced by many nurses studying their undergraduate degrees in todays climate. But we also have many, many laughs! 

We hope you enjoy this last and final episode of our mini series for 2024 International Nurses Day, thank you to all our guests and to all nurses out there in the world. You're doing a great job!

visit our website at www.paedseducation.com.au

Transcript

  We acknowledge the traditional owners of the land and pay respects to Elders past, present, and emerging. We recognize their connection to country and their role in caring for and maintaining country over thousands of years. This PEDS  Small Talk mini series is a little different to our regular programming.

Instead of chatting with parents and children, in light of International Nurses Day on the 12th of May, we're going to speak with five incredible paediatric nurses who will share their journey into becoming children's nurses, and the diverse roles that they all have now.  We discuss the amazing highs and the very real lows of nursing, along with some nurses humour along the way.

So blanket warning for all the body fluids here. These are the stories of five women who consider it a privilege and an honour to have made a profession out of nursing. And we hope you enjoy the special mini series edition of Peed's Small Talk.    

 To kick this podcast off before we get stuck into talking to our next excellent guest, Sarah, my question for you this time is what are the not so nice parts of being a nurse for you?  

My last answer  is very long winded. This could probably be pretty long winded as well, but I don't think it's necessarily isolated to nursing.

I think any job has its pros and cons in particular for nursing. The first thing that comes to mind For me, a shift work and yet it's a double edged sword because I actually really love the shift work life. Pre kids, I didn't love missing out on things because you do miss out on a lot of events and you do feel a little bit out of the loop With a lot of, your friendship groups because they're doing things after work during the week or even on the weekends and you miss out on them.

So that was a bit horrible at times, but also good. Cause if you didn't feel like socializing, it's very easy to pick up an extra shift and earn a little bit more money. And it is good for the pocket during shift work as well. So I think it's a double edge. Now I've got kids shift work is probably quite helpful in terms of being able to choose, to work on the weekends or do a night duty.

Fit in with your life a little bit more in saying that it's a little bit tricky now, because I really don't want to miss out on things with my children. I don't want to miss out on their sport on the weekend and going to family events. So yeah, that's probably for me, the hardest thing about nursing, but I wanted to mention something else.

And it's come up throughout the podcast series that we've done. And that is how nursing has changed over time. So when I first started nursing, there was a really big emphasis on that sink or swim. Notion that we've talked about. But there was also something that happened and that was that if you were good at something, you've really got slammed with it, like you did it a lot.

And that was really challenging for me because I became really good at palliative care. And I love palliative care with a passion. I think that you can end.  Someone's life, help someone at the end of their life be very beautiful. I think palliative care can be beautiful. So I became quite, skilled.

I'm not sure if that's the right word, but I developed a passion for doing it really well. But I did get a lot. So I did deal with a lot of palliative patients in the ICU and it ended up burning me significantly for a little while. But there was no support. And I think back then it was you'll be okay.

You can just get on with it. It's really challenging to talk about these sort of things outside the hospital environment, as we know, people don't understand you in nursing. So your nursing friends understand you, but no one else understands you. We have a dark sense of humor. We talk about inappropriate things at the dinner table.

And when you're amongst nursing friends, That's okay because everyone understands, but when you're not it's not really socially acceptable. So I think it was really hard back then. I think it's changing. Nursing is changing a lot for the better. And there is so much more support for nurses who are dealing with some pretty intense things every single day.

But I think that can improve, that can always improve the support that we give to nurses to offer them that support. If they choose to take it up, then fantastic. If not. Then that's their own choice. And I know that has changed because in our ICU, we now have a psychologist. Yeah, that's a great change, but it also, yeah really hard part of nursing.

I think. How about you, Grace, tell us the flip side of all the wonderful things about nursing.  

Firstly, I just want to acknowledge that would be really hard and I can see, I can definitely see where you're coming from. And that, when people do excel at a certain thing, when they do get given it over and over again, and whatever that is, it becomes hard to keep doing it.

And I can definitely see why that would be difficult. And you know what? I just was reflecting on how I had a conversation with a school friend one day about organ donation and made her cry. And so ever since that day, I was like, I really need to be more careful in how I talk to people who are not nurses.

Sorry.  These guys are laughing at me because they can probably imagine how I delivered it too, which would have been so matter of factly. And yeah, and I was like, Oh, actually that  didn't fall very well. But look, yeah, look, I'm probably going to be, I'm going to go to a place that probably, It's talked a lot about in our profession, but I don't know how much it's talked about outside of our profession.

