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Our plans to settle in Perth soon disappeared from our minds for as soon as my sister was in Sydney, she met her husband-to-be. As I had many cousins in Sydney, I soon found myself settled in Sydney too. The many experiences which I gained in America were a great asset to me in Australia. I was rostered to work in the Orthopaedic ward during my first two months at the Prince of Wales Hospital, New South Wales. I dreaded the place. The ward practiced a type of nursing called Team Nursing, which did not actually functioning as a team. In the ward the Charge Nurse appeared only to do rounds with doctors, supervisors and nursing directors. She did not lift a finger to assist with any nursing care except to give orders and delegate duties to her staff members.
Photo: Lai Fun and partner (left) with sister Lai Ching and husband Geoff (center) and brother TS and wife Kim (right), at Lai Ching and Geoff's engagement (c. 1976, archive ref. A05/020)
The Australian Charge Nurse was unlike the Head Nurses I worked with in America who would even offer bed-pans to patients. I remember on one shift whilst I was performing a catheterization on a patient, the Charge Nurse walked up to me from the nursing station. She wanted me to give an injection, a pain killer, to a patient instead of giving it herself. The poor patient had to wait in pain longer before I could give her the injection as I had to finish a catheterization, walk back to the nursing station and look for a nurse to counter check the medication with me as it was a narcotic, and then prepare the injection before giving it to her. That period was more than half an hour. Either the Charge Sister was too incompetent or too lazy to do anything besides walking around the ward with the authorities, or disappear from the ward for some so called meetings. Her behaviour caused a lot of resentment in the ward among her staff members. After a couple of months working in her ward, I had to approach the Nursing Director to take me out of the ward and assign me to the Intensive Care Unit as I was employed to work initially in an intensive care ward. I found out later that they had assigned me to the orthopaedic ward because they were short of staff and no one wanted to work in the ward with the charge nurse. I suppose team nursing did not seem to work in this ward as the staff did not seem to be working together and the role model the charge-nurse gave was not a very good example. A nurse is also an individual who enters nursing with different reasons, has a mind of their own and perceives things differently and with different motivations than other nurses. Therefore there were some diligent nurses who worked hard, some who would only do the minimum to survive, and some who were just too lazy to do any more than they should and allowed others to carry their load. The ones who worked hard would eventually find themselves burned out. The charge-nurse was no role model for any young nurse to follow and I was glad to be transferred out of the orthopaedic ward.
I was transferred to the Intensive Care ward soon after meeting with the Director of Nursing. The Prince of Wales adult intensive care ward was a ten bed unit. There were six patients in the main area of the unit and four patients across the main unit area. The cubicle unit was often left for patients who required isolation due to an infectious condition or for at-risk patients with low immunity. There was a unit solely for burns patients or bone marrow transplant patients. The ventilators used were units put together by the Intensive Care Assistant Director who was an anaesthetist. The Bird's Mark Five respirator was attached to different gadgets from other ventilator parts to make up the type of ventilators used in the ward. I was told that the unit managed to provide more ventilators and save a lot of money by having ventilators of this type. After each use, the ventilators were pulled apart for washing and sterilization. The "pink lady" cleaned all the ventilators' parts. She had worked in the intensive care unit for a number of years and was trained for this type of work.
The change to the intensive care unit was great as one was responsible for one's own patients. The stress in the unit was much greater than in the ward as all the nursing responsibilities to the assigned patients were on the one nurse assigned. The advantage of working in the intensive care unit was that one could practise "true" primary nursing. The nurse assessed, planned, evaluated and carried out the care for the patients assigned, in contrast to team nursing in the ward, where the patient had a number of nurses carrying out their care and if anything were to go wrong, each nurse appeared to blame the other nurses. There was no continuity of care to the patients in the ward. In the intensive care unit, it was a good feeling to see patients getting better and being grateful for the care one gave. The continuity of care was there. Moreover, one did not need to carry the responsibilities of the other nurses working in the unit.
