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'What amazing things have you witnessed while on placement?'

On placement the other day I witnessed a practical procedure that left me feeling truly astonished.

It was a procedure called ‘cardioversion’. When a patient’s heart is beating out of rhythm and the symptoms are severe enough to warrant the risk of a general anaesthetic they are connected to a defibrillator and shocked. The hope is that this process will restart the heart’s natural rhythm and alleviate any symptoms.

I was genuinely amazed that this process even existed. It’s one of the amazing things about being a student nurse, you can turn up one day and be introduced to something you may never have considered before.

So while I was pushing the resuscitation trolly out of the recovery unit towards the theatre in preparation for the cardioversions, I started thinking about other things that have amazed me while on placement.

There was the time when I came back from work after spending a day in the x-ray department. I told my wife that I had seen the most amazing procedure to date. Under the guidance of x-ray, a doctor had inserted wire into a patient’s groin up one leg and down the other and inflated a balloon to allow blood to flow through the vein. Then just to make sure, he inserted a stent (a little tube to keep the vein open).

It was one of those occasions that really made me marvel at technology.

I want to know what procedures or treatments you have come into contact with through your training that have left you lost for words.

What are some of your wow moments?

Readers' comments (65)

  • Iain Collingwood

    Hi Adam, I am not actually on placement yet as I start my course in September but have personal experience! After 42 years I was diagnosed with hydrocephalus and underwent two separate operations on my brain at Addenbrookes.

    I am in awe of the surgeon, how does one learn to perform such operations? If you would be interested in more detail let me know!

    Kind regards,

    Iain Collingwood

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  • Anonymous

    watching open heart surgery (with Mozart playing gently in the background) from the observation gallery of a London teaching hospital.

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  • Anonymous

    Whilst working as a HCA in a palliative oncology setting before starting my training, I was about to assist a patient with a bed bath when she had a stroke right in front of me. Another time, I was actually in the room when a lady in her 30's passed away after a long and painful battle with cancer.
    Whilst neither of these were enjoyable, they were both truly amazing, and I feel privaledged to have been able to care for them at such a vulnerable time in their lives. The memories of both experiences will stay with me forever, remind me of the fragility of human life, the power of nature, and help me to put things into perspective when I am struggling.
    After all, birth and ultimately death are the only inevitable things in life. The opportunity to be able to holistically care for another life at it's most vulnerable is a truly amazing experience in itself.

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  • Anonymous

    Anonymous | 28-May-2012 7:04 pm

    you write an excellent post. After a long career I realise that in hospital you see patients who are sick without having seen them beforehand when they are well and it is the situation that one accepts in one's job of caring for them.

    It wasn't until my Mum died suddenly and at an unexpected moment in front of my eyes I realised how truly fragile life can be and how it can be drained out of somebody in a matter of seconds. Here with you one minute, and gone never to return the next.
    I have never again looked at anybody's life, and especially my own, in the same light after such an experience but it is strange that many patients who look as though they cannot survive may suddenly bounce back and yet some who seem to have a relatively good chance of survival can so suddenly pass away which is why through so many experiences I am opposed to the 'end of life' label until the very last two to three hours when it appears inevitable.

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  • Anonymous

    Mr Roxby

    Did you proof read your contribution ? Are you comfortable with your use of English?

    Whilst you seem to have been "amazed" what have you learnt?

    I am truly "amazed " how did a "wire" inserted in a patients groin then manage to then go up one leg and down the other? I am also amazed that "wires" also have balloons !

    To witness a cardioversion for the first time may be "amazing" but I do not recognise what you call "beating out of rhythm" as a diagnosis which would lead to cardioversion being undertaken.

    So what abnormality of cardiac rhythm was the patient suffering? Would you recognise the same rhythm again? Is cardioversion the only treatment for this rhythm? What level of defibrillator energy was used to effect the conversion? Did you find out if the defibrillator was a biphasic model or a different type ?

    Was the patient really given a "general anaesthetic"?

    Did you discover what contraindications there might be to cardioversion.

    Finally please do not think of me as being critical of you. What I am doing is hopefully assisting you to reflect on what you have learnt and how that is going to help you care for your patients !