And that is the culture of nursing can be beautiful, but it can also be really harsh. And you've, we've touched on it a little bit, but bullying and the workplace can be really heartbreaking for some people. And this is probably not unique to nursing. I'm sure that many workplaces experience this, but there's a cultural hangover  in nursing in particular, through. 

The generations in which it's evolved if we know the history of nursing, we know that it was, Florence Nightingale, we're celebrating her birthday after or anniversary of her birthday after all for International Nurses Day, and, that transition from now the way that we practice now, there's a lot of, Stuff that lingers over that is bullying and I've seen it break some really awesome people and I've seen them leave the profession and that's probably what that's the least thing I like about nursing some days when I come in and I see that happening and I don't understand why.

People can't be kinder to one another and give them grace and, give everybody a little bit of understanding  because, we are dealing with a lot in our professional life, but we also bring with us stuff from our personal life too. And we should always give everyone the benefit of the doubt and just have a conversation with people.

rather than judging them. And I think that's the thing that is hardest on us as nurses, like people will judge us if we're not performing at a certain level, if we're not interacting in a certain way.  It's a complex issue, so I probably don't have the ability to really get into it within this podcast, but I think, those, when I think about the days where I really  didn't like work, it was because I saw something like that happening.

And. I didn't feel like I had the power to intervene or I wasn't able to  be there to help that person at the time or happen to myself even, it might've happened to myself or someone else that, was in my circle of colleagues. 

Yeah.  I think that's a really valid one. And we've spoken to previous guests about how as nurses, we see a problem and we want to fix it.

So when we can't fix it, it's really frustrating. And when you don't have those powers or that ability to be able to do it, then it can be really challenging to be able to support people in the way that you really want to and need to support them.  Okay. Let's get on to our amazing guests today.

We welcome another Sarah to the podcast. So Sarah is actually one of our incredible employees here at Peds. Sarah trained in the UK as a child. Pediatric nurse at the university.  She did a number of placements in lots of different areas, including cardiac, renal, oncology and infectious diseases. And then went on to work in King's hospital in London, which is one of the largest liver transplant centers.

In the country in the ICU there. She moved to Australia just before  COVID where she then worked at the Royal Children's Hospital in the intensive care unit and has gone on to have her beautiful little son and then come and work for us. So welcome Sarah to Keep It Soft. I would love for you to just tell us a little bit about your journey into nursing, why you started and that journey, because it's quite different from Australian nursing systems.

So I'd love you to touch on that if you would be happy to. 

Yeah. Oh, thanks for having me. Yeah. So I I was always really interested in first aid and I always really liked programs. I don't know if you have it here, but I'll be sitting casualty, which like hospital dramas. And I was obsessed with them as a child  and I went on to be like a lifeguard.

So I really just  pursued more of my interest in first aid. And I was really, always really interested in like human biology at school. and things like that. And then when I was 16, I went to college and I did a qualification in health and social care. And as part of that qualification, I would have to do a placement every week.

So every week I over a course of two years, I did a placement and I worked in an  elderly people's home, I worked in a special needs school for children, I worked in a nursery for a bit, in a daycare centre, and it was when I was working in a special needs school that I was really like, oh, actually, I really, can see myself working with these children, the children that had the really complex needs.

And I was like, then I was like, Oh, I know I want to be a nurse, but actually I really want to be a children's nurse.  And that's what I can, I know that I've got really good skills with children and I really want to foster that.  So then I went and I went to university in London where I'm Went to a university that has like the biggest intake of children nurses in the country because they have a lot of capacity to have placements,  which was a really lucky that I did that because I've got such good placements and such a variety of placements.

One of the biggest differences between Australia and the UK is that we do a lot more placement hours in the UK. And I was actually quite shocked when I came here speaking to one of the students about how much placement they do. And I was like, wow, we would do that amount of placement in one year that you do for your whole entire course here. 

I was like, wow, that's really.  It's surprising how different it is. Yeah. 

Do you get paid for it? I'm just curious to know because there's a lot of stuff going on around now about placement poverty for nurses. So I am segwaying a little bit, but do you get paid for that placement and more placement in 

the UK?

At the time, if you were doing a diploma of nursing, then you got paid. You got paid so about I think it was about 7, 000 pounds a year. So about be about 14, 000 a year and you didn't pay any fees either. But now they've moved to degree structure and I think they've got rid of the bursary, but they have seen a real drop in the intake of people applying for nursing  now.

