In early 2025, the SVNA Committee introduced a new feature titled One Profession, Many Pathways. This section now documents diverse pathways, opportunities and experiences of nurses who are/or have been associated with St Vincent’s Hospital. The Committee would love to hear from you, to share your experiences with Alumni Members. Feedback is also welcome.
Please send reflections of your professional journey to date to stvsnursesalumni@gmail.com
The Alumni Committee is pleased and proud to advise that two nurses working at St Vincent’s have agreed share their stories with you. The SVNA Committee thanks Kim Choate, Pain Management Nurse Practitioner, Department of Anaesthesia and Acute Pain Medicine; and Deeanne Hams, Acting Nurse Unit Manager Emergency Department for allowing us to share their respective profressional journeys. Thank you both also for leading the charge in providing insight their journeys of enabling and excelling.
INTERNATIONAL NURSES DAY CELEBRATION AT ST VINCENT’S HOSPITAL
12 MAY 2025
Key Note Presentation
Kim Choate, Pain Management Nurse Practitioner, Department of Anaesthesia and Acute Pain Medicine
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“Thank you Jacqui for inviting me to speak today, 36 years in nursing! When I say it out loud, it sounds like a long time!
Well it is a long time. The world has changed. Nursing has changed. Being asked to make this address has prompted me to reflect upon my career which started
at university through study for a Diploma of Applied Science (nursing). The transfer of nurse education from hospitals to higher education had only occurred a few years earlier. The
move had not been fully embraced by those that trained in a hospital based system and during clinical placements their hostility to the change made me feel isolated and
unwelcome. However, in retrospect, the move into the tertiary sector has been possibly the most significant change in the history of nursing in my lifetime.
Upon completion of my diploma, I began the graduate nurse program at The Royal Melbourne Hospital followed by work in various areas including orthopaedic and cardio-
thoracic nursing. From this solid clinical foundation I moved into Intensive Care and completed a Graduate Diploma, then began a long and fond association with The Alfred
Hospital’s Intensive Care Unit. I spent more than a decade at the Alfred, transitioning from bedside nurse to Associate nurse manager then developing and working in the role of ICU
liaison nurse whilst completing a Masters in Clinical Nursing. I found myself at a crossroads after seven years as an ICU Liaison Nurse, and felt I needed a
fresh start. From the Alfred I took a position at St Vincent’s in 2008 as a PACU/Anaesthetic nurse. A year later I filled a relief position in the Acute Pain Service and have continued in
that role since that time. The Acute Pain Service is a small team, consisting of two nurses, a pain medicine registrar and an Anaesthetic consultant. We are a consultancy service that
cares for patients with complex pain following surgery or trauma. After having worked in the team for a while, I felt that there were gaps in the service. Frequently, I would be called to
review a patient without the presence of the medical team and I would waste time finding another doctor to chart medications or change an order. In these situations, I would
ultimately provide the advice and direction on how to manage the patient. I worked within this frustrating contradiction and began to consider how it may be resolved through nurse
practitioner endorsement. Fortuitously, a nursing colleague made me aware of the Victorian Nurse Practitioner Project Grants through the Department of Health. When I approached the Director of Anaesthesia,
Professor David Scott who was also the Head of the Australian New Zealand College of Anaesthetists at the time with my thoughts about the role - he was forward thinking,
supportive and encouraged me to “go for it.” My application for the grant was successful and I received further wholehearted support
from the Surgical Services Manager at the time Melissa Evans. My NP journey would not have started without St Vincent’s Hospital affording me the opportunity and material
support to explore this new role. To embark upon the path to being endorsed as a nurse practitioner is a long-term
commitment, the process took me almost three years. The two common pathways to NP involve study at master levels, either a Masters of NP or NP subjects to augment previous
Masters study. It’s a significant commitment which involves studying, clinical assessment with your mentor whilst working a day job. Once accepted into a candidacy role the time up
until endorsement is intense with an ongoing need to demonstrate one’s skill & knowledge. The process was arduous, however my medical mentor Dr Andrew Stewart was invaluable
during this period.
