Today, May 14th, we visited Robert Harvey House, a nursing home in Birmingham. My experience today was amazing, and I left feeling so accomplished and like I truly made a difference in someone’s day. I was excited, but nervous about going to the nursing home today because I have experienced a lot of loss in the past year regarding my grandparents, and although there were parts of the day that triggered hard feelings for me, I think it helped me to connect more with the residents. Also, my great grandmother who is 105 years old was put into a nursing home this past year, so I have recently spent a lot of time in the nursing home environment. I think this gave me a really good set point to compare American nursing homes to those in the UK, as I have gotten pretty familiar with the system.

We first started the day by watching the nurse do hand off to the care assistants, and she basically let everyone know how each resident was doing today based on how they slept last night. I then shadowed a nurse, Keke, on the floor which was so exciting! I watched her do controlled medicine checks with the other nurse on staff today, which is a mandatory check where 2 nurses count all of the controlled medications at the beginning and end of each shift. They both also checked out the controlled medications needed for their patients that day. I watched them log the medications on the MAR which is a paper charting system. After checking out the medications for the patient, Keke then brought them to the patient and made sure they took them by mouth. I noticed that the nurse had to check the medications and then bring them to the patient one at a time, charting in between each. The nurse could not do them all at once, ensuring mistakes were made. At this nursing home, Keke and the rest of the staff treat residents with varying levels of dementia, and many had Parkinson’s disease.

After shadowing Keke, we rounded with the GP who basically checked on all of his patients to make sure no new issues arose since the last time he saw them. This was fun because the GP was questioning us on possible pathologies that the resident could be experiencing, such as discolored toes due to lack of blood flow, gout, or other potential issues. Next, we received a proper tour of the nursing home, where we visited “sensory street,” a dedicated area that looks like the 1950s/60s where residents can go or bring their family to spend time, calm down, and encourage memories. The flashback theme is intentional because the hope is that it will trigger memories from the past for the residents, since those are what they will remember best. On our tour, we saw many bird cages, two goats, a dog, as well as the laundry room, hair dressing room, kitchen, and many other facilities. 

This is a standard room for each resident. It includes a bed, chair, television, and furniture.

After our tour, we had a long time to spend with residents, and this ended up being my favorite part of the day! I sat down next to a resident, and we ended up talking for over an hour about our families, lives, and stories from the resident’s past. My friend and I showed pictures of our trip to the botanical gardens and pictures of our family to the resident who loved this. We connected so well, like true friends, and the resident told us at the end of our conversation that they felt like we had known each other for a long time because we had connected so easily. The resident wanted to show us pictures of their daughter so badly, and they ended up bringing picture frames to lunch to show off! The resident also asked us to write our names down so that they wouldn’t forget us, and was excited to tell their daughter all about our visit. Not only did we make this resident’s day, but they helped me feel confident in my ability to speak to patients and connect with them. I left feeling like I might actually be a good nurse one day, and I felt so fulfilled after visiting the nursing home today. I made sure to give the resident a big hug before leaving, and I am so grateful I was able to spend quality time with them today!

I am using they/them pronouns in the prior paragraph to protect the privacy of the resident.

These are some of the animals at the nursing home for residents and guests to interact with!

We finished the school day with lectures at BCU on endometriosis, period product accessibility, and female genital mutilation (FGM). I learned that endometriosis affects 6-10% of cisgender women/people assigned female at birth worldwide and that it has for the longest time been considered a enigmatic gynecological disease. This means that it is like a puzzle, there is no rigid definition or diagnosis, but instead only explained through theories. It was originally believed to be due to retrograde menstruation, meaning that menstrual flow moves upward instead of downward to exit the body. However, this is outdated as the disease is now seen as a systemic condition where patients need to be seen as a whole person. Also, the only actual treatment and diagnosis for this disease is through surgery, and since it takes over 8-9 years to diagnose, the results can be quite severe. The sad thing is surgery isn’t even the best practice for all forms of endometriosis, but there is a lack of funding toward women’s health research and the disease is severely complicated. It is believed that endometriosis might actually encompass multiple different diseases as its target population is not only menstruating people, but it has been found in people prior to their first period, people after menopause, and even cisgendered men in rare situations. All of this goes to show that the disease is more complicated than we think, and it needs further research to find out what actually causes it, how it progresses, and how to treat it.

In the presentation about inclusive period dignity at BCU, we learned about the push in the UK for the law to provide free period products in public places. The pink tax was eradicated in the UK, but the nation still struggles with affordability and accessibility of period products. Also, inclusivity needs to be considered when talking about period products. For example, we can help eradicate stigma by using the language “period products” rather than “feminine hygiene products” which implies women & periods are dirty, or “feminine products” in general because not all females menstruate, while some men menstruate. Women may have biological or surgical reasons for not menstruating, while others may take a contraceptive that temporarily stops their period. Also, calling the issue period “poverty” places a a stigma on period projects and may steer people toward not partaking in free products. So, calling these projects simply “period projects,” where products are accessible for anyone to take anonymously will be the most successful. Another huge thing I learned is about where to place these products. In the past I have learned to be mindful of my language by saying “people who menstruate” when referring to people who have a period as members of the LGBTQIA+ community may not identify as female, but still have a period. However, I have never thought about putting period products in men’s restrooms to be inclusive toward these groups of people, and make period products accessible to men who menstruate. BCU actually has period products in the men’s restroom and there are stickers on the bathroom doors of all restrooms stating this so that everyone knows that period products are available for free.

Our final presentation of the day was on female genital mutillation which is a topic I have never learned about in a school setting. This is essentially any procedure that involves partial or total removal of external female genitalia, or injury to the female genital organs for non-medical reasons. This is also called “cutting” because that is what is happening to the female genitalia without any form of anesthetic or pain relief. This often happens to young girls around age 5-8, and it is prevalent in the UK because people from other countries will move to the UK and already have the procedure done. At the same time, some of these women will send their daughters on “holiday” back to their home country to receive circumcision and then bring them back to the UK to heal and recover. What is so scary about FGM & FGC is that so many complications occur as a result. For example, recurrent UTI’s/infections, pain, abscesses & cysts, infertility, and more may develop after the procedure. This also creates severe complications during childbirth, PTSD, and increased risk of bleeding. This procedure can be reversed, but the tissue that was removed cannot be replaced, and scar tissue will forever remain. What shocked me the most about FGM & FGC is that mothers are the people perpetuating the cycle because they have shame about it occurring to them, and want to do what is best for their daughter when it comes to finding a husband and living a successful life. Yet, no one is actually checking to see if FGM & FGC occurred, so mothers are creating pain and trauma on their daughters for reasons that they believe to be providing their daughters with a better life, but instead cause pain and severe health complications.

Overall, today was a very informative and exciting day, despite many the heavy topics we discussed. I cannot believe we have finished our last day at BCU, and I am sad that this trip is coming to a close! Tomorrow we will be visiting another college, and then we leave for London, so I am excited to see what the rest of this week brings!