The nurse did the rounds of their assigned patient with the doctors and charge-nurse or supervisor. The nursing care plan was then changed after each shift or whenever applicable after the doctors had seen the patients. During the rounds, a nurse could learn a lot from other health personnel. The next day or even for the whole patient stay, the same nurse could be looking after the patient unless the nurse found a strain, conflict or stress in working with the same patient. A different patient would be assigned to the nurse if she requested for one. No doubt we seldom had to go to the extent as to request for a change as the stay of the patients were often short in the intensive care ward. Once the general condition of the patient was stable, the patient was very quickly transferred to the ward for convalescence. There was always a shortage of beds in the intensive care unit and moreover the cost for a bed in the unit was too high to allow the unit to keep patients longer than necessary.
There was always a doctor rostered to the unit for three or six months during their internship. A registrar overlooked the intern's work and the anaesthetist in charge or the Director of the unit overlooked the whole medical team. A physiotherapist was assigned to the unit. All the respiratory problems of the patients were attended to by the physiotherapist. In the evening and at night, the nurse carried out most of the physiotherapist duties for the patients. The physiotherapist only came in once or twice during the night. The nursing care plan was revised daily and again whenever necessary. I found Primary Nursing Care could be administered in the intensive care area with less problems than the ward areas as each nurse was assigned to a same patient most of the time in the intensive care area unlike the ward where the nurse could be working in one area of the ward and then another the next day. Besides, there are other nurses in the ward who might also look after the same patients and revise the nursing care plan without even informing the primary nurse. Therefore one had to be vigilant and check the care plan constantly to ensure nursing care was carried out as directed by the other nurses.
The nurse played many roles as care giver, protector and patient advocate, comforter, rehabilitator, teacher and manager. The nurse carried heavy loads on their shoulders, however, the load carried by the Australian nurses was much lighter than their counterparts in Malaysia, England and the United States. Generally the Australian Nurses had a ratio of one nurse to one patient in the Intensive Care Unit. I had a great time working in the unit as compared to the three years in the States having to look after at least two intensive care patients during each shift as well as overseeing the Practical and Assistant Nurses' patients.
Image: Nursing pin issued by Royal College of Nursing, Australia (ref Z25/09)
Image: Nursing pin from Cumberland College of Health Sciences (ref Z25/06)
The Intensive Care Nursing Supervisor oversaw the smooth running of the intensive care unit. If there was sufficient staff, she allowed a registered nurse to work in her place and she did some other personal things or told us that she wished to catch up with work. We often felt this impossible to believe as she was often not in the unit or on the floor when she was required to support or assist her staff. The standard of nursing was what the hospital administrators made of it - high standards for supervision and management and lacking in the better selections of nurses. The Intensive Care Nursing Supervisor often favoured the staff she socialised with. Nurses who were not favoured by her found their morale very low and there was talk amongst them of moving on to other wards. There were often changes of staff in the unit. Nurses just could not find a happy medium working with an irresponsible supervisor. I remember one of the staff members initiating a petition against her. She got most members to sign the petition and it was handed to the Director of Nursing. I do not remember what came of the petition and whether any action was taken by the Director of Nursing. As soon as the incident happened, I left the unit for another ward for two years of night duties to pursue my Diploma of Nursing Education at the then Cumberland College, Lidcombe, New South Wales. I was told the supervisor was seconded to another ward and eventually her position was taken over by another more suitable nursing sister. My only wish for the unit was that the new supervisor would be able to lift the morale of the nurses and help them to carry out the responsibilities of the unit nurse, with less stress and trauma.
I believe working in the intensive care unit was stressful in itself. We held a great responsibility, with a patient's life in your hands, and other responsibilities like an arterial line, monitors, transformer, drips, ventilation and drainage tubes etc. to look after besides family members and friends to support and console. The intensive care nurses required their authorities' support and empathy to work in the unit effectively without added stresses. A nurse could easily get burnt out and a little thank you and a pat on their shoulder now and then could do wonders to one's morale. I found this to be what the Australian nursing supervisors lacked compared to the American supervisors. I felt the need to get out from the rut, and requested and was granted a change in position. The good thing about the nursing profession is that one can move on to another area of work before one could be pulled down morally and physically with the work.
