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Sunday 24 August 2014

Final Blog Post...

This is my final blog post for my time here as I am leaving to come home tomorrow.
My decision to come here has been the best one I have ever made in my life. I have genuinely loved every minute of my time here. I have learned such an incredible amount about myself which I did not expect at all. Moreover, I have learned a huge amount about mental health and the nursing profession. Seeing this from a different perspective has allowed me to question, reflect and appreciate contemporary nursing practice.

As this is my final post, I wanted to share something that I have been thinking a lot abut during my time here...

From the moment I applied to do a mental health nursing degree I have been asked the question “why mental health?” from family, friends, associates, lecturers, nurses, mentors and most recently, Swede’s. For some reason, I have always struggled to find an answer in the face of this question. My inability to provide a concise and consistent answer really irritated me and until recently I didn’t know why I struggled with it so much, especially considering my passion for the field. 

My time in Umea, has taught me a huge amount about myself. Having time alone, to truly reflect on each experience professionally or otherwise, has finally equipped me to be able to answer this question. Although it is most certainly not yet concise. I have tens of reasons why I want to do this, but for the purpose of this blog entry I have tried to summarise my most prominent ones.

Reason 1:
Have you ever had a day where you just feel down? … You don’t know why you feel down. There is no reason for it. Your mood simply will not lift – you wish to isolate yourself, you feel lazy, you have no interest in anything. And the next day, you wonder what yesterday was all about and move on. Every second of which, taking your mental health for granted. That “down day” is life for someone with depression.
Have you ever been home alone and think you hear someone/something? You tell yourself it’s nothing. But then you hear another noise and are now uncertain if your anxious mind is playing tricks on you or someone is in your home. Then, you rationalise and know that you’re being ridiculous. That frightening, anxiety provoking small noise is simply a fraction of what someone experiencing auditory hallucinations is like. Furthermore, these noises are rationalised like yours - but are still real.
I used these examples as a way of demonstrating how close each and every one of us is to “madness”. Being mentally unwell is not alien, nor is it that far removed from what we consider “sane”. Now, I am well aware of how complex mental illness is and the cause of each diagnosis has been researched for years, each one differing slightly. However, my point is that becoming mentally unwell is every bit as innocent as becoming physically unwell. Our mental health impacts on every single aspect of our lives: from our appearance, to our relationships, to our ability to eat, to our ability to simply get up and have a wash. This experience has shown me that no matter where you’re from or what your culture we are all human and therefore we all experience the same joys and difficulties. Therefore, reason number one – why not mental health?!

Reason 2:
Because I’m a people person. I’ve always been a people person. Every single school report since I was five years old has said “pleasant girl – chats too much”. I love getting to know people and working with a person. I have been told I am a friendly person and I feel proud of that. I think this had a lot to do with my appreciation for the authentic beauty of mental health. Having a chat with someone, or even better having a laugh with someone is one of life’s greatest simple joys. Therefore, reason number two, put simply, is that I did not want to become a mental health nurse simply to care for and treat people who are mentally unwell, but because I have a passion for the sanctity of mental health and wellbeing.

Reason 3:
Because mental ill-health is grossly misunderstood and under-represented. We as a society in the United Kingdom are living in blissful ignorance of the prevalence and difficulty of mental illness. This ranges from simply not feeling safe to talk about it at our dinner tables or at our pubs to the horrifically stigmatising attitudes of our media and films. Words like “psycho” or “junkie” are still thrown around as something negative, embarrassing or even humorous. It is utterly shameful that these labels and prejudice still own a place in our society.  It has never been easier to find out the truth, we live in a world of social media and instant information. Yet somehow, myths about mental illness are still rife. Furthermore, we tolerate such discriminating and downright appalling labelling of our own people who have simply fallen unwell. We live in a culture of blame where the “alky” is there cause he chose to drink. Where the “psycho” can’t be trusted cause she’s “dangerous”. I feel continuously angered, horrified and heart-broken by this and I know that soo many people feel the same way I do. So, reason number three: If I can do my part, somehow, to change some of these attitudes and be a part of the increasing movements seen by health professionals and mental health charities then I will consider every day worthwhile. A career which I can dedicate to this cause, to take this passion I possess and contribute to a culture of change. That is the career for me.


“Rather, ten times, die in the surf, heralding the way to a new world, than stand idly on the shore.”  -Florence Nightingale.


Reason 4:
Because I’m inspired and ever-challenged by the fact that I will never know it all. In mental health, each and every person is so unique that the job is always interesting and there is constantly more to learn. The thought of being in a career where I will never stop learning is the most motivating prospect I could ever imagine. What’s more is it’s a career where you don’t do something for someone. Instead, if you’re lucky, you get work with people, supporting them and assisting them to get better. In mental health there is no magic fix. There is no easy answer. In order to find an answer you are required to try in partnership with someone to find a solution that is right for them. The very fact that already, certain people have intrusted me with their story and welcomed my input into their lives makes me feel unbelievably privileged. As a mental health nurse I can continue this work and I can’t begin to imagine anything better than that.

