A Little Piece of Paradise

This weekend was my last in Savonlinna :( Very sad, I know. It's been a weird feeling, trying to get my last moments all summed up, taking more pictures in my head of everything I want to remember.

One of those things is the beautiful summer cottage out by the lake. Many people in Finland have a family summer cottage that is further away from cities, and an escape into nature. Leena and I have visisted hers a few times (where we made the snowman). It is on a beautiful lake with wooded forests surrounding it, about 10-15 minutes drive from town. Leena's parents owned the property when she was growning up, and they would spend their entire summer there, and then move into town when it was winter. They even kept horses! When she and her siblings got older, the land was separated out, so now there are several cottages for those siblings on that lakeside.

One of the most wonderful things at the summer cottage is the architecture that Leena designed for it. Eastern Finland has a strong "Karelian" history. Karelia used to be on the far Eastern side of Finland but was taken by Russia after the Finland-Russia war, and many of those Finns moved into what is now Eastern Finland in order to not be under Russian rule. As such, they had to leave their homes, histories, and homeland. Among the older generation here especially, this longing for Karelia is very strong.

Traditional Karelian Orthodox style church

Some of the culture includes the architecture, music, dialect, food (riisipirakkas), and dress.

My absolute favorite! Made with rice

At this cottage there is a little retreat to paradise. The little sauna at the end of the dock.

I can't put into words how nice it was to spend an hour or so chatting in the sauna, and when it got hot, just stepping outside to dry and cool off. Surrounded by such beautiful nature, looking out onto the frozen lake and in such wonderful company, it was really a beautiful moment that I will remember forever! Coming to the cottage for the sauna is like a retreat and a place to "become one with nature." 

It's a little surprising to me how well I've adapted to the Finnish culture while here. Sauna has become very important to me, and my endurance for it has grown a lot. It's so relaxing and refreshing, and it helps calm my mind down. I also have loved all the food, learned some of the language, and learned to appreciate aspects of Finnish history, like Karelia. I think that Finland will always have a little piece of my heart, and this cottage retreat and sauna is part of that piece!

Playing around

Well, I just finished my clinical hours at the health center. I was suppposed to go in this evening (uhh...my last Friday evening in Savonlinna). I had a meeting with my clinical instructor though to go to beforehand, and the first thing she said to me right when I walked in was,

Her: "I've been looking at your schedule."
Me: "Yeah I wanted to talk to you about that."
Her: "You don't have to go today."
Me: "...uh."
Her: "Really."
Me: "Thanks!!!!" Big Smile on my face

I didn't want to spend my last weekend at the Health Center ward, and it was a beautiful day!

No, my days at the Health Center ward were actually pretty good. It was a rehab unit, and it gave me a good picture of what nurses do here in Finland.

There are lots of similarities but also lots of big differences. Like I've already mentioned, there aren't any CNAs so the nurses not only give medications, do wound care, ect, they also do all vital signs, bathing, turning, lifting, ect. So these nurses have 8-10 patients during the day, but can have about 20 at night. The nurses also don't do physical assessments. In the United States, nurses carry and use stethoscopes very, very often. It is a critical and expected part of our work skills to assess a patient's condition very quickly. I was surprised that Finnish nurses don't do this.

The Day Room

The nurse preceptor I had these two weeks was absolutely fabulous! I loved being around her and we had a great time. Even though I wasn't able to communicate in Finnish, she did a great job translating rounds, nursing report, and conversations in general to me.

We also never could pose for a serious picture....

 Unfortunately, this was the first time I really got that in my entire time here. So I feel like I learned a lot more from that. She also let me do things right away, which I appreciated. Like, "do you want to give this shot?" Or on my first day, "Ok, you change this (very big, very bad) wound." No problem. She also was just so much fun to be around. I think that nightshift bonding really helped, but we laughed and had so many great times comparing nursing and cultural differences between Finland, US, and Germany (where she was born.)

Just having a fun time!

The "serious" picture! We cracked up right after this was taken

The work at this ward was very difficult, and I think that it would be hard for me to want to do it long term. It's physically demanding on your body, lots of lifting and moving patients who may not have or be able to use limbs. It also takes a lot of mental strength to take care of that many patients on your own.

Part of the day room

Rehab room

We saw patients with everything from dementia, to strokes, joint replacements, heart failure, amputations, and infections. Some patients had IVs, but not all. Some also had catheters.

