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Ambulansfärd, powernap och kinesisk örtmedicin i Wenzhou

2016-03-01

Hej hej!

I måndags började praktikveckan med att vi blev upphämtade i en ambulans av vår lärare för dagen. Detta var en mycket speciell färd – bland annat på grund utav att takhöjden med knapp nöd överskred 1 meter samt att Martinas säte enbart satt fast med en skruv. Detta gjorde att färden till praktiken för Martinas del mest liknade en berg och dalbana. Vi fick aldrig något svar på varför just ambulans ansåg som ett lämpligt fordon att hämta svenska studenter i.

Efter ambulansfärden visade det sig att läkaren som skulle följa med oss för dagen, inte var på plats. Ett par förvirrande antal minuter förlöpte. TIllslut bestämdes det att vi skulle spendera dagen med sjuksköterskan Bao på Apoteket. Förmiddagen bestod av mycket information – bland annat hälsoråd gällande högt blodtryck och kolesterolvärde. När detta spännande ämne var uttömt – gled samtalet istället in på enbarnspolitiken i Kina. Fram tills i år fick varje familj bara skaffa ett barn. Detta infördes på 80-talet (om vi förstod tolken rätt) för att begränsa befolkningsmängden. Vår lärare förklarade för oss att det för bönder tidigare var okej att ha två barn, för att kunna få hjälp att sköta gården. Familjer i stan fick dock enbart få ett barn. Om mamman blev gravid igen var hon tvungen att göra abort. Om detta inte gjordes var det mycket dyra böter (5-6 gånger årslönen) och de kunde även förlora sitt jobb och sina hem.

Tiden flög iväg och helt plötsligt hade vi enbart en timme på oss att ta oss från vårdcentralen utan bussförbindelser och åka till universitet för att äta lunch och sedan tillbaka. En omöjlig ekvation. Vi kom tillslut fram till att stanna på vårdcentralen för att äta lunch där. Här uppstod nästa problem – det fanns inga lunchställen. Vår lärare förslog att vi kunde äta kakor och dricka mjölk till lunch. Vi tackade vänligt nej till detta eftersom att vi var hungrigare än en fånge i Katla-grottan. SJuksköterskan på vårdcentralen erbjöd sig då att köpa dumplings till oss (without pork). Detta var dock svårt att finna så istället blev lunchen risbollar med en söt fyllning i (alltså någon form av dessert). Hilda kämpade tappert i sig 10 risbollar medan Martina enbart fick i sig 2. Konsistensen var allt annat än lajbans. Därefter var det dags för ett nytt inslag i vår vardag – powernap på jobbet. Läkare och sjuksköterskan fällde upp varsin tältsäng, medan vi fick hålla tillgodo med infusionstolarnai i väntrummet. Lamporna släcktes och vi lyckades slumra till en liten stund. Detta anser vi borde införas på samtliga arbetsplatser i Sverige (dock ej i infusionstolarna och gärna i ett rum med högre temperatur än 13 grader). Efter powernapen var det dags för hembesök där vi tog blodsocker och blodtryck (förvånade va?). Det visade sig att man enbart tar blodsockret på patienterna en gång i månaden. Om patienten känner sig dålig eller har symtom kan de uppsöka en vårdcentral/sjukhus för att få blodsockret kontrollerat. Annars gäller samma ordination på insulinet varje dag. Detta skiljer sig i stor utsträckning från Sverige, där vi tar blodsockret 3-5 gånger dagligen. Vi frågade om det inte var vanligt att patienterna hamnade i hypoglycemi (diabeteskoma). Detta var tydligen inte helt ovanligt (surprise surprise), men patienterna rekommenderades att alltid ha godis i fickan för att kunna undvika detta tillstånd. Vi frågade tolken flera gånger för att verkligen kontrollera att vi hade hört rätt och det hade vi. Vi hoppas att vi har sått ett litet frö angående nyttan med täta blodsockerkontroller.

Idag har vi haft en mer komprimerad dag, eftersom läkaren hade andra planer (som att hämta sina barn på förskolan). Dagen inleddes med information om hur man kartlägger personer som är i riskzonen för högt blodtryck och diabetes. Man kontrollerar män som är över 55 år och kvinnor över 65 år. Om deras värden avviker från det normala görs en uppföljning för att fånga upp dem och om nödvändigt behandla deras tillstånd. Därefter fick vi besöka Apoteket för traditionell kinesisk medicin. Det doftade en blandning av blomsterlandet och en 4H-gård. Här fanns allt från torkade blommor till larver och frukter och som självfallet kunde användas till att bota alla möjliga tillstånd. Även här gäller att läkaren måste skriva ett recept på medicinen för att patienten ska kunna hämta ut den. Medicinen är väldigt billig och man betalar per gram. Ett gram kostade runt 5-10 kronor beroende på vad man skulle ha. Förpackningarna till medicinerna såg ut som vanliga medicinförpackningar och allt var sorterat noggrant i olika lådor. Eftermiddagen spenderade vi på stan. Här fick Martina dricka sin första riktiga kopp med kaffe på nästan två veckor!

To be continued……

Martina och Hilda

Fuzhou – En dag på rehabkliniken och en solig dag i parken.