Reason 5:
This is my most personal reason. For the last two years, I have tried to deny to myself that my personal circumstances are what got me into this field. But it is impossible to deny such a thing that impacted upon every aspect of my life. My mother’s battle with mental illness not only introduced me to complexity of mental ill health, but gave me direct insight into its plights. What’s more is it taught me from the heart, qualities which now lie at my very core, such as empathy and compassion. It showed me the heart-ache, the anguish and the pain of mental illness. As well as the importance of small and seemingly insignificant victories in an attempt to recover. I also experienced first-hand the impact such ill health has on families, relationships and lifestyles. And most significantly, it taught me to be a skilled and compassionate carer who truly understands and appreciates person-centredness and how centrally important this is.

So there it is. I believe I can now answer this question – provided you allow me thirty minutes or so to explain it! I hope this wasn’t too boring or insignificant for some of my loyal readers.
This experience here in Sweden has been so unbelievably valuable to my development as a young woman and as a young mental health professional. Coming here was without doubt the best decision I have ever made in my life. Thank you for the encouragement and support from lecturers, family and friends. And thank you very much for keeping up with blog. It means a lot. See ye’s in Glesga!

Monday 18 August 2014

End of Week 12...

I now only have one week left in the most beautiful place in the world!

This week I have been working closely with the social work team to understand the work they do here which has been really enjoyable. Their roles and responsibilities are very similar to that of social workers at home. What really impressed me though was the clear and effective communication between social workers and other relevant agencies such as supported living and Försäkringskassan (job centre plus).

I also worked with another nurse continuing with medicine preparation and administration. I also attended a few home visits, one to a supported living for young people which was again, really interesting. We also visited a kind of "youth centre" for young people along with a patient who was interested in their activities. The staff there were really friendly and provided a lot of information about the activities available, most of which were completely free and this is located in the city centre.

I also visited "Teg" which again, is a community based care team but it is set in a very large house in a residential area. Here, they work mainly with people with a diagnosis of a personality disorder. Some of their service-users live in the home for a period of time for consistent support and this is very person-centred, each person has their own bedroom, decorated to their tastes. They also share the responsibility of the running of the house and get involved in outings or group activitites as well as group therapy and individual therapy. This appeared to be very much an "open house" those who had previously lived here and were now well enough to live independently often return to "fika" or for a chat if need be. It was so enjoyable to see such a forward-thinking, recovery-focussed model of care.

I now have only one wee left here and I feel heartbroken about that.

I will post my final blog post next week. 

Julie :)

Monday 11 August 2014

End of Week 11...

I am now at the beginning of week 12 here in Umeå and i really cannot believe how fast it's all going in!!

Last week I spent two days at the methadone clinic here which was a really interesting experience as I have spent time on these clinics in Scotland. What surprised me most was the difference in presentation between the service-users... All of the service-users here have permanent housing, and most of them were in employment. Which is a stark contrast from what I have seen in Glasgow, where the majority of the service-users have come from or are still living in relative poverty.
However, unlike in Glasgow, the service here in Umeå does not offer a needle exchange programme nor does it operate Naloxone training or give out Naloxone kits. However the principles and aims of the programme were very similar to home as well as the terms of commitment to the programme. I believe needle exchange programmes do operate in some of the bigger city's such as Stockholm.

At the weekend I spent time with some friends, as some of the people I have met here have been finishing up there summer jobs and having a short break before classes begin again.

This week I will be spending a lot of time with one of the social workers on the Rehab team to find out more about their role within mental health care here in Sweden. I will also continue with medicine administration and some home visits.

I am still absolutely loving it here and beginning to panic about how little time I have left!

Julie :) 

Monday 4 August 2014

End of Week 10...

Week 10 in Umeå was another really great one - I completed my last shifts on the in-patient ward for the summer so the remainder of my placement will be on the out-patient unit. I really enjoyed my time on the ward as it was a really unique setting in that we don't really have anything similar at home. I also met some really inspiring patients who were more than happy to tell me more about themselves and in English. I believe the care and treatment of people with substance misuse problems here in Sweden is fantastic and the experience has further motivated my aspirations as an soon to be mental health nurse.  

My friend, Emma also came to Umeå this week to visit me! It was so good to see a good friend after over 2 months. We spent most of our time in the sun and made the most of the lake which is so nearby. I will attach a beautiful photograph I took while there.

I am absolutely loving my time here and the thought of going home in just three weeks is starting to panic me as I could very happily stay on here!

This week I will continue on the out-patient unit and I am spending two days at the methadone clinic which I am really looking forward to. I feel my Swedish language is coming along too, although my own patter isn't yet perfect I am able to understand other's pretty well and can usually follow the general idea of a conversation by listening. 

Again, this entire experience has proven to me first hand the importance of non verbal communication and has shown me not only how important it is to assess this effectively in a service-user, but how imperative it is for me to be aware of my own non-verbal communication as a way of developing my therapeutic relationships.

