Ward managers - do they need qualifications or training?

Today I would like to introduce you to another participant in my intensive course this week.

My name is Cora, I'm a nurse and nursing teacher and I'm working currently at the Department of Continuing Education in a little hospital in the south of Germany. I'm responsible for the ward manager course, which has 720 hours and lasts about 16 weeks.
Times are changing very fast and the conditions in our health care system, too. For future ward managers the tension between economics (controlling costs) and ethics (e.g. sufficient conditions for the staff, satisfactory conditions for patients to get better again etc.) will get worse. I need to adapt the course to these changes and I'm thinking about the difference between the two words qualifying (Qualifizieren) and education or training (Bildung). Does a qualification (in terms of getting tools, like how to write a duty roster or knowledge of labour law etc.) covers sufficiently the daily requirements of a future ward manager or do they need more "training" in terms of developing their own personality. I think it`s not sufficiently enough to put, for example, conflict management in the timetable without other skills like networking, coaching (and being coached) or willingness to learn.
The ability to reflect on oneself while exchanging in an intensive way with other ward managers or deputy ward managers will maybe be one of the "key competences" to react properly to the (sometimes daily) changes taking place in hospitals and nursing homes. But the training of these soft skills is more difficult, needs more time and is more expensive; the current timetable and conditions surrounding the training program are very limited, so this will be my personal challenge: finding a balance between economics and ethics to find a good way to train future ward managers who can stand the daily demands for longer than just a few years.

Two more nurses on the way to London

This week I am teaching a 5-day intensive course in Nursing English in Frankfurt. There are 7 nurses in the group, two of them are planning to start work in London this spring. I will let them introduce themselves to you.


Hi, our names are Bianca and Franziska. At the moment we're working in a hospital in east germany on an IMC (Intermediate Care) and ICU ward. Since August 2009 we have planned to go to England. We read an article in a special newspaper for nurses and there we found out that there`s an agency who supports nurses who want to go to Great Britain. We gave a phone call to the agency and the contact there sent us some information about that.
In January 2010 we had an appointment for two interviews in London. We were very excited when we travelled to London because we didn`t know what they expected from us in the interviews. They were very nice to us and tried to take away our fears. But that didn't work very well because we were absolutely nervous. One day later our agent called us and congratulated us on our new posts in England. We were very suprised and happy that our dream of going to England will come true. And now we`re planning the move to London. Keep your fingers crossed for us.

English*Practice*Reflection in Frankfurt

For a number of years a group of nurses in the Rhein-Main area who participated in one of my Nursing English courses at some point have met to continue to speak English, discuss nursing topics, and share experiences. The group meets once a month in a session called "English*Practice*Reflection". The name of this meeting means that we practice English, and that we reflect on nursing practice. We want to use this blog to introduce you to the members of this group and to give them a chance to get more experience in writing English for a larger audience.

Let me introduce you to Doris:

I have participated in medical English courses more than 20 years. It started out with a weekend course, when I was working at a paediatric practice. At school I learned English in an old-fashioned way, and what we learned there didn't have much to do with speaking English in reality, so I first had to learn a lot of vocabulary and practise speaking in that course.
Then we lost contact over some years, and met again at a week-long course in English for nurses in my hospital, which is a large one in the Rhein-Main area. I work there as a children´s nurse. The course was really helpful, but we pointed out, that it was necessary to keep in practise with English. So Yvonne started these monthly meetings. Here we talk about our work, and often had some papers to work on in the group. We learn new vocabulary, pronounciation and so on.
I find this really helpful, because sometimes you have no English-speaking patients for weeks, and forget a lot ;).-
For example, some days ago on my late shift I had parents who had to admit their 18-month-old girl after an eye accident - they understood a little German, but spoke only English. I had to show them the ward, their room, and speak with them about the treatment which the girl will would receive. The parents told me that they were really glad to have an English-speaking person in this horrible situation. Without practising English once a month, this would have been much harder for me. So I really appreciate these meetings.

And now here is Marianne:

Hello, I met Yvonne at the English course for Professors and Adjunct teachers at a University of Applied Science in Hessia. The main topic of this course was Social Work. I'm a nursing and health scientist and asked for a special course with nursing topics. So Yvonne invited me to join the "English*Practice*Reflection" group and I started this course in 2007. I met a lot of nurses with different special competencies in nursing. During our meetings we talk about our experiences at work and some of our daily problems. We have to speak in English so it is a good practice for learning new vocabulary and training our pronounciation.
At the moment I'm teaching in a nursing school and I'm writing a course book for a further education program for nurses.
This is my first post in Yvonne's blog and I hope somebody will read it.

more news from Julia in London

Julia wrote me a couple of months ago to tell me of her plans - I forgot to post this then, and would like to share it with you now. Julia did some traveling for a couple of months and then planned to work in the NHS to get some experience there. I hope she will write to let us know what her impressions are.