2016-02-27

Vi var på Rehabkliniken igår, fredag. Våra ergonomilärare hade svimmat om de varit med oss, kan vi lova! På Linnéuniversitet så lär vi oss om hur man ska arbeta ergonomiskt och använda hjälpmedel osv för att underlätta för både patienten och personalen; det ska vara både tryggt för patienten och ergonomiskt för personalen.

Vi kan ju börja med att berätta att i Kina så är det mycket familjemedlemmar som främst tar hand om patienterna. De tvättar dem, hjälper dem på toaletten, fixar mat åt dem osv. Inne på rehab var det fullt ös, massor av folk, en blandning av läkare, sjuksköterskor och anhöriga. Och vad vi nu menar med att det är oergonomiskt så kan vi berätta, att om en patient skulle från sängen till rullstolen, så bar en släkting dem. Vi såg en kvinna bära på sin mamma, från ena sidan av rummet till en säng på andra sidan. De båda kvinnorna var ungefär lika stora, och vi såg hur mamman började glida ur kvinnans famn medan hon rusade genom rummet. Bredvid den sängen hon skulle till sitter det två stycken läkare eller sjuksköterskor och bara glor på medan kvinnan nästan tappar sin mamma, huvudet först, ner i golvet, men lyckas precis få ner henne på sängen (eller britsen) och sedan bökar runt för att få sin mamma i en ok ställning Men avdelningen var väldigt bra annars, varje patient hade en sjukgymnast vars vid sin sida. De hade väldigt intressanta metoder och vi fick även själva prova på lite saker. T.ex. fick Sofie och Rebecca prova på TENS – plattor på armen och halsen. Annsofie fick prova en sak som slår på ryggen för att stimulera lungorna.

Huvudsjuksköterskan på avdelningen och de studenter som vi gick med var väldigt nyfikna på hur vi har det i Sverige. Så vi satt i ungefär en timme och berättade om alla hjälpmedel vi har, undersköterskornas jobb, vad en sjuksköterska gör osv. Det ar väldigt lärorikt och intressant. De hade många frågor till oss om vården i Sverige och vi frågade dem en massa.

Idag, lördag, har vi strosat runt på upptäcktsfärd i stan. Det är en väldigt stor stad! Vi hoppade in i en taxi för att ta oss till en park, som låg bredvid floden. Där promenerade vi och satte oss och käkade lunch och blev solbrända. Vi besökte även “Iland of Love”, en liten ö som ligger mitt i floden under en av de stora broarna som korsar vattnet. Det var en mysig liten park för bara fotgängare. Vi köpte varsin glaserade Havthorn pinnar och vandrade över den lilla bron till ön och gick ett varv. Det spelades harmonisk musik ur högtalare, hängde röda lantern i buskar och träd och det var grönt och fint. En liten oas mitt i staden. Det blev även ett varv på en stor marknad som vi hittade.

I fredags blev vi bjudna på lunch av vår students engelska lärare.

Han guidade oss runt i ett tempel. (Skönt med 2 h långa raster!)

“The white tower”, som man ska gå tre varv runt för att få tur i tre år.

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Här har vi Sjuksköterskorna på Rehab!

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Rebecca får prova TENS på halsen.

Det fick även Sofie göra.

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Annsofie provar någon slags resmaskin, där en patient som inte riktigt orkar stå på sina ben blir fastspänd och hissas upp i stående ställning en stund. Detta görs innan de börjar stå och gå träna.

Två glada små barn med sin mamma på moped.

Här säljs det både glaserade Havtorn, jordgubbar och andra bär.

På promenad längst flodkanten i solen.

En liten del av den röriga marknaden som besöktes.

Många kramar från Soliga och varma Kina!

Rebecca, Annsofie och Sofie

Bergsbestigning och a trip to the ER i Wenzhou

2016-02-22

Hej alla fans!

Vi har en glädjande nyhet, vi har fått värme i vårt rum! Klockan 8:00 imorse dök det upp två kinesiska herrar med en stor verktygslåda som började hamra på vår ac. Efter att ha hällt ut tjugo kg damm ur den så började den fungera igen, så nu är det härliga 25 grader inomhus, lyckan är stor!

Saker och ting blir inte alltid som man tänkt sig… Igår morse när vi skulle stiga upp för att bestiga bergen blev Hilda super-yr när hon satte sig upp. Det var värre än en tur med slänggungorna eller när man går och lägger sig efter en riktigt riktigt bra utekväll. Jag (Martina) begav sig ut på promenad medans Hilda stannade kvar i sängen. Dagen gick och promenaden som beskrivs som “not so far” och “we are back to lunch” var lite längre än så. Färden gick upp, upp och upp i minst 3 timmar, för branta trappor. Mina ben och vader skrek av smärta, men tjejerna från skolan som var med mig ville inte stanna. Högröd i ansikte nådde jag tillslut toppen. Väl där var det dags för lunch, men eftersom den mest bestod av ben från höns avstod jag och min svensk mage måltiden. Därefter var det dags att vandra ner för berget igen, vilken var något enklare. Mina fötter och vader kommer dock aldrig bli desamma igen…

