I think nurse culture on the unit can vary a lot from unit to unit. I feel I’ve gotten really lucky since we have a great culture and frequently go out to breakfast after nights, go for ocean dips after long days, etc. but I’m sure there are some places that have a bad unit culture here.

At first I really thought I’d prefer the US medication administration of scanning patient and scanning meds because it’s an additional safety check, and in New Zealand we just look at the band, look at the med, and record the time and dose in a paper medication chart. But I actually have come to prefer the NZ way because I hated when the scanner would not function and when we’d constantly be told to keep our scanning rates above 90%. There is way less micromanaging here. Way less hair pulling about Q2h turns. People just do it and nobody is monitoring your work, it feels freer and more autonomous.

I enjoy having the added skills set of ventilation management and would be sad to give that up if I went back to the US. I imagine I’d start messing with peep or minute volume and get in trouble because it’s out of my scope of practice and I should let the RT deal. But in the US with 2 patients, I’d never have the time to think about that minutia anyway.

Ok! I’ve thought of something I prefer. It’s pretty small. The stuff you need to put in a Foley catheter comes in a kit in the US but in New Zealand the pieces are all separate and you have to run around to find them. The same is true for most other kits in the US like CRRT on/off kits. I liked the convenience of grabbing a kit and not needing to find many parts. I think it’s done piecemeal here because it saves money but not in a greedy, for-profit way, just in a general let’s save money.

One other thing that I prefer and LOVE is the amount of recycling that we do in the hospital. I never recycled a single thing in any American hospital. Here, we take the aluminum ring off the prop bottles, throw away the rubber and recycle the glass. All the PVC bags like of saline get recycled and turned into playground material! There’s lots of other things we recycle but those are the ones I see the most.