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  • Dear JRT,

    I consider your response to Adam to be excessive and bordering on the offensive. He is trying to stimulate discussion of placement experiences that stand out in the mind - not providing an exegesis of their technical aspects. I agree that he over-uses "amazing" but tant pis or so what?

    I'm glad that you (partly) ID'd yourself; I wish contributors would put their names to their contributions rather than hiding behind anonymity. I apply the same principle to anonymous complaints. We should not be reluctant to ID ourselves, in my view. Perhaps someone could explain to me the rationale behind this cloak of secrecy.

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  • Anonymous

    "Perhaps someone could explain to me the rationale behind this cloak of secrecy."

    it is an option offered here by NT and it is thus the right of every commentator to exercise this choice if that is what they feel most comfortable with. If you wish to challenge it address your complaints to NT instead of taking out on those who have chosen this label.

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  • Hi, I wrote the post that starts 'Whilst working as a HCA in a palliative oncology setting...' and I would like to explain why I posted it anonymously.
    I was worried that my comment would not be viewed as constructive by some people who have different views on death and mortality to me. Whilst I believe as nurses we should be accountable for our own judgements and professional rationale, on a personal level, our opinions and beliefs can often be misinterpreted. On a forum such as this, where there is a fine line between personal and professional accountability, I did not want to be misinterpreted and prompt angry, personal comments. Since the mood seems fair and I dont seem to have offended anyone (yet), I am happy to be accountable for my comment; whether you agree or disagree with my view; and any constructive discussion that may arise from it :)

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  • Anonymous

    Laura Wyles | 29-May-2012 9:38 am

    the anon option is provided by NT to be used for fairly obvious reasons and you do not have to justify why you chose it to anybody.

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  • I did not feel I had to justify my actions, rather offer an explanation as to why someone might choose to use the 'anonymous' option when posting a comment :)

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  • Anonymous

    I saw an organ donation retrieval during a placement and it was amazing but not for the practical reasons. I was so impressed with the respect and care shown by 2 expert surgery teams to the patient whose organs they were removing. A not particular nice procedure but such a great experience for the right reasons of seeing a team respecting the spiritual and practical needs of a patient and the family.

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  • Nice post Adam. Refreshing to hear that, from time to time, our job can still be just a little awe-inspiring and it is always worth remarking upon. In amongst the day to day bustle and negative stuff going on in nursing and the NHS, it can be easy to forget that we see and do some amazing things as we go along. I could fill a book (as could most nurses of my vintage) with amazing stories from when I was a student and throughout my career, but I won't bore you with them. The good thing is, you will continue to have your 'wow moments' because your mind is open to those experiences. The learning? That's a cinch. You'll just sponge it up as most enthusiastic students do. Stay amazed. It's healthier for you.

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  • Anonymous

    If I was a patient I would prefer to be nursed by Adam, Laura or Mags than by JRT who appears to be somewhat lacking in empathic skillsthat are so vital in nursing.

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  • Anonymous 5:32

    As you wish - be nursed by someone who is informed and knowledgeable or be cared for by someone who will be "Amazed" at the suddenness of your demise !

    Do not be fooled into thinking that someone who has extensive skill and knowledge lacks empathy !

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  • Anonymous

    JRT | 30-May-2012 6:03 pm

    Interesting that you think it has to be one or other. Don't be fooled into thinking that someone who has the capacity to be amazed isn't also knowledgeable, highly skilled and empathetic.

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  • Anonymous

    JRT | 30-May-2012 8:03 pm

    ".....be nursed by someone who is informed and knowledgeable or be cared for by someone who will be "Amazed" at the suddenness of your demise !"

    Read your own post.

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  • JRT | 30-May-2012 6:03 pm

    "As you wish - be nursed by someone who is informed and knowledgeable or be cared for by someone who will be "Amazed" at the suddenness of your demise ! "

    Would I be correct in thinking that in your opinion I am neither informed nor knowledgable??

    To be honest, I am somewhate astounded that you should be able to make such judgements after reading a few sentences I wrote!

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  • Anonymous

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  • Anonymous

    Anonymous | 30-May-2012 8:27 pm

    I suggest that you and JRT read the article again, consider the context and purpose, climb off your high horses and give a student a chance. I do not believe for one moment that you both came to nursing, full of knowledge and skill (even if you may believe otherwise). By all means correct mistakes and impart knowledge. But, give yourselves a slap and remember that you are supposed to be supportive and encouraging. On second thoughts, just give yourselves a slap.

