"News from ETSU Students and Faculty in Northern Ireland and Italy"

Week of February 28^th

            Wow, this week has been a whirlwind.  After having two days of snow last week, I am now sitting in my room looking out on the aftermath of snow yet another time, but in much larger amounts.  We received about 1ft. of snow yesterday and well into the evening.  Rebecca and I had a free day, so we accomplished a lot of homework and then, along with my building of residents, enjoyed dinner in our community kitchen and then continued the festivities outside with an all out “guerra” (war) in the snow.  We built part of a snowman and in igloo out of snowballs with a lit candle inside.  We had an incredible time!  I also found “un ristorante messicano,” last Saturday, so the international students in my building and Rebecca and I went out for dinner.  It was so good to have guacamole! J

            At any rate, I will fill you in on our experiences in the hospital this week.  On Monday, we began our rounds at San Antonio Ospedale (hospital) which is only a few more minutes walk from the Policlinico Ospedale where we originally toured at the beginning of our stay.  We are assigned to observe the 7^th floor which is the geriatric ward.  Here in Italy, the practice is evolving slowly, so the elderly here are very used to this practice I am about to mention, but I found it quite odd and frankly would be embarrassing in our culture.  When touring the floor, the Caposala (head nurse), Graziella, led us around to the patient’s rooms, and in particular, we were able to observe an admission skin assessment on a diabetic patient.  Usually in an American hospital, the usual practice would be to pull a shade and to have some privacy to the other, individuals when sharing a room with other patients.  Here in Italy, however, there are no privacy curtains, and in most cases, there are 6 patients to a room, some housing only two, depending on the patient’s state.  When the patient was being inspected for ulcers, they are exposed to everyone else in the room.  We saw this as quite strange, but the patients almost would be offended if they didn’t have this because they are so used to being directly involved with each other in the hospital, that it makes for a sort of community especially in the geriatric ward.  In fact, on Tuesday, I was with the nurse while she gave medicines, and I watched one patient who was able to walk and in pretty good health, feed another patient on the other side of the room who was virtually immobile probably due to a stroke or some other illness.  This form of community was very comforting to see, showing a true caring side of humanity.  We also were able to view the doctors doing rounds on the patients which was interesting to see because it reminded me much of the rounds at home.  The relationships that the nurses have with the doctors are much the same here as at home, depending on the location.  Some joke with each other, and others don’t have a very good relationship, usually depending on the personality of one of the two individuals. 

            Personally, I have learned so much Italian and am very excited that I can now understand when someone else is speaking and carry on a full conversation with someone in Italian.  This makes for an easier time here better communication between us and the staff and professors and tutors (clinical instructors).  The time with the professors has been very enlightening and we have been made to feel very comfortable after all of the adjustment bumps were smoothed out.  We have the opportunity next week to visit the psych ward and the operating room to see what management is like and I am very excited about this.  As well, we are going to be meeting with the international nursing students that have just arrived to have an informational international discussion/focus group to learn more from them about their programs.

            We are presently getting ready to go skiing tomorrow for free!!  We only have to pay to rent snowboards, so I am very excited about this opportunity.  We are staying in a friend’s parents’ condo and will be able to snowboard for two days and also enjoy the beauty of the mountains and take lots and lots of pictures.  Above all else, I am having a fabulous time, and things just get better and better the longer we are here because we are more used to the schedule and such.  Next week we are going to Milan on Friday and then to Venice again so that we can experience the sights and sounds of Venice without the hectic ness of carnevale, which was wonderful, but quite a lively and fly-by view of Venice.  I am very thankful for this opportunity and can’t wait to share more with you. 

Sarah and Rebecca

The Derry Five

 Judy McCook has safely returned from her rendezvous in Ireland. Before leaving Ireland, the students finally got her into a pub. By the way, they’re drinking coke!

Pictured left to right: Aaron Bates (ETSU), Fawn Brown (Hampton), Anne Gifford (Otterbein), Judy McCook (ETSU) and Martina Rawlings (Hampton).

Thus far, I have experienced much more of the culture and have been able to engage with students on more occasions.  This week consisted of more home health visits with a little snow coming our way.  Previously, though, to the home health, we were able to visit Rome as a weekend trip.  Becky and I visited the Coliseum as well as Vatican City which were both very interesting sites.  I had never realized the full history of the Coliseum, and it was quite intriguing to have my knowledge expanded.  At Vatican City, the experience was very meaningful to me, so my faith is very important to me. I am, as you know, not Catholic, but value the history and reverence of Catholicism and was able to experience much of the Bible coming alive in the walls of St. Peter’s Basilica.  I also toured the art museum of artifacts that have been recovered and donated to the church as historical symbols, some of which actually used to be displayed in the church.   I very much enjoyed this, and hope to learn more about Vatican City with the book that I bought. 