Only 3 weeks to go so I'm off to enjoy them! hope you like the photo. This truly is the most beautiful place in the world. (in my opinion).

Julie :)



 

Monday 28 July 2014

End of Week 9...

Week 9 in Umeå was another really enjoyable one! I continued with my own patients and was given the responsibility of some more challenging situations which were brilliant learning experiences. The weather here has been absolutely gorgeous, sunny, clear skies and temperatures of up to 32 degrees.

I feel as though my therapeutic relationships with service users are really coming along as well as my relationships with other team members - nurses and MDT members which is making this an even more enjoyable working experience.

I have also been involved in some admin which is done here to ensure patient safety and quality control which has been really interesting. I have picked up some good practice which exists here which I am very keen to bring home with me to Scotland and share with colleagues.

At the weekend I spent time in the sun as well as spending time with a friend who is a psychology student here, which again is a great opportunity to find out more about the Swedish healthcare system in an informal way. 

On Sunday Helena and I went to the beach to go swimming which was amazing! swimming in the sea surrounded by forest and trees. I am continuously getting the chance to do new things and live typically "Swedish".

This week my friend, Emma is coming to visit which I am very excited for. Today we also arranged for me to spend a day next week at the methadone clinic here, I have had short experience of the way this works in Scotland, so again I am interested to compare the two.

Julie :)

Sunday 20 July 2014

End of Week 8....

I have now completed week 8 of 13 here in Umeå and I'm starting to fear the the countdown is on for coming home...

I now feel very settled into my wee life here and really enjoying it. This week at work I continued on the out-patient unit and at the inpatient ward where I continued with medicine administration and building upon therapeutic relationships. I've also spent more time studying both Scottish & Swedish mental health law and comparing these too.

This week I also flew to Stockholm for 24 hours where I met my dad and his partner. Stockholm was amazing - but I experienced a bit of a culture shock, within a culture shock. Stockholm is so busy and vast compared to Umeå. It was so good to see the capital city and all it has to offer. Although I was only there for 24 hours I managed to get a lot done!

On Saturday night I went swimming in the lake as the weather here has continued to be amazing! My father and his partner then came to Umeå and met me here too. It has been great to spend time with family as I have not seen them in such a long time. Although this entire experience is flying in! I cant quite believe I've been here 8 full weeks already!

I've attached a video link for a brilliant video! ... Just like in Scotland, here in Sweden there is a major shortage of nurses. Although, unlike in Scotland, this is because there simply are not enough nurses in Sweden to fill the jobs, as opposed to Scotland where due to lack of money there simply aren't enough nursing positions within the NHS. 
Anyway, the hospital I'm working at is a massive university hospital which meets the needs of the majority of Northern Sweden. The staff on the ortho ward decided to make a promo video to try and get nurses to apply for the jobs they are struggling to fill. I think this video is amazing. It was filmed in the real ortho ward and all the people in it are real staff, even the hospital manager features. The song is in Swedish but the lyrics basically say "we really need nurses, we're a brilliant team, come and work with us please!" Enjoy....

https://www.youtube.com/watch?v=HbDW4He3jUg


Another busy week at work starting tomorrow.

Julie :)  

Sunday 13 July 2014

End of Week 7...

This week on placement I continued working between the out-patient rehab unit and the in-patient ward. I also took part in out-patient medicine administration. This was an interesting experience to compare this service to ones at home. Unlike at home, the healthcare system no longer uses Kardex's or written notes as all record keeping is done one the computer on a shared system. I find this to be a far more efficient method of storing records as everything is on a central system and locating previous notes is incredibly easy.

On Friday afternoon I also had the opportunity to visit a supported accommodation unit. This supported accommodoation was relatively new so everything was of very high spec. Every person's room reflected their personal interests and character. It was very person-centred and really interesting to see.

On Friday night I spent time with Helena as the weather has been so good here! and we went to a bar in the city centre. On Saturday I spent most of the day relaxing and sunbathing and on Saturday night I visited the lake again.

Week 8 begins tomorrow and this week I am going to visit Stockholm!

Julie :)


Sunday 6 July 2014

End of week 6...

Last week i continued work on the in-patient substance misuse ward. I am beginning to get the hang of the routine and running of the ward now and I'm continuing with medicine preparation and administration.

I also spent time on the out-patient unit continuing to work with my existing patients and this week I met with a new patient to obtain the service-user's perspective of mental health care here in Sweden. This was a really interesting opportunity to hear about this patients experiences with mental health services: what was good and what was not so good about his experience. I also used this opportunity to find out what nursing skills and approaches this service user felt were necessary to build a therapeutic relationship built upon trust. This gave me further insight into the massive impact we, as mental health professionals can have on a person's life and their recovery.

This week I also booked a short trip to visit Stockholm for one night where I will meet my dad and his partner, which I am really looking forward to.