So there are lots of talks about bringing that back because There's a lack of people. And it's also  what I don't know how what you see here in Australia, but when I was training, because we had that bursary, we had a lot of like young people, but we also had a lot of people who were doing second degrees or who were older people who had a lot of life experience.

And I think they've lost that older set of people coming through have got that really valuable life experience that they would have had before. Yeah. 

Yeah the cost of living, if we just think of that alone, like I know what it was like when I was doing my undergraduate degree in terms of being able to keep myself afloat, like I needed to work as well as study, and then we have our placement as well.

But we know that the cost of living situation is so completely now. So if you do think about those. older generations of people who probably have mortgages and maybe kids. Yeah, exactly. Like, how can they go off and just like work full time? And it's so sad because you're losing 

such amazing people that have got, and a lot of them are like healthcare assistants who've been healthcare assistants for quite some time.

They've got a lot of like knowledge and skills already to bring. It's so sad. . I really hope they bring it back one day and I hope they bring it here as well. , it's such a full on course in the UK.

about here in Australia, but it's like when you're in uni, you're in uni five days a week, nine till five. You don't really have time to work on top of, and when you're doing placement, you're doing full time working placement hours as well. Like you don't have time to work really. So it's a shame that people have to, the people who did have to work, they were really, it was really hard for them.

Yeah. 

I think that's why though, our UK nurses are pretty highly sought after because you are really well trained. I don't remember going to uni five days a week, nine to five. Can I just say, I'm pretty sure  maybe three subjects a day or something. I was still very full on. Like I'm still.  Stick course.

But certainly the placement thing I think is interesting because that is where you learn so much. Yeah. Not so great if you don't get a great placement or you don't get great support. But certainly that's where you do learn a lot of that skill based, yeah, knowledge.  Definitely. So you completed your your training.

Once you completed your training, what happened then? 

I then applied for some jobs and I got a job at King's College Hospital in the children's critical care unit, which was like part  high dependency unit, heart and children's intensive care. And then I worked there for  nine years. I think it was quite a long time until, and then I moved to Australia after that.

So I was quite a senior before I came to Australia in that role. Yeah.  

, is that a hard transition to make? Like when you go from a senior position in an area which you've developed some expertise to a whole new country,  are you starting at the bottom again? 

Yes. Yeah. It was so hard. It was so hard. I started I felt like I was a newbie again, like I questioned everything again, and I think although there was a lot of things that were the same because I'd not done a lot of cardiac intensive care and I'd gone to a unit that does cardiac intensive care, that was like a whole new level.

Learning curve for me, like I'd had a little bit of experience, but not as much as that. And a lot of the ways that you do things, your policies and procedures around liver transplants, for example, are very different to what they are in my previous job as well. So it was like I was having to relearn a lot of. 

Yeah. It was really hard. It was a really hard transition. Not to say 

that drives me crazy, Grace and I worked together in a clinical nurse consultant role. I've really discovered how different countries are. Despite us looking after a child who has the same condition, who has the same sort of surgery,  Despite all working off the same evidence based.

Knowledge that we have our guidelines and our protocols do far so much. And that is crazy because the pediatric world is very small. So we should all be doing the same thing. And I think that is one thing that really frustrates me really a lot about nursing in general, but yeah, I can imagine how difficult that would be.

Can I just say too, that I relate to how you feel because coming back after my fourth baby, prior to going and having children, we grace, snow, were very senior positions and the, the more I've gone back after you had babies and then gone back you feel like things change all the time.

Like within a week I feel stuff can change so quickly. So that feeling of having to relearn things that you actually already know, but it's just changed from a protocol perspective. 

Yeah. 

On top of, trying to get back into your skills and, you would be learning new equipment and new people and your team is there when you're in an intense environment like that.

Yeah. So 

you were in the intensive care unit at the Royal Children's Hospital and what was your, what did you, find as your passion in that area?  Obviously liver transplants is something you did, but 

Did you 

discover a new passion?  

Oh, what, when I came to Australia? Yeah. I think I started to really enjoy a lot of the cardiac stuff actually and I did a cardiac course as well to help get my skills up.

But generally the biggest thing I like about working in intensive care is like working with the families and supporting them. That's a really big thing. I really enjoyed that. Yeah. And that relationship.  