On more of a nursing note, I participated in more home health this week, which consisted of visiting homes with the home health nurses, called infermieristica domicialare.  I have enjoyed, profusely, the opportunity to do these visits, and cannot wait to be able to experience this type of work in the future.  Currently, I do home health in Johnson City, but would like to make more of a practice of working with the elderly (ananziani, in Italian) as well as with new mothers and their infants.  The juxtaposition of the very old with the very young is very interesting to me and I would love to study more about this. Next week begins our experience at the hospital, so  I  should be able to tell you more about the conditions and institutional clinical experience next week.  Thank you for your time, and have a great week!

            In His Grip, Sarah Randolph

 

From: Aaron Bates

Sent: Wednesday, February 23, 2005 2:45 PM
Subject: week four summary

week four

Last week we were placed on Ward 22, stroke unit, at Altnagelvin Hospital. I was amazed by how long some of the patients had been there. A few of them were admitted in November. It just does not happen the way at home, they are trying to get patients discharged as quickly as possible. The clients stay on the floor and are taken down to the day hospital for rehabilitation, instead of being admitted to a rehab center.
 

The first day we were there, they were two out of four nurses understaffed. Needless to say, it was very hectic. The ward sister, clinical leader, and another nurse divide up the 16 patients. Anne and I had the opportunity to jump in and help by assisting with feedings and bed making. You would not believe how much they appreciated us. The next two days were much better. We were able to ask lots of questions with regards to socialized healthcare system. We followed a patient down for a C.T. scan and were amazed by how long the actual scan took. I have see loads of C.T.'s working in the ED and the scan may take a minute. The great thing was there were two doctors in the control room reading the results on the spot. By the time patient transport arrived they
had already written the report and gave it to him to take back with the patient. This process can take forever in the States.

On Thursday we four nursing students hired a car for the weekend. I finally got a chance to see some of the beautiful country-side I have heard so much about. Driving on the other side of the road wasn't as bad as I had anticipated, good thing they gave us an automatic! The first day we drove the North Antrim coast road and made several stops at castle ruins and touristy things. County Donegal in the Republic was our next stop followed by Galway, my most favorite place on earth. Sunday we tried to visit Newgrange, an ancient burial mound, but we arrived too late for the last tour. It's a good thing Dr. McCook had the opportunity to go so I can at least see pictures of it.

 

WEEK # 3

This week we spent two days at Edenballymore Nursing Home and one at the Seven Oaks Day Center.  On Tuesday at ENH we met Oonagh Carson’s sister Catherine, she is the Matron.  We also met one of the two Lieutenant Nurses.  They have three nurses on during the days, including the Matron, and two at night.  Six or seven carers assist with the residents ADLs and help during feedings. The facility has 44 beds and 40 are presently occupied. 

We sat in on the a.m. report and had a Q&A session with Mrs. Carson that afternoon, it was very informative.  The experience was very similar to my placement at NHC off of Bristol Hwy.  The residents were elated to have us there for a couple of days.  I was able to have many wonderful conversations and to hear countless amazing stories.  Anne and I observed Mass for Ash Wednesday, sang songs, and played Bingo all in the same day. It was uplifting to hear them singing in their native tongue.

M.L., a resident, is 100 years old and was a nurse from the time she was 19 until she was 71.  You can only imagine some of her stories about the World Wars and how nursing has changed over the years.  She worked in Scotland after receiving her midwifery training, and came back to Ireland to run a nursing home for many years here in Derry.  I was reviewing her chart and noticed her religion was Baptist.  She informed me that only 1% of the people in Northern Ireland were Baptist.  We have a church date this Sunday!  I cannot wait to hear some more of her stories.

The Seven Oaks Day Center is open seven days a week and allows the clients to come from 1015 to 1515.  The clients are all Alzheimer or dementia patients.  They have 43 in the books and 15-18 are there at a time.  The Tuesday- Thursday group is composed of mostly early stage dementia patients, but some of the more advanced attend everyday. The organization allows social interaction, as well as, some respite care for family members.  I was very surprised that the manager was not a nurse but a level 3 carer.  The employees must be registered carers and they prefer at least level 2.  I am still working on the difference between the levels.  I know the level 3 is the equivalent of an Associates Degree.

The day we were there, they had a bus ride organized for two hours.  I was so glad to get to see some of the countryside.  Michael, one of the carers, drove us up to Grianan of Aileach on top of a very large hill.  Grianan is a large circular fort that dates back to B.C. times.  We had an astonishing panoramic view of Laugh Swilly and Inch Island.  We had the opportunity to chat with a pleasant 73 yr old gentleman whose memory was only slightly impaired.  He told us all about growing up on a farm near the DuPont Factory and raising his own family. 

This weekend I was invited to a cup match for a local football (soccer) team by one of the carers at Edenballymore.  Kevin, also a local musician, is taking me to a pickin’ session after the match.  Should be a real good time or as they say here” it’ll be good craic.” 

Aaron Bates

Hey, how is everything in the States. Things could not be any better
here! Well, maybe the weather. Derry reminds me of the weather in Seattle;
it does not rain hard just a frequent fine mist. The people definitely make
up for the weather though. Almost everyone we have had the opportunity to
meet has been extremely friendly and very helpful. We have gotten settled in
and the accommodations are even better than I had expected. I finally have
the town down pat and am ready to start venturing out of it. I believe a
few of us will be traveling to Belfast this weekend.