On Saturday I spent the day enjoying the sun here in Umea as the weather has been gorgeous this weekend. On Saturday night I went to a BBQ by the lake with some people I have met over facebook. It was great to meet new people and socialise.

Today I am spending some time catching up on reading and later this evening I am going for dinner to a new friends house.

Start of a new working week tomorrow!

Julie :)

Tuesday 1 July 2014

End of Week 5...

Week 5 was another brilliant week in Umeå !

I spent more time this week meeting with more patients with my mentor and on my own. I am continuing to work through medicine evaluations with service-users in order to assess the positive effect of their medication and any possible side effects they may be experiencing, whilst measuring their vital signs.
 
I am beginning to build therapeutic relationships with my own patients now which I am really enjoying.

On Friday I spent time with the lead Occupational Therapist at the OT department. This was a really interesting experience. Most of the assessment tools used are very similar to that at home. Most of the duties of the OT’s here involve supporting out-patients, however, within this municipality, there are also OT’s who work with in-patients, and some who work directly with “youths”: people aged 18-25. There is also an OT at the equivalent of the Job Centre.

The occupational health department is an entire department purely for the work of occupational therapists. Within this department is several meeting rooms, as well as a large kitchen, an arts and crafts room and even a woodwork workshop. As well as providing therapeutic activities, this use of space is also a great environment for the occupational therapists to be able to effectively assess service user’s ability to carry out these tasks and level of functioning.


Also this week within the city centre of umeå was the Swedish Beachball Tour. An area of the city centre was turned into a beachball stadium and over the course of the week a tournament took place from 9am-9pm. The weather was nice last week too which made it even better!
 

I am continuing work in the rehab outpatient unit as well as spending morning shifts on the inpatient ward and I’m enjoying the variation!
 

I’ve also enjoyed some really nice cycles this week and managed to get some beautiful photos which I will upload ASAP.

 

Julie J

Sunday 22 June 2014

End of Week 4...

I have now completed week 4 here in Umea

On Monday afternoon, Helena and I visited a community mental health team named “TIPS” which is early intervention for first episode psychosis. This community mental health team are based in a large house in the community. This type of environment seemed to me to be very relaxing and therapeutic and therefore a really interesting use of space. TIPS are often used for various types of therapies including family therapy. The environment was bright and spacious and very “non-clinical”. Most referrals to this team are made by the mental health A&E department as it is crucially important to begin care interventions as soon as possible after first episode psychosis. As it is in a large house, there is also a kitchen which can be used by service-users, garden space, and large sitting rooms for relaxing, as well as other rooms containing space for tables, chairs and flip charts used during therapy. TIPS appeared to be entirely person-centred and recovery-focussed and my visit there was thoroughly worthwhile.

On Tuesday, I spent the day at the mental health A&E department. I spent most of my time with the lead nurse and ward manager, Erik. We spent the day by the phone which is very similar to NHS 24, however, set up specifically for mental health crisis and emergencies. People can also call this line if they simply wish to discuss their concerns with a professional or have a chat. This was a really interesting experience as nothing this specific exists within Scotland, the closest thing is our crisis teams, however, it was really motivating to see mental health and illness dealt with in the exact same way as physical health and illness. This was also a really unique opportunity as I was able to understand more about the process of mental health law here in Sweden as several of the calls we received resulted in communicating with key workers, consultants and the police to ensure the safety of service-users and consequently resulted in the use of “LPT” which is similar to the Mental Health (Care and Treatment) (Scotland) Act.

On Wednesday morning I spent time on the in-patient ward. This in-patient ward is for the care and treatment of people who are addicted to drugs and/or alcohol. As previously mentioned, drug and alcohol addiction are included in Swedish mental health law and therefore in-patient treatment for these illnesses within the mental health care sector are the norm. On the ward I was able to participate in the medicine round including morning meds and vitamin B12 injections. All record keeping here is done on a computer system, including drug Kardex’s. Which seems like a far more convenient and safe way of keeping records.

Wednesday was a half day for Helena and I as it was my birthday! We finished on the ward at 12pm and had lunch; we then went into town to do a bit of shopping! Helena knitted a beautiful scarf for my birthday and gave me some home-made lavender soap. After shopping, we met another friend, Stina and we went for the best sushi I have ever had in my life! It was delicious!

Later, Helena and I went to the airport to pick up my boyfriend, Gavin, who is here to visit for two weeks. Gav brought with him lots of birthday cards and gifts from my family and friends at home, I felt very lucky!