I was posted for two years to the Children Convalescent unit as a night nurse-in-charge whilst I was completing my Diploma of Nursing. I enjoyed my child nursing. I regretted somewhat not having gone into child nursing earlier. The children did not complain as much and always had a smile on their faces when cuddled or talked to. It was pleasing to witness the development of the children under your care and recovering from whatever illness or disease they had.
Photo: With a newborn patient and incubator while working at the Children Convalescent Unit (1979, archive ref. A05/069)
During my Diploma course, I was required to complete hours of practice teaching in the School of Nursing. I was able to do three hours at the Prince Henry Hospital at Little Bay, Sydney and the rest of the practice teaching at Balmain Hospital School of Nursing. I was able to complete my hours of teaching at Balmain Hospital because of my friendship with one of the nurse educators from the school. Once again in any profession it is often not what one knows, but who one knows. I enjoyed the practice teaching at Balmain School of Nursing, but not at the Prince Henry Hospital. I found the big teaching hospital had their own cliques of old staff members who were quite discriminative and unwelcoming, and too impersonal for my liking.
Photos: Lai Fun with parents at her graduation from Cumberland College (22 March 1986, archive ref. S70/006)
Photo: Lai Fun in graduation dress after completing her diploma (1986, archive ref. B03/017)
The Head of School at Balmain Hospital was pleased with my work and contribution so she offered me a position as a nurse educator to her school after I completed my Diploma of Nursing Education. I was very pleased to accept the job and she was kind enough to keep the job for six months until I completed my Diploma of Nursing Education. I learnt a lot by teaching and studying at the same time. The hours were good and I did not have to do any more night duties so I could enjoy the social hours with the general population. I could go out with my friends who worked normal hours during the day. I was given autonomy which I never had before and the chance to widen my horizons. The shift from an autocratic type of management was difficult to take as compared to the nursing autonomy which I had been subjected to for many years in America and in the School of Nursing. I was grateful and pleased with myself that I was given opportunities to practise my freedom at work and my initiation. When I was bored at the school, I went to the wards for some clinical teaching and updates. I enjoyed my teaching years at Balmain Hospital for about nine years until there was a power struggle at the school.
Photo: Nurse Educator ID badge, Balmain Hospital (archive ref. B03/026)
The second-in-charge wanted the position of Head of School and therefore was running down the Head of School and lobbied other staff members to go against her. I had seen this type of politics through my years of nursing and was not willing to be drawn into it. Of course I was disliked and soon I found I was no longer in my friend's favour. I remembered the times at the Prince of Wales Adult Intensive Care Unit when I refused to go with the crowd and fell out of favour with my supervisor and senior staff. I believed I worked hard and was conscientious with my work and had made constructive suggestions to improve things and had tried to please the authorities. If my best was not appreciated, so be it: I could not make people like me and I had a mind of my own. If what I believed was wrong, I had to stick to what I believed was right and not go against my principles. It was a big stand to take as I knew I would be unpopular. I went ahead and did not take sides, and of course I was not popular and my last two years at Balmain School of Nursing were not pleasant. All the same I took the opportunities to broaden and improve my qualifications further and the Head of School was very supportive. She told me to go ahead and take the degree and she would give me all the time off I wanted. She kept her word and even told me to go to the library to study when I had assignments to be handed on time and examinations to take. Those times when I had to study and work full time were not very easy. I gave up lots of my social life and activities which I liked to pursue. I had to both support myself and be independent and yet still be able to afford things I liked to have and do, so I had no choice but to work hard for my future stability.
