Clinicals and Stockholm :)

Thursday 11/4
On Thursday, I had clinical for a half day at Skiftinge Vardcentral. Sometimes, I only have a half day because the nurses have to spend a lot of time doing phone counseling. On Mondays especially, the central gets hundreds of calls from people wanting advice and appointments. The nurses must do a few shifts of phone counseling each week. I noticed this was similar to the United States, when I was at the Riverside community health clinic, the nurses had specific hours and times assigned to work the phone, call patients and give advice or make appointments.
In the morning, we had several patients there for blood pressure screenings. The nurses get a lot of cases like this, where the patient comes in to get their blood pressure taken three times. This is when their medication changes or perhaps they had been screened earlier and found to have high blood pressure. In these cases I take the blood pressures and pulses while the nurse talks to the patients. Maria, the nurse I was working with, does a lot of diabetes and nutrition counseling. The next patient was a lady who wanted to lose weight. One of the issues was that she was from Iraq and spoke Arabic. So a translator had to be there. Maria spoke directly to the patient instead of the translator. She did height and weight, BMI, daily intake, when she eats, how she exercises, and all of that. A plan was made for the patient to follow and she was to return in two weeks to check on the process. If no progress was made, Maria can prescribe a gym membership for the patient and she will be given exercise to do. Also, I gave a vitamin B12 injection to a lady. B12 injections are very common here. Patients get them every 3 months, 2 months, 1 month, or 2 weeks, depending on how low their B12 is.

Then I went to Berlin for the weekend, but I posted about that in case you are wondering about the gap in my blog. For those who care!

Monday 11/8
Today was another half day because on Mondays many of the nurses do counseling on the phone. I was following Lotta again. Her first patient was one I had had the week before. He was a man who had liver problems and got compression dressings on his legs because they often became quite edemas. Today, he finally got his special compression socks ordered from Germany. Now he will not have to come to the clinic as often for dressings, this will be very convenient for him. Lotta is a nurse that specializes in incontinence. The next patient was an older lady struggling with incontinence. Lotta gave her advice about training her bladder muscles and pamphlets to take home with her. She also gave her a variety of different adult diapers and incontinence pads. She instructed her to keep a log and measure her output. I also learned about just in case peeing. If you go to the bathroom before you are going somewhere just in case you have to go then it is no good for your bladder. Your bladder needs to fill up all the way in order to train it to stretch and work properly. The rest of the day consisted of B12 injections, vaccinations, and blood pressures.

Tuesday 11/9
In the morning I was following Lotta again. It was very similar to the day before. There were some interesting patients. Nurses have to give advice for everything. A girl thought she had a sinus infection but when the lab results came back it showed she didn’t. This lady was also a smoker, so she was counseled on smoking cessation. The rest of the morning consisted of injections and blood pressures.
In the afternoon, I followed Tess. She specializes in cardiac patients and is new to Skiftinge. She had worked in the hospital up until about a month ago. In the afternoon, we had all blood pressure cases. Tess is really cool and fun to work with though. She tells me all about Sweden and her cardiac care nursing experience.
Anna and I went shopping I finally got some good Swedish groceries! I love Anna she is so sweet and really cool. She misses here daughter so she was cool with going out into the snow with me. It snowed today like 4 inches and its absolutely freezing! But Sweden looks so pretty in the snow! Some places are just meant to have snow, I think Sweden is. And of course all day all the people complained about getting their snow tires on. I think you get a ticket if you don't have them on by Dec. 1st. I think people in columbus need to get some snow tires, at least I do! Also, I seemed to be catching a bit of a cold today, ewwwwww!