This weekend here in Sweden has been “Mid-Summer Weekend”. Midsummer celebrates the longest day of the year and it’s a very long-standing tradition here. Traditionally it is a fertility celebration of the animals on the land, it is said that at mid-night on mid-summers eve everything comes to life. I spent mid-summer at Stina’s house with Helena, Gav and Stina’s family. Mid-Summer traditions also include a lot of eating and a lot of drinking! We had a BBQ and tried to some Swedish delicacies including different flavours of pickled herring, which we really enjoyed, and shots of “Schnapps” which is Swedish herbal liquor. There is also a traditional song which is sung before drinking the schnapps, it was so great to see and experience a real Swedish tradition. Stina’s house also has a Sauna, which seems to be pretty standard for the Swede’s. Gav and the men spent time in the sauna before eating. Later on we played “Kubb” which is a traditional Swedish game, where you are divided into two teams; the object of the game is to knock over the other team’s wooden blocks, using a wooden baton. By this point, everyone had had a few drinks too so there was a lot of laughs during this and we really enjoyed it! It is also a mid-summer tradition for girls to wear flowers in their hair, and at midnight on mid-summer ever, she is to give the flowers to her one true love, and this will secure their love forever. Helena made me my very own flower arrangement for my hair which I will attach a photograph of. We also had a “may-pole” which is put up for mid-summer and traditional is danced around to celebrate the fertility and “coming alive” of the wildlife and animals. We did not do the dancing around the pole, but it was great to see how this tradition is done. On Saturday we had a pretty lazy day, all exhausted from Fridays celebrations. Mid-summer was without doubt the best day I have had here in Sweden so far!

On Saturday night Gav and I enjoyed a good cycle along the river, I’ll attach a short video.

Beginning of a new working week tomorrow. Will update as and when. Apologies this entry was so long, but it was quite an eventful week!

Photos attached. Julie :)






Sunday 15 June 2014

End of Week 3...


I am now at the end of my third week here in Umeå...

I've had another busy, but brilliant week. On placement this week I began my first appointments with my own patients. It was great to finally get started on this and book future appointments. This is the first time, in a community setting I have had the opportunity to build my own therapeutic relationships which is something I'm really looking forward to. My own patients are happy to communicate with me in English, some of my mentor's patients aren't so confident in this. However, I have also found this to be very valuable: as I am unable to understand their verbal communication, and them mine, I have appreciated this to be a truly unique opportunity in which to build upon my non-verbal communication skills. Not only am I able to authentically assess the service-user's non verbal communication, but I too am able to assess my own non-verbal communication and how this reflects my attitude, skills and practice to the service-user. I have to constantly mindful of my own non-verbal communication to ensure I am reflecting myself well as a mental health practitioner.

I also spent a morning this week on the in-patient ward. As this is where the majority of my experience has been in Scotland, this was a fantastic opportunity to compare practice between the two country's. I only got a snapshot at some of the work done here, but as the weeks continue I will be spending more time on this unit. 

I also had my first visitor from home this week - my lecturer, Lesley. It was really good to see a familiar face and spend time with her on practice. Picture to follow!

Yesterday, Helena took me with her and her friends to a summer party BBQ. Here I met a lot more Swedish people. Helena's friend gave me a tour of her house, which was very unique and typically "Swedish". Out in the middle of no where with plenty of land and loads of space. The homes here are generally a lot bigger than at home, and more open planned. Having green space around your home seems to be important to the Swede's and seems like such a brilliant way to live. Being so close to the city yet feeling a million miles away. After the BBQ, they started several party games. I didn't get involved in this as there were so many people there, but it was great to watch and see how family and friends gatherings here are done. Generally speaking it was different from what I'm used to in Glasgow! I will attach a video of one of the games where balls are placed on the grass, and players must cover there faces with just a small hole to look through and be the first to find the balls. 

After this, we went back to another friend of Helena's and drank some wine and enjoyed good conversation. Here we discussed more about the societal differences between Sweden and Scotland and this proved to be really interesting for me! Just small differences, but that would make a difference to our daily lives. 

I have always admired Scandinavia's social and political policy for example higher taxes, fairer society generally by way of education and welfare. While I still believe this to be true, I have learned that social interaction and way of life here is different from what I am used. Last night's conversations reinforced my life-long love for Scotland, and in particular Glasgow as a friendly, inclusive city where often you can truly be yourself, celebrate your success with people and drown your sorrows with them also. I appreciate even more now how friendly a city Glasgow is. 

Anyway, I can feel myself rambling a bit here and don't want to bore my loyal readers! 
Start of another working week tomorrow and the arrival of my second visitor which I am very excited for!
Julie :)









Monday 9 June 2014

Quick update

My plan is to update this blog once a week, but I have been finding I forget some stuff and since today was such a good day, I thought I'd do a quick update in case I leave it out at the weekend...

Today I learned a lot more about the Swedish mental health care system and law. This was mainly positive, some negative and some just different... I will begin with the negative so as to finish of a positive note!

The first major difference is the use of physical restraint. Just as in Scotland, physical restraint is always a very last resort and not something any person or health professional would ever like to be involved in. However, what is different here, than in Scotland, is the use of belts and isolation rooms as a form of restraint. This form of restraint must be approved by a specialized doctor, and as I said, as a very last resort. However, even the thought of this kind of restraint has proved to be distressing to me. A person may be kept in an isolation room, for the safety of themselves or others, for up to 8 hours. After 8 hours, a doctor must review the situation carefully, and if he/she decides this restraint is still necessary, it may be continued for a further 8 hours. As for the use of belts - belts may be used to physically restrain a person - a belt around the torso, and one around each ankle and each wrist. A person may be kept in this restraint for up to 4 hours, and then reviewed by a doctor. As I said, I find the thought of this very distressing and very far removed from restraint procedures in Scotland, of which I have fortunately not yet witnessed.

