Today was our last full day in Birmingham and we were able to go visit a nursing home with half of the study abroad group. We first got a taxi to the front of the nursing home and was guided by the director inside. We saw parrots in the front of the nursing home which was really cool. We went to the conservatory with the director where she first gave us an orientation. She talked about the difference of a residential nursing care and nursing home care. Residential is when people choose to come to the care home and get care needs. These types of residents must fully fund their health at this type of nursing home. If the resident is in nursing care then this means they are unable to hoist themself or carry out activities of daily living by themself and also need a nurse to administer medication to them. If the patients is high enough on a scale the NHS will pay for them to go to a nursing home. We then asked about the amount of nurses and nursing aids within the nursing home. We learned that there is 2 nurses for every shift that administer the medications to residents and there are 2 nursing aids for every 8 residents, which we thought was a good ratio. I noticed when walking through the nursing home that they have a lot of empty beds, which is very different from nursing homes within the United States. There are open beds here whereas in the states residents are on a waitlist.
We then were able to shadow the nurses that were giving the medication to the residents. We learned that they get paid 20 pounds per hour which is very different from the pay for the nurses in the United States. I noticed how nice the nurses and staff were when we arrived. They were so excited for us to be shadowing them and to hear about how we are trying to compare our systems. We were able to observe a shift change between the night shift and the day shift. They run through the list of their and say how their nights went, if a resident got enough sleep or not, and what to expect from the resident when they first go in. The nurses all have a work phone that has the residents on them and has medications on them. When we were with the nurses they kept talking about carrying out good practice and to always keep it in mind. I liked how personal the patients and nurses got, which I think is a positive about working within a nursing home. We saw the nurses go through a check with the controlled medication, like morphine, and they have to have 2 nurses present for this in order to make sure they have the correct dosage and the right patient. When on these medication checks I noticed that there are a lot of Parkinson’s patients which I found very interesting.
After this we were able to get a tour of the facility and saw that it is very nice. The facility has a lot of animals like a dog and goats. We saw they have a laundry room for the residents laundry and a very nice kitchen that is very accommodating. We also saw that they have a street called sensory street, where residents can go and have a little village to play with. We then were able to talk to the residents and have conversations with them. Emily and I were put with this one female patient and we found that she was very sweet and very excited to talk to us. We learned so much about her and she was very talkative. I think a lot of residents just want someone to talk to and just talking to her for an hour, we made a difference. After our conversation she mentioned how talking to us made her feel as though she had known us for awhile and that she really appreciated it. She also wanted us to write down our names because she wants to keep in touch. This conversation made my day to see that we made such a difference in one residents day. We then had lunch with some residents and took a taxi back to Seacole.
When we arrived back at BCU, we met with professor Annalise Weckesser. She came to talk to us about endometriosis and menstrual poverty. She is a medical feminist anthropologist and has done studies on endometriosis in the past. She first said that endometriosis is considered rare and very painful. The symptoms include painful and heavy periods, infertility, pain during sex, pelvic pain, pain with bowel movements, bleeding in the bowel and many more. There is no cure or treatment breakthroughs for this specific disease. It is considered a complex disease that we don’t completely understand yet. The early definition of this disease is often very sexist and was said to only affect white affluent women who have neglected to have children. 1.5 million people in the United Kingdom are affected by this disease and these people are considered endo-warriors. From the presentation it was said that there are two types of endometriosis; those who are normal in every way except that marriage and pregnancy are delayed, and those who have a stigma pf pelvic underdevelopment… It is therefore better that there be earlier marriages and that contraception be put off until let one or two pregnancies have occurred. Patients have been told that getting pregnant will improve their condition and are encouraged, which is crazy. She then talked a little bit about inclusive period dignity.
We then had a conversation with Dr. Jama Egal, a midwifery lecturer, about FGM which is female genital mutilation. (WARNING – in this lecture we went very detailed into the procedure and what happens, so it’s graphic beyond this point). This is defined by compromising all procedures that involve partial or total removal of the external female genitalia, or injury to the female genital organs for nonmusical reasons. If the procedure is done for medical reasons it isn’t considered FGM. We learned that 200 million people worldwide come into contact with FGM and nearly 3 million people are at risk. We learned about the different types of FGM. Type one is a partial or total removal of the clitoris, type two is a partial or total removal of the clitoris or labia, type three is narrowing of the vagina with the creation of covering seal by cutting and stitching the labia, and type four is pricking, piercing, incising, or scraping. We learned that type three is the worst and is even worse during labor. FGM is considered a human rights issue. The reasons for carrying out FGM is custom or tradition, religion, secures virginity, hygiene, preparing for marriage, and enhancing fertility. Children at the age of 8 have these procedures happen to them and these are done in groups. FGM is done in groups so that the children are all thinking the same thing and thinking its normal rather then trying to rebel against it. They often try to celebrate FGM and make it seem like a good thing with celebrations. The short term complications include death by bleeding out, urine retention, injury to adjacent tissue, HIV, fracture or dislocated limbs from being restrained, and neurogenic shock. Long term complications include UTI, clitoris pain, infertility, abscesses due to infection, sexual dysfunction, problems in childbirth, and psychological trauma which is the most prevalent. To diagnose FGM you need to be able to observe and look at the patients history. Deinfibulation is the opening procedure for women with type three FGM and is considered a reversal of the procedure. It may alleviate symptoms but can’t replace the tissue. Reinfibulation is the reclosure of a woman with type three FGM usually after childbirth and is illegal within the United Kingdom. Patients can carry out an FGM appointment which is an hour that goes into detail. We learned about the importance of using trauma- informed care with patients and being culturally aware. We should give them a safe space to disclose information. This lecture was very enlightening about the current situation in which I didn’t know about until coming to the United Kingdom and I appreciate having the ability to learn about this important topic.
After a full day at the nursing home and lectures at BCU, we walked home to our hotel to pack. Tomorrow we will be active in the morning and then be on a coach bus to London in the afternoon and I cant wait !
