From journalism to nursing: a Ukrainian woman's work experience in a Czech hospital
© Photo: socportal.info
Finding herself in the Czech Republic because of the Russian invasion, our colleague Elena Rasenko, who had worked as a journalist for many years, changed her profession dramatically. Now she is an ošetrovatel (ošetrovatel, junior nurse) in a Czech hospital. She wrote about her daily experience and the reasons for her decision in an article for Socialportal.
My colleague says that before a person dies, their cheeks droop, the corners of their lips droop, their skin turns grey and their eyes cloudy. She pointed out to me two patients who she thought were going to die soon, and she was not wrong.
I work in a hospital in a small Czech town, in a department that in Ukraine would be called a general practice department, where patients with various diagnoses are admitted. Young people are less common; more often, they are elderly people who can no longer look after themselves or do it very badly. They are brought in with dizziness, pain in different parts of the body, cancerous tumors, anemia, blood clots, malfunctions of the heart, kidneys, those with liver failure, leg failure, bleeding of internal organs. Sometimes they are patients with dementia or aggression. Our ward is almost always overcrowded, and staff often don't have time for a coffee in the morning hours.
How is my work going
The day shift starts at 6 AM sharp with hygiene. Those who can walk are directed to the shower room. At this time, they are given a complete change of bed linen. Those who are unable to do so are taken to the shower room on special seats or rubbed down with hygienic foam in bed. Their underwear is also changed. In parallel, nurses check the condition of bed sores on the patient's body, change bandages on wounds, apply ointments with special products for swellings and bruises. Or simply rub baby oil into the back to prevent the skin from becoming too dry.
Then comes breakfast, cleaning of tables, and disinfection. We load plates and cups into the dishwasher. We go through the wards, recording data on who drank how much in the morning, keeping a record of the amount of urine collected in special bags with a scale.
It is important to go to the nurse in charge of the ward and report your suspicions if there is a clear discrepancy between these values.
After that, the examinations begin. Some patients are taken for an ultrasound, others for a colonoscopy or gastroscopy, others for an MRI or lung examination. Often it is necessary to carry the analyses selected by the nurses to the laboratory or go up to the blood bank. Bedridden patients are moved to the side or back to avoid more pressure sores.
Around this time, new linen arrives, which needs to be shelved, added to the trolley with which the rounds are conducted and indicated to the charge nurse what is missing from the ward. Disposable diapers, oversized diapers, tooth brushing sticks, and drip solutions usually run out very quickly.
Lunch on the ward is early. As early as half past twelve, it is brought hot from the kitchen. We distribute it and feed those who can't cope on their own. I must say that they don't skimp on portions for patients. There is often meat on the menu, they can always choose protein yoghurt, ask for a supplement or bread. There is always plenty of the latter - sliced black and white flour rolls, as they are called here, "rogliki". Buckwheat, oatmeal, and pearl porridge are not cooked in the hospital, but every day there is soup.
After lunch, cleaning, disinfection, putting dishes in the sink, and then hygiene and discharge. In the latter case, the bed is washed, the bedside table used by the patient is washed, and a clean bed is made. Adjusting the height of the bed. They are all connected to the network, and if necessary, you can raise the patient's head or legs, or even both sides at once.
Next to each bed, there are buttons to call the nursing staff, and some patients frankly abuse this.
These are usually people with memory, personality, and behavioral disorders. They may keep ringing the bell when the nurse is already in the ward. And it happens that such calls come from several wards at once, and it is necessary to respond to all of them, because it is impossible to predict the seriousness of the situation.
Thanks to such calls, we have already caught patients on balconies, lifted from the floor those who had too much faith in their own strength, or nurses started resuscitation of those who were suffocating.
Hospital protocol permits tying the arms or/and legs of patients to beds who might harm themselves by their actions. In my small practice, several patients have had their IV needles ripped out of them, lacerating their veins so that both the beds and the floor near them were covered in blood. Others wanted to get out of the hospital in a state of unconsciousness.
I caught one such patient in the doorway, almost naked, trying to get to Romania. Still others' actions are aggressive. Recently, a nearly ninety-year-old man kicked my colleague in the head when she came to tie his hands. Another colleague barely managed to dodge an almost professional punch in the eye from a sixty-year-old patient.
I confess I have my 'favorites'.
I am very sympathetic to patients who read a lot, who say “thank you” for seemingly nothing, who make jokes, and try to “get back to life”. I like to talk to them. I ask how old they are, where they live, where they used to work, how big their family is, whether they have a cat at home, and whether I can bring them more coffee or tea. They ask me where I'm from, if I have children, a spouse, or parents. Some gratefully hold my hand, and recently, a reclining old man in his eighties said he was in love with my eyes because they reminded him "of life." When I came in a few days later for my shift, he was gone.
