Is the enrolled nurse course hard??

Kate

I responded to one of your posts from the other day - I hope you saw it.

I am also in WA (Perth) and will be studying the Diploma of EN at Challenger TAFE in Fremantle from this month.

Can I ask where did you hear you could do the EN diploma one night a week for 2 years? I have never heard of the Diploma being offered part time or even as evening classes? Unless you are in country WA somewhere.

As I mentioned in my previous post - I would recommend you do the Cert IV Preparation for EN course - as it will solve your problem of not having good maths and english to gain entry into the course. Also, it will give you an idea of what level the studies are at. I personally found the Cert IV very easy - although I have a feeling the Diploma will be a bit more full on.

I have two young kids and run my own business and will be studying full time. I definately think that if you have a good support network you should be able to work part time and study. If we are motivated I think we can achieve anything... that is what I am hoping anyway!

Good luck with it - don't give up if it is something you want to do. I applied 20 years ago the first time - but now the time is right.

Cheers
Rebecca

Hi Schizo,
Thank you so much for your reply and your advice, I really appreciate it along with your vote of confidence. Wow you deserve a big pat on the back for getting up at 3am to study before you kids and hubby got up. You sound so devoted and motivated to achieve what you want. You have put my mind at ease like you wouldn't believe with what you wrote about the maths and english side of the course. I really just needed to know how hard it is all going to be. I'm a very organised person and a hard worker so I'm sure that will count for something and I really want to become a nurse so I need to follow my dream.
Can I ask you what the majority of the course is made up of,I am sure there will be a lot of biology am I correct? what part of the course did you find hard, just our of curiosity?
Once again I am very grateful for your advice.

Thanks

Kate

Hi Schizo,

Thank you so much for your detailed message and the advice you have provided, it is much appreciated. I will make sure that when I come to my placement I will ask about the different classes of drugs and get as much info about the “lol” drugs, thanks for that.
Can you tell me what your general day consists of as an EN? I know if would depend on what department you are placed in but I just want to get a general idea of what I would be faced with in a day. If you have ever worked in an ER what were you duties there?

Thank you again, you are such a great help.

lol...Kate, the example of the "lol" beta blocker drugs is only an example of how we can improve our knowledge beyond that of just what the Unis teach us or can teach us. The scope is too big and I think TAFEs and Unis are trying to teach students to initiate self directed learning. Another example is what's the difference between warfarin, heparin and Enoxaparin for VTE purposes? Heparin is short half life, enoxaparin has longer half life. Enoxaparin's molecular structure (lower molecular weight) lends to contraindicated for use with patients with renal failure because of poor GFR.

A rough day schedule in a ward is as follows -
1) Handover
2) Medication round or conduct observations of patients, whichever comes first. Mornings its drugs then Obs, in afternoon shifts it the other way round...generally. Observations include taking BP, Temperature, Oxygen Saturations, doing a neurological assessment of patient...usually check level of consciousness based on GCS (Glascow Coma Scale), In Qld's we have a scoring scale which we conduct of the patient, this will determine if we need to escalate interventions to include medical review of medical emergency. Of course we also take into account of many other observations...Example a pt has a low blood pressure of say 85/55...but the patient is asymptomatic...no dizziness, has adequate fluid intake, not neurologically impaired, afrebile and generally in normal presentation. What do we do...escalate? I would tend to increase my observations and inform team to keep an eye on patient if he/she should turn. Conduct another set of obs on patient 1/2 or 1 hour later to see if any changes.
3) Assist pt with hygienes, toileting needs and changing into the appropriate attire for the day/night
4) Inform doctors/medical team of changes in patient's routine or medical condition for them to review meds. Some medications can be nurse initiated. Example - I have requested a doctor to reduce enoxaparin from 40 mg to 20 mg because patient is fairly active, not bed bound and has a lower weight ratio.
5) Review medication charts as you dispense meds to see if there are any meds you feel needs to be added or reconsidered. Example, pts presenting with delirium and accompanying aggressive behaviour, you note colour of urine is suss. Collect a sample and request doctors to issue pathology order for possible urinary tract infection which could be the cause for the delirium. Again delirium could be caused by meds or any other superimposed condition like dementia.

The ER is an exciting place to work in if you get loads of codes. But it can also be a crazy place where you see lots of drug addicts overdosing or people behaving badly because of it. Generally ER is staffed by RNs because you need to cannulate, do IV drips and etc which ENs are generally not accredited to do. ER staff seldom use infusion pumps unlike those in ICU and general Wards. Won't go into why...lol. Have worked in ED and its was fun...very hectic on friday and saturday nights.....

Hope you will enjoy your course and wishing you all the best.

Hi Kate,

You are right about the one night a week study at TAFE for two years. I am in the process of applying to study to become an EN also and this is the route I will be taking.