There was a doctor on hand during the days. Apparently, there used to be one always there, but they've had to make money cuts somewhere, and that was one way to do it. Also, there is a shortage of doctors around here, too. Because of those two things, they are closing wards at health centers and hospitals. For example, the labor and delivery unit at the hospital here is closing, and people will have to travel to Kuopio (100km away) in order to have their baby! I think that is so far away.

The health center ward is part of the same hospital/healthcare system. After they are discharged from the hospital, if they need more rehab they come here. Afterwards, they might go to a nursing home or assisted living. People might stay anywhere from 2 weeks to a few months, but no longer. It's not intended to be a long term care facility.

And for all my nursing friends out there, I know you're interested in their different medicines and IV equipment :) haha, maybe not.

Med Room

SO much easier to use...

Ok, so it wasn't the location that I really wanted to be at for clinical. Let's be honest, I wanted to be at the hospital. But it turned out ok. I had a great time with the nurses there, the patients were very kind and patient with my lack of Finnish. One sweet old man knew no English except for "Good Morning, Darling." THAT was funny :) and sweet. Another lady laid her head on my shoulder when I was sitting next to her on the bed, and another lady whose legs had to be amputated was always so so happy to see us enter the room, and gave such big smiles, it made ME happy. I found that these elderly patients were very sweet and accepting of me!

And clearly I have no self-preservation....

Racing down the hall

Oh look!

In spite of the awful white uniforms, I learned a lot and enjoyed overall my time at the Health Center Ward 1!

The Walking Dead

Twice this week I'd say this was a pretty accurate description of me...

The First
My clinical place last week and this one was at an inpatient ward at the Health Center. This is a rehab ward, so we have lots of patients that are recovering from surgeries, might have infections, or something acute, not severe enough for the hospital. The doctor is there during the week, but on the weekends, if anything happens, they have to send patients to the ER. I think this is almost between a skilled nursing facility and an in-hospital rehab unit. We have patients with IVs and give injections a lot. There are others that have pretty severe wounds, some of the worst I've seen. We take of quite a few patients with amputations. We have dealt with catheters, blood draws, taking out stitches, and those normal nursing jobs. The one big difference is that nurses here don't use stethoscopes at all, even in the hospital. In our hospitals, nurses do a physical assessment at least once a shift, listening to lungs and hearts, feeling for pulses, edema, checking mental status, ect. These nurses here do a basic assessment, not a formal one, but for the most part, don't learn about listening to lungs and hearts, which is important for telling if the patient is breathing ok. My preceptor told me that she learned on her own, and will sometimes take a stethoscope if she is seriously worried, but when no one else is on hand to help. The RN's also do a lot of CNA work, liking showering and taking people to the bathroom, ect. There aren't CNAs actually (lots of LPNs though), but two nurses take care of 8-10 patients and do everything.

In case you're interested...all the rooms are shared. 

Anyway, at this ward, I have to work the shifts that my nurse preceptor works because there are few that speak English well enough to feel comfortable taking a foreign student. They do 8 hour shifts, 5 times a week. But on Sunday night she was scheduled to do a double shift, from 4pm-7am. Let's just say it was a long night. There wasn't really that much going on (besides lots of lifting and turning patients), but somewhere around 4 am, I just really felt the exhaustion creep in, like when you are at a sleepover and then things get crazy. That is what it felt like! My nurse preceptor is hilarious and ended up putting medicine cups on her eyes, saying they were the "wake up cups." We thought it was hysterical. And then we were wheeling ourselves in these wheelchairs and that lay straight back. Around 6am we went into a patient's room, where we were told, "you both look exhausted." We were.

Am I tired??

Yes of course!

At the end of the night, it was the weirdest thing to say good morning to patients that we had said goodnight to only hours before. I started falling into walls, and the long long 45 minute walk home was torturous. I'm pretty sure I was walking all zig-zag like. As I stumbled out of the health center back aching, feet sore, tired eyes, I felt like the walking dead. 15 hours is too long. The normal 8 hours they do makes you feel like you always have to be at work. However, our 12 hours is just perfect. I will never never grumble about them again!

The Second
Today I took a day off from the ward to see how home care nursing works over here. There are several offices around the town, and I had to go to the one that's about 2 miles west of the city center. Because I had to be there at 7, Leena was so nice and dropped me off in the morning, but I had to go back on my own. It was supposed to be a straight shot...more on that later.

We never did any kind of home health clinical at BYU, and I really enjoyed this. Remember, they have a public system, not private agencies that contract out home care like ours. So when the patient leaves the hospital, the doctor writes what the patient needs (such as medicines, lab draws, ect), the home nurse does them and writes in the the chart, which the hospital specialist (whose office is called the polyclinic) can then see the results. There is a doctor that works just for the home health once a week, but because everything is connected to each other, the healthcare really flows well. It also is growning quickly. They don't have enough facilities or nursing homes, so there is more need for nurses to work in this way.