Idag snurrade hela världen fortfarande för Hilda så hon har varit sängliggandes sen igår morse. Våra nyfunna kinesiska vänner tyckte att en “tripp to the ER” var berättigad. När vi anländer till akutmottagningen blir vi genast lokalkändisar och absolut alla därinne stirrar och pekar. Efter att ha vandrat runt mellan 4 olika ställen för att kolla blodtryck, blodsocker, temp och gjort neurologisk undersökning var Hilda färdigutredd. Hon blev ordinerad vila och kinesisk medicin som vi just nu håller på att googla vad den innehåller. När undersökningen gjordes befann sig hela Kinas befolkning i undersökningsrummet, sekretes verkar inte vara deras starka sida. Inga handskar användes heller, welcome to China! Det var inte riktigt så vi hade tänkt vår första skoldag, men nu har vi fått uppleva hur det är att vara patient och anhörig i Kina i alla fall! Vi håller tummar och tår för att Hilda är pigg som en lärka imorgon!

Bilder kommer när internet vill samarbeta med oss…

Intensivkurs i Savolinna, Nyslott

2015-10-10

Det började med att våra lärare la upp en inbjudan om att åka till Nyslott i Finland. Nyslott kallas av finnarna för Savolinna. Savolinna är en stad som är ungefär så stor som Kalmar och är lik Kalmar lite svårare tillgänglig att resa till med kollektivtrafiken. Nyslott har även ett slott som är ungefär lika gammal som Kalmar slott och byggdes också i etapper genom århundraden. Det var faktiskt en gång i tiden svensk. Så mycket likheter med Kalmar.

Det var inte så att jag var intresserad av att åka till Finland först, jag hade mycket att göra i skolan, men sedan dök det upp ytterligare ett mail på nätet då en klasskompis ville åka och sa att det fortfarande behövs 2 personer till för att åka. Då jag frågade en annan klasskompis och på kort varsel bestämde vi oss för att åka med till Finland. Eftersom ingen annan ville åka var detta perfekta sättet att se en del av Europa jag inte hade sett tidigare och komma bort lite från Kalmar och se andra sjuksköterskestudenter!

Vi packade våra väskor och åkte med tåget till Köpenhamn. En lärare från Linneuniversitetet skulle följa med vård resa. Det blev Kristiina Heikkilä som faktiskt ursprungligen är från Finland. Det visade sig vara rätt hjälpsam då Kristiina visste en hel del om Finland som hjälpte oss att få mer ut av vår resa.

Meningen med resan var att tillsammans med andra studenter från Norge, Danmark och Finland diskutera och arbeta med teknologi inom vården, kort och gott, robotar.

Från Köpenhamn flög vi till Helsingfors och tog sedan en hyrbil från flygplatsen till Nyslott.

Finland är ett land som är del i EU och som på många sätt har kommit länge i arbetet med vården än Sverige. Vi fick reda på att det arbetas med en teknologisk dosa som heter “Mirella”. Mirella kan ställas in för olika sorteras behov i hemmet hos människor med behov av hjälp som lever ute på landet där det inte alltid är så lätt att leverera god vård. Mirella kan läsa av temperaturskillnader i en lägenhet, luftfuktighet, den kan anslutas till sändare i säng och matta bredvid sängen – allt för att på ett kontor kunna se hur personen har det i hemmet. Vi diskuterade både för- och nackdelar med teknologin, men sammanfattningsvis kom vi fram till att nya sätt kommer att behövas i framtiden då behovet av vård- och omsorg håller på att ökas och kommer fortsätta att öka med tiden då fler människor blir äldre och vårdpersonalen redan idag inte räcker till.

Det var mycket spännande att se en annan del av Skandinavien, en del som är till stor del influerad av öststaterna. Vi hann tyvärr aldrig titta på Helsinki (Helsingfors), men det får helt enkelt bli en annan gång. Jag hade turen att kunna grilla marshmallows med de finsak och danska studenterna och fick på vägen hem se denna fantastiska vy:

Som avslutning bjöd skolan på spa på hotellet bredvid studentlägenheterna vi fick bo i under vistelsen. Där passade några finska studenter och ja på att bada iskallt i sjön efter en äkta finsk bastu.

Resan till Nyslott gjorde oss 3 hp rikare i våra betyg och blev betalt av samfundet Nordplus. De organisera var fjärde år en resa till en av de 4 universitet som arbetar tillsammans från Norge, Sverige, Danmark och Finland.

Typisk finsk: lakritsi. Här på en glass.

Operation TLUX

It was on one of my days at my praktikum I heard there would might be a patient who would receive a lungtransplant. Already at the beginning of my praktikum here at the ICU ward “9D Transplant” at AKH I told my supervisor it would be my higest wish to be watching an organ transplant. Though the lung-transplant (besides of the combination transplant heart-lung, which is not made that often anymore) is the biggest kind of transplant you can do compared to any other transplants.

So there I was, put to the operation. It took a while, because there are a lot of doors before I could reach the right operating-room and find the right operation-nurse who would take care of me. At first Dina took care of me, but they changed later and afterwards Brigitte was the operational-nurse who explained a lot to me. She was a wonderful woman who guided me through a lot of my questions and even had so much more information I would never find in a school-book.

