Finland and MINE!

I was excited by the time I arrived in Finland. The white snow was simply an experience, even though it was accompanied by a novel temperature below zero! The scene was pictoresque, however I might add that no artist could depicit the exact beauty that was indeed present.

Multi-National interaction:

I might have expected as a Maltese to find our group to somewhat differ in customs to our European neighbours. This preassumption was easily shattered once I got to know the other students, and it was astonishin how close and global European culture has become. Most have the same food, same clothes, same manners and similar expectations. Furthermore we were all studying nursing, which made this experience even more common to us all. I have to say that it was a fantastic experience to socialise with foreign students in a foreign country. Even though from different background including language, we all managed to communicate effectively and work with each other well. As a result this provides students and mentors alike some experience which we may use should we ever decide to work in a foreign country in Europe.

First day and hospital tour:

The first day was basically all about orientation. We got to meet other students and mentors, both by class introductions and by activities which were organised in the gym. I considered these exercises as ice breakers: to laugh with each other (and at each other), while getting to know each other in a social manner. In nursing practice, while working on wards, we might all need something of this sort to sometimes relieve ourselves from work stress, which is ever present. In the afternoon, all participants in MINE were taken to see a typical Finnish hospital, in this case the Satakunta hospital in Pori. I could immediately create a mental picture and point out a couple differences when compared to our local hospital. First of all, everything seemed to be organised and calm, unlike the usual hectic scene I am used to back in Malta. This might be due to the fact that the hospital in Pori caters for less people than that of my home country, where we have one general hospital for almost half a million people.

One of the Maltese group observed that Finnish nurses wore sandals rather than shoes in their practice. While this in Finland was common practice, back in our country we wear shoes provided by the hospital which are supposed to be safety shoes. I took the freedom to look at literature to have an insight on what it suggested. Manheim (2011), suggests that ideal nursing shoes should be made from rubber, since this provides comfort especially when worn for extended time frames, avoids slipping on liquids that might be on the ward, but at the same time being impermeable to spillage of fluids. In our country we adopt this system, and most healthcare professionals abide by it since there is a valid rationale supporting it.

Another difference was that nurses in Pori hospital had a standard policy of what Personal Protective Equipment (PPE) to wear in case of infectious patients. In every case, nurses wore aprons, gloves and an N95 mask, regardless of what the risk was. In Malta there is no existing policy, other then that wearing aprons and gloves when in contact with these sort of patients. Indeed, there is in my opinion a lack of knowledge when it comes to decide in what instances a nurse should wear a mask. Moreover it is my belief that a mask when unecessary, may cause some apprehension for the patients. Therefore, I would educate nurses better on instances when a mask should be worn, since most isolated patients do not require a nurse to wear a mask. Cases that require a mask might be when there is presence of respiratory disease which could be caused by Tubercle Bacilli (TB), or for example the presence of diahrroea and vomiting which might signify the presence of noro or rotaviruses which may have airborne spores. On the contrary when a patient is colonised with Methicillin Resistant Staph. Aureus (MRSA), a mask is of little to no use to a nurse, unless the patient is consistently coughing (Landers et al., 2010). By educating nurses, it is my belief that while safety is kept, unecessary patient apprehension could be avoided.

A furthur point of reference was the nurse to patient ratio Finnish hospitals adopted. On most occasions in these wards, the nurse to patient ratio was 1:2 and 1:3. This, in my opinion allows space for excellent and complete holistic care of the patient, and I believe this is an ideal situation which all healthcare facilities should adopt. In Malta this ratio may vary, the worst being nights shifts in geriatric hospitals, where it can be 1 nurse : 42 patients, which I personally believe is a potential hazard. The situation in Malta several times leads to a job burnout, and thus reducing job satisfaction, and may indirectly affect sick and leave rates, making the shortage of nurses even worse. While I do understand that every hospital must reduce its expenses, such institutions also have the duty to ensure high quality patient care and safety, while keeping working staff content and reducing potential risks for burnout as much as possible.