Update on Progress and photos!

Hey guys. I'm now in the middle of my fourth week on placement and I'm thoroughly enjoying it. Here is an update on my progress and some pictures of my placement area, plus one from my recent visit to Copenhagen.

 After quickly finding my feet at the sheltered residence with the help of my mentor, I made up action plans to clearly identify how to meet my objectives. I'm working closely with two residents with whom I have developed really good relationships with. Usually I meet daily with these residents and along informal discussions, I help provide support with their problems, help in the management of their medication and encourage them with recovery focused activities. I have also been spending time with a few of the residents who cannot speak much English, one of which has had recent periods of being quite unwell. On discussions with my mentor this provides me with interesting reflections on my therapeutic use of non-verbal communication. I feel I get a lot out of my reflection sessions with my mentor, whereby she is helping me look into specific situations in detail with the aim to argue an evidence base for my actions. I've also been having structured Danish lessons from a resident whose actual first language isn't even Danish. Although my progress is quite slow, this provides the resident with a strong focus on one of their many resources and is lots of fun.

One thing I've found interesting here is that although there is only one nurse working in the sheltered residence (my mentor) there is actually much of what would be traditionally coined "nursing work" to be done. This is shared out between other professionals working at the residence, which blurs the line between different disciplines somewhat. For example, whereas usually in Scotland only registered nurses can dispense and administer medications, here at the residence this is done by mostly everyone, including social workers and nursing assistants. There are also a different group of professionals working at the residence, entitled 'Paedagogs'. These are professionals who primarily focus on behavioral development and although most work with children and adolescents, many also apply this knowledge and work with adults experiencing mental health problems.

Another interesting difference Ive found, is that here at the residence, and from what Ive seen and heard in Denmark so far, there is a lot less emphasis on structured tools for the use of assessment. Although written care plans are made and evaluated on average every three months, there is little or no use of tools which formally assess the needs of residents or focus on issues such as risk for example. All this information is still collected, however this is done on an informal basis through discussions with residents and other staff members. On discussion with my mentor, this is something which is set to change in the coming years so that more formal paperwork is used. Although the current situation does increase the chance of some information being missed, or interpreted less objectively, there is a lot less paperwork to be done which provides more time for other activities, including a lot more patient contact.

On the whole there is a great feeling to the place and I feel my mentor and other staff provide an invaluable service in supporting the rehabilitation of residents. All the residents seem to thoroughly enjoy living here and are provided with a safe and supportive enviroment which helps to faciliate their recovery.

 Here are some photos.

The residence. View from the garden.

Kitchen and dining are at the residence.

Lounge area at the residence, with rooms above.

Copenhagen Harbour- from my recent visit.

Second Placement!

So I have now started my second placement which is in a sheltered residence for clients recovering from long term mental illness. The residence, which is very homely and is surrounded by a beautiful garden, houses up to 14 clients and has a small and very friendly team of healthcare professionals working there. I have had such a great welcome by all staff members and clients and again I am suprised at how eager everybody is to talk English with me, and at such a high level.

My mentor has been so good in helping me quickly get settled in the residence and always takes the time to translate anything from dicussions with staff and clients which I am really grateful for. Within my first week and a half I have been able to develop good relationships with clients and found there to be alot of learning opportunities such as client counselling and dispensing and administration of medication. Yesterday I gave my first depot injection in year (which was well overdue!!) and have many more planned. There is also enough time to have regular reflections with my mentor whereby she is helping me to link practice to theory in relation a rehabilitation. We have also been having many discussions about the common ethical dilemmas encountered at the residence and the best nursing approaches towards these.

So as usual the time is flying and I have suddenly become conscious I will be home in Scotland before I know it. I will post on here again soon with my progress and some pictures of the residence.