Yes if you don't like working with families when you are an ICU nurse, then you're in trouble because, most of our kids are sedated.

So we're not actually spending a lot of time talking.  

Although, not all of them are sedated. I think some people think that because, the night after they get extubated is often one of the worst 

times. That's when parents are very much needed, isn't it? But yeah, I think, it's very much family centered care when the children 

are 

intubated and ventilated because we're not playing with them 



okay. Are you still working in the intensive care now, Sarah, or we know Sarah, other Sarah,  I need to figure out a way to differentiate between the two. You can call me sarah B. All right. Sarah D mentioned that you work for us. Is there anything else you're doing as well at the moment?

No, I'm just mainly working with you guys. I, but also another company, again, teaching first aid to parents as well and teaching some perinatal first aid, which is all about mental health, which I quite enjoy. It's about helping parents recognize giving them the tools to recognize that they might be suffering from something like postnatal depression, which I quite enjoy.

Yeah.  

That's really important work, isn't it? I think, As a person who has suffered from, postnatal anxiety and even being in a healthcare provider, I didn't recognize it at the time that's what I was going through. It took me probably coming out the other side and then going back and looking at myself in that, in that period of time and going, Oh, I was really struggling. So I think that's really important. 



That's incredible. And you can see the joy that obviously brings you when you talk about it.

And that empowerment for others is just such a gift that I think we're so privileged to be in that position to be able to educate people like that. It's just, it is such a gift, not only for them, but for the rest of the community and society as well,  which is the theme for International Nurses Day this year. Sarah, I just want you, and I think you probably touched on a little bit. I just want to ask you, what is something that you absolutely love about nursing?  

Just really love the privilege, like the privilege of getting to be there for people's most intimate moments and just like the knowledge that you have made what is like a horrendous time for them just a little bit more bearable.

I feel like this is a common theme, Grace, that we're hearing from all of our guests is that it is a privilege. Like we're hearing that so much, aren't we? And you are very right. We are granted access to their most vulnerable moments which I can't think of any other profession with.  

All right. What don't you like then? What's something that you're like, I could really just leave that part of nursing out. And, Sarah and I were chatting about what we would just leave by the wayside. Do you have something that you like? If it just didn't have that, it would be the perfect job.

Honestly, I think it's very similar to Sarah, but for missing out on like bank holidays and stuff like that, when people are like, what are  you doing this long weekend? I'm working. And I think for instance when I was in the UK, I think we had the Queen's Jubilee, we had the, a royal wedding and I ended up working like, All of those extra bank holidays every time as well. 

It was just like, yeah. Missing out, doing stuff with your family and friends. Yeah.  Yeah. 

I'm going to go off on a whim here, Grace. We haven't talked about this as a question, but I really want to know, because I'm really interested. Is this something that you, that makes like you a bit giddy or makes you a bit sort of light headed in nursing?

I feel like everyone's got one thing.  

That's a really interesting question.  

Everyone assumes that as a nurse that you can deal with anything. And I've got mine, but I'm going to ask you first. Oh, you mean 

as as in something that you just don't like doing?  Yeah, so not happy giddy, but Oh yeah, I was thinking happy 

giddy.

Like dry ranch. 

Or, I don't like I don't like limbs that have lost their circulation, yeah dealing with that, I'm not so good, I'm not, yeah. Gross wound cream. Yes, necrotic. Okay. Yeah, like stuff, 

yeah. Grace, what's yours? I'm asking you now. 

What is fine? You know what? I don't really like, like oral injuries.

When we have to talk through first aid and we talk about like how you can put the teeth back in I always feel like someone's like scraping their fingers down the chalkboard when they're talking about it. And then when they also have to talk about using the tinfoil to then keep it in that just makes me, Shiver, like I'm shivering down the back of my spine when I talk about it.

Like it's not like I couldn't do it, but I would like, like I would have that ick feeling like whilst I was having to do it. So yeah, I don't know. And if one of my kids lose their teeth and they're like, look, my tooth is wobbly. I'm like,  don't show me, just show me when it's out. I don't know. It's weird.

I don't know why that bothers me. 

No, so mine I can put out with any gory stuff, apart from poo, I'm just going to be straight out there. Once I get past about six or seven,  I have lots of strategies that helps me deal with bowel actions in the ICU. And that is just one thing that like vomit, blood, any of that stuff.