Now on to the "just different" ... here in Sweden dementia care is not under the umbrella of "mental health" instead it is under the umbrella of "geriatric" or "somatic" care. Therefore, mental health nurses generally do not work in the care of people with dementia. Furthermore, there is no such nursing field here as Learning Disability nursing. Instead, learning disabilities come under mental health. And therefore, the care of people who have a learning disability is the responsibility of mental health nurses. These two seemingly small differences actually change a big part of the role of a mental health nurse between Scotland and Sweden.

And finally, what in my own opinion, is a very positive difference. I have been fortunate enough to work, for only short periods of time on placement, with people who are addicted to substances such as drugs and/or alcohol. What has saddened me, however, has been our society's attitude at times, towards such people. Very negative language is often thrown around with a very little insight of a person's circumstances. Furthermore, what has disappointed me is the fact that addiction does not fall under mental health law. In many ways it is still viewed as "an adult choice" of which I, personally, strongly disagree. Here in Sweden, there is a law named "the Care of Alcohol and Drug Abusers (Special Provisions) Act (LVM)" generally called "LVM" I will include a short description of the development of LVM and a link which concisely and shortly describes the act for anyone who is further interested. I feel this law proves the general reputation of Sweden as a socially inclusive country, one in which it's citizens strive to take care of one another. One in which prejudice does not belong. From speaking with Swedish people both in a professional and a social capacity I have been informed that unfortunately, this culture is changing. Social tolerance and compassion is running low. And therefore I am aware this country is not perfect. I am still in love with Scotland and it's fantastic health care system and mental health care system. However, I believe it is good to learn and take form each other what we can.

LVM:

The Swedish Act on ward for substance abusers in certain cases (LVM). In 1980 a new
Social Service Act passed the Swedish Parliament. This law did not contain any legal
foundation for real compulsory interventions. An important aspect of the act was that individual measures should be based on voluntariness and the right of self-determination (SOU 1981:7, p 7). However, the Parliament expressed a strong wish to elucidate the topic of coercion further, and in 1981 the Social Committee presented a proposal for a new bill (LVM) (SOU 1981:7). This proposal was introduced to the Parliament without any mayor changes (Prop 1981/82:8) and passed the Parliament in December 1981 (Rskr 91). According to this act compulsory placing was permitted for 2 months with an opportunity to prolong the stay for another 2 months under certain circumstances.
During this time it was important to motivate the substance abuser to accept further treatment on a voluntary basis. The conditions for compulsory interventions were attached to different kinds of dangers. Firstly, the health condition of the abuser and other kinds of serious dangers to him-/herself related to certain situations (for example risks of accidents or freezing to death). Secondly, possible risks related to the security of his family. The reason for this last condition was, according to the committee, that family members were not properly protected from domestic violence by the Penal Code. Due to loyalty and fear such cases were rarely reported to the police. Since substance abuse often was an important cause of such violence, the committee at the time found it adequate to regulate these kinds of problem in social law (SOU 1981:7).
In 1987 the Social Committee presented a proposition for a revision of the act (SOU 1987:22) that also lead to an extension of the foundation of compulsory intervention. The committee emphasized that the respect for the client as a person should not result in passivity concerning a previous heavy substance abuse. It could not be accepted that the social workers just waited for a client to change his/her motivation for treatment (op.cit. p 245). The Social Service had a duty to initiate an investigation to make sure that the substance abuser was given proper support and help. The co-operation between the Social Service and the police ought to be intensified. As a result of the committee’s proposals the scope of time for compulsory placing was increased from 2 to 6 months. The reason was to give the substance abuser a realistic foundation to fulfil a long-range treatment program. In section 4 the word “can” was replaced by the word “shall”, meaning that compulsory intervention had to be decided if the criteria of the law were fulfilled. The committee also discussed if the protection of the family should comprise an unborn child (foetus), but concluded that such an interpretation was not to be recommended. One main argument was that this might scare the woman away from contacting the relevant public services and thus decrease the chances to help her by voluntary measures.
The revised act was effectuated the first of January 1989. Even though the respect for individual autonomy and integrity (as formulated in the Social Service Act) was emphasized as the founding principle in the care of substance abusers, the decisive factor of the LVM was the need of help related to substance abuse (Norström & Thunved 2001). The act does not request that voluntary treatment have to be tried (and failed) before compulsory interventions may be effectuated. Related to the health-criteria (serious risk of damaging mental or physical health) the committee had added a “social indication” which emphasized the risk of substance abusers to damage their lives more generally (related to work, education and “normal behaviour”). The reason for doing this was to enable the Social Service to intervene at an earlier stage, especially towards young adults.
More info on this link which is short & easy to read! It's a bit more concise too:
http://www.domstol.se/Funktioner/English/Matters/Compulsory-care/Substance-abusers/

Hope this post was too boring for those of you who are not nurses/mental health professionals.
Julie :)

Sunday 8 June 2014

End of Week 2...

