My study abroad experience as a senior at The Ohio State University has not started the way most would call the “Norm”. I have spent my first week with two trips to the hospital and I am currently in the hospital called Charite Virchow-Klinikum which is located in Wedding Berlin in the Mitte district. This is a teaching hospital that is part of the university so the first thing I noticed is how young all of the doctors seem to be. They are all recently graduated and practicing medicine for the first time. A huge difference, I have noticed, between the US and here is that these doctors do not work alongside a more experienced doctor to be taught. They are out practicing on their own and, I assume, just have to report to their teaching professional(s). This is a little astounding to me because my understanding of a teaching hospital is that the new doctors are being taught and learning from their supervisors/superiors. In the United States at teaching hospitals that I have been in you would never see a doctor in their first few years alone, they are always working with their superiors to make sure they develop proper techniques and the best possible patient care. This is the first of many differences I have noticed.
Upon arrival I first thought it was strange that the check-in was inside the ER and you had to go back outside of the ER to wait. You had to push a button to get back to the ER, but the door opens right when you push it – no real security. Once back there, you could truly just walk wherever you please, there is no direction or flow to the hospital and the room to check in is just a small office with 1 person sitting at a desk. In my experience in the US there is a whole front desk usually with multiple administrative/registration staff to check people in and a waiting room in that same room to facilitate communication. The same room that you check in here is also where I went to check out the first time I came here, but the admin staff seemed confused when I asked if I needed to check out. I had not paid anything yet so I was expecting to be charged for something, but he just asked for my email and said they would send me a bill, which I never received (I assume because insurance covered it). Someone could totally walk right out of the hospital without ever paying here because they have universal health care. This is very different from the US because we are the only country with private insurance, so we are charged for everything, often even twice a visit (co-pay and fees after).
My first trip to the ER was similar to the US in terms of wait time but the longer I have been here the more I realize how slow they are here and how terrible the communication is. When I was in the ER the second time, they performed a procedure on me that, when I was transferred upstairs upon admittance, no one had any clue that I had received. This would be beyond unacceptable in the US and if I hadn’t told the doctor I received it he probably would never have known. This procedure wasn’t major or life-altering but if it had been and he gave me something or performed another procedure this could lead to serious negative health outcomes in patients. The US is very adamant about record keeping and communication (although errors still occur) and they use electronic records to help ensure that everything is documented and accessible to any health professional who may need it. In my experience, doctors and nurses in the US usually have carts they wheel around with them that have their laptops, or they carry a tablet, so they can document everything. Here, at least in the area that I came through, they only have computers at the stations and the nurses use paper logs in binders to keep track of information, which seems so inefficient. I have asked/informed the doctor and nurses of multiple items during my stay and it seems that the communication between them seems to be lacking. One example of this I experienced was that the doctor ordered protein drinks and a nutrient IV for me and after asking twice and waiting over 4 hours I had still not received them. Finally, when I was in tears from a headache from lack of nutrients, they brought me the drinks but the IV was pushed off and in the end was never administered.
The US is very private about patient information and will not give out patient information without a HIPAA document showing the patient gives permission to do so. The German’s do seem to be fairly private people based on all of the paperwork I had to fill out, including a HIPAA document. A big thing I did notice was the personal information they asked for, like my religion, again, never would happen in the US. The beds in the ER are side by side, no more than 5 feet apart, and there was only a divider between a few of them, all others were just open and next to each other. In the admitted rooms there are 2 beds also extremely close to each other (you can see this in the picture) and no divider at all. In the US there is required to at least be a curtain between each bed for privacy. My roommate in here is very sweet but she speaks mainly Arabic and very minimal English. It is shocking and saddening to me that when the nurses and doctors come in to see her, they often times cannot communicate with her so I wonder how they can even treat her. They do not bring in a translator for her, which would be required in the US, and it seems that they are just guessing and doing their best to treat her which could be extremely detrimental to her health depending on her condition. I must say I am surprised by the number of people who speak English here, I have come in contact with only a handful of staff who could not communicate with me in English, which is amazing considering the amount of interactions I’ve had.
Another difference I have noticed is when drawing blood, inserting an IV, etc. they spray a bottle of, what I assume to be disinfectant/sterilizing spray on the effected area and that’s it. Two little squirts from a spray bottle that is left in the room on a shelf with other assorted equipment. Anyone could open those bottles (and who knows how long they have been there); it just seems so unsanitary and unsafe. Once the spray has been applied, a gauze-type pad is used to dry the area. This gauze pad is in an open container and is not in an individually sealed package, just a bunch of them sitting in there which is grounds for all kinds of contamination. In the US they have an iodine treatment first that gets rubbed around the area for “x” number of seconds, followed by an alcohol treatment for “x” number or seconds and is not touched again before inserting a needle to eliminate any other contaminants.
Structurally, this campus is very pretty with a beautiful courtyard outside the hospital and a park inside as well. I took a picture with one of the Berlin bears that is located in the courtyard right outside my building (on a street called Mittelallee) during one of the walks my mother and I took. Some of the buildings almost look like old classrooms but I believe they all are medical buildings now for some specialty or another. The buildings are all rather old and the hospital is dated as well. There are not monitors and TV’s like seen in US hospitals and the equipment seems fairly old as well. This is different from the US where everything is modern, technology is up to date, and there is state of the art equipment. I figure this is due to the fact that we have private health insurance and spend millions more on healthcare than they do here.