My time at the University College of Lillebælt with photos

 

 

 

My small amount of time at the university was fun and gave me the opportunity to learn something new and to meet other students from different countries. I found the style of teaching very similar to home and enjoyed the small friendly group discussions as a way to get to know people better. It was good to learn more about the Danish healthcare system in comparison with other countries in Europe.

The study visit to the Danish technological institute was really interesting and is something very different to what I would get to see in Scotland. The technology that was presented to us was all designed in the hope to improve the delivery of healthcare in conjunction with the predicted future economic and demographic challenges. The many inventions shown to us included PARO the fury robotic seal which responds to being petted and has been shown to be effective with people experiencing late stages of dementia. Also we were shown a telecommunication device whereby patients can consult with nurses through a video screen and send them measurements such as blood pressure and oxygen saturation. The device aims to increase patient empowerment and to save on hospital visits and nursing time. Many of the inventions gave myself and the rest of the class mixed reactions, brought up some ethical discussions and it was interesting to give my view on things from a mental health perspective.

My time at the uni finished this week with a group presentation on some of the issues around what we had learnt about. This went well and created some interesting debate.

Now im just about to start my second placement which im really looking forward to!

Here is a few photos of the uni and of some of the welfare technology we viewed. (Sorry a few are not of the best quality, my lense had steamed up without me realising, but you get the idea) :

University College of Lillebaelt with so many bikes outside!
 



Wheelchair at the technological institute with a very skilled arm.

 

Telecommunication device (on right) with fitted spirometer.

Myself with PARO the seal!

 

Design for new patient bed. Also an automatic hoover on the bottom left cleaning the whole apartment.





 



Week 4 and 5!

Hey guys,

Things have been so busy the last week and hence the delay on this entry. I’ve now completed a week at the university, which was really interesting and a great way to meet other students, both international and Danish. I’ll tell you a little more shortly but first I would like to go over the week previous to this, which was my fourth and last week of my placement.

The whole four weeks shot past really quickly and came to an end successfully, with all my assessment documents (both Scottish and Danish) getting signed off and with my talk to the staff going really well. On reflection it was definitely one of my favourite placements areas I’ve worked in. This made me a little sad to leave although it has also encouraged me to consider working with children and adolescents in the future. On one of my final days the temperature hit 30 degrees, not normal at all for Denmark this time of year, and so the activity was changed to a huge water fight in the garden, which went down really well with the clients.

Within my talk I first gave an overview of mental health in Scotland, giving statistics as well as talking of my own experiences of working in different placement areas. I then spoke of the structure of the course at home and my experiences so far of studying mental health. People found this very interesting as there are many differences, for example student nurses in Denmark do not specialise until the very end of their training and have fewer yet longer placements. I also brought my portfolio and explained its uses as Danish students do not keep one. Staff found this interesting and thought it was a good system.

Whilst making comparisons between my experiences in both countries I found there were many similarities such as the core nursing roles, values and ethics underpinning practice, a multidisciplinary approach and many similar attitudes and approaches to student learning. I also discussed some of the main differences I have noted. For example the very organised approach to note keeping and medication administration. All records were documented digitally in a very organised manner, for example nursing notes are divided up into many different headings such as the behavioural, psychological, social and nutritional aspects to each clients care.

I also noted there is more resources available to mental healthcare here in Denmark. I thought it was amazing how on the ward there were sometimes four or five members of staff for around ten patients which gave more time for client contact. There were also many games, a full music room, art room, table tennis and table football tables, a trampoline, plenty of bikes and even some canoes for the clients to use. I must note however that I have never had firsthand experience of an adolescent psychiatric ward in Scotland and therefore these observations cannot be definite comparisons.