Wednesday 11/10
Today was my last day scheduling for classes at Capital! I can’t believe I am almost into my last semester of undergraduate nursing school! This morning I was with Maria. One of our first patients was a long time diabetic. He had recently switched from a private doctor to the community health center. Up until about a year ago, some private doctors were still getting paid by the Swedish healthcare and able to take patients. Unfortunately, there was little oversight for them and they took as many patients as possible, caring less about quality. Most of these private doctors are not used anymore or supported by the Swedish government health insurance. The man that came in was here for his first visit because he needed another insulin prescription. He brought in an ancient glucose monitor. This thing was seriously 10 years old. The battery in it had expired in March 2010 and his test strips (a canister of 25) were from 2007. Obviously, this man had not been taking his blood sugar. We got him a new monitor, one of the 5 the Swedish government provides free test strips for. It used to cost the taxpayers about 7 krns (1 dollar) for each test strip, but now that they only use 5 kinds of meters its on 2.30 krns for each strip. It’s discouraging that all of this healthcare is available to the people in Sweden and some still do not take advantage of it. I did a wound dressing on an elderly lady I knew from last week. She was very happy to see me again. It’s cool how after two weeks I am already starting to become familiar with some of the patients. Then, I took some more blood pressures and gave injections, Maria lets me do pretty everything except for actually counseling the patients. Some of them have a very difficult time with English. Also, if she talks to them in Swedish they will not miss anything.
In the afternoon, I was in the lab because all of the nurses had to do a CPR class. The lab is a very busy place. They are constantly drawing blood, and analyzing samples of blood and urine. The women working there are very efficient. Leyla, came to Sweden as a refugee from Africa. She was very nice and taught me about everything. She plans to go to Stockholm to work at a very special lab in January. It sounds pretty interesting. We were both feeling a little bit sick from the weather change so we swabbed our throats for strep. I’m happy to say we are both streptococcus bacteria free. I think that it’s just this cold weather that is getting to me. It snowed on Tuesday and Wednesday and it appears to be sticking around.

Thursday 11/11
In the morning, I was with the pediatric nurses. I loved seeing all of the babies. In Sweden, the children come to the community health clinic for well child check-ups and vaccinations until they are six years or starting school. In which case they receive all of their vaccinations and well child care from the school nurse. So, the school nurse can have as many as 500 or 600 patients they are responsible for. For the first month of life, the baby comes every week, then again at 2 months, 5 months, 8 months, 12 months, 18 months, 2 years, 3 years, 4 years, and 5,5 years. They do not receive the Hep B vaccine at birth, but instead when they are 2 months old. Also, for the first 2 years children in Sweden receive Vitamin D oral drops because of the lack of sunlight. Another thing they have in Sweden for the babies is Vallerming, which translates to gruel. It’s like a formula vitamin supplement given to babies, but it is not the same as formula in the United States. Another thing that I thought was really awesome was the maternity and paternity leave in Sweden. Most mothers and fathers get about the first 9 months to year of their child’s life off. They really get to be involved in their child; I think that it is great. First I did an 18 month and 3 year old well child check up. They do tests similar to the Denver Developmental examine, a physical examination, and vaccinations. Then I went with the nurse Fia to a well child home visit. They like to do a home visit when the child is around 8 months because then they can give anticipatory guidance in the house. At this age, they are moving around and getting into a lot of new things. It was an interesting visit because they mom was from Iraq and only spoke Arabic. A translator was needed and the nurse was incredibly confused and kept accidently speaking English to the interpreter and Swedish to me. Then we can back and did more well child check-ups the rest of the morning.
In the afternoon, I followed the physical therapist, Frederick. We saw a patient with shoulder and back problems and followed patients during their workouts. It was interesting to learn about physical therapy but also to talk about the health care system. In Sweden, they receive a lot of refugees from Iraq and Iran. The government sees how much money they get from taxes, and based on that number they let more immigrants in. The immigrants can go to Swedish school and get paid for it, free healthcares, education, housing, and food. A lot of refuges seek help and want to move to Sweden because they know they will be well cared for here. It is very interesting.
Went to Vasteras at night and hung out with Natalie. We ate a ton of junk food and just hung out. I watched the Paul is dead documentary on Youtube, its pretty interesting to watch. I don’t think Paul is dead though, obviously. I think the Beatles were just a putting a joke on people.