Week 2 here in Umea has been a busy one!

I have had a great week on placement continuing in the rehab clinic.This week I met with more service-users and luckily many of them were happy to communicate in English for me. My mentor, Helena and I planned my next seven weeks at the rehab unit and worked with service-users, booking in future appointments which I will lead myself.. I now have 4 of my very own patients here. Helena also talked me through some of the assessment tools they use here which was really interesting. Most of which is similar to in Scotland. 

On Tuesday I met with my clinical supervisor, Genny. Genny took me to the mental health Accident & Emergency unit in the hospital.. This was a very interesting experience for me. Unlike in Scotland, here in Umea, they have a specialized A&E department here for mental health and a different one for physical health. This means that people get specialized help immediately from health professionals who are trained in mental health. Luckily, Genny was able to arrange for me to spend the day there in a couple of weeks time which I am really looking forward to. I am most interested to see how this affects stigma and discrimination of mental illness which I know a lot of people in Scotland face and if it has a significant impact on internalised self-stigma also. This mental health A&E department has expanded in recent years and is now available in 5 city's in Sweden. From what I have seen so far I believe this is a truly excellent, person-centred model of care.

On Friday night Helena took me to one of her friends house for a BBQ. This was a great opportunity to meet more Swedish people and see what socializing in Sweden was like. After the BBQ we then went to a Social Dancing event! This gave me a great insight into Swedish culture. This happens every Friday night  in a barn, in the middle of nowhere, in Northern Sweden. The dance is from 9pm-1am with a half hour break in the middle. A live band plays, it was really busy with ages ranging from about 18-80! There are quite specific steps which Helena and her friends tried to teach me before we left the BBQ. However, a lot of people put their own style on to the traditional dance. It was an experience that was out with my comfort zone as this is not the type of thing I would usually get involved in. But I really enjoyed the experience and learned a lot more about Swedish culture.

Last night I went out clubbing with some Swedish students which was another great opportunity to meet new people and enjoy new experiences.

The weather this weekend has been absolutely gorgeous! So I have spent the day relaxing and enjoying the sun before another working week begins tomorrow.

I have attached a video of the social dancing 

Julie :) 

Sunday 1 June 2014

End of week 1...

I have now completed week 1 of 13 here in Umea!

I am just about getting the hang of things here... 
Umea is designed as much for cyclists/walkers as it is cars, so I have spent a lot of time this weekend travelling on cycle routes to see where I end up... It only takes 10 minutes to get from where i live into the city centre, so of course, I did a bit of shopping there. There's loads of market stalls in town selling all sorts of stuff, i'm not sure if this is the norm or if it's just in place for summer, or maybe the fact that Umea is European Capital of Culture 2014.

On Friday morning I spent time at the ECT department here in Umea. The procedure here is pretty much exactly the same as in Scotland. However, the procedure is carried out and overseen by specialist nurses! and there are less MD professionals present during the procedure. Again, ALL staff were so friendly and welcoming, often switching from speaking Swedish to English purely for my benefit. The lead nurse spent a lot of time teaching me more about the procedure and explaining everything to me. Just like mental health nurses in Scotland, the mental health nurses here too have an excellent sense of humour! I wonder if its a requirement for the job...
We then enjoyed "Fika" and my working day ended about midday.   

On Friday night I went out with a couple of my room mates, (luckily i still had one of the bottles of wine i had bought at the liquor store), we met up with two more of their friends and travelled between different student accomodation as there were a lot of party's going on this weekend! It is was great to spend a bit of time with people my own age too. It's quite surreal experiencing the social scene here...

For a start they don't get taxi's places or walk...everyone cycles, which is a but dodgy after a few. But so fun all the same, especially because where I am is the "land of the midnight sun" during the summer so it's pretty much always light! it gets a little dark between 1am-2.30am and then it brightens right up again. I also found it strange to be in the company of so many people form so many different countries yet everyone communicates in English! I was with a Norwegian, a Swede, a German, and later on a guy from France and a guy from Spain... but everyone communicates in English - i find this really impressive and also i feel soooo lucky to have English as my mother tongue.  

Unfortunately, classes here are now finished, which was the reason for all the party's this weekend! ... so most students, including those I met on Friday are all leaving Umea for the summer!
But starting from tomorrow I will begin full weeks of shifts, and the first of my visitors arrives a week today! 

I'm gonna chill out today and catch up on some reading.

I will update as and when!

Thanks, Julie :)
(ALSO, I saw a REALLY massive dog in town and HAD to take a photo!!! seen below.

