Internship- We meet again!

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As nice as it has been having a more laid back schedule these last 5 weeks, compared to my hectic nursing 50- hours-a-week-on-20-hours-of-sleep thing I’ve had going on the last 2 and a half years, it was so nice to step foot into a hospital again. I think as I go through my program, I get caught up in the work and the stress. I fail to appreciate how incredible I actually am doing and in that, how incredible of work I am doing in my rotations. Not in a baggy I’m doing amazing way, but just the component of the work itself by caring for people.

When I put on my scrubs again, a piece of my soul ignited up and I felt at place for the first time in 6 weeks. At hospitals here in the Netherlands, uniforms are supplied to every staff member and you kind of scan them out each morning. My badge thankfully worked and let me be the first to say, their sizes run suuuuppppeeerrrr large. Scrubs run large in general but these uniforms run even larger. I wear an XS in pants here and an XXS in shirts here: fair warning to any future students. Also, my badge worked wonders for checking them out but not for getting into the locker room so I scurried my way inside to change.

I spent one day on Obstetrics and two days on Cardiology at  Radboud Medical Centre. It is the largest in Nijmegen and they take all of the critical cases. There are some minor, but vital differences that I noticed in my experience here. First off, there is a plentiful amount of doctors available whenever you need one! One to three is stationed per floor which is just unheard of in the United States. As a result, the doctors are responsible for the physical assessment and observations while the nurses here are responsible for med pass and vitals primarily. This was a huge shock for me as I was ready to do head to toe every 4 hours and I did not even listen to a heart or lung sound.

Aside from the physician difference, their general way of operating day to day is different. Everyone works 8 hour shifts and the nurse before your shift pre prepares your patient’s medications for you. Depending on the nurse you are with, they will double check to make sure it is correct but some of them will not which I thought was different. Hand washing is not as common here and they don’t wear gloves for most procedures. They primarily use hand sanitiser and wash the nurse wash their hands *maybe* once a shift.Again, this varied on the nurse I was with but it appeared to be a common practice.  In my two years in the states, I was border line failed and critiqued immediately for not doing either of those things so I kept that practice when I did my rotations to ensure sanitation.

The last difference I noted was the lack of Caesarean sections, which I appreciated! In the United States, mothers are scheduling cesarean sections like they schedule a dentist appointment and that is not always the way to go. I believe in surgery and it is safe but in my practice, most mothers are signing up for it without knowing exactly what it all entails which can be dangerous. Here, they deliver breech, posterior position, and even omphalocele births, which is almost an immediate C-section in the United States. They also don’t deliver within 72 hours of a mothers water breaking and they will wait as long as 7 weeks! I learned that there is apparently is no evidence based practice for delivering immediately when a mother’s water breaks and she can wait to ensure adequate fetal growth as long as there is no infection present. The more you know!

 

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