The degree program came at the right time to broaden my horizons further. I had completed my Diploma of Nursing Education at the same college and so there was no difficulty for me entering into the degree program. In fact I was given some credit for the program with my Diploma of Nursing Education. It took me five years to complete the nursing degree program part-time. There was a component of Clinical Education and a choice of hospitals which we could negotiate for our clinical experiences. I chose the Psychiatric Hospital close to my work place. Those clinical hours were an eye opener. I saw that the psychiatric nurses were there for the job and not for their patients. It was very sad to witness such a state of affairs. I was helpless to do anything to change the situation and so finished my clinical hours at the Psychiatric Hospital and moved on. I liked the Behavioural Science area a lot. The area helped me to understand human nature and human reactions to problems and life. I could apply this knowledge not just at work but to my everyday life. Other subjects like Nursing Science, Principles of Physiology, Microbiology, Anatomy and Pathophysiology were all subjects covered in my basic course but the depth of knowledge to those areas was extended in the degree program. Those five years at college were not easy and without problems. I had to contend with work hassles as well as problems with lecturers who were discriminatory. Some lecturers picked on non-English speaking students who tended to be timid with their authorities due to their culture. For example, often in an Oriental family, children are reprimanded when they answer back if chided by their elders. Children are taught to be seen and not heard. I was different, having lived in a Western world since I left school. I survived by fighting back, although this was not without any problems. The main thing was that I managed to survive and gain my nursing degree, my dignity and my self-esteem through speaking out and daring to be brave, and appealing to the authorities when injustices were experienced. I fought for my rights and my principles. I stood strongly for my beliefs and values in life. However, I also knew when to fight and give up.
Image carousel: Selected slides from a lecture on moral development and ethical standards in nursing produced during Lai Fun's time at Balmain, starring Lai Fun role-playing as an abusive patient (archive refs. S66/001, 031, 033-036)
Whilst at Balmain I gained many experiences clinically and educationally. I was also able to give a hand to my colleagues at the school and the nursing sisters in the wards. Often the nursing school staff were seen to be an easy resource when a problem arose in the ward. We were expected to have all the answers to whatever problems the ward encountered. We were humble in saying we did not have the answers when we did not but were willing to research and find out a solution or answer for them. The library was just down the stairs which was very well equipped for the size of the nursing school. I had my good and bad times there, but on the whole I could say I gained a lot of valuable nursing experiences clinically and politically. I assisted in formulating nursing care plans for the clinical areas and introducing the nursing care plan into the hospital. These tasks were not without problems, as there was much resistance from the wards. The clinical staff thought that much of the valuable time was taken from patients' care formulating the nursing care plan which they had been doing anyway, except that it was not in a written format. The nursing care staff had to be convinced that nursing care plans were a form of legal document and if nurses wished to be recognised as a professional body, having nursing care plans was one of the ways to go.
Changes in any workplace are often difficult to introduce. At Balmain, the senior nursing staff's lack of knowledge meant they very much resisted change. Diplomacy was very important and they required very gentle persuasion. We managed to get the Director of Nursing to be involved and assisted with the introduction of the nursing care plan. Eventually we managed to convince the nursing sister-in-charge to implement the nursing care plan into their wards. Other roles I had were nursing in-services for overseas students and nursing staff, and making nursing educational videos for the School of Nursing. Sometimes I taught nursing staff and students that were more senior than I was and this was threatening. However, I gained confidence with myself and overcame the apprehension of speaking in front of people more senior than I was.
Around 1987, nursing education in Australia was transferred to all colleges and nurse training at hospitals was discontinued. One by one the Nurse Educators at Balmain Hospital were moving on. One Nurse Educator took an early retirement after being diagnosed as having breast cancer. Another took a position at the College. Part-time Nurse Educators were requested to move on as the school was closing. Towards the final year of hospital nurse training in the hospital, a nurse educator and I were the only ones left towards the last group of third year nursing students. We had to take over all the units which were left by other staff members who had left the nursing school. We called in doctors from the hospitals to give some lectures which were not within our scope and expertise. We had an obligation to the nursing students who were in their final year. I felt obliged to assist the nursing students to finish their nursing course as there was only one more year to go.
