I can not explain to you in words how much I have been loving my clinical experience this week. I am fortunate to have been placed in home care for my clinical. Home-care in Norway is a government funded program, just like their healthcare, in which a person may “apply” for home-care for a variety of reasons. This type of care is more than just a bridge from the being discharged from the hospital back into the community. Home-care is more health and wellness management to keep people from going into the hospital. The home-care nurse and student nurses are responsible for a variety of skills and assessments that take place in the person’s home. These skills maybe ones performed in the hospital as well, but some are very specific to home-care that may be surprising.
Some things I experienced this week working with the student home-care nurse are as follows: calling patient to remind to take medications; sitting with a patient to talk about life and recent diagnosis of cancer and to discuss how treatment is going; prepare and serve meals (breakfast and lunch); apply compression sock; perform peritoneal dialysis; dressing changes; administer meds; check glucose and inject insulin; give bath, change bed linens, do laundry; provide communication with the the home-care office in real time; pick up Rx from pharmacy and deliver; wellness check after fall; nutritional intake checks; breathing treatments; catheter care and tubing change; washed dentures; shaving face; removing trash and recycling from the home. The italicized items were tasks I felt going above and beyond to holistically serve the person.
We started our day arriving to the home-care office. We change into provided scrubs and sit down to collect our thoughts for the day. We eat breakfast, drink kaffe or tea, have a small chat with the other team members. It is not hurried or loud or fast. The nurse, who is like the charge nurse, she gives report to everyone about the persons we will be seeing that day. After report, we collect the supplies we need for the day. This can include keys to apartments of the persons we are visiting (if they provided them, I’ll touch on this more later), the iPhone which has our tasks we need to complete with each person for the day, if we need bikes or scooters or helmets we check those out too, any additional supplies we may need like shoe covers, gloves, masks and saline flushes. Most people we visit have their our supplies available that were given to them by the government that are specific for the type of care they need.
Some things I noticed there were pretty consistent from each home we went to were the windows were open to allow the sunshine to come their, and some with the windows open for some fresh air; there were live plants in almost all the homes and even throughout the apartment complex walking in from the street; the person was in a buttoned down collared shirt (even if they were not always wearing pants, haha); and the homes varied from government assisted living to very big and lush.
One barrier to home-care that I think this program has overcome is access to the person in the program. When I mentioned before that we grab the key to their apartment if it’s been provided is an example of overcoming the barrier to access that person. Some of the community members we visited were not able to come to the door to let us in, or couldn’t come downstairs to let us into the apartment building. Not all people we visited provided a key, but they were able to buzz us in and open their apartment door when we arrived.
We ended the day with a very interesting lecture about breastfeeding culture here in Norway. Breastfeeding is widely accepted in Norway. As a country they take great strides to support the breastfeeding parent by having resources such as lactation consultants who can refer to other resources such as physical therapists, chiropractors, DOs, massage therapy. The reason for these referrals is because the baby may have tense muscles from birth requiring massage and PTs to help strengthen and relax tongue to better latch, suck and swallow. There are massages the parents can perform on baby to help with breastfeeding as well. A few big takeaways from this were 1. The more we see breastfeeding happen, the more likely others will breastfeed. 2. We should not be offended by the “wrapping” of the breastmilk, ie the breast. 3. Educating breastfeeding parents that breastfeeding is complex that has many working parts. I walked away from this lecture feeling like this information should be part of annual education provided to all companies, not just those in the healthcare sector.
The following SDGs were observed this week including today: #3 Good health and well being; #11 sustainable cities and communities; #13 climate action; #16 peace, justice, and strong institutions.