Sunday there was a peace march for the events that occurred on Bloody
Sunday, 32 years ago from Sunday's date. It was a very interesting
experience, but terribly sad at the same time. If you guys aren't familiar
with the situation, 13 "innocent" protesters were killed by British soldiers
during a Civil Rights march that end at the Bogside (an area in Derry).
After the march they read a list of names in remembrance of all those who
have been killed by the British; it was about 30 in all. Several family
members had the opportunity to speak, and a man from Palestine closed the
session. He was comparing what happened here to events that occurred in
Palestine in 1998. There is a monument in the Bogside that reads "You are
now entering, Free Derry", and they added the colors from the Palestinian
flag to it.

We have been paired up and have gone on three placements thus far. The
other students are great, and we all seem to be very compatible. The first
day we (myself and Anne from Otterbein) were placed at the University of the
Third Age (U3A). It is a program started by Pascal McDonnald some twenty
years ago. I had the opportunity to talk with him over a cup of tea. The
program is for adults over 50, but the majority of them were in their 60's
and 70'S. It is like a social club that offers classes such as language,
calligraphy, potting, instruments, computers, and even yoga and exercise.
Anne and I were able to participate and speak with the members. The members
pay a 30£ (about $55) fee per year and each class they chose to participate
in cost a set fee between 30-60£. The classes last around 10 weeks and are
taught by outside people. The program is to help keep cognitive functions
acute by stimulation and learning new things.

The second placement was with George Caldwell who is the clinical
leader of a Community Health Team. His team is divided into a functional
mental health team (stress, anxiety, depression, etc.) and a team
specifically for dementia. They only recently split and we could notice some
static when he was describing the reasons for the division. Northern Ireland
is divided into four subgroups for healthcare; north, south, east, and west.
The Foyle Trust and Social Services Trust are the main entities responsible
for allocating funds to community service organizations here in the western
quadrant. Each community mental health team is comprised of 4 mental health
nurses, 1 social worker, 2 nurse's assistants, consult psychiatrist,
psychologist, and an occupational therapist. They go to patients houses to
provide a wide based specialty service to those over the age of 65, who are
suffering from mental illness. The service includes a multi-discipline
assessment and treatment is specifically tailored based on the physical,
social, and psychological needs of each individual. The Community Mental
Health Team offers therapeutic interventions and team members have a broad
base of core skills; such as counseling, anxiety management, grief
management, and cognitive work. The C.M.H.T. is a secondary service and can
only accept those who are referred by a General Practitioner.

For our third placement, Anne and I were at the day hospital located
inside Altnegalvin Hospital. The day hospital is an out-patient
rehabilitation service for elderly who have been discharged from
Altnegalvin. We were placed with physical and occupational therapists that
provide this service Tuesdays, Wednesdays, and Fridays. Seven patients
attended the day we were there, but Patsy P.T. informed us their enrollment
was down due to unusual number of patients who have passed over the past few
months. The majority of the patients we were working with have suffered
strokes within the past six months, and one of them has MS. The employees
were great; we got to ask loads of questions.

Liz Mitchell, our mentor, has a brother-in-law who works in the A & E
department (accident and emergency) at Altnegalvin. She has arranged an
extra day for me to go and observe how the ER operates here in Ireland. I
can't wait to go! Sorry it has taken me so long to get in touch and I hope
this is what you were looking for in an e-mail.

Best Wishes,
Aaron
Thursday, February 03, 2005
 

Greetings from Dr. McCook in Ireland

Just want you to know we are having a wonderful time in Derry. The people are the kindest, most enthusiastic and friendliest I have met in my life. It reminds me a bit of my Irish relatives in Brooklyn that I spent each summer with. There are definitely genetic memories tugging at me.

We have explored the walled city of Derry. I have a new digital camera and have figured out how to use it and the photos turned out beautifully and now I need to send you a few photos.

The 4 students I have with me are wonderful. I could not have asked for a better group. Please tell their Deans and faculty they made excellent choices in selecting team players, who adapt well to new situations. They are getting along so well with one another. We spend almost everyday together. They have their placements (clinicals) in pairs. So they are visiting a variety of senior daycares, centers and hospitals.  

The students have individual flats (rooms) with a shared den/kitchen and bath with a couple of showers. There are our 3 girls and Aaron and a guy from France whom they enjoy very much. I have my own ensuite flat (with a bath) in the graduate dorm with a shared kitchen. Several Americans cluster in the graduate suite as well as international students.

We are learning the currency and the language. Even the keyboards for the computers are arranged differently. The Irish drive just as fast as they talk. Not only do they drive on the opposite side of the road, they walk on the left side as well which had us a bit confused. Everyone waves or greets you as you pass. I am going to Belfast tonight to attend a midwifery research day and may stay over for another program on the European union and health. Everyday is different so I don't know where I'll turn up next. Very different behavior for a serious planner. I am trying to just go with the flow and take advantage of all opportunities.

all best

Judy

 Page updated March 7, 2005