I have wanted to be a nurse for forever but somewhere along the line I got sidetracked (kids will do that to you!) 20 years ago I did a year at WAIT Uni while working full time where I got a Dipoloma in Dental Nursing. Did that for 7 years, then started a family where I became a writer for 20 years while raising my children (my mother is a journalist so not such a big stretch - I was always going to write lol) I have since started working in Aged Care after getting my Cert 111 and I do Community Support Work. Its scary embarking on new and strange paths (I am giving myself a pep talk here too, as I am about to enter a whole 'nother new world also.. eek)

Like you I am nervous about what I am about to undertake. Kids, family, husband, home, friends, and on top of that working four days a week takes a lot. Add to this two years of study and I'm fit to burst. But you know what? We can do it! If you have a good support system around you and you love anything medical (which I always have) you will do well. You also have the advantage of being just that little bit older. I have 15 years on you and I am scared - but I'm still going to try. Time will pass and in two years we can either have our EN Diploma or be exactly where we are now with two years gone and nothing to show for it. (Words of wisdom from my husband lol.)

I say go for it. And most of all - good luck. To the both of us lol.

hi danii2011

Does the Cert 4 automatically articulate into Diploma of Enrolled Nursing? And, given I'm in year 12 now (I finish on 11/11/11 woo!), would you recommend doing my enrolled nurse before going to uni to become an RN?

Schizo - having read through your extensive post on the 'typical duties' of an ED nurse, I'm very intrigued.It seems all nice and rosy from the other side of the fence (being a Qld RN) - but what about in Sydney... or as a patient, or family member?

Having been a patient of emergency, and a tragic "Medical Emergency" and "R.P.A." viewer, some of the nurses, if not many of them seem poorly qualified for the job, or in need of further training. Are nursing students or graduate RN's often placed on emergency ward rotations? I once had a nurse laugh at me because I was scared of needles and didn't want to have blood collected. She would not explain how much blood she intended to collect, or from which vein she intended to collect it - whenever I asked her a question she just shook her head and laughed. Eventually the ward manager came and put a cannula in, which they left in my arm for three-four hours without ever putting any meds in. And this was at one of Sydney's 'leading public hospitals'.

I have always found that Children's hospitals provide a better standard of care for the patient and their family.

As a nurse, Schizo, how do you explain the behaviour of fellow nurses who speak little to no English, and do not inform the patient on the forever changing details of his or her condition? Is it a question of staffing ratios (within NSW)? And how do we newer nurses or students confront these issues?

Sorry if this is felt as a personal attack, it's just my reflections on the state of public health in NSW hospitals (particularly metropolitan Sydney).

Haha Danii, don't worry, they say the pub is a nurse's best friend! :-P And thanks - it did make sense, and very helpful. Come early August, I'll put my UAC application in online. Will probably list these courses as preferences:- B Nursing/BA in International Studies (UTS -Ultimo), B Nursing (UWS-Parramatta), B Nursing (UWS-Penrith), then as a fall-back B Arts at Macquarie Uni.

Sound good?

Anyone know which universities or private colleges in NSW offer the most holistic, practical nurse degrees? :-/

*safe nurses

Upcoming RN, I can only say, let your experience in hospital spur you to be different. Providing care is very personal, unless we are motivated in what we do and not just see it as a job, we can never be good nurses.

As for graduate nurses going into emergency, yes...they do take graduate RNs but seldom EENs for the following reason - IV access, most EENs are not accredited to do IV therapy, so it limits their scope of practice on the floor., Graduate nurses joining the ED team are NOT rotated. You must want to be in ED or not. Because ED is a department where you need to gain competency in veni puncture and complete a transitional program into ED. This is to familiarize you with the skills required on the floor, including Advance Life Support.

One thing - There are also views that nurses and medical staff do not share with Pts. Such as behaviourial issues. Ok, someone keeps on buzzing in the ward and when you attend, pt ask you to move overtable closer to bed (pt is able to do herself). What would you do? Ok you do it this once, next she buzz 5 minutes later to ask you to apply lotion on her legs. What now? As a point of note, this is a real case I experienced. Here its NOT nursing you're doing. Well we requested that she does it herself. Pt c/os saying that we are not nursing them. What do you say now? there's always two points of view. However we need to define what our roles both as a nurse and a pt. Upcoming RN, you will be surprised how many serial buzzers come into the wards. Two nights ago, I was on night shift and one of them buzzed 15 times over the course of the night! Here's a list of things she requested - a new pull up pant, request to see the continence nurse immediately, apply moisturizer to her arms, move her overtable tray (she is physically able to walk and move her arms), asked for a cup of tea at 2 am, asked for a bottle of water when she has not even emptied half of what she was allocated, c/o that the food was not good and asked for kitchen to prepare supper for her...at 1.30 am and etc etc.

Another example - I asked a pt if she could wear her slippers herself when assisting out of bed to toilet. Pt is capable but insist that you bend down and slip it on for her? Now here's the logic...when the pt is capable to do so now why can't she do it herself And she returns home, who is there to provide the Hilton 5 star service? I think people mistake nursing as maid service. Remember the goal of nursing is to help a person get back to being themselves before the adverse event, we are NOT maids. How would we achive that goal of caring if we baby everyone?

BTW, i would recommend you go straight to Uni after year 12.

Hope I have answered your questions.

Hiya Schizo,

Thanks for the good wishes - and I imagine there would be a lot of 'shouts' as well as slog over the next 24 months lol. I guess I need to take up drinking first but hey - I'm up for anything if the way my life keep evolving counts for anything.

I just have to get through this Numeracy and LIterary test - that's the first hurdle - and the rest will follow soon enough. :)