After all the time and effort, Did having a NP improve the acute pain service? I believe it certainly improved the timely way we are able to provide pain management for
patients after surgery. These days, I can take a referral and review a patient from any department within the hospital. My practice involves diagnosing the pain problem,
prescribing or deprescribing appropriate analgesics, planning medication regimes, also referring to other teams such Addiction Medicine, Psychiatry or the Chronic Pain Service.
In recent times, we care for many postoperative patients that additionally have a chronic pain diagnosis. Chronic pain affects 1 in 5 Australians over the age of 45 years. Patients with
chronic pain are more likely to be women, have other chronic health conditions, and stay in hospital longer. The impact of chronic pain can be far reaching and includes physical, social,
financial and psychological distress. A common referral to our service is the post operative surgical patient, often female,
between the age of 45-65, with chronic pain sometimes from a previous injury, or workplace accident. They may also have been diagnosed with depression, are very anxious and may
also have a panic disorder or PTSD. This patient cohort often take high doses of opioids and other pain reliving medication to manage their pain or they may have developed a substance
use disorder. Whilst inpatients, these people are often highly distressed, teary and catastrophic in thinking about pain. Their pain is very difficult to manage and it can be
challenging for the staff that care for these patients. To improve postoperative outcomes for this patient group evidence in pain literature described the emergence of subacute pain
clinics around the world. These clinics targeted complex pain patients to improve their postoperative pain experience and reduce the risk of harms associated with high doses of
opioid medications. Through discussion with my colleague Wendy McDonald, a clinical nurse consultant who works with me in the acute pain service, we came to recognise that as experienced pain
management nurses we had the clinical knowledge and background to provide a similar service. An Ann Cook Scholarship in 2019 provided me with the time to explore if a targeted, patient
specific preoperative review service was available in hospitals throughout Australia. The scholarship also provided the necessary time to discuss the idea and its composition with
the Department of Anaesthesia. The review and discussions culminated in the commencement of the Acute Pain Service Perioperative Pain Clinic at St Vincent’s Hospital in March 2021. The clinic is the first nurse-
led perioperative pain clinic in Australia. The clinic’s work encompasses review and consultation with patients before their surgery, provision of pain education, and discussion
of pain expectations after surgery with optimisation of the patient’s drug regime through change in their analgesic medications. The patients are also provided with strategies and
exercises on minimising their stress and anxiety. Importantly, we do what nurses do....we spend time listening to the patient’s pain story, developing rapport, connection and building trust so that when the patient with complex
pain emerges from their anaesthetic they see us ready to assist and able to reference our discussions and conversations. Patients are more likely to draw upon their resilience and
strength when they feel cared for, and listened to, and this can make a significant difference to their postoperative experience through lessening their anxiety and distress.
I am proud of my work as a Nurse Practitioner at St Vincent’s Melbourne through the strong clinical focus of my role, the opportunity to undertake research and involvement in
educating doctors, nurses and allied health professionals about pain management. I am not the only nurse practitioner. There are many of us working in different roles and
departments within the hospital and in the community that makes up the St Vincent’s health network. There are currently 17 nurse practitioners in a variety of roles including Aged Care,
Palliative Care, Emergency, Diabetes, Dual Disability, Renal and Addiction Medicine to name but only a few.
In 2024, there were 2900 endorsed Nurse Practitioners in Australia. The value of work performed by nurse practitioners is gaining greater recognition and is expanding. Any nurse wanting to become a clinical expert in their field, where a gap in a health service
exists or health care needs are inadequately provisioned for may have the opportunity to develop their knowledge and skills as a nurse practitioner in the future. I would encourage
anyone wanting to advance their scope of practice to consider a career trajectory that involves NP.”
Deanne (Dea) Hams, acting Nurse Unit Manager
Emergency Department
I've been nursing for 21 years. I did my graduate year in 2004 at St V's and then a rotational year in 2005 so I worked on 5W (where our very own Nat Green was my first preceptor), 9E, 7W, 8W and finished up in ED. I have worked agency and casual shifts across many hospitals, but have always maintained some hours at St V's. I have covered other roles for short periods of time but nothing has kept me interested long enough to move away from ED. I have been an ANUM since 2011, moved into the Deputy NUM role in 2023 and now am an acting NUM alongside Di. I have a husband who is a police officer, two children Archer 9 and Piper 7, and a poorly trained dog (schnoodle) named Odie.