So there they where: 2 big boxes containing a lot of ice and one lung each – of course packed in 3 plastic bags to contain steril. There where a lot of people in the operation-room. I counted at most 13 people: 2 operating surgeons, 1 surgeon-student who was assisting, 2 operation-nurses (one assisting at the surgery at the time, the other assisting the nurse who assisted the surgeons), one person watching the ECMO-machine (a mashine I already wrote about earlier), 2 foreign doctor-students, one other student (for a job where they sterilize probs for operations), 2 anasthesia-personnal (I think on nurse and one doctor) and med. So you can understand that it wasn’t so easy to take a look at the operation. I wasnät able to see everything, but I cpould see a lot. E.g. I could see how the cheast really looks like spare-ribs from the inside. I was even allowed to touch the new (through the plastic bag) and the old lung with gloves on, but I could feel the damage on the old lung.

The person who was operated on was a girl, 18 years old. She had lung-fybrosis which is a disease who gives the person not only a hard time to breath after some years, but it also gives the person problems with hormones. That means that this girl actually looked like she only was 12 years or younger. Now, the new lung was from a boy only 14 years old. The operation-nurse sayed the lung was really beautiful and it would be good for the girl to get such a beautiful lung!

I feel really gifted and happy for this opportunity, because to be part of and watch an organ-transplant was my greatest wish at my internship at AKH. They called this surgery school-book-example transplant becaause a lung-transplant often needs 8-10 hours of operation. Even the recovery of the girl went well and she could get from our traansplant-ICU to an ordinary ward within 2 days.

This transplant was a dubble-lung-transplant. Earlier years they mostely used to transplant only one lung, but it is now more common to transplant 2 lungs at the same time. In Vienna the lung-transplant is a really common transplant-procedure and approx one lung per 10 days is transplanted in Vienna. Acctually all lungs in Austria are transplanted at AKH in Vienna. But that doesn’t mean that it isn’t a complicated procedure. There are some risk to consider by having lungs transplanted in your body. E.g. is the approx life-time of the transplanted organs 10 years, which means that this girl might has to have another lung-transplant in some years. Of course not having a trannsplant wouldn’t have been an option in her case, though of her heriditated disease, but you should consider smoking or not wearing masks in certain working-enviironments – for the health of your lungs. Other complications by transplanting lungs ccan be infections, but there is a risk that the organ that is transplanted not is in a good condition. I have still not really understood why the AKH do transplant organs that are not fully fit for transplant (e.g. a lung that is from a smoker and not so much better thann the lung the person had before – this does not regard the young girl, but other patients I have seen). But I can think of 2 reasons why:

There are not enough organs to choose between. Austria is indeed one out of 3 counttries in Europe where every human beeing automatically is a organ-giver (besides you write a will not to before you get sick/die), but they are also part of an organization ccalled “Eurotransplant”. This is a organization between 8 european countries which work together to distribute organs in these countries. But, they do still have a transplantt-list and people do have to wait for organs. So if there is a person in desperate need for an organ, the person will get it, even if it is not fully fit.
Prestige of doctors – doctors who like to do surgeries and want to keep up a high rate of organ-transplant on their Curriculum or for the hospital. Or because people “buy iin” themselves for an organ. I have accutally heard that this was possible once, but I have no idea if it still does.
There is procedure where you can put e.g. a lung in a glas cube to ventilate it before extransplant it.

WIT – Wiener Intensivmedizinische Tage, Vienna Intensive care medical days

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As I am about to write this I am sitting on an empty train, waiting for it to depart so I can get to work on what I think is going to be a beautiful morning (I feel that today is going to be a sunny day). As I am sitting here I saw a train pass through the station i Mödling where I stay at my mothers house. I often say that my mind is like a child and my patients have thought me that you never loose that child inside of you, no matter how old or sick you are or get. So I did what I always do when seeing a industrial-train: I count the waggons. This time: 36 empty car-waggons.

A week ago my supervisor said there is going to be big congress for hospital-staff, especially for intensive-care staff. He had three tickets for the staff in his hand and said “Oh, look at her, I can see how your eyes just sparkled!” Yes, of course they did! My brain is constantly telling me to want more information and knowledge, it is like a sponge that just won’t fill up till the end! I can only explain this phenomena for myself through the fact I was told when I was little: the human will never use it’s brains full potential, the human brain can just be used partly in life. By writing about that I am thinking about how science has found out that people who use their brain more in their life, e.g. through reading, learning and brain-excercises, tend to have a lower risk of getting dementia. So I can always say that this is my way of preventing dementia in the future.

Well, Wednesday came and the first day of the big convention started. The congress planned 2 Rookie-seminars: one for doctors, one for nurses. So I thought I go to that Rookie-seminar for nurses working in intensive-care. I went to the congress that morning but they told me at the counter that this seminar was not included in the ticket I got from my unit, it was an extra seminar that would coast an extra fee and besides of that it was sold out, the lady told me. At first I was sad and thought, why? I wanted to go to that seminar so badly! So I went up to the unit, sad and disappointed. There I thought about it and how in Vienna the way of thinking is more soft than in Sweden and Germany. So I asked a co-worker if I should try to sneek in instead – he agreed. So I went back. Now with my confidence in my pocket that I would get in as a paying member. It worked! Noone asked about an extra ticket or a booking-confirmation. Besides of that the lady must have meant that the Rookie-seminar for the doctors was sold out, because when I got to the seminar of the nurses, the room was only filled with about 75% of the people who would fit in.