Many patients from our department who cannot be helped are sent to another department on the territory of our hospital, where they live out their days. Others are placed in nursing homes by their children. There are many of them in the Czech Republic. Some old people can stay in the hospital for months, waiting for a place to become available in such homes. My colleague from surgery in another city told me that as soon as one of her patients learnt that her daughter had decided not to take her home after the operation, but to register her in a nursing home. She became ill, refused to speak or eat.
And the seemingly good results of the operation were nullified.
I don't know what was going on in the life of one of the patients I was looking after. He was quite rude, not verbal and unwilling to hold a conversation. He came to the ward on his own and was able to look after himself initially. I don't know why, but he was moved to another ward, the only one that overlooked the maternity ward of the hospital. I went to see him one morning and he told me that he had been looking through his windows all night and he thought there was a newborn baby crying. I asked if he had any children, he said no and the only close person he had left was his sister. He "left" a few days later.
I notice how important what patients feel is. And their positive emotions are often the only thing that keeps them alive.
Why healthcare
Today, there are hundreds of adverts on Czech job search websites looking for doctors, nurses, cautery workers, orderlies, bakers - those who are willing and able to care for the elderly in nursing homes.
The Czech Republic has been short of nursing staff for a long time.
The queue to see a narrow specialist can stretch for months, and private clinics that do not work with insurance companies are not affordable for most Czechs. The situation with children's doctors, dentists, allergists, endocrinologists, cardiologists, and psychiatrists is difficult. More than a third of specialists working in the field of health care in the Czech Republic are of retirement or pre-retirement age, and, as the Czech government points out, there will be no one to replace them.
Paradoxically, the interest of young people in medical specialties is consistently high. However, many medical graduates tend to leave the Czech Republic and find better-paid jobs outside the country.
Many of them go to Germany, Austria, Switzerland, where medical jobs pay more.
Nurses and those who are ready to work in the field of care for the elderly also tend to go there, as the problem of staff shortage is also typical for neighbouring European countries.
In total, according to the Czech Statistical Office (ČSÚ), the country is currently short of about six thousand doctors. In addition, 91 per cent of hospitals lack nurses and nursing staff. The situation is a issue for the whole country, but it is particularly acute in the Central Bohemian Region, the Karlovy Vary Region and the Ustec Region.
The Ministry of Health plans to increase the number of medical graduates and to introduce remote medical care — telemedicine as one of the key solutions, as well as to attract doctors from abroad.
Today, about two thousand foreign doctors are already working in the Czech Republic.
Among them there are quite a few Ukrainians and Ukrainian women.
However, in order to get the right to practice medicine in the Czech Republic it is necessary to: nostrils the diploma, learn the Czech language at an advanced/free level, pass an approbation exam consisting of written, practical and oral parts. Regardless of their specialization, foreign doctors undergo a general practice examination, i.e. they pass an examination in all the main areas of medicine: therapy, pediatrics, gynecology, surgery, anaesthesiology. Such a process takes time and a lot of effort.
How training takes place
The shortage of nursing staff in the country, my fatigue from the monotonous work as a night editor of a newswire, the need for movement and new sensations formed the very mixture. This pushed me to the decision to learn the profession of a couch surgeon. It's a nursing assistant. In essence, a nurse who, among other duties, can measure blood sugar, blood pressure, perform simple manipulations with drips, make dressings, assist in the sanitation and treatment of wounds of patients, and perform a lot of other practices.
The training took place in the south of the country in Brno and lasted about 10 months. It included both theoretical part and practical training in local hospitals. We did this in gynecology, surgery, orthopedics, general practice departments and where there are heavy, often dying patients. The practice also included shifts in a nursing home.
Both practice and theory were free for the students, but paid for within the European Union. Non-residents were partially reimbursed for hotel accommodation. No one demanded that we work in our specialty after the course, but they emphasized in every possible way that the Czech Republic was experiencing a severe shortage of nursing staff and extra hands were very much needed.
In my student group were all Ukrainians from different regions of our country.
Four of them were doctors and the rest were people far from medicine, just like me. We all successfully passed the final exam and received certificates allowing us to work throughout the European Union.
I will not lie and confess — it was hard for me when I went to work. The main problem was the lack of vocabulary.
Some of my colleagues were hostile to me, suspecting that I had "infiltrated" the team in order to write a “nasty” article about them.
In addition, the actual work responsibilities were much broader than what we - far from medicine - had been told in lectures. The big challenge was the 12-hour shifts. For the first few days I was literally picking myself to pieces, feeling pain in almost every joint, but because of the constant movement I lost weight and the swelling in my legs, which had developed over the years of sedentary work, was greatly reduced.
Am I satisfied? I don't know. But for the first time in a long time, I like what I'm doing. I have also realized that it is never too late to try doing something new.
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