Fine. But yeah, poo for me. And the other thing is, what are your 

strategies? What are 

they? So you never breathe through your nose and Oh yeah. And I always have to wear a mask and I always breathe through. So COVID was great because everyone was wearing masks prior to that. I was the only one that had to put it on, but breathe through your mouth.

But I feel like I can smell it even when I get home. It's so bad. And like the patients, I treat them with the most dignity and respect. But in order to be able to do it yeah, that I just have to, and sometimes I've even taken my shoes off. On the cold floor to do it. So yeah, it's so interesting and yeah, I'm fine with my kids, but anyway, it's just that.

And then the other thing is, and it's because I've had two knee reconstructions on the one leg from netball, but I can't stand joint injuries. So knees, hips even fractures. I've had to really learn to not be, I've had to desensitize myself. So I actually have. Sat and watched multiple people fracturing their limbs to try and desensitize myself.

I have, four kids and I live on a farm. Someone's going to fracture a bone. In fact, all of my kids have had a break. Two of them coming out of the womb, but that's, there's still breaks. But yes, I think fractures for me is that blood boiling as well. But Yeah. And I think it's because of my experience having, yeah.

Sarah, I'll tell you this story, right? This is going to gross you out majorly, but I was entering a poo bag once and I can't do the block, sink. Cause for some reason there's this like defiant part of my head that goes, you should breathe through your nose.

Grace do it. Just breathe through your nose. And I can't do it. Stop myself, but there was that, but then I tripped, and I spilled the poo bag all the way down in front of me. So can you imagine  this on the way to get rid of it? And then I was just frozen. Cause what do you do when you're covered in poo?

What do you, how do you recover from that? You've got nowhere to go. No one wants to help you. No one's rushing over to go, Oh, Grace, can I help you? Cause everyone's Whoa. And ran. Did you grab your 

scraps after that?  But I would have 

to shower to go Oh guys, I've got to shower.

And then yes, I went into the like scrubs and I could I couldn't wear my shoes anymore. They had to go in the bin and yeah, it was like,  so now I'm a little bit like triggered by poo bags. When everyone's Oh, can you empty the poo bag up with it? Oh, I'd rather not. If there's somebody else who could do that, I'll do anything else for you, man. 

That's 

yeah, you got 

PTSD from the poo bag incident.  Oh, yeah.  

I need a peg as well because My body won't listen to me. Like I just, yeah. Which probably is not a good look either. So  

you'll be fine.  All right. We totally diverge there. Sarah I'm not even sure what we're up to. That I've totally lost track.

I 

find it pretty much done. The only other thing we ask is if you have a funny anecdote or anything, that you think of that it might be something you whip out at parties. And parties. And parties. Nurse 

parties. I was gonna say, I was like, I thought we established how that we inappropriately trauma dump around normal people. 

The reason why I don't get invited to parties. I'm. I'm. 

I'm.  The only thing I can think of now that I've brought up before is that I was having to hand vent, we were hand ventilating this child who's very sick, and I started hand ventilating her and they were oxygenating at 100 percent and then the consultant like, And she was a very fierce consultant, like very, generally very intimidating.

So she took over for a bit and she couldn't get into bag at 100 percent this child. And she was like, now, why can't I do that? And I was like that's because you're not maintaining your peep.  And then later on, we had to move this child. And she was like. And someone went to give her the bagged bag and she was like no, Sarah can bag, because she can bag better than me. 

That's the only fun part.  I love it. Wow, 

that's eating some humble pie, isn't it? Yeah, I'm 

impressed.  

 Poonami stories then. Oh, that's, you've got to have a good career if you haven't had a poonami like Grace. 

Oh, I have had poonamis, but I think they're, shut off in my memory. 

 Locked away. 

We're very good at being able to block things, I think, from our mind. Yeah, 

definitely.

Alright thank you so much for chatting to us today, Sarah. We've really appreciated having your insights and it's actually been really fun. I think we've enjoyed just talking to you. It's going down memory lane ourself a little bit. And really appreciate you taking the time to come on the podcast with us.

I can't talk anymore.  Really appreciate you coming on the podcast with us today.  Thanks. Thank you. Thanks for having me. 

 Well, everyone, that's it for today. Thank you so much for tuning in to another episode of Pete's Small Talk. If you love this episode, we'd be so grateful if you left a review, subscribe to our podcast, and follow us on social media, where you are guaranteed to find life saving tips and tricks for keeping your little ones safe.

See you next time.