Friday 11/12
Liz came today! So I met her at the train station and then we came back to my apartment and had some Swedish food for snacks! She didn’t sleep at all traveling all night and day! Crazy girl! Then of course we had to go shopping and get our train tickets for the next day! It was so fun to actually go shopping with a friend here! We got some dresses at Bik Bok, it’s like a European store, pretty cute stuff there. Then we had to rush over to the alcohol store because it closes so early we got some yummy ciders and wine. I got a cider in every flavor to try. It was really my first time buying alcohol at the store in Sweden. Then we came back to my apartment and unfortunately I could only offer Liz a delicious dinner of Ramen noodles, but we were both too hungry to care. I was starving by the time we ate. Then we showered and went to go hang out with Bella and Hanna. It was so fun. We played Kings (yes they have that game in Sweden) and had so much fun. Then we came back to my lovely apartment, that Liz helped me to clean, hehe.
Saturday 11/13
Ahhhh, Stockholm. The day began with a few mishaps, first we left about 10 minutes later than intended and walking very fast it takes twenty minutes to get to the train. So I was freaking out the whole way making us and run and everything… I know I am super annoying. But we got there with 7 minutes to spare. I really thought we might miss it, but Liz was cool and collected unlike me. Once we got to Stockholm, we went to Peter’s apartment where he was letting us stay for the weekend! Thanks, Peter! And he had left us the key in a secret hidden spot, but it had fallen out of reach and we couldn’t get in the apartment. Oh no, panic again! Luckily we called him and he had a secret way in. So good thing his neighbor was home and could let me climb over her balcony. It was like an 8 ft high wall with nothing to grip on to get from one balcony to the other. Plus I was on the fifth story, but I scaled that wall like a spider. Huge adrenaline rush! Then Liz and I went to explore the city.
Olde town in Stockholm is amazing. We decided to start at the Central station and walk from there. Thanks to the helpful little guide book I got at half priced books and Liz’s navigational skills we were set! It was so pretty in Stockholm and I took about a thousand pictures to prove it. (Soon to be posted, don’t worry) We just walked around looking at all the cool buildings and little shops. Then we got tickets to the royal palace! We saw the royal apartments and it was so cool. Plus just about every view in Stockholm is amazing. We kept walking around even in the pitch black and did a bit more shopping even! Then we went back and got ready for a night out. We went to a Rainbow party first. It was a girl from Columbus , Heather and her friend, Charlie, we met over the best and most useful website ever couchsurfing. So we went to the party and met a bunch of really fun and some lovely flamboyant Swedish people. The best part was the group picture of like 50 people that Liz volunteered to take (I think to get out of the pic, hehe) but I loved it. Then I went out again in Stureplan, it is so fun there. I love to dance and the bars stay open until like 5am!

Sunday 11/14
Early morning for us! We went to the National museum and I learned a lot about Napolean and the current royal family’s beginnings. They are actually French. I know, weird. But it was very cool to see and this neat photo gallery of the royal family. The crown princess Victoria is such a celebrity here! Then we met up with Liz’s friend Maria. She is an au pair in Stockholm and went to American Univ with Liz. They had to some much fun catching up and it made me think about how I am almost graduated and pretty soon the people I have been seeing for four years will be all off doing their own things. You keep in touch with some people but not everyone, its weird because I still live in the same town I grew up in so I still see so many people. I don’t know what will happen after graduation but now that I have seen what is out there I know I will have to move somewhere. Coming to Sweden has really showed me that I can do it and go somewhere new! Not that I don’t loooooove Columbus or anything. Anyways we had lunch in this old vault from the 1600’s. It was super cool and the food was so good. Walking around and shopping Maria educated us so much about Swedish Christmas traditions. Yes, they are already setting up for Christmas. It was a nice time and great to be able have such nice conversation. Thanks to Liz for answering all my questions. I know I asked her a ton of silly questions, but she had good answers. I swear, my goal is to travel like she does, I think it’s the coolest. She has been to so many places and now she is going to grad school in London. Saying good bye is the hardest part. I hated to say good bye to Liz, we had such a fun eventful weekend. It was good to have girl talk and constantly be so hungry we just grabbed the nearest food. Even weird diner food! But I get to see her in a few weeks, yay! By Sunday night I was passed out tired!
Love you all! I know this is last week, but Im a bit behind, this week is soon to come!
Holly