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  • Laura Wyles

    I am sure that you are informed , knowledgeable and empathetic.

    Now we have cleared that misunderstanding will you please explain to me the "wire" mystery and the appalling level of ignorance displayed in the original post which was, initially about cardioversion.

    It is notable that neither the original poster or his defender who attempted to impress me (and you!) with his vocabulary have bothered to respond ! I wonder why ?

    The original poster I believe prides himself on responding comments made about his posts ------ I am waiting to hear from him!

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  • Anonymous 8:27

    For you information I did read the article more than once . Now you force me into being totally honest.

    Now you read the "article " then explain to me about wires that can be inflated and "general anaesthetics" being given for cardioversion !!

    Yes I was a student at one time and I was very grateful to the many nurses and doctors who assisted me on my journey to qualifying.

    What i never did was display in public my lack of knowledge and my "amazement".

    In my opinion the young man who wrote this article needs to take a close look at what he wants to achieve, if "amazement" is the peak of his ambition then I am truly and empathetically sorry for him.

    I will repeat, again , placements are not intended to provide freak show entertainment for students. Placements should be used to gain practical skill and to enhance knowledge.

    This article whilst proving the writer was "amazed" did nothing to demonstrate what he learnt

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  • Anonymous

    JRT | 30-May-2012 9:06 pm

    You may have read the article, but did not understand it, or did you? I suggest that you re-read his last line. The article is not meant to be an essay on coronary angiography, but I suspect that you already know that. Much more fun to humiliate the student, is it? Yeah, met your type before. Like I said, give yourself a slap.

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  • Anonymous 9.27"

    How dare you ?!

    The last line is a plea for more of the same voyeuristic, freak show type entertainment which the writer was so thrilled and "amazed" to observe !

    I have never attempted to humiliate anyone.

    The writer must stand by his article which displays a level of appalling ignorance. I started out by posing a few simple questions to the writer and now I find myself accused of attempting to humiliate him. !

    I have assisted many students to achieve their goal, thankfully I never had a student who willingly displayed their ignorance in public!

    The young man need some serious guidance !

    Wires do not inflate and (at least in my extensive experience) GA's are not given for cardioversions.

    I repeat , again, placements are not intended to provide freak show entertainment for students.

    If you witness something that "amazes" you the at least learn about what you have experienced and report on fact!

    I sincerely hope that you are not one of those mentors who never "fails" a student --------- if you are then you are doing a great disservice to the profession.

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  • Anonymous

    JRT | 30-May-2012 9:59 pm

    "How dare you ?!"

    Ooh, a veritable puffball of pomposity. Of course, you are trying to humiliate the article's author.

    However, hilarious guff and bluster!! Thanks for the laugh. Give yourself.....ah you should know the rest by now.

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  • Anonymous

    JRT | 30-May-2012 10:29 pm

    "Attempting to insult, ridicule or humiliate me is doomed to failure.."

    Why so upset? Ahem. Now calm down, take a deep breath, then rinse and repeat......matey.

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  • Anonymous

    JRT
    Go and get some help with that attitude.You are accusing others of not being professional when you are showing absolutely no insight into your own dreadful behaviour.What age are you?You have set about insulting ridiculing and trying to humiliate others in all your posts.You are the one who needs to grow up.

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  • JRT
    Have to agree with you on this one. Perhaps Mr Roxby gets a lot of his training from watching Holby City, not one ounce of insight into the procedure. Now, if he had said that he was 'amazed' at how high the patient comes off the trolley when shocked, then I would have to agree, it certainly does surprise a lot of students.
    However, it's not entirely Adam's fault (sounds to me like he is only in his first year, do correct me if I am wrong Adam). Whoever was his Mentor should hang their heads in shame, letting this poor lad think that what he was seeing was next to witchcraft and without explaining one single piece of what was happening. Conversly, Adam, you need to be a lot more critical in your outlook towards nursing especially if you want to get into any kind of speciality, a sense of wonderment is just not enough I'm afraid.

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  • Redpaddys12

    Many thanks for your support. As I have repeatedly attempted to point out placements are provided to enable students to develop practical skills and hopefully
    enable a better understanding of the processes which contribute to a patients care plan.