London itself is a very interesting city. I enjoy living here. But my husband and I have decided that England won´t be the right place for growing up a family. Actually, that´s the reason for leaving London. At work I can not see the financial crisis, maybe because the HCA Gruop is a private company and our patients are arriving from all over the world.

Otherwise, Agency Nurses are telling me that the condition for NHS Nurses is getting worse. Their talks reminds me of the situation back home in Germany. I have not written it in my report, but a lot of the western nurses are going further to the USA, Australia or Canada (like I am planning to do). And a large number of nurses are from India and Pakistan. It makes me sad to see that the nursing standard becomes worse, because a lot of them are not very well
trained.

Another German nurse in London (3)

Here is the third part of Julia's report.

Training to enhance Competency and working hours differences

Because of the Nursing Council, my manager is obliged to offer me a special amount of courses every year. I find it very nice, because I am able to choose from a lot of verities. The attended time is counted as working time. And like this, I am able to qualify myself in the field which I want to. So far I can mention it, it seems to be a little bit more professional organized than as back home in Germany.

In my point of view, the most beneficial advantage are the working hours. On the ICU, I care one patient for 12 hours from 8am to 8.30pm, or during the night shift from 8pm until 8.30am. Only one patient! My weekly total amount of working hours are 37.5. But because of the twelve hours shift, I am working just three till four days in a week. During my spare time, I am allowed to work as a Bank Nurse. This means, I am working self employed for the hospital and get extra paid for a shift. Like this, I can increase my salary up to my own capacity.

I see myself being very fortunate that I got the possibility to work here. It is just one step before the next one. It is a wonderful experience. I am pleased to see that nursing seems to be a profession which is respected. Back home, I saw a lot of nurses leaving their job because they were simply over worked. In Germany, the hospitals try to cut their costs, and mostly they are cutting the nursing staffs. It makes me very sad, because how we can establish our profession if we do not have time to show what we can? And how beneficial we are to cure the patient?

Another German nurse in London (2)

Here is the second part of Julia's report.

Beginning Days with Multinational Staff

When I began to work, my colleague were very helpful. It was not very difficult for me to get integrated, because almost everybody in the ward is coming from abroad. London itself is a very international city. There are only two nurses from the UK in our whole ward and all the others are from Australia, USA, Canada, New Zealand, India, Philippines, Pakistan, Sri Lanka and some from Europe too. This creates a very exciting working environment. It is interesting to see how differently we all focus at our work. For example, nurses from the US focus highly in medical skills and the Canadian nurses are more focused on a supportive role to balance the deficits of the patient. Like this, we learn a lot from each other.

In the beginning, I carried a small red diary with me all the time. I used to write down all the expressions and abbreviation which I did not know. And the English people like abbreviations! For example FBC means Full Blood Count and SOB Shortness of Breath. Every evening I have written in my diary a small summary about what was new for me on that day and the difficulties I had faced. Like that, I started very fast to work independently and I got familiar with all the different kind of documentation. Furthermore, I could reflect my work and could see the weakness I needed to improve.

The different names of the drugs seemed to be the highest barrier for me. But this problem got solved. Lots of drugs are made in Germany and the package of the drugs were very helpful. Mostly, it was easier to read the drugs name than to listen it. The English pronunciation was really strange in the beginning. And I remember standing with a colleague in front of the drug cupboard. She taught me all the pronunciations, and on the end we were just laughing about this strange English way.

Another German nurse in London (1)

Level of difficulty: intermediate

I received an email this week from a nurse who attended one of my intensive English courses a little more than a year ago. Shortly after the course she got a job in London. In this email she reports on some of her experiences there.

Hello,
My name is Julia and since September 2008 I am working in London as a Registered Nurse. Before I start to write about my experiences in England, I would like to tell a little bit about my nursing career.

In 2006 after completion of three years nursing school, I attended the German Nursing Exam “Gesundheits- und Krankenpflegerin”. Afterwards, I travelled for seven months in Asia where I used my skills on a volunteer basis to everyone who was in need. During my travel, I decided to learn more about nursing skills in the English speaking western world. With this decision, I came back to Germany. During this time, I came in contact with Kate from med-jobs. Kate was very helpful, and said honestly, that I need to gain more working experiences before I can think to work in England. That’s why I started to work in an ICU for one and a half year in Germany.