Photos: With colleagues at Balmain Hospital (1984, refs. B03/006, 014)
Image: Invitation to the last ever graduation ceremony held at Balmain Hospital before Australian nursing training was transferred away from hospitals (24 October 1986, archive ref. B03/012)
Even then the Nurse Educator who was left with me at Balmain Hospital would undermine me all the time and wanted to see me go too. I knew I have to move on. Soon there would be no student nurses to teach and nurse educators would have to move to the clinical areas at the hospital. The hospital required a nurse educator for clinical duties only. My chances of getting the position were slim, I was sure the other remaining nurse educator would secure the position, she saw to that by crawling to the authorities and often seemed to undermine me. The stress and tension around the workplace was too great for me. I thought to myself that with my qualifications and experiences as a registered nurse, I should not have any problem finding another job. I needed to move on to remain sane. I had to thank the Whitlam Government which abolished higher education fees and had allowed me to complete my degree in nursing. I had years of experience in intensive care nursing, children nursing, adult medical and surgical nursing and with my other post basic nursing courses in psychiatry, cardiac thoracic and midwifery I should not have any problems in securing another nursing position.
There was an opening at the New South Wales Ambulance Service for a Nurse Educator. I applied for the position and was accepted. I was given some orientation to the Ambulance Service clinical areas during my first few months with them. I was taken for a flight and a mop rescue and witnessed the Paramedics at work. I went to numerous ambulance calls with the ambulance officers and enjoyed seeing what they did in the field. I had to understand their work so that I could relate to them at lectures and help them to coordinate theory and practice. I saw a lot of good work done by many ambulance officers and some not very ethical work. I had to be tactful in correcting and commending their work. I only taught Anatomy and Physiology Units since I was not a qualified Ambulance Officer. I participated in the First Aid Classes for the Preliminary Trainees as an assistant to the first year Ambulance Officer.
I enjoyed Preliminary Trainee classes as the students were respectful. A military type of discipline was provided during the trainees' early years. Trainees were even taught how to march and were expected to march and salute their superiors during graduation ceremonies when they finished their Preliminary and any other short courses which the Ambulance Academy ran. I found the Ambulance Service observed their traditions closely. I wore my graduation gown and the Officers wore their full uniform and stars during the graduation ceremony. The graduation officers put on their full uniform and marched out in front of the dignitaries and saluted them on passing the stage and had to stand to attention throughout the ceremony. During the graduation ceremony I was the only female on stage with the Director of Education. I had the duty of handing out the awards to the Health Minister or Superintendent in Charge of the New South Wales Ambulance Services. After a while I found the tradition a drag. It was just too hot to wear too many layers of clothing for the ceremony during summer. The only thing I eventually enjoyed at ceremonies were the tea parties they gave to friends and relatives of the graduating officers. I had a sweet tooth and the cakes and cookies served were just delicious.
Photo: At a NSW Ambulance Service graduation ceremony (5 December 1986, archive ref. B03/020)
Towards the end of my year with the Ambulance Academy, my brother from Darwin sent me an advertisement from their Darwin local paper. The Darwin Community College advertised for a Nursing Lecturer and a Tutor to their School of Nursing Department to commence their first Diploma of Nursing Course. My brother persuaded me to apply for the position. My brother informed me that even if I failed to obtain the position, I would most likely qualify for an interview. If I was offered an interview, I would be given an airfare to Darwin and I could spend a week or two with my brother and his family in Darwin fishing after the interview. I was very hesitant to apply as Darwin was not my favourite city to live in. I enjoyed my family's company and the many fishing and boating trips with them but to stay in a hot place indefinitely was not in my mind. My brother was persistent in encouraging me to apply for the lecturer position and rang me a few times to ensure I had applied for the job. Eventually I told him I would, but had no confidence in securing the position.