    Now , hopefully for the last time placements are not intended to provide freak show entertainment !

    What a pity that so many of the posts on this thread fail to recognise that whilst a student might be "amazed" that is not enough to demonstrate competence let alone knowledge !

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  • Anonymous 11.40

    "Go and get some help with that attitude.You are accusing others of not being professional when you are showing absolutely no insight into your own dreadful behaviour.What age are you?You have set about insulting ridiculing and trying to humiliate others in all your posts.You are the one who needs to grow up."

    Thanks for that ! Whilst you might be happy to underwrite and support ignorance I am not. Patients depend on my and my colleagues skill, knowledge and yes our empathy.

    Unfortunately it would seem there is now a breed of nurse masquerading as RNs who have little knowledge and who are prepared to be "amazed" .

    Well , I am "amazed" at all the bad press some of you "professionals" attract.

    Patients are now actually scared of what might befall them should they have the misfortune to need hospitalisation.

    My attitude is in no need of adjustment I ensure my patients are safe and well cared for !

    Just for your information I am also able to recognise cardiac arrhythmias and know that "wires" are incapable of being inflated!

    DO you really want to make a difference ? If so then make a start by rooting out bad practise and the culture of ignorance which it would seem you support.

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  • Anonymous

    JRT | 31-May-2012 5:57 am

    "Unfortunately it would seem there is now a breed of nurse masquerading as RNs who have little knowledge and who are prepared to be "amazed" ."


    Sitting up all night dishing out ill-informed judgement and passing it off as evidence-based fact? Go get some sleep dear, and maybe a little humility pill with some reflection. That massive ego of yours is causing rant diarrhoea. You really do need to get a bit of perspective. Got to say though, it is hilarious.

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  • nadine woogara

    Hi all

    This area of the website has been designed to create a safe place where student nurses can share their thoughts and reflections without judgement, and we would like to keep it as such.

    I ask you all to bear this in mind. And I would like to thank those of you who have noted that Adam is eager, enthusiastic and passionate about learning.

    We certainly value him as student nurse editor of Student Nursing Times.

    Thanks
    Nadine

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  • Anonymous

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  • Anonymous

    Nadine ------I see you have had my post removed !

    Well done !

    Now please explain exactly why it was removed.

    How exactly did it break the "rules"

    I am, as a student, anxious to learn

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  • nadine woogara

    Hi

    Please refer to the "Online Forums - Rules of Acceptable Use" section of our terms and conditions https://www.nursingtimes.net/terms-and-conditions/

    many thanks
    Nadine

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  • Redpaddys12

    Help !! I am being moderated out of existence !

    I will receive no objective feedback from the moderators so I am appealing to you.

    As you have clearly read the posts and participated in the debate I would value your opinion.

    Be brutal and honest!

    Do you believe I have broken the "rules" ? and if so how ?

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  • Anonymous

    For JRT | 30-May-2012 9:06 pm

    "Now you read the "article " then explain to me about wires that can be inflated and "general anaesthetics" being given for cardioversion !! "

    http://www.medicinenet.com/coronary_angioplasty/article.htm#1whatis

    http://europace.oxfordjournals.org/content/12/11/1558.full

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  • Anonymous 3:03

    Thank you

    Your first link refers to coronary balloon angioplasty

    I don't recall this being the subject of debate.

    Perhaps I am wrong in which case I am sure you will direct me to the relevant post which I must have missed.

    Your second link does not exist.

    My original questions about inflatable "wires" and GA's being provided for cardioversions remain unanswered

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  • HEY

    Ladies and Gentlemen !

    I have just received received an email from Ms Woogara the "Acting" on line editor of the Nursing Times.

    I will not bore you by reproducing the whole document but invite your comment on the final sentence.

    Here it is ! :-

    I hope that you consider this warning and adapt your behaviour on nursingtimes.net accordingly. If you do not, I am afraid that we will be forced to disable your account.

    Fortunately a friend who just happens to be a lawyer was with me when I opened the mail.

    I am pleased to have been guided by her in formulating a response to Ms Woogara.

    We have asked for a full and open apology to be published in the NT. I sincerely hope that happens

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  • Adam Roxby

    Hello everyone.

