Today, we got the chance to learn more about the healthcare system in the UK and experience it firsthand, and it ended up being a really emotional day. First, we had a lecture on female genital mutation (FGM). This is something I thought was not much of an issue now, but learned that it still effects over 230 million females today. It started as a ritual in northeast asia, and has continued for thousands of years. They originally thought it would help to control womans sexual urges and prevent them from having sexual intercourse. It is typically done to children under the age of 15, but can also be done later than that. Since it is illegal all across the world, it is usually done by family members, but some healthcare providers have been caught doing this as well. We also had the chance to watch videos from survivors of FGM, which was really sad. I had not known much about this topic before the lecture, and hearing the facts about it was completely different than hearing real stories. In both the videos we watched, the survivors vividly remember being held down and the excruciating pain they felt during and after the mutilation, both physically and mentally. This really helped me to better understand how we need to treat patients who have undergone trauma like this differently, and we can not just focus on what we see medically, but also remember to consider how we act and what we say and how it may cause them to react.
After this, we got the opportunity to tour Birminghams Children Hospital. The hospital was in a very old building, and was different than I was expecting. In all of the wards, they have bays which hold multiple patients, instead of everybody having their own private room. Especially in the PICU, there were 3 bays, each with 10-11 patients just in an open area. I found this really weird because in the US, each patient is giving their own room with a bathroom and I felt like it would invade both the patient and the families privacy with everybody being able to see you. Even just walking through, I felt a little awkward when the patients parents would look up at us and then continue comforting their child or the other parent. Later, we found out this is because in the UK, they care more about safety than privacy, and it is much easier and faster to get emergency, lifesaving equiptment in and out if there are no doors or walls as barriers.
We then got to hear from their chaplain services. These were pretty similar to those in the US, and I didn’t really notice any big differences. In the chapel, they did have trees with papers clipped onto them from parents whos children have passed. We got the opportunity to read some of these, and it was really heavy. I had never thought much about having a child who passed, but reading the messages to their children from these parents was hard. One thing that stood out was that they will offer memorial services each year for the families of the children who passed as a way to remember them and also show the family they have support. I am not sure how that works in the US, but I think that is a really incredible idea, because it does not have to be in a religious way, but just a way to remember those who have passed.
After this, we got to learn about the magnolia house that is on site. This building is used to create a safe, comfortable environment for patients and their families as they have to make extremely difficult decisions about end of life care. It was designed by families who had gone through similar things, and know what they would have wanted during that time. It does not feel like a hospital at all, it is set up exactly like a home and has no medical anything in site. The biggest design element I found interesting was how many exits the builiding had. They said this was because during these convorsations, sometimes parents just need to get up and take a break, and in traditional offices or patient rooms, there is one exit and you are usually surrounded by healthcare professionals and can not just leave. We then went into the family room, which has a similar design but is more private. One thing the magnolia house allows is for families who want to stop care and allow the patient to pass , they can do so in a private bedroom rather than in the hospital. This allows parents to be in bed with their child and be in an overall more comfortable, private area. One thing that stood out to me was that very limited staff have access to this building. They said it includes those who work in berevement/palliative care, and a few other staff, but no doctor, nurse, etc. can come in because they do not need to be there during this time.
We then got to tour the rainbow room. This room is similar to the magnolia house, but inside of the hospital. It is used either for patients who passed on the wards, or who passed in the magnolia house and have been there for over 4 hours. It is in the hospital near the morgue, so the family will wait outside as they prepare their child, and then they can go in for up to an hour. When we walked in, I immediately noticed the temperature drop, which made me really realize how difficult this is. Although they do not tell parents it is next to the morgue, just the coldness and the freezer-looking dore really make you realize what has happened and why you are in there. It was definetly hard to talk so much about death in children, but is something important to learn about, especially for those considering pediatrics. To end out night, a few of us plan to go explore the city and the local restaraunts and pubs and then rest before a long day of walking tomorrow!