The LPNs might come several times a day to make sure medicines are taken, that they eat, can shower, go to the bathroom. The RN comes maybe once a week to do a more complete assessment, do wound dressing changes, give injections, do lab tests, fill medicine boxes, ect.

I liked this because the nurse can work pretty independently. They have a schedule that the computer program makes for them, based off the patiens' orders in the computer, so she takes the list and her car for about five hours in the morning, and in the afternoon she charts. She is independent and can make decisions on her own. She always has resources if needed, but does a lot of really cool things. These patients tend to be lonely and crave company, and the nurse I was with said that bringing them that company and helping them feel another's touch is why she loves her job. I think the day shifts 7-3 is really nice and especially the driving and not being in an office.

After the day was over, I had the make the trek home. I knew it was going to take about 45 minutes, so I started out jamming to my music. 45 minutes later I start noticing that there are fewer and fewer houses, cars, and people. I'm the only one on the road. That can't be right...I should be getting close. Then I pass the sign that shows I'm leaving the city boundaries....oops. I pulled out my phone which thankfully google maps shows me my direction and location. I just kept going west instead of east!! So then there was another 45 minute walk to get back to my starting point, and then the real 45 minutes to get home. I can't believe I was so stupid! I should have looked at the map earlier, but I was content just walking and singing that I didn't even think I was going in the wrong direction!

Yep. WAY off course!

By the time I got home, my upper and lower back was hurting, my muscles were all tight, and my hands were getting swollen. It took me over 2 hours to get home, and I don't think I have ever been so happy to see the Blue House!! Again, I felt like the Walking Dead, because I walked so far I felt dead! I just collapsed onto my bed and starting writing this rant. I will be grateful again for the only 40 minute walk to the Health Center ward tomorrow! Ah, it's those little things in life!

Like a familiar lake and knowing where I am again!

Welcome back winter!

You thought winter was over?? Psych. It came back with a vengeance today with over a foot of snow. Last Friday we were enjoying this:

And then today we found this (At the same time of day!): 

It's really ok. I like snow. But the nurses all told me that the reason it snowed was because it's market day. It only happens twice a year, and only for two days. And every year, it snows. I was thinking, of course Finland is the only place where a market is so dedicated that it would stay open in spite of inches of snow!!

There were breads, sweets, sausages, food, toys, handmade wooden carvings, wool knit socks and scarves, clothes, ect. People from all around the area travel here for these two days. I didn't buy anything, but I was so happy to find out when I got home that Leena had already bought some of the sweet breads :) Yum. I'm going back tomorrow...maybe I'll buy something!

On another note, last week was the last week of our Finnish lessons. This week we decided to get together and celebrate not having class anymore. I was grateful for this class because it has helped me meet many other exchange students here studying different things. Also, I have never been part of a more international group, and it was both fun and exciting. German, Austrian, Chinese, Hungarian, French, English... My favorite moment of the night was when we were talking about how animal sounds are said in different languages. Everybody cracked up when I said that a rooster goes "cock-a-doodle-doo."Meeting so many friends from around the world has been a great experience, learning about other countries, cultures, mannerisms. I was amazed tonight that there were 12 of us, from around the world brought together by this experience in Finland, speaking English to each other, but at times breaking into these other languages. 

No matter the political conflicts or differences of opinion, people are people and by human nature we bond and create friendships regardless of backgrounds, culture, language, or country!

Blue House Bakery

I'm very pleased to announce the opening of the Blue House Bakery! We've decided that we don't care about our weight, and so we've made many goodies these last few weeks. So here's a small sampling of these goodies. Keep in mind that these were all gone almost the next day we baked them. Anyone who knows me knows how much I love to bake. And to eat.

First,

Pulla of course

These are the next creation that Saarika and I did. They were delicious!

Vanilla cupcakes with lemon frosting

And finally, this weekend Leena said that she was craving some apple pie. Now, did we settle for just one type of apple dessert? No, we had different ideas of what apple pie was, so I started making my version and she started hers and we ended up with three varieties!

Yum!! How many calories is that? I don't care

And we destroyed the kitchen while we were at it!

And now, because I rediscovered these that we made my first weeks here:

Bread Pudding

And for your own enjoyment, this lovely gem:

If you want to stop by the Blue House Bakery, please do! But don't expect there to be anything left!