Jan 31, 2011, 12:39 pm
Let me begin by saying that I am not an enrolled nurse, and that I have no experience in the nursing industry, however I am very interested in pursuing a career as a perioperative nurse (surgical nurse) and therefore have a lot of knowledge about nursing theory, nursing care plans, taking obs, first aid and resus etc.
The Diploma of Nursing (Enrolled Nurse) course includes a medication administration and monitoring module if it is studied through TAFE NSW. Therefore all new enrolled nurses have endorsement and can administer medications orally, enteral/enteric administration (suppository/duodenal feeding tube) and parenteral, e.g. direct injection into a vein. So all new enrolled nurses in NSW should be EEN's.
An enrolled nurse in a hospital either works under the direct supervision of a registered nurse, or if they are more experienced they will work as an associate, in partnership with an RN. Daily duties on a typical medical/surgical ward would include:
- Checking on patients to validate their wellbeing
- Taking observations, otherwise know as checking vital signs such as pulse, respirations, temperature, blood pressure and oxygen saturation. As a trained nurse you will be held accountable for determining whether any abnormal vital signs are just red herrings or whether they should be investigated and referred to a nurse practitioner on the ward or to the patient's nominated medical practitioner (if you work in a public hospital, the patient will not have chosen their doctor as a general rule).
- Administration and monitoring of all medications at the times prescribed by the patients' medical practitioners, including oral, enteral, and parenteral (injection). You can do an on-the-job course to learn how to cannulate and set up an IV, particularly if you work in a surgical ward. If the patient has an allergic or otherwise abnormal reaction to their prescribed medication, as a nurse you are responsible for reporting this to their doctor or nurse practitioner.
- ADL's (Activities of Daily Living) - enrolled nurses in particular are responsible for making patients' beds (without creases! as creases can cause bedsores), showering or sponge bathing patients, particularly the elderly, wiping bottoms, changing babies' nappies and changing adult diapers and colostomy bags (this is a bag used to collect faeces from a perforated bowel; some patients who have had a cystoscopy and no longer have a bladder also have a bag to collect their urine externally). You may need to go the extra mile to make pedantic patients comfortable by shaving their beards, cutting their fingernails and toenails and massaging arthritic joints or tender areas of pain. A lot of potential nurses are turned off by the ADL's, which can involve cleaning up blood, faeces, urine and, although rare potentially even semen or vaginal discharge (menstruation or otherwise). You may be required to insert a catheter, apply wound dressings to sensitive areas, place incontinence pads on someone's bot and change them as required or even monitor surgical drains. Wound dressings and management of wounds is a key role in the nurse's domain and most nurses are more skilled in this area than their doctor counterparts.
- Taking obs, administering and monitoring medications and assisting with activities of daily living make up the bulk of a nurse's clinical work. There other less hands on jobs to do, particularly for registered nurses there can be a lot of paperwork and documents to sign. Enrolled nurses need to write their obs on the patient's chart and read the chart, noting any concerning abnormalities that could indicate a change in the patients condition, for better or for worse. Documents such as discharge forms all need the signature of an enrolled or registered nurse.
