Career Mirror -- by Mark Sproxton

Nurses work in dozens of different settings, even within a hospital. Some of these departments include orthopedics, pediatrics, oncology, maternity.... And no matter where they work, nurses will assess, monitor, educate, counsel and help patients in a variety of other ways. Here's a look at two specialized nurses, one working as a mental health staff nurse, the other as an operating room staff nurse.

Registered Nurse -- Mental Health Staff Nurse

Looking at the scene, a teenager with a baggy pants and a skater shirt seated on one side of the table and an adult dressed in casual clothing on the other, nothing out of the ordinary seems at hand. Yet, today is the first time the teenager has spoken more than a few words. If things progress as hoped, soon enough this teenager and adult will developed a unique bond. But only time will tell.

"I like that every day is an interesting a new challenge, as well, you really get to know many of your clients and their families and establish some pretty intense relationships with them," explains Matti, a registered nurse working in mental health who asked her real name not be used. "I like that I don't have to wear a uniform to work, or that I don't have to deal with blood and bodily fluids."

Working "office hours" in the acute care section of a local hospital, Matti also knows potentially dangerous or disheartening situations come with the territory. "I dislike that sometimes I may be threatened or be in physical danger from the occasional aggressive client," she said. "It can also be frustrating that some clients aren't really ready for or don't really want your help."

Knowing that won't change the main goal of her work, though. "The most important function of this job would be to assist and enable others to examine their own mental health issues and facilitate them in setting and attaining goals to address their problems," said Matti who has worked as a mental health staff nurse for over five years. She said those who are tolerant of people who may be abusers or addicted to substances, empathetic and good communicators would make good mental health nurses.

Matti long-knew she wanted to become a nurse. During her nursing studies at the University of Calgary she took courses that concentrated on mental health. After completing her degree and writing the national exam to become a registered nurse she began working in a community setting with troubled teenagers. "I just ended up getting my first job in this area and have stayed in this specialty ever since because I enjoy it so much," she said. She has also taken many specialized courses in this area offered through her employers.

Now, working standard day shifts with no call or weekend work, Matti knows no two days will ever be the same. "Every person has their good and bad days, and the clients in this setting can have especially unpredictable and bad days," she said. "The nurses need to be flexible and adaptable, calm and consistent to ensure that the setting can be as safe and nurturing as possible." Other mental health nurses may be required to work varying shifts that could include, nights, weekends and being on-call. Registered nurses entering the workforce will earn almost $22 per hour based on the nursing union's scale.

Matti offers this advice for anyone considering working in mental health: "You might want to observe a nurse in this area, or volunteer in a mental health assessment, and/or treatment setting before committing to take this on as a career. It's not for everyone."

Registered Nurse -- Operating Room Staff Nurse

Nearing the five-hour mark of standing on her feet in the cold and busy hospital operating room the nurse's concentration remains high. The surgery is nearing completion but until the patient is stitched closed and moved into another room, the operating room nurse has to be ready to react to any situation that could arise. Changing pace from a calm, controlled setting to one of reactive action is the norm here.

"If a trauma comes in the door, you always have to be ready to change in a second," explains Hilda, a registered nurse who asked her real name not be used. "You can't count on the schedule." What you can count on, she adds, is a workload that challenges the body and the mind. "It's very physically demanding on your body. Standing virtually still for upwards of seven-hours at a time, it can take days to recover. The unpredictability of the day-to-day running of an operating room... can become mentally tiring. You've got to be able to think on your feet and be willing and able to work with strong personalities and egos."

Despite what many believe, working in the operating room is not full of guts and gore. "It's surprisingly bloodless," Hilda said. "For the majority of the time it's a controlled environment." And because not every day sees urgent cases come through the door, there are many opportunities to enjoy the work to its fullest. "When you're working as a group of people and you're all in the same train of thought, the day flows perfectly," Hilda said. "When a day goes like clockwork it makes your job easier."

Alongside other nurses, she'll regularly work with surgeons and anesthetists. Once an operation begins, one nurse will work as the scrub nurse, meaning she stays at the patient's side from start to end, while other nurses will circulate, meaning they move all around and in and out of the operating room getting the supplies and tools required by the doctors and scrub nurse.

Unlike many nurses, Hilda knew early on she wanted to work in the operating room. "During my first year of nursing school I had a an opportunity to observe in the OR and was really taken in with environment. I thought this is where I want to do my nursing." In her last year of school Hilda was able to gain practical experience in the OR by taking an optional class allowing her to work in that department. Typically nurses interested in working in the operating room have to take a special operating room course after they have graduated from nursing school.

For 10 years Hilda has applied her nursing skills in the operating room. "Our main goal is to ensure (we're) always the patient's advocate. Because most of the time they're asleep, they're unable to speak for themselves. We have their best interests in mind. That's what always comes first." Hilda works eight-hour shifts in the day or evening, sometimes works weekends, holidays and does call as well. Other OR nurses will work 10-hour shifts in the morning, evening or night. Almost all will work weekends, holidays and be on call.

Her typical day-shift will begin about 7 a.m. The nurses will look at the operations booked for the day, plan who will work on each case and then proceed to help set up the instruments for the operation and/or bring the patient into the room and answer any final questions the patient may have. Because of the sterile environment of the operating room, nurses wear hospital-provided scrubs and hats.

Registered nurses in the OR are paid based on the United Nurses of Alberta scale. Beginning nurses will earn around $22 per hour. "It's an exciting area because the science out there is always changing," Hilda said. She offers this advice to anyone considering operating room nursing: "Be sure you're fully informed of what it's like to work in this area. Talk to a variety of people."