About the seminar: There where especially 2 presentations that cought my interest. The first was about aromatherapy – something they use here at the ICU for their patients. This can be by putting essential oils (in a really small amount) into the rooms of the patiens or by massaging or washing/bathing the patient with a small amount of oil mixed with water. These eessential oils are acutally not used for therapy in the hospital, but they are used for nursing. It is important to know that diffrent oils are used for diffrent purposes. E.g. is peppermint used for cooling, while lavender is for warming but still, calming. It also depends on how you use the oil. E.g. in massage or to smell in the room. Did you know tthat smell is the only sense that goes right up to the brain without talking “extra sidetracks”? That means that the smell is the first sense the brain realizes. And did you know that the airport in Frankfurt, Germany uses lavender in tiny amounts in the air for calming and preventing flight-axienty? At least they told me that at the seminar. The amount of lavender used in the air is so small you can’t smell it, but the brain still can. This is acctually sientifically proven, the woman told us at the seminar. For me this information is especially interessting because I am studying a course about complementary and alternative medicin, or integrative medicin during my time in Vienna at Linneaus university, over the internet. In Sweden we learned a lot about diffrent integrative methods, but I didn’t hear about aromatherapy before that. So I am really going to take that with me as a future nurse and maybe I can be one of the nurses to start using aromatherapy at the hospitals in Sweden one day. Here in Austria this woman was one of the first to use it at her hospital and now they use aromatherapy at many different hospitals in Austria, even at the ICU where I had my praktikum.

The second seminar that cout my attention was about humor within nursing, means keeeping up the spirit at your workingplace with the other co-workers and with your patients. The semminar was so good so the audience laught the 60 minutes he was holding his lecturing. The man told us about how he often found empty boxes in the medicin-cabin, wondering who would ever put an empty box in it! That meant that he got angry about his collegues and this made his day negative. He told us then that he changed HIS attitude by thinking “where is the empty box”, “where are you?”, expecting it to come out and when he found it he got happy. I am acctually thinking right know that there is something I have had hard times to handle in my life. That one thing is everytime someone askes me where I am from. Especially in that small part of Sweden where I live now people tend often to ask me about my heritage. I am actually angry everytime they ask me, because I feel that they judge me asking about this. I don’t want to be “the german” or “the austrian”. The main problem is, though I have multiculture background people always seem to get it wrong where I am from. So maybe this is the time where I have to change that feeling into something good, to think and act like noone else expects me to. Wow, this was accutally a wonderful and fun seminar! He also told us about that there is laughing-yoga you can practise for more fun and happiness in life. And did you know that there is a laughing-institute in Germanny? The work with sientific research there. I find this so funny and I am thrilled to implement more humor and fun in my life. I am acctually already trying my best to be more fun and saying things people don’t exepct me to. Of course, I am not that fast of a thinker when it comes to humor, but I hope I soon will be able to live my life in a more positive and funny way!

Taking a nap at work

Did you know that there are studies who have been made with doctors if it is good to take a nap at work when you work a long shift? These studies have shown that it is good, and that you can gain back your concentration. Here at the ward they have the modell to take a 30-minute nap at working hours sometimes. I know that not everybody is doing it every day they work, but I know that my supervisor e.g. does it sometimes. I was allowed to do that too one day and I can tell for sure that this is a modell I would like to have at my future-working-place. I felt so much better and stronger afterwards again. Just 30 min in a nice room with beautiful lights and calm music. This is actually something I want to take with me to Sweden, not just for doctors and not just for people who work long hour shifts!

The end of my trip

2015-10-08

My 5 weeks of clinical rotation are soon turning to an end. Today I will do my last day at the hospital MCCG (The Medical Center of Central Georgia) in Macon. There have been a lot of good bad also bad experiences. Though this is my second time doing a clinical rotation outside of Sweden I feel that this is normal, because the health-systems work different and different countries have different issues.

When it comes to obesity I haven’t actually seen so many obese people, more obese children. But when children are obese, they aren’t as obese as grown ups can be. Some of the students told me that it does not need much weight for a child to be obese, but it does for a grown up person. So I think the issue here is mainly children that have fast-food and a lot of sugar in different drinks. The typical drink in Georgia is sweetened-tea. It is tea that is boiled and than they put in a lot of sugar. After that it is served with a lot of cold ice. There is also a good lemonade that is typically for Georgia or you could mix both the tea and the lemonade to get a 50/50. But, there do serve unsweetened tea as well, which I am totally fine with drinking. And everybody drinks it with a plastic-straw. In a styrofoam-cup. From what I experienced here a lot of plastic-dishes are used here, instead of washing dishes. Even at the hospital everything that is used in patient care is basically one-way used. So a lot of plastic. Even the spoon, forks and knives are made in plastic and single-packed in plastic.