Nursing English

During the registration process, I attended the course “Communication with Patients” with Yvonne Ford in Frankfurt. I will not forget those five days. The class was during the summer time and she tried to give us students the best working environment as she could. She taught lovely the basic English skills of nursing. During the class we had very interesting discourses about essential nursing skills and personalities. I studied during these days the new vocabularies very deeply. When I look back, I realize that this course was very helpful for me to get started in my new work place. Yvonne prepared me also for the interview and her judging mind supported me very well.

Registration Process and Interview

In spring 2008, I contacted Kate again. The registration took almost two months and all worked superbly out. She helped in many different ways and arranged two interviews for me. On my 26th birthday in July 2008, I had an interview for a position as a staff nurse on a cardio surgical ICU in London. And two days after I arrived home, I got a positive result! It was a very exciting time.

Ebay for nurses ?!

Level of difficulty: lower intermediate

In the USA there is a shortage of nurses. The reasons for this are complex. However, the shortage means that new ideas are being developed to deal with the problem.

One idea is a website (http://www.nurseauction.com/) that allows nurses who want to work to put their details online. Hospitals who need a nurse can get in contact with them. Nurses can sell their time for one shift or more. They decide how much they want to earn - and the hospital or health care institution can accept their price if they need a nurse urgently. The website is free for nurses.

Some hospitals have their own internal auction programs: if a nurse is needed, the hospital puts the information on their website. If it is a shift that no one wants to work (for example, Christmas Day) then the nurse can demand high pay. The hospital will give the work to the nurse who makes the lowest bid (of course, the nurse has to be qualified for the work area.) If not many people make a bid, then the nurse has a good chance of getting higher than average pay.

These strategies will not deal with the shortage of nurses, but will allow nurses to choose better working conditions.

Working in London, Irina's report, part 3

Level of difficulty: intermediate



This is the third and last part of Irina's report.



Another big difference is the documentation. In this hospital group there is a special US computer programme where they document everything. This programme is very hard to learn because it is very compact and sometimes complicated. But as soon as you know how it works it is ok. The documentation of everything needs a very long time. I thought in Germany we have too much documentation, but this is a lot more.


I also had difficulties in the beginning with understanding handovers, because there are a lot of foreign nurses who have different English accents and they use a lot of abbreviations which I didn’t know. And of course the medical English is very difficult, though written is much easier than spoken due to the pronounciation.


Besides all these problems in the beginning ( which is quite normal ) I’m very happy to work here. My new team has been very supportive and friendly, they helped me a lot going through all of this because a lot of them went through this by themselves. They were all very understanding.



Now I can work on my own and I am a lot more confident, though I still have a lot to learn and a lot of questions. It is sometimes busy at work but I don’t have the kind of stress I had in Germany and it is much better to work 12 hours. The salary is also a lot more than back home. Though London is very expensive, I can live a very good life and even save a lot of money.



As a summary I can say that I enjoy being a nurse again and it is great to live in London!!!

Working in London - Irina's report, part 2

Level of difficulty: intermediate

This is part 2 of Irina's report.

I want to tell you about my job now. I’m working in a private hospital, which is one of 6 American hospitals in London and which has a very good reputation. So there are a lot of foreign people who come there to be treated. I’m working there on the neurosurgical ward with about 20 patients. Each nurse has about 4-5 patients to look after.

There is no A&E department (emergency room), so there are mostly planned admissions. The sister in charge is there for problems with patients; she also allocates patients to a nurse, knows which room the admissions come to and which nurse will admit them.

I work 12 hour shifts which I like very much because I only have to work 13 days and therefore have a lot of days off to recover.

For me the first weeks of work were very difficult. Sometimes I felt that I’d never done nursing before. It is very different from how I used to work in Germany. For example nurses here do things that I’ve never done before. They do ECGs, remove clips and drains, give i.v. injections and blood transfusions; sometimes they take blood or put in cannulaes.

There are a lot of further training program where I have to go to learn everything. Also the equipment they use at this hospital was unfamiliar. But the training courses help me to get used to everything, also to get to know all of the hospital policies.

Giving medications is very different here and also very strict. Medications are prepared when they are given; the nurse who prepares the medication has to give it and also watches the patient take it. All infusions, injections and controlled drugs have to be signed by two nurses before they can be given.