The Chameleon

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Today was it: the final hours of my BSN are complete. 1000 hours in and it is done. I am in utter shock and disbelief at how quickly it has gone by. Especially my hours here in the Netherlands. Buurtzorg made me a gift basket to say goodbye and all of my clients wished me well. So this final blog written in Nijmegen is for you all.

Now, I can’t list you all by name for your own privacy but I hope you can tell which one you are! Maikel, help them out here.

  • My dear! You have healed so well in the past few weeks and it always made me smile waking you up each morning. You manage to keep your head up, even with everything that has happened in the past two years. You are strong, inspiring, and I wish you well.
  • Beautiful! You may have children that are as old as my parents but your youthful smile hid any sense of age. I wish you and your son well and thank you so much for the chocolate bar. ALS is a difficult disease but I know you will find strength to help your loved ones through it all. But take care of yourself too ūüôā
  • My favourite couple! I adored listening to your stories, even if I heard some of them a couple times. It was such a relief each day having a conversation with you both in English and I know how hard that can be to translate, so thank you. I’m looking forward to sending cards to you and I wish all the best.
  • Oxygen! I swear I was just there to cheer you on, you did it all. I hope your appointment went well and that you can get a portable tank. Your beauty and kind heart made me feel so welcome, and I thank you for that.
  • With the flag in your front yard! I’m sorry we did not get a proper goodbye but I hope you receive the results and a treatment. You reminded me of my grandfather and I enjoyed the laughter you brought, even in some rocky times.

To my preceptor who deemed me the Chameleon, that is exactly why I included two pictures. I swear that’s still me in both! Your jokes and flexibility made me feel at ease in internship. You believed in me and allowed me to take care of my own clients after the first week and even though I didn’t think I was ready, you somehow knew deep down that I was. Thank you for instilling confidence into me and always greeting me with “Hello nurse!”. We are graduating at the same time and I wish you well in the future! Thank you for showing me what home care is holistically and translating Dutch to English for over 250 hours.

To Buurtzorg, thank you for allowing me to do my internship with you. I did not get to work with all of you but each of you were so unique in the way you took care of clients and it all worked well. I’ll make sure to bring the Flag back with me and hang it up! This is Rachel, signing off from the Netherlands. Next stop, America.

American Culture

This is it folks: the final countdown. The last 5 days, 18 hours and 5 minutes (or 5 days and some odd hours, depending on when you are reading this). But who is counting right? As I reflect back on my time here, I wanted to reflect back on what I learned about American culture and what other people think about the American culture. I know this sounds odd, trust me, but you learn two cultures when you go abroad: the host country’s and your own.

From the moment I stepped off that plane, I realised that even though my exterior appearance could pass me off as Dutch, the moment I open my mouth that facade disappears. And people become as interested in me as the lion exhibition at the zoo: “You’re from America?” “Ze komt uit¬†Amerika!”.¬†I can’t type out the way they say it but insert some fun jazz hands and you are pretty close.

The Dutch, in their nature, are very straight forward and I have found that every initial conversation when I meet someone new is about one of the three following subjects:

  1. Trump
  2. Obamacare
  3. Their travels/family travels to America

Typically if it begins with either of the first two, they always bring up both. This made me realise how little Americans talk about politics in public. It is always a “hush hush” conversation and is reserved for people who know you best. That went out the window here and I’ve talked more about politics here than I¬†ever did back home.

Once that person and I got past those unavoidable topics, we got to talk about how I’m doing here, what I think of the Dutch, what they think of America and so much more. It was eye opening to learn about their perception of my country and to hear how they learned it. ¬†Through these conversations and my courses, I feel like I am ready to answer the semester long question of:¬†What is the American culture?

I’ve realised that America is one big boiling pot of cultures. There is not any single “one culture fits all” that I can use to define everyone. The country is just too large with too many people that one over sweeping statement is simply not possible. With all of this being said, I learned that while there is no one culture, there is some common practices:

  • Bigger and more! Whether this be food portions, trucks, houses, we have this perception that the more we have of something, the better¬†it is perceived to be.
  • Customer service oriented. Whenever we shop somewhere or eat out, we feel this sense of “the customer is always right, even when they are not”. This means¬†that every action is important from the business side so we smile and consistently ask if we can get them anything or do anything better. The reasons can be debated all day (wages, competition) but compared to the Netherlands, this is¬†different.
  • Fast food. We thrive off of it. When I was asked what typical American foods are, I thought of fatty, fast and easily accessible meals first before I thought of anything homemade.
  • Hollywood and media. Popular social outings and conversation topics revolve around “this actor is starring in this movie” or “this artist just released this new song, have you heard it”? The world also listens and watches to what American’s produce so this isn’t anything uncommon but I now realise how integral it is to our culture.

