Minä puhun vähän suomea

Remember how I'm taking two Finnish classes here? After three weeks of frustration and feeling that it would never come, I can now officially say that I wrote my first paragraph in Finnish. 

I was so proud of this until the teacher corrected it...

And I can conjugate verbs and am beginning to understand all the endings people add onto words. I obviously can't understand or even follow conversations, but I can talk "pleasantries" and every now and then during a patient interview I recognize a few words and can understand the general topic. From that and by observing body language, I really have been able to understand the things that people are concerned about when talking to the nurse/doctor. It's quite amazing. I don't expect or even anticipate that it will come easy, but I have to say I'm really proud to have come this far in just 3 weeks. 

We have a test next week in the Finnish class that Leena signed me up for (the one that's been meeting since November), but we were doing the exercises today and when the teacher asked me if I understood the text, for the first time I was able to say that I did. 

Some of those things I learned are:

Minä olen amerikkalainen ja olen kotoisin Indianapolisista, USAsta. Minä opiskellen sairaanhoitoa ja minä puhun englantia, espanjaa, ja vähän suomea. :) 

I have to admit though, this feeling only came today. This week has been rough, and to be honest, culture shock has begun to set in. I realized that I miss hearing English and even Spanish, that I missed America and just American things haha. Also the realization that I have to start studying for NCLEX and my KU application is due in a week really started to stress me out. I've had to get up earlier and earlier each day this week, 6am and then walk 30 minutes to the school. I know that's really not that early, but I can't seem to get to bed before midnight! 

Tomorrow is my last day at the elementary school. But for now, I'm up to my neck in Finnish books  :)

I didn't mean to, I promise!

Today I accidently went to the store...What I mean is I went to the store for one tiny little thing.

I'm assuming this is contact solution. The name is the only thing in English...

And I came out with this...

I just needed it, ok?

In other news, I am now the newest school nurse at the Normalkoulu Primary School, this week anyway. It's been a very interesting week so far. The school nurses here do a lot of health checks as they call them. The child's yearly physical is actually done at the school, and the nurse acts as the primary healthcare provider for those physicals. Once a week, a doctor comes into the school and does another physical for kids in grades 1,5, and 8. So basically, all of the vaccinations, height and weight charts, and eye, ear, other exams are done at school by the nurse. Instead of having a primary doctor to take care of preventative care, the nurse does much of that in the school. It's really very interesting. The nurse is also the gatekeeper, of sorts, to their healthcare system. If a child needs something that is non emergent but would like to visit the doctor (sprained ankle, plugged up ear, not feeling well), they will come to the school nurse first, and then they visit a doctor at the health center clinic if the nurse thinks the doctor needs to follow up. Nurses don't prescribe anything, it's more of an assessment and triage. 

I'll be posting more thoughts at the end of the week, with some of my opinions and observations. Stay tuned. If you need me I'll be in the nurse's office (all day, all week)...

Emergencies!

On Sunday, our Branch President (leader of the congregation) approached me and asked if I would like to visit the firestation where he works and learn about how the Finns do emergency care. Of course, I can't say no when someone offers to show me something...So I got my very own private tour of the Savonlinna Firestation. Be impressed.

This adventure started off with the 30 minute hike in negative degree weather to the firestation...that I had only ever seen in passing. I just jammed to the Frozen soundtrack on my phone (I can really relate you know? Especially that line "the cold never bothered me anyways." It's like repeating that line will actually make me believe it haha :) ) Actually, when I'm bundled up in my ski pants, hat, mittens, and fat scarf, it isn't too bad!

So here is the gist of what I learned. The firefighters and paramedics operate under one jurisdiction. The government supports both with about 1% of taxes. The government organizes the country into regions, and these regions are responsible for the cities and firestations in their area. So Savonlinna is part of a district that covers Mikkeli, Savonranta, and a few others, and the firefighters can float among those areas. Because the federal government regulates the firestations, everything is structured so similarly. The branch president told me that if he had to go to Helsinki to work for example, he would be ok because the order of things, the layout of the trucks, and the system is so precise. There are no volunteer firefighters, it is their career. He said that that is how it should be, because the people are paying for their service, so they expect quality.

I had to admit that I didn't really know much about how our system works. All those elementary trips to the firestation haven't seemed to pay off much. After researching it, I relearned that ours are regulated by the city or local government, and we have about 70% (according to the website I found) volunteer firefighters.

I was very impressed with the Savonlinna station. The firestation has a dive team, a water boat (because of all the lakes), several fire trucks, their own mechanic shop. And every member of the team is cross-trained for every job. They have hydraulics for opening cars, so many electric tools, generators that can maintain electricity for entire buildings, saws for dealing with storms and fallen trees. They deal with water rescue, animal rescue wildfire, car accidents, fires, medical emergencies, you name it. Within one minute of receiving the call, they are ready to leave for the run. Basically, I've decided that a firefighter would make a good boyfriend because he would be handy to have around.