Fresh Donut after a long day of clinical at the hospital 🙂

When it comes to the patient care I see that the nursing-education is very anatomy- and physiology-focused. When I look at how the nurses work though, they do work a lot more with caring-sience, which is not much educated in school, from what I understood from the students. This is the total reverse from Sweden, where the nurse is the expert in caring-sience and the physician (doctor) is the expert in the medical field. I also saw that they use restrainment-orders on arms and legs for patients that are bed-bund and are in need of intensive-care. I recognize this from Vienna in Austria where this also was used for patients awakening from anesthesia from an organ-transplantation. It may seem strange for a Sweden like me, because this is not used in Sweden and totally banned. At the ICU in Kalmar they have nurses (LPN) who sit and wait on the patients, just holding down their hands if they try to fight the tube in their throat. I have been discussing this treatment with nurses in Austria, Sweden and the U.S. and I found that there are advantages and disadvantages. It is easier to work with restrained patients, but it is also a restrainment of one others life. I think here in terms of that another person must feel trapped while awakening, but is it better to hold down the hands and legs by e person? It probably is, yes. But it also needs a lot more staff and people who watch their patients 24/7, every minute of the shift. And after my summer at the ICU working 3-shift, I can tell that it is a HARD job!

Nursing-station in the hall-way at the pediatric-ward.

This clinical rotation was supposed to be a 5-week rotation in the community. With a community nurse. It turned out not to be exactly like that. I was the first student from Linneaus university to visit GCSU. There have been several students in Växjö at LNU’s campus, but none has gone over to the U.S. from my university. I have had issues with getting to places of my clinical rotations (everything is far away here, but thanks to ALL the WONDERFUL nursing-students I could get my way to all the rotations with them. I did organize a lot of those trips by myself and my roommate Anna which also is a nursing student. I think that 5 weeks is to short to come over to the U.S. for a clinical rotation, because there are a lot of preparations that have to be done while in the States. Their law HIPPA is for the patients safety and confidentiality and is hard regulated. I also heard that nurses have to prove their registration (legitimation in swedish) every other year at a board, so they still have the knowledge for their work. This law makes it hard to just get to a clinical rotation, especially because I am not American.

Treatment-room for children.

It has been of huge help to live with Anna, Jennie and Beth. They helped me with a lot of questions and also allowed me to borrow their cars, which made it easy for me to shop groceries and get to barns where I spend some of my free-time riding. To live with local people is a easy way to get closer to the community and I think the whole travel mainly gave me a grate cultural experience.

Cars for children at the ward.

Now the time has come for me to take some vacation. Since I have made all my time for my clinicals and I got signed all my papers, I will leave for Miami on Sunday. I booked a flight yesterday and I hope that I might even make it for a Cruise to the Caribbean. I still don’t know, but there are also other option, e.g. the network called “Air bnb”, which is a homepage where people rent their apartments for a good price. It also gives you the opportunity to meet local people. I plan on grabbing my bags and leaving them at the airport in Atlanta. I will than only travel with my backpack to Florida and later next week return to Atlanta for my final flight home.

I hope you had a great time reading my blog, I will return with some vacation pictures though.

Georgia is a State well known for casting movies. “Forrest Gump” and “Fried Green Tomatoes” are two movies recorded in Georgia. Anna and I went to “The Whistle Stop Café” which was build for the movie “Fried Green Tomatoes” and we had food with fried green tomatoes which was delicious. Even though the place is simple, it has outstanding food and is situated in a neat surrounding. And of course it looks just like in the movie! A special thank you to Anna Agyao, without here all this has not been possible!

See ya later!

Two weeks, one big post

2015-09-29

Week 2 started out good. I found to a barn and some horses. It is hard to be away from my animal-friend, a horse namend Lovely who lives in Sweden. Happily Jennie (one of my roommates) helped me to find a place called ”Horse Dreams” which is really close to where I live. At Horse Dreams they work with having 2 horse-camps for children in the summer – all for free! For children an families that can’t efford their children to ride. So during the rest of the year the 18 horses that Mrs. Paula owns have to be feed and exercised. At it is here she has a lot of college-students helping here with that in exchange for riding.

And than Walmart. Again. I love Walmart – the big store that has everything! In this picture you can see crazy scrubs that the nurses have to buy by themselves. I learned during the last week that the nurses here have to wash their own scrubs. I also learned that the nurses don’t use aprons, only if their patient having diseases that their know about. I have even seen nurses not wearing anything besides their scrubs when helping a mother giving birth to her child. I also learned that Georgia is a State where forbidden by law to teach anything else than abstinence from sex as contraceptive, which means that people can’t have sex if they don’t want a baby. Or at least it means that the schools don’t teach about condoms or other contraceptives.

In this picture you can see what it takes to buy a weapon in Georgia. You have to be of a certain age and you have to show a by government issued identification, preferable the drivers license. That means that everybody in the State of Georgia can buy a gun. I know though from my roommates that you need a certain license to be able to carry a gun with you. But it is easy to get that from what I have heard. One night there was a shooting near our house. I still do not know why, but my roommates told me that there are gang-issues and have been all summer long.

Of course I had to bake a “kladdkaka” or as I call it in english “mudcake” for my kind and always helping roommates! I am actually allowed to borrow their cars sometimes which makes it easy for me to get to the barn, the gym and, of course, Walmart! I am pretty proud of myself to find myself through the jungle of streets here. But it helps that the streets are so big, it makes it easier to drive and see the traffic.

One of my days at the university I was allowed to spend with eldery people who where bicycle-racing. Not so harmless I have to say… One broke his wrist, one crashed is bike and probably his hip too and one made it as only male in 90+ to the gold-medal. The 90+ man you can see in this picture. He said he didn’t think it was so hard though he hadn’t any competition, but he waits for the next year for someone to claim his prize.

