In the morning we had a great tour of the campus by Mrs. Dawn Cameron. We saw all of their facilities and their dementia friendly simulation unit. The unit was innovative in the sense that it anticipates the patient’s needs. For example, it was impressive to see that they thought to color coordinated doorways and toilet seats, in order to bring greater attention to them. Afterwards, we had a meeting with the nursing staff to coordinate our placements. Mrs. Lockett then took us to Stirling Castle and the castle graveyard for some sightseeing.
At 6am we left Inverness to meet the wonderful Mrs. Lockett. It was a long and quiet drive because everyone was asleep. Before we knew it we arrived in Edinburgh and took a tour of the Edinburgh castle. For lunch we walked down the “Royal Mile” and dined in the “Birthplace of Harry Potter,” the Elephant House. Afterwards we visited St. Guiles Cathedral, the Scottish National Gallery, the Scott monument, where Reed and Andrew took the time to climb up the 264 steps to the top, and St. Andrew’s square. We looked for platform 9 and 3/4 in Waverly Station, but we could only find platform 17 to Stirling. We arrived at Stirling University where we took a brief tour of the campus and had a delicious meal prepared by the university’s chefs. It was a long but fun day.
Scotland Juy 12, 2017
by Kelly Garvin
This morning we met at breakfast and then dispersed for the day’s assignments. Taylor and I got a special chance to see Maggie’s, an Integrative Medicine-Respite for cancer patients, complete with tai chi, yoga, makeup tutorials for women who’ve lost their hair, etc. After, we reported to our wards: some got Children’s inpatient, some got Inverness West Community, some got Renal unit–with all different varieties of dialysis. I was there with Taylor, and we got detailed in-services on hemodialysis and peritoneal dialysis. We met at least 7 patients and spoke with them extensively about their kidney failure journeys. Today’s highlights included an in-depth teaching session on peritoneal dialysis and feeling a strong thrill in a fistula! It felt like a train. The patients were great, and the nurses handle different types of fistulas: traditional, buttons, necklace, etc. The “bloods” and medications were familiar to our lectures: check K+, “urea” (BUN), and administer EPO for anemias, After getting everyone set up and checking them Q hour, we went for a tea break, and met the rest of the dialysis crew; they were friendly and chatty, and we talked about Florida and winter.
After placement, we met for dinner and went to Culloden battle field…wow…much of Scotland’s history is replete with warfare…it was surreal to walk on the grounds that had once been saturated with blood, battles that cast the die for Scotland’s future. Here, in the mid-1700’s, the Jacobites fell to the English, and thousands perished. The rote names of history come alive here; we imagined how the widows felt, identifying the bodies of their dead husbands…the grave sites mound up behind the tombstones…It was oddly serene and peaceful here, as in Fort George, overlooking the Moray Firth.
From there we went to a quaint little place on the edge of Loch Ness, called the Dores Inn. It is a compound sprawling across the rocky beach of the loch, with picnic tables strewn across the lawn and pub fare readily available. The waters were so tranquil…the sun indecisive; would it blaze; would it hide? Weather in the Highlands is predictably unpredictable, but so far has been cool, but sunny, with just a hint of melancholy. I would say we watched the sun set, but that would be a lie; daylight here is relentless, the sun sets after 11, and rises by 4:30.
Now back at the dorm, I think back over a long, full day of experiences I will never have again. Our American obsession with gloves. The Scottish penchant for socializing (socialising) with patients in hospital. Our need for 100% efficient productivity, all the time. Their appreciation for quality of life, all the time. (Even our dialysis patients took holiday, thanks to NHS). So far, Scotland is an enigmatic blend of ancient and modern, predictably familiar and yet just different enough to keep me guessing. Tomorrow is another day.
July 8, 2017 Stirling
By Sara Ross
Today we decided to take the mighty trek up to the top of Dumyat Mountain which is right off of the University of Stirling campus. The group and I had been planning for and looking forward to the Dumyat hike all week and we were so excited to start our adventure when we woke up and saw that the weather was so sunny and beautiful. We weren’t exactly sure how to find the beginning of the trail to the top of the mountain so after consulting with a few of the university’s employees the group and I set out on our own in an attempt to embark on a “self-guided” tour up Dumyat. After wandering around the woods for a few minutes we found what looked like a trail and began to follow it over rocks, large tree roots, and even rivers and an hour later had finally made it to the beginning of the ACTUAL trail. From there we hiked over hills and fields covered with colorful flowers and wildlife (we even saw some sheep) among many locals which included children and lots of dogs. After almost 3 hours we finally made it to the top of Dumyat Mountain and snapped a few photos before our stomachs were too hungry to wait for lunch any longer. We had all packed some snacks and had a picnic at the top of the mountain which was so rejuvenating and refreshing before our long trip back down the mountain. By the time we were back on campus John had arrived in Stirling and it was almost time for dinner so we relaxed on the patio outside the dining hall until it was time to eat. After a delicious dinner we walked into Bridge of Allan once more to show John the town and enjoy some ice cream. Overall, our hike up Dumyat Mountain was difficult but totally made worth it by the view from the top and it was my favorite activity we’ve done thus far!
July 7, 2017
By Taylor Brown
Today started off with traveling to St. Ninians Health Center. From there, I was off with a district nurse named Kirsten. A district nurse in Scotland mostly tends to patients with ailments that can be treated at