    As always, this is my most enjoyable part of my work with the Student Nursing Times; responding to the comments.

    Now obviously I can’t respond to each one in person but I will try to address some of the major themes and threads of conversation and possibly the best way to start with that is by talking about some of the criticisms.

    Firstly I’d like to apologise for my lateness in appearing in the comments section but I’m just taking some time out from churning through an essay.

    Here we go, I think some people have misunderstood what I meant by amazement. I don’t consider the procedure I saw to be some result of magic but I am more amazed at the fact that it’s a procedure that I knew nothing about despite having had a number of years’ experience in a hospital. I think in general, people who work in healthcare can become immune to the astonishing things that they do and it’s only when we talk about them to people who aren’t involved in healthcare that we begin to have an appreciation for what we do every day. In that respect I think amazement is the right word although I could have probably got away with saying it just the once.

    On another point, my use of slightly layman terminology was not to demonstrate my full range of knowledge but rather to get my point across to students, professionals and members of the public. These articles are read by a variety of different people and in the space that I had I wanted to ensure that I wasn’t leaving anybody behind. Hopefully if people’s interest has been stimulated then they can seek out one of the peer-reviewed clinical articles provided by the Nursing Times but the purpose of this article was to give an anecdote from my own experience but also to encourage others to share their experiences from practice. I’m glad that people have shared their stories and have found the learning process exciting. The ability to have an exciting and entertaining placement doesn’t preclude professionalism or learning.

    So thank you once again for being engaged and I’ll see you on the next article.

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  • Anonymous

    Adam Roxby | 31-May-2012 4:27 pm

    as usual, Adam, a good, original and refreshing topic for discussion, especially for students and for those who cared to stick to the title and add their own observations. I find it a privilege, which also adds an interesting perspective to one's own experience, that qualified nurses and anybody else may also participate by reading and adding their comments.

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  • Adam ,

    Well done ! at least you have put in an appearance.

    However , perhaps you would be better advised to pursue a career in Politics! You say you will respond to your critics but then sidestep the issues !

    Go back and look at my very early post and answer the question ----------Then I will be really impressed.

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  • Anonymous

    Frankly Adam I'm amazed you've bothered to give the nasty and sarcastic criticism your time of day. Well done for doing so in a composed and dignified manner so sorely lacking in comments you are responding to.

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  • Just to keep you all updated and to ensure the Acting Editor cannot deny receipt of this message


    Nadine

    You will have received my email dated May 31 2012 timed at 21: 36 and I note you have failed to respond.


    I am now advised to require you to respond within the next 48 hours .

    Failure to comply with this reasonable request may result in legal action being taken against you personally and the NURSING TIMES.

    Yours




    Apologies for removing my full name, I am sure you will all understand

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  • Anonymous

    JRT if you have the patience for the 2nd link to open it does exist. It is an article published on behalf of the European Society of Cardiology

    "General anaesthesia for external electrical cardioversion of atrial fibrillation: experience of an exclusively cardiological procedural management"

    Well worth a read.

    As regards Balloon angioplasty in simple terms isnt that effectively a guidewire introducing a balloon tipped catheter (inflated once its target obstruction reached) into an artery to relieve said obstruction?

    Just checked with my partner who is a Cardiologist and he agrees with my comments.

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  • Anonymous

    JRT
    Exactly what legal action against do you intend to take against the Nursing Times and the Acting Editor?

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  • Anonymous 6:12

    Many thanks I will try the link again

    However , I have to say that in a career spanning many years I have never witnessed a GA being administered to a patient undergoing cardioversion.

    You do not need to explain in "simple terms" what balloon angioplasty is ----------I know !!

    My point relates to the original article which describes an anatomically impossible procedure !

    The original article made no reference to balloon angioplasty.

    Once again I feel forced to insist that student placements are not intended to provide "amazing" freak show entertainment. If students witness a procedure which they do not comprehend I would argue the student has a duty to inform themselves before rushing to publish nonsense.

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  • Anonymous 6:19 pm

    That is not for me to say. My solicitor having reviewed my posts believes a case can be made against the Assistant Editor and the NT.

    I will keep you and everyone else updated on this matter as it evolves.

    It would of course be much simpler if Ms Woogara and the NT just issued a Public apology.

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