This travel has so far been a cultural challenge for me. There are many things I’m not always sure about. But sometimes signs help me to know how I should behave or dress. For instance this sign which explains the dress-code for the gym. I was by the way able to buy a membership for the gym for the time being in Milledgeville. The gym is really nice and modern. It has 2 swimming-pools, 2 big sports halls, a big gym and is all green, which means they don’t have any emissions. E.g. they use the energy the students make by riding bicycles and running on the thread-mill.

There are a lot of interesting animals here! I have not been able to catch all on camera, but they will always be there in my memory. Or at least as long my memory works as it should. In the first picture you can see a Mantis, in the second you can see a cockroach. The worst thing with cockroaches is that they can fly too… And one night one ran over my foot when I opened the door just for one second… I washed off my foot afterwards. I’ve seen big spiders and caterpillars too, but also a lot of birds, e.g. the big white Egret, such a beautiful bird!

Everything in the U.S. is possible to get by car, even medications, coffee and money from the bank – drive-thru! In this picture you can see a drive-thru pharmacy. Medication here is not the same as in Sweden. There are some painkillers, stomach-medication, antibiotics (for the skin) and even some sleeping-pills you can get easily without any prescription. In the next picture you can see all the medications I just described below, all for under 1 Dollar at Walmart. Even ointment for smoother muscles.

Between the days at the university I am able to take a swim in a outside pool as well. The day I took this picture was unfortunately one of the last days I saw the sun. The weather is still humid, but it is starting to get more cold though fall is due here too.

The clinical rotation in the community at Georgia College also means that I have to gain knowledge from different activities in the community. One of my days with my fellow nursing students I spend at the Ocmulgee National Monument Park where Indians from all over the U.S. had a big meeting. In the first picture you can see how different the food is from the Indians usual food compared to our modern food-rations. At the park we students had to be in a first-aid tent waiting for people in need of first-aid. (Un-) Fortunately there where no people in need of care when I was at the station so I was able to go and see all the fun stuff the festival had to offer. In the second picture you can se an Indian mound, a hill build with clay by Indians. I was able to walk inside it and it is believed that the mound functioned as a place for rituals. In the third picture you can see the typical lunch here. As we where volunteers we got food for free. As a poor student I do not complain about free food, but I wanted to show you the picture of it because a lot of food over here looks just like that. I do actually cook a lot of food by myself, just because I like to know what’s in the food. In comparison here a picture of the food I made with food from a farmers market. I used potatoes, sweet potatoes, butternut squash pumpkin and Ocra. Ocra is a vegetable which is typical for the South of America. I really enjoyed my Ocra as my supervisor/teacher Sallie Coke (who got me to Georgia) recommended me to taste it. I think I liked it most as a raw vegetable, crunchy! In the 5st picture you can see me in front of the ambulance they had at the festival. Actually they did leave to motor on, because they’re otherwise afraid of the engine not to start again. It is still a car that need a lot of energy to work properly. The last picture here shows my little key-chain I bought at the market from a really, really nice and pretty dressed woman at a tent. Such a magnificent handcraft!

Later in the week the students had to give each other and all people who came in and wanted, a flue-shoot. It is a vaccine against the influenza and is offered all students for free, but is mandatory for all nursing-students. Other people from different places in Milly can choose to stop buy and pay 20 Dollars for the vaccine as well. This gives the students a great opportunity to practice a intramuscular injection in the deltoid muscle.

And than of course more horses again… I bought this wonderful leggings with horses, of course, at Walmart. And I rode in them, because it was to humid and warm to wear my usual riding-pants. You can also se Mrs. Paula driving here golf-cart on the trail. It was interesting to see how far the car could go, but there are so much stronger than I ever thought! It went a lot up- and downhill!

The nature around here is also very beautiful. Here you can se the hibiscus, one of my favorite flowers when painted.

On of my days at the students clinic I spent learning a lot about pediatrics and I also learned how to intubate a baby. Even if neither the nurses in the USA nor in Sweden are allowed to intubate patients if they aren’t an anesthesia-nurse, it is always good to have the knowledge of it!

Georgia is known as the State where a lot of movies are recorded. One of them is “Fried Green Tomatoes”. I had the pleasure to borrow the movie from my roommate and I loved it! But of course I hade to try real fried tomatoes to and I loved them too! Here you can see how the look like for real.

As a lot of my friends at home know I am a nurse to be involved in a lot of discussions about the future salary for nurses. Here at Georgia College there is a organization called “Start Smart”. They had a workshop about how to start smart with a good salary, because there is a huge gap between man and woman. During a lifetime a man can earn 1 miljon Dollar more than the woman…

I don’t know why, but I didn’t believe that all the things I have seen on TV from America where for real. One example is here: they do play beer-pong at parties and there are people producing a spirituous called “Moonshine”. Moonshine is known as alcohol that is made outside of the borders of the law, it is forbidden do make your own alcohol in the U.S, just as it is in Sweden. But there are people (yes, in Sweden too) who make Moonshine. And then there is Moonshine that is sold legally. In the picture you can see Moonshine at a liquor-store.

And here one last special picture. Buy wine at the pharmacy. You could buy all that is needed for the evening there: pills, DVD’s, toys for kids, candies, body-products… And of course wine…

Sunday, Monday and Tuesday – clinical training center, shopping, swimming and food

2015-09-16

Hi there far away and near!

Or whoever is reading my blogg. Sunday I spend with taking it easy at home with a lot of chatting with my roomates – the best girls I could find to stay with! Than in the evening Beth and I took a short drive to the mall and we found this funny thing, a fountain with a bible and a cross.

Monday morning was my first day at school. My expectations where to found something like our clinical training center in Kalmar. I went to school in my scrubs I was allowed to borrow from the university. I have one set with dark-blue scrubs with the logo from the university, a lab-coat (when it turns cold in the classrooms they can use it there, the scrubs are for using at the clinical training center and when visiting at the hospital) and 2 polo-shirts for working in the community. This is me before walking to school:

Here are some pictures from my 10 minute walk to the campus. This morning it was actually only 12’C, so a little chilli. But later on during the day it became nice and warm again.

Here are some pictures from the day at the clinical training center. On the first picture you can see 2 students training with a teacher how to take a blood-sugar sample.

In the second picture you can see another teacher take care of a decubitus-wound at stage 4 on a model.

In the third picture you can see a doll with a stomach with four different ostomies. Besides the doll you can see the different intestines of the human body, but from another model.

In this picture you can see a part of the university. The campus looks pretty much like this everywhere. After the clinical training (which was basically what we used to train in semester 2 and 4 at the nursing-program in Sweden, and I couldn’t find any difference between how they work and we), I had to go to the office for doing test on the computer for a hospital where I should go for some clinical training during my weeks in Georgia. It turned out to be a really big test and I felt totally overwhelmed – it was not what I had expected. The thing is here in the U.S you have to sign papers for everything you do and apparently do a lot of test on the internet too… I was about to start crying, because the first test out of 10 was over 100 questions, and even though I understand a lot of english and speak it pretty well too, I had hard times to understand some of it. Happily some of my new made nursing-friends from the clinical training center could help me out to do the first and biggest test. Man, what a day… I thought getting to the U.S was the biggest part, but no. Here it came again…

After school I was able to borrow my roommates car and I drove for the first time a car in the united states on my own! It felt pretty weird, but I was so proud of myself that I did found my way to the mall and home again and could manage the traffic and signs I am normally not used to! After the afternoon in school I had to go shopping to cool down my depressed nerves.

As I had to put gas in the car I realized for the first time HOW cheap the gas prizes are here! I put gas in the car for 10 dollars (which is less than 100kr) and half of the tank was full!

It turned Monday and I gotten to the drug-screening part of my journey and leaving a blood-sample. A kind student from another nursing-cohort (=class) helped me to get there and we decided to go to a swim-class in the morning, though the clinic was in the same house as the fitness-center. While waiting to get to the nurse at the health-care clinic they have for students, another student came and talked to the girl who has drove me to the clinic. Her friend, a young man, came there apparently because he had been poisoned by poison-ivy – a common plant in the U.S I hd heard some of on different american tv-shows. In this picture you can see the poor guys rash after getting in contact with the oil of the plant “poison-ivy”. This rash shall never be scratched, though it itches a lot. The rash-bubbles can explode and they said they can be contagious. Poison-Ivy can get into your blood-stream too, and apparently this poos guy had had that too. If the Ivy gets into your blood-stream it can actually get really dangerous, so the Ivy is definitely a plant to be beware of!

After giving away my blood and urine for the drug-screening (I even had to sign a paper (again!) that I was about to donate urine…………. In the next picture you can see a cabinet from the changing-room for the swimming-hall. As you can see there is a shower and in close connection a dressing-room. I post this especially regarding to the ongoing discussion about weather children in Swedens schools shall shower separately or together.

In this picture you can see a machine that spins so your wet bathing-suit gets a little dryer before putting it into your bag. Funny invention!

After the swim-class Bethany (the other one, also a nursing-student) took me to a place called Chick-filé-A. The Southern part of America (where I am at right now) is especially known for it´s fried food. I ate a classic burger with fried chicken and vegetables. As I got a menu I ate the funny potato-chips you can see in the picture here. To that I got a typical lemonade that tasted sweet and a little bit sour.

As you maybe know from my earlier trip and clinical training in Austria I am all about the toilets in foreign countries 😉 Here I found a funny thing I would like at many other toilets: a machine that gives you free mounth-wash after the dinner.

In the evening I went to do some shopping and I found these fun scrubs for nurses at Walmart: all kind of nice colors and styles like The lion king, the minions and Puh the bear.

I was also surprised that you could my sleeping-pills without persecution for less than 1 Dollar…

Here you can see the typically license-plate on a car in Georgia. My roommates told me that you can choose the sentence underneath “In god we trust”, but you can only have that or “The State of Georgia”. As many of you know there is a lot of Christians living in the United States. On the plate (which I have been editing on the computer, for confidentially reasons) you can see the Southern peach – the fruit of Georgia. I have already tried one too and I have marmalade with peach in my refrigerator.

Well, have a good one! I am now going to visit a stable who take volunteers and they are allowed to ride to for volunteering in there stable.

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