These are just a few of the “ah-ha!” moments I had about what it means to be American. We are such a large country with so many ideas and people that, despite the frustration and complications this brings, is unlike anything else and is truly¬†remarkable. The Dutch grow up only with the Dutch. The French, only with the French and this goes on and on. We are integrated with cultures and viewpoints from all over the world and that is something incredible.

 

The Art of Nursing

“Nursing is caring and caring is nursing” by some author in a textbook from my first semester of nursing school. To all of my classmates, do you remember reading this single phrase over¬†60 times in the same book? In my eyes, it was the first moment we all bonded as a cohort and it was over something so simple. As graduation gets closer and more realistic, I can’t help but reflect back on¬†this and how true that statement has come to be.

As mentioned, I am in¬†a home health clinical and in this, I do not get to do as many hardcore “nursing skills”. In this, I mean the things that makes nursing look freaking awesome. The IV’s, the catheters, blood draws, critically thinking in the moment to save someones life: the things that have been drilled into my head and the things that make me feel, well, awesome when I get to do them. Home health, especially home health in a different country, isn’t focused on those skills. People aren’t always in a state of crisis as they are in hospitals and things kind of slow down.

This is not to say that home health isn’t important. But as a soon to be young, new graduate nurse who’s passion is critical care, the diseases and high intensity environment is what I’ve grown to love. And that is¬†one of the core reasons I chose to do this study abroad: to challenge myself to get back to the art of nursing.

Nursing is caring and caring is nursing. Nursing is all about caring for other people in all different walks of life. While those hardcore nursing skills are incredible to perform, I feel like it’s easy to forget how impactful smaller moments mean. How much it could mean to hold someone’s hand when they can’t remember who they are. How comforting a small foot rub is when putting on their socks. How soothing kind words can be when their loved one is going through hard times. How much joy can be brought by washing their hair and making them feel beautiful. It’s in the showers, helping someone getting dressed and¬†letting them know that you are there for them whenever they need you that means the most.

Caring is in both the small and big moments and in home health, you get a lot of opportunities to make the smallest moments seem enormous. You¬†are invited to enter someone’s safe haven and I think that, in it of itself, is beautiful. So thank you Buurtzorg, for reminding me¬†of the art of nursing and showing me how to make every moment feel meaningful for my clients.

My daily routine

It is official: I am officially on the three week countdown of my study abroad experience. As it gets closer, my schedule gets busier as I move through¬†the final 200 hours of my clinical requirement. This, along with lack of time to do as many adventures, has made it harder to write a blog every two days so I’ll be writing every 3-4 days from here on.

This part of the study abroad trip was the part I couldn’t stop¬†asking more about so I am going to tell what my days typically look like!

0700- Wake up call. I bike everywhere to my clients and I like to start off the day with a nice breakfast. I say nice, but its a rotation between oatmeal, eggs, and bread with nutella, depending on if I actually wake up at 7.

0800- 1130- Client visitation. I am not taking care of my own clients and it ranges from 5-7 per day. For the first week and a half I was with this home health agency, I went around with my preceptor. He observed the client’s that I clicked with and we formed the schedule from there. Most of them have some English speaking capacity but some of them don’t and they still like me to care for them. Guess I make funny enough of faces haha!

1130- Back to the main office for charting. At my location, the nurses document on an iPad and have their own access code. Because of limited resources, I do not get my own so I go back to the office and chart on the computer. Translator app at the ready, I type out my report on each client in Dutch and then ask a coworker to correct the sentence structure

1300-1400- End of the day with clinicals! 2-3 days of the week I also work the evening shift in addition to the morning one and that goes from 1800-2200. I enjoy taking this one because it allows me to work with other nurses and see more clients other than the ones I see in the day.