Wednesday 28 May 2014

Days 1 & 2 - Umea

Days 1 & 2 - Umea

So yesterday was my first full day in Umea... I began the day doing some exploring on foot of the uni campus and the uni hospital and found my route to placement. My sense of direction is TERRIBLE so took some time but got the hang of it now!

I then met one of the lecturers who took me to the medical department's uni library and showed me around which was brilliant! the library is really modern looks like a great place to get some work done.

Then I met Helena - the staff nurse I will mainly be working with and together we drove in her car to the city centre where she helped me get a Swedish SIM card and bus pass. The to a big supermarket, where i got some food, towels (which i stupidly forgot) and there was an H&M there too! so i got a pair of trousers for starting work today.

Helena also had told a colleague i was in the market for bicycle, and he brought one in for me! a great wee bike with two locks! its a bit rusty but has new tires and a new saddle and works perfectly well! (picture to follow) he's allowed me to borrow it for the duration of my stay and i've not been charged a thing!


Today.....

Today was my first day in the Psychiatric Rehab unit. I started my day with two MDT meetings and was introduced to all of the staff in the area. Luckily, Helena speaks perfect English and translated most of this meeting for me. The meeting also gave me a short insight into the way the healthcare system, and particularly the psychiatric care system is run. After the meetings everyone sat together and had a chat and some coffee and even some cake! in Sweden they call this"Fika" pronounced "feeka" the literal meaning is break...but it means much more than that to the Swedes...to "fika" is to spend time with one another, to feel comfortable and chat, to stop worrying for a short time and have a refreshment, it seems like a very comforting, nurturing thing and my impression is that it is important to them.

After the MDT and our Fika, Helena then took me on a tour of the psychiatric unit within the hospital. The ward layouts are similar to in Scotland. I also got to meet the ward manager of the ECT unit and arranged to spend Friday morning this week there to experience it in Sweden.

Next, I went another nurse, Camilla on a home visit to one of her patients. This is when it hit me just how different the lifestyle is here...

Firstly, all staff in this unit just where casual clothes, even jeans are fine! When it was time for Camilla and I's appointment with this patient, we cycled to the patients house!! cycled in the sun a short distance away..and got to spend over an hour with the patient. Again this had to be translated for me after it finished, but everything seemed so person-centred and recovery-focussed it was so motivating and refreshing to see! There were other healthcare professionals there too who are also involved in this individuals care. It is VERY IMPORTANT to the Swede's that you remove your shoes when entering their home...and nurses are no exception to this rule. We arrived and took off our shoes, sat together around a table and drank coffee and had a lengthy discussion...

Today i also got to visit treatment rooms, pharmacy, acute admissions unit and have good conversation with a variety of staff members of varied experience at lunch time. 

Tomorrow is a national holiday here in Sweden so the service is shut. But Helena has given me some great books written in English which I am going to study and look over. Plus i now have my own bike, so Umea is my oyster!

Julie :)

Tuesday 27 May 2014

Day 1 - My welcome to Umeå

27-05-2014.

So I finally arrived in Umeå yesterday about midday! 
Luckily, Susanne, a member of nursing education staff here at the University picked me up from the airport and I receieved a really nice welcome from her. We then drove to the University, through the city which was a great chance to see a bit of the place. Umeå is beautiful and has so much greenspace! When I arrived at the University, I met Chatrin - another key member of nursing education staff. Yet again I was given a very warm welcome and signed a few peices of documentation.

Next, Chatrin and I took a short walk to the International office where I signed my housing contract and colllected my keys. While there I met Jennifer, the "Buddy Programme" co-ordinator. Unlike in Scotland, nursing education finishes for the summer just like the other degree courses. However, Jennifer knew about this and straight away connected me through facebook to some pages for finding bikes, talking to other students, and finding students who will also be in Umeå for the duration of the summer!

Next, I attended the ID photo office where I collected my student card.

Now, for the exciting part! ... I then met my clinical supervisor, Genny and agreed a time to meet up and chat with her. Then Chatrin and I walked through the university to the University hospital and got to the psychiatric unit of the hospital where I met my mentor, Helena. Helena had clearly put a lot of thought into my visit and we discussed what she had planned for me over the next seven weeks whilst I am working with her.

By the sounds of things I am going to be lucky enough to get to experience a wide range of mental health settings and work within an MDT. I also got my uniform - all white scrubs!!!! However, as at home, I will only where this in the ward and not in the community. It sounds as though my first placement will involve a lot of 1-2-1 time with service users and I will get to use my newly found counselling skills in a real environment which is nerve-racking but exciting!

Today I plan to try and buy a bike, which has proven to essential here i think I am the only person without one! and do a bit of exploring around the city. Later this afternoon I am meeting with Chatrin to register at the Uni library, and then I am going into town with Helena who is going to help me get hold of a Swedish SIM card and bus pass. 

Eveyrone has really gone out of their way to make me feel welcome and ensure I have no problems.

Also - my room is lovely, huge big window and plenty of space - internet connection's brilliant too!

Anyway, I'm away out now so i'll update on here as and when! 

Julie :) x