I mentioned that the paramedics fall under this jurisdiction as well. In the old days, firefighters were crosstrained as paramedics and they did both. Now it has become so specialized that this isn't practical. All the paramedics now are specially trained nurses. They went to nursing school and then furthered their education with a 4 year specialty training. They can give about 55 different medications on route, and have full authority to treat the patient in the ambulance.  Our branch president actually trained as a nurse too and then moved to the firefighter side.

As a nurse, I really like this idea of nurse run paramedic teams. I don't claim to be an expert though, so please don't quote me on any of this. In our system, paramedics are only able to give a small handful of medicines: nitroglycerin, saline, morphine, epinephrine, some basic medications. They can do resusitation, and some can intubate. Because the paramedics are trained nurses, they can treat on the spot much better than in our system. We have to take the time to deliver the patient into the care of doctors and nurses, but here, the nurses and sometimes doctors too come directly to the patient. By the time they have arrived at the ER, many patients are stabilized. This provides for continuity of care. Also, since this is part of the federal government, it is structured very exactly. Everything is the same anywhere you go. In the US, training and certification of EMTs and paramedics also is very variable and differs in different cities, or states. I think that sometimes our system is very fragmented by shifting patients from different hands. This continuity of care is one plus for their healthcare system.

Overall I was impressed with the emergency care provided by the government here in Finland. I was thinking about this through, and realized how difficult that would be to implement in our country. Think about it. We have to train more specialized nurses...but what would that do for the livlihood of all our paramedics? And we are already short on nurses. The ambulances would need to be affiliated with an organization....is it problematic that our private ones have limits to which hospital they go to? With as many people in our country, could we pass a law requiring 1% of taxes to go to this service? The sheer number of private hospitals and lack of nurses would make this a very difficult project. I can't help but see, though, this system provides continuity of care in a way that improves outcomes for patients. In an emergency setting, the structure of this system is what patients need to be stabilized.

The whole time I was there I kept wanting to take pictures of everything. But I decided to be polite and wait til the end so I could get a picture with the branch president. Too bad they got a call and he to leave. Literally, we were talking and one minute later he drove the firetruck away. Talk about an exciting end to it all. So all I have is this selfie after I was left alone :)

Comments or questions? Anything I left out? I'd love to answer any or find out the answers if there are any :)

Just a little dip in the lake...

Tonight all the nursing exchange students were invited to the Director of Education's house for a little get together...Finnish style. What does that mean??? SAUNA (And winter swimming)

Now, I've been going to the sauna with Leena many times these last two weeks. In fact, she has one in her house, so for example, we have gone four or five times in the last week alone. So I have already had a good experience and have realized how much I love it.

Sauna is a very old tradition in the Scandinavian countries. It is very common also in Russia and Sweden. I have asked around but no one seems to know how, when, or why it started. I think it must have started because of how cold it gets up here. (You know, we are only hours from the Arctic Circle) Sauna is so important that many people treat it as a sacred place for meditation and a place to talk or sort out your feelings and emotions. It is wear business deals are talked over or where you bear your soul. For some reason conversations that are difficult to talk about any other time are easy to talk about in the sauna. I think it breaks down social barriers and strengthens and builds friendships. I have already noticed that with my friends here.

In the old days, people used wood burning saunas and built them a distance from the house. Now many are electric and can be built in the house. This Savonlinna area is the lake district, so here many people build them by the lake so after the hot sauna warms them up, they can cool off in the lake right away.

Saunas are built in nearly every apartment complex and families have a designated hour once a week to go. They are built in homes, summer cottages, rec centers. They really are everywhere.

Typically, women go together or all men go together. If a family has young children, they will all go to the sauna together until the children get a little older, and then they will separate.

So tonight were were invited to sauna with our professors. The Director of Education has a wood burning sauna at her house by the lake. The wood ones are better because the heat has more humidity and makes it easier to breathe. So we enjoyed a while in the hot sauna and then ran out to the tiny hole in the lake that had been recently cracked open, and we took turns taking a dip (or two!) in the frozen lake. It was soooo cold! After, I couldn't feel my body at all, but the best feeling was running back into the sauna to warm up. The change between being so hot you can't stand it to being so cold you can't stand it is actually exhilarating :)

(I tried and tried to get the quality of this better, but for some reason, even though my camera has a good video, when I uploaded it it looks terrible....but you'll get the idea.)

Can you tell how cold it it???

Sauna is something I'm only beginning to appreciate, and I don't think this small post can do justice for how the Finns feel about Sauna. We asked the director if we were crazy for wanting to do this twice in the freezing weather. She said, "you're just like us." I hope so.