Photo: Lai Fun with brother TT on one of the 'many fishing and boating trips' in Darwin (1984, archive ref. D07/020)
I was surprised when I received news that I was selected for an interview. I attended the interview and enjoyed my two weeks with my family. I was confident at the interview, but was not confident enough that I would be selected for the lecturer position. I did not inform any of the Ambulance Officers that I went up to Darwin for the interview as I was not confident that I would secure the job. I told them I went up to see my family. I did not hear from the Darwin Community College for about six weeks after the interview. One day whilst at work, I was told I had a phone call from Darwin. I was surprised to hear the Head of Nursing Department voice. She offered me the Lecturer One position with a rise of A$10,000 from my present salary. I would be given a return airfare once every two years back to Sydney and eight weeks leave annually. The offer was good, but I needed to think it over. I asked the Head of Nursing Department to give me a few days to think over the offer. She agreed and said she would look forward to hearing from me again.
It was a difficult decision. Should I take the job or not? At the time I enjoyed working with the Ambulance Officers. I was the only female teaching staff member and the males were easy to get along with. No doubt I experienced teasing now and then, and these days the teasing might be considered sexual harassment. The majority of the students were male too, so there seemed to be less bitching and complaints during class and out of classroom. I must admit that there was a particular Ambulance Officer whom I was sure to be a sexist. He often tried to find fault at me, clocking me in and out of the School, calling me names, etc. I did not receive any co-operation from him when I tried to write the course curriculum for the School. He was not my superior and I did not give him the joy of seeing me defeated and join them in the rut doing minimum work and drawing a healthy salary. The Superintendent in Charge of the Academy was very appreciative and helpful to my work. He was humble and dared to admit that he was not aware that the Academy required a curriculum. He did not know what a curriculum was and was grateful that I could advise him on what was required to pass an accreditation. He also admitted to why the Academy had failed its accreditation previously. I was invited by the Director to attend meetings at the main office to help plan the course curriculum for the Academy.
I decided the offer from the Darwin Community College was too great to be refused, even though it was difficult to leave the Academy with so many ideas for its development in my mind. When I rang my family up in Darwin and discussed the offer, they told me not to hesitate and accept the offer. There was no harm in accepting as I could always come back down to Sydney. I could rent out the unit I had bought in Sydney in case I did not like it in Darwin. I had my family in Darwin. The next day I rang the Nursing Department and informed the Head of Department that I would take the position as a nursing lecturer if she would release me for a month in July to take my parents to China. She agreed that all other offers would still stand. I needed to put the acceptance in writing to the College and start work in early January of 1989. It was difficult to break the news to the Ambulance Academy of my leaving. They had often told me that the previous Nurse Educator had done nothing for them over the ten years with them and they appreciated the work I had given within the year I worked with them. I enjoyed the challenges with them and it was difficult to leave but the offer from the Darwin Community College was just too good to refuse. I handed in my resignation to the Superintendent in Charge of the Ambulance Academy. He was disappointed that I was leaving and he said he could not stop me from moving on. He would miss all the help and guidance which I had contributed to the Ambulance Academy. It was a good feeling to know that my work was appreciated. The Superintendent thanked me for all the help I had given to him. He told me there might be a brighter future at the University and remaining with the Ambulance Service could be a dead end job. A farewell party was given on my last day with them. I told them that I would visit when I was in Sydney and I kept my word. It was great to see my photograph hung up on the wall as a past member of staff during my visit.
Photo: Lai Fun (right) with sister Lai Kheng (left) outside her apartment in Coogee (1986, archive ref. S70/026)
Photo: Lai Fun with her parents in Hangzhou, China between leaving Sydney and starting work in Darwin (archive ref. A09/065)
I had to start looking for tenants to rent my unit and get the removalists to transport all my personal belongings up to Darwin. I was given six weeks of hotel accommodation in Darwin whilst I looked for a place to rent. I was given all the expenses and insurance to have my personal belongings transferred up to Darwin and if I stayed in the college for over 10 years, I would be given the expenses to transport my belongings back to Sydney, but if I stayed less than that, I would have to pay my own expenses to return. There was no difficulty in renting out my two bedroom Sydney apartment. It was within walking distance to Coogee Beach and not too far from the city of Sydney. The day I moved out, the real estate agent managed to get someone moved in. The Coogee apartment has been a great investment, giving me years of rental and the appreciation of the unit will keep me comfortable during my old age.
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