The rest of the evening is spent making dinner, showering and writing up these blogs! I have been studying for my boards here and there and have set the plan to travel somewhere on the weekends within the Netherlands. Most recently I went to Keukenhof and Amsterdam so stay tuned for next week’s adventure!

Living History

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All throughout school, students are taught about the world wars. In particular, World War II is talked about the most for many reasons. Millions of people lost their lives, ground breaking machinery and weapons were invented and it tore the world in two. I was taught all about the war but my patient summed this up the best: I was never taught how it felt. I was never told about how it felt to have your entire city blown up or how it felt going 5 years without a decent meal.

Pictured here is Kranenburg, Germany. I biked to this town this past Sunday and today I visited a town called Kleve. Both of these cities contain so much history in such a small space. There are still remnants of the war, stories being told and burial sites with soldiers from all over the world. There were bombs dropped, parachuters entering and lives lost and created.

I’m hopping on my soap box here but I feel like as much as America was impacted in the war, it does not compare to what was felt in Europe. Troops never marched our shores, overnight aerial bombings did not occur nearly as often and we didn’t have to bury our tin and metals so the Germans wouldn’t get them. I’m not undermining at all what America lost and gave but it was mind-blowing to see the long term impacts on the other side of the globe.

One of my favourite parts of doing home health rotations here is meeting people who lived through it. There is a couple, born in 1935 and 1936, who grew up post World War I and lived through all of World War II. The Netherlands is the border country to Germany and at one point, the country blew up their connecting bridge to stop the brigade. This couple met and fell in love in a time of turmoil. They still wanted to raise children¬†after seeing how¬†dark the world can be. I look forward to many more stories with them and absorbing as much as I can.¬†It’s all about perspective and walking around in a living history book is one of the best ways to gain a new view.

 

Money Management Abroad: Budgeting

The biggest factor for many students in general is money. How am I going to pay for this, how am I going to pay for that and overall, how much is it going to cost? This is especially true when you are fortunate enough to study abroad because costs skyrocket. You now have a flight, living, food, and other things to account for¬†that are bound to pop up, especially if you have never been to that country. It causes a lot of stress and while I am not perfect with this, I’d like to think I learned a few things.

Step One:¬†Budget before you commit. Studying abroad can be impeccably expensive. You had the round trip international flight, rent, food, traveling and that’s all before you even step foot to depart. You had application fees, international insurance and it all adds up, very quickly. Look at the estimated cost you are given and¬†see if it is something that you can make work before clicking accept.

Step Two: Plan it out. For myself personally, I was extremely fortunate enough to receive scholarship, grants and early graduation gifts which paid for my entire study abroad trip. I applied for international ones, nursing ones and received enough to fund it. Once I knew the money would be there, I went ahead and started planning how to divide it and here is what it looks like:

Flight: $1300

Rent: $1200 (400 per month times 3)

Linen/Cooking Package: $110

Food: $600

Personal expenses (including travel): $750

Your study abroad typically pre-arranges living situations for you so that is easy to calculate out. Food is very individualistic and for me, I knew I could survive happily off of $50 each week. The packages ordered were arranged by my housing unit and saved me from bringing my own linen/cooking supplies. Personal expenses varies but I utilised this as my travel budget while here.

Step Three:¬†The¬†unaccounted for. My budget above looks all nice and good and let me be the first to say, none of it went to plan. There were way more costs that I didn’t calculate for and hopefully you can learn from my mistakes.

We flew into the Amsterdam airport. I did not even think about the cost of the train from Amsterdam to my city so that was another $25.¬†I didn’t calculate out the rent in euros, I did it in USD so that was an extra $80 extra dollars. I didn’t calculate for foreign transaction fees because I thought my card was the right one so that is another $60. My internet was solely ethernet based and my computer doesn’t have an ethernet cord, another $80 for the conversion piece and phone bill I racked up. Finally, once I add in all the things I forgot to pack (which is a whole different story), I spent about $300 extra that I did not account for with the help of my “oops” budget.

Things are going to pop up while traveling.¬†You often end up accruing these¬†unexpected expenses the first day you arrive so make sure you have an “oops” budget. Traveling is all about embracing the unknown and learning about yourself. You are bound to forget something or have something pop up so ensure you have that barrier so you aren’t fretting the entire trip.