Getting down to business

So I guess amid all the exciting posts these last two weeks, I may have you all confused into thinking that I'm on a vacation here in Finland. I'm actually not... Starting next week things really pick up big time. So let me give you low down on what I'll actually be doing here. (Let's be honest, I just found out today haha)

Basically, this is my capstone semester, my last semester, before I graduate with a bachelor's degree in Nursing. If I had stayed in Utah, I would be doing about 216 hours on one hospital unit during the semester. I would work with one nurse and sort of get a feel for nursing and learn to be my own nurse. We also have classes about leadership, NCLEX (board exams) prep and basically preparing to graduate. However, I'm not really doing any of that while I'm here.

When I decided to come to Finland, the BYU College of Nursing agreed to accept any work I do over here as my capstone. This university in Finland signed me up for their Community Health and International Nursing class and Finnish Language and Culture class. They are taught in English and have a mixture of students from other countries. This community class is only three weeks of lecture, three weeks of clinical practice. So I have already spent one week in that class, and next week I'll start everyday all day in community centers for clinical for three weeks. I'm very excited! I'm doing the first week at an elementary school, the next at a pregnancy clinic, and the last at a pediatric clinic. Now, this class wraps up at the end of February, but I have to fill my time somehow right?

The last month or so I'm here will be so crazy. After the community class is over and I celebrate my one week ski holiday (yay! finally a spring break!) I'll be working 2 weeks in the Pre-op/OR/Post-op at the hospital, 2 weeks at a rehab/progressive care at the hospital, and one week in a nursing home. That combined with the three weeks before in the community will give me around 280 clinical hours. No more sleeping in and having fun days :(

Actually, I'm very excited to see all the different areas of healthcare here. Finland has socialized medical care, so as I learn about each of these places, I'll be updating my blog and sharing my thoughts on their system and how it compares to ours. Stay tuned!

And see, this page doesn't even have a single picture! Proof that this is a serious, studious trip :)

Cinema Club at Sininen Talo

So earlier this week Leena and I were sitting doing some work (me homework, her bills) when she got a "plan" as she likes to call them. She light up and told me that she wanted to start a Cinema Club once a week so we can become more cultured. She was so excited. So yeah, this happened today. It was my Saturday night. We watched classic James Bond with Sean Connery. We ate oatmeal, candy, and drank hot chocolate. It was awesome.

Cheers for the inaugural event for the Cinema Club at Sininen Talo!

Becoming cultured and cracking ice

Disclaimer: Excessive photos of the same stuff over and over again. I just loved every picture so I couldn't choose!

Today our school organized a cultural event for all the exchange students (there are only 16 of us). I was really excited because this is the kind of stuff that I really like. Our morning started by touring the Olavinlinna Castle in Savonlinna. This castle was built in the 1600s and has been in control of the Swedish and Russians. When Finland became independent from Russia in 1917, it was abandoned for a time until it was restored in the 1970s. It was used as mainly a war castle, and it's position on the island in the middle of lakes made it ideal for defense. It was really interesting to see the castle and learn about Scandinavian history. And the castle was so beautiful! Also, it was freezing!

Next we stopped at a museum by the castle to learn about the history of the Savonlinna area. The most important thing I learned is that baby seals will be born in February. Don't worry, I'll be looking for them on the lakes :)

After the museum we took the 30 km drive to Kerimäki, which is home to the world's largest wooden church, built in the late 1800s. The official religion of Finland is Lutheranism. It's only open during the summertime because it's dangerous of course in the winter to light fires in there, so we didn't really expect to be able to go inside. However, the caretaker of the church happened to pull up as we got there so he let us in. It was huge and freezing. But very fascinating. It can hold up to 5,000 people. In that time, they wanted a church big enough to fit most of the congregation in at one time. So, high ceilings and wall to wall benches. Leena told me that on Christmas Eve they hold a service, and each member holds a candle, so they worship by candlelight. I think that must be a sight to see!

After Kerimäki, we took a drive through the countryside, stopping at different places of interest, that were closed. We would drive for 20 minutes, pull up, learn something about it, and then hear "well unfortunately it is closed so..." The best part of the day came last. We pulled up over a ridge that overlooks the Lake Saimaa in Punkaharju (near Savonlinna) in a national forest. We originally stopped to take pictures of the sunset, but we ended up going out onto the frozen lake. We had so much fun making snow angels, taking jumping pictures, and running around. Until we heard a loud crack! That sent us all running for the shore. My heart jumped into my throat! But it didn't crack, just made a few more loud noises. So we were safe!

All in all, it was a beautiful day today in Finland. I'm learning to develop an appreciation for the snow. It makes the whole world so beautiful and clean looking. I love it!