This week has again been full of new experiences socially and medically. I have been able to be more clinical in the hospital, as well as seeing a bit more of Finland, geographically and culturally.
I’m afraid there’s a bit of reading before we get to the pictures, feel free to skim a bit if you’re not so medical and find that stuff less interesting!
Due to the academic study I need to keep up with, I took monday off clinical practice and took a study day instead.
I followed this with three early shifts in a row, which meant getting up at 6am (a lye in for a nurse, but still early) and starting at 7. One perk of living where I do is that I can walk through the trees next to my block and be in the hospital within 5 minutes. It’s great now but will be even better once it gets colder and we have snow! So anyway, overall my shifts have been similar to last week, but I am noticing a gradual improvement with translation and communication with my mentor. There is still a lot I could do, but I am having to be patient and make the most of what he gives me. During one lunchtime when I sat with one of the student nurses that I talk to easily in English, he joined us so was able to see me in a more relaxed social context chatting to her about herself, Finnish life and the healthcare system. He seemed to be quite interested in our conversation and I felt it helped him to get to know me a bit more.
There were two very interesting experiences this week on the ward, both involving patients who were very ill.
The first one gave me more insight into what happens here on a ward when a patients’ health rapidly deteriorates, requiring nurses and doctors from ICU (Intensive Care Unit) coming up to intubate (put a plastic tube down someones throat to help them breath), carrying out CPR and then taking them to ICU for closer monitoring. I was able to watch the process of nurses and doctors making decisions as a team according to the patients’ needs, and then acting quickly as the situation took a turn for the worse. There were many things during the 2 hours I had never seen before and made me think a lot about why they gave the care they did, what could have been done differently, how they worked as a team and what things differed from being in the UK. Generally speaking, the process and team work was the same in regards to the roles of the doctors, nurses and ICU team. The biggest surprise was how long the team carried out CPR- a minimum of 10 minutes (yes the patient was that ill) and they managed to get him back! (sadly he is now back on the ward in a coma with a poor prognosis). It all happened during the first two hours of the shift, which was a great experience for me, though the day returned to the normal routine quickly.
The following day I was able to take some blood pressures and other observations of some of the patients and put these into the computer. This made me feel more involved with the patient care, though I did take quite a long time recording the information as the computer was completely in Finnish. Whilst this was all happening, a patient on the ward ended up on the floor (I still don’t know quite how it happened) whilst a nurse was getting him out of bed. There was a shout for help (in Finnish so I had no idea what she said) and my mentor quickly scurried off. Of course I didn’t know what had happened at that point, so from my perspective I thought that it was likely to be a nurse shouting something I didn’t need to know down the corridor, which is the normal situation, so I decided to stay and continue with my number crunching. But it turned out it was a ‘help’ shout and my mentor quickly came to get me. We managed to get the patient back on the bed (using Finnish manual handling techniques, which would never be done in the UK!). Sorry, I’m so used to using nursing jargon now some of you probably don’t know what manual handling actually means. Basically it’s any way we assist a patient to move or be moved, either safely with our own body or with equipment, which will, or should, prevent injury to us and the patient. It turned out the patient was being given end of life care due to cancer, and from his cognitive response during that incidence, was not in any state to care for himself. Overall, I found the situation quite worrying as to how that particular patient ended up where he did in his state, and what the nurse was trying to do. What also made it worse was that she used to be a sister on the ward. I asked my mentor a few questions about it but he didn’t really know about the patient and didn’t seem as concerned about the incident. Which made me even more worried. But there was little I could do or ask and I felt that I wasn’t going to get the answers I was looking for.
I have also been able to watch a few bronchoscopies (a camera in the lungs), heart echocardiograms (ultrasound of the heart) and watched a doctor on the ward put in a chest drain for a patient who had lots of fluid in the lungs. All fascinating and thankfully with a bit of translation.
One thing that I’ve noticed after these few weeks is how much I do actually know about how care is given in the UK. When you are put in a new situation, you find you know more than you realised and learn a lot through observation and practical learning. I am reminded of so many of my patients and situations I’ve been in on previous placements and all the methods and protocols I used to care for them. Most being completely different to Finland.
Now onto the more fun stuff (though of course I enjoy my nursing too!)…
Hiking, Ice hockey and Church
Friday was my first day off of the week and I took the opportunity to go for a 10km hike (which as more like a long walk) with some Finnish friends and Barbara, a short distance into the Artic Circle. I can now tick off another continent of my travel list! It was lovely to be outside in the forest with some new Finnish friends, and as a typical Finnish tradition we made a fire and cooked sausages on the fire pit near the lake half way through the walk.
1) Entrance to the Hiking area (which we finished at); 2,3,4,6) we enjoyed looking at the beautiful autumn colours as the season changes and leaves start to fall 5 6 5) it is very traditional in Finland to enjoy the outdoors walking, hunting, berry picking, fishing or making a fire and eating. Here some of the Fins were picking Lingonberries, blueberries and cranberries;
7 87) near the end we walked through a camping area when anyone is able to camp at during a hunting or hiking trip in the forest. They are totally free and maintained by the government. The Fins obviously appreciate them and look after them due to a respect for the forests and other people who will want to use them at another time. They are clean, no grafity or any sign of damage. 8) The two hikers in purple and blue are Barbara and Pilkku respectively. A quick action shot really. Sadly it was raining a bit.
1) A few snaps of the bbq we had in the middle of the hike.
2) Another log cabin we walked past which had a fire pit to the right. Inside the cabin was a raised platform as shown and a fireplace to the left. It was so lovely and looked after really well.
On Saturday after my morning shift I went to watch a local Ice hockey match in the Arena near us with some of the other exchange students. It was my first live ice hockey match and enjoyed it a lot…
Due to a somewhat disturbed sleep on saturday night from a few parties in our block (I swear someone was using a table and wooden spoons as a drum kit at 1am!), I had a lazy morning and massage (a nicer one than a few days earlier which was more like a deep tissue massage and left me feeling rather bruised), followed by coffee with Pilkku and church at 4.
We also have a new flat mate which was a surprise for us as we’ve been here for three weeks with no sign of someone moving in. Barbara and I had just come back from the hospital and having a catch up chat when our front door opened and there was our new flat mate. After the initial shock and awkward introductions due to our surprise, we found out she’s called Carla and a student midwife from Belgium. I was quite relieved at her vocation as we will all be doing shift work and so respectful of our sleep needs and highs and lows of our medical jobs. She’s a lovely girl and we have already enjoyed many long chats comparing the different healthcare systems we have between us.
I’ll end it there as again I’ve written rather a lot! And I have to start the next one already!