Twenty years is not a long time in the grand scheme of things but I am now realising that some of the new grads may have only just been born when I was walking into my first day as a nurse! A few things have changed but the best things about nursing (in my humble opinion) have stayed the same. My current role as acting NUM means days are often filled with work that at times feels very removed from clinical nursing: KPIs and budgets, patient complaints, Riskmans, HR issues and future planning for an ED with significant infrastructure challenges, but two things that have kept me in nursing also help me to focus on what is important - memorable patients and wonderful colleagues.
There are patients who I've been involved in their care that I will never forget. Sometimes they have been the most critically unwell and clinically challenging with lots of technical nursing skills required, others are those that have required just the 'soft skills' of care and compassion, long conversations and cups of tea. I very clearly remember when working on 5W a young man who was coming to grips with a terminal diagnosis joining the nursing team for chats and coffee during our night shifts when he couldn't sleep. I love the feeling of relief and satisfaction after having been a part of a resuscitation team in ED and then hearing later that the patient has recovered well and left the hospital 'back to normal'. ED nursing has allowed me the privilege of being a part of teams who intervene to provide life saving resuscitation, and other times we have provided patients with dignified and caring end of life. I've even been present to welcome two babies into the world during surprise births in ED (one in a car in the AV bay so only just in ED!).
The people I work with are the reason I have stayed in this job. I am lucky to have worked many colleagues (not just nurses) who have inspired and encouraged me. At work I've laughed until I've cried on many occasions, shared frustrations and fear, and felt grief and sadness - sometimes all in one shift, and it's the people around me that have made these experiences important. The friends we make at work are sometimes the people that understand best why we do the things we do and feel the way we feel. Nobody gets into nursing for the money, but I still recommend it every time—because in my experience, the work is meaningful, and it’s the people you work with who make it truly rewarding.
The IND theme for 2025, "Our Nurses, Our Future: Caring for Nurses Strengthens Economies," highlights my responsibility as a leader and manager to focus on strengthening the future of the nursing profession and ensuring that nursing remains a desirable and sustainable career path Prioritizing the safety and wellbeing of our team is essential to retaining nurses in the ED, and fostering and maintaning a strong culture of teamwork and mutual support plays a vital role in that. We have to make sure we are supporting nurses professional growth and development and strengthen pathways to career advancement. Each EBA has had some improvement in recognition of the unsociable hours worked by nurses but while pay increases and allowances are great, there are long term impacts of working shift work that ED nurses can't easily get away from. We need to keep advocating for improved staffing and conditions to ensure we are caring for rather than exhausting our highly skilled workforce.
Thank you to all the nurses in the department for everything you do everyday in providing excellent care. I feel lucky to be in a position of leadership for such an outstanding team.
Ida O’Dwyer
Ida O’Dwyer completed her training at St Vincent’s Hospital in 1902. In 1906, Ida O’Dwyer joined the Australian Army Nursing Service Reserve (AANS). By 1914, Ida was called up for active service and held nursing positions in Egypt, France and England including sister-in-charge of the third Australian Clearing Station in London, before returning home in 1918. For her devotion to duty and service Ida received the highest honour for nurses that is the Royal Red Cross.
As the Charities Board of Victoria states:
The boys in the tranches never could repay their debt to the nurses, nor did those at home realise the respect they entertained for those noble women. Not only were they “all there” in efficiency, but in the little touch of sympathy that means so much to a sick man. (1962, p9 in Mary Sheehan 2005, p 60)
In 1923, whilst working at the Army Hospital in MacLeod, Ida established the St Vincent’s Past Nurses Association (now the St Vincent’s Nurses Alumni) and became its first President. Ida became a Life Governor of St Vincent’s Hospital and a Life Member of the Royal Victorian College of Nursing. (Sheehan, 2005)