One more difference I have found is the policy on the use of force and restraints. Although the policy in both countries is very similar in the way that the use of force and restraints is a very last option and should be avoided wherever possible, the policy does differ. In Denmark restraint belts on hospital beds can be used as away to protect a person if they are deemed to be at considerable risk to themselves or others. After some discussion I understood that if a person is physically restrained by others there are times when a person can become more agitated by the intrusion of their personal space which can be a very precious commodity if someone is very mentally unwell. The belt then can therefore act in a way which protects the person whilst giving them their personal space and could have the possible advantage of less reliance on medication. However arguments against this could be that it is a more restrictive method and if a person is restrained by others there is the opportunity for the restrainers’ to use their closeness therapeutically through communication and touch. Luckily any form of restraint is very rarely used in Denmark and is avoided at all costs, giving patient freedom and choice wherever possible. However I found it a very interesting comparison between the two countries.

So finally this week at university has been really interesting. I am partaking in the first few classes of a module entitled Health in Nordic Countries and there are both international and Danish students. The Danish students have chosen to take the extra challenge to study in English and so are very eager to welcome and get to know us international students and there is a very warm, friendly atmosphere to the class. We have so far been making comparisons of different healthcare systems around Europe and have been studying about the major future challenges to the way healthcare will be delivered in Denmark. As to see some of the possible solutions to these challenges we will visit the Danish Technological institute to view some of the possible ‘welfare technology’ hoped to improve to standards and efficacy of the Danish Healthcare system in the future. I will take my camera and post the pictures on this blog.

So that’s everything for now, such a long entry, I guess it shows how busy I’ve been! J

End of Week 3 and Photos!

Hey! Im just coming to the end of my third week on placement and as usual I can´t believe how quickly the time is going. Im still really enjoying myself and I am happy as my mentor and other staff are pleased with my progress so far. Next week will be my last week on this placement and im giving a small talk to staff on the Scottish mental health care system, the structure of my course at home and some comparisons between Denmark and Scotland. I will let you know how it goes and what I said next week. For now heres some pictures from my placement and the surrounding area!

My ward and garden.

One of the living areas in the ward.

My mentor in the medicine room.

Me and my bike.

Along the river that runs through Odense

Kerterminde beach. I had a 2 minute swim and it was freezing! :)

First Blog!

Hey guys,

So im now into my second week in Odense, Denmark and its been a great experience so far!

On arrival last week I was kindly welcomed from the train station and shown around by my buddy who is a friendly danish nursing student assigned by the university to help me get settled. Odense is a small relaxed town on the island of Fyn and is surrounded by nice countryside and not too far from the beach! I have everything I need with my accomodation and its close to my placement and the town center.

So my first placement is in the psychiatric department for children and adolescents and even though its on the hospital grounds its a disconnected building surrounded by greenery and feels very homely and relaxed. The building consists of three wards for different age groups, a small school for the clients, various activity rooms and a kitchen so all the food is freshly made. Im on a ward for adolescents and there is usually between 8 and 12 clients there at a time.

My mentor has been great with me getting settled, introducing me to nursing in Denmark and helping me clearly identify my learning objectives in relation to the placement. Each day I get to spend alot of time with the clients and there are scheduled activities which have all been fun to be involved in. Alot of the clients can speak english really well and its been a happy suprise for me to find that they enjoy to speak it and to interact with me. They are also teaching me danish (which is really hard!!) and they seem to really enjoy having a useful skill that they can share and help me with.

Alot of the nursing activities are role modeling and teaching life skills, medication, communicating with other professionals and families, providing a structured day and alot of activity therapies- games, drama, art and music etc. Its really enjoyable to work there, I feel its a great enviroment for the clients which really seems to focus on them having fun and building on their strengths and talents. I have been assigned to work with one client in particular who speaks fluent english and we both get on well. I have regular reflections with my mentor and she always trys to help me link my practice to relavant nursing theory which is really helpful.

In other news I get a free bike from the university! Denmark is very bike friendly and ive been enjoying exploring the surrounding area in my free time!

So thats enough for now, I will soon write again and put some pictures up on the blog! :)

Good News!

Stuart has arrived safe and sound, and started placement today.  He is keen to start blogging when he finds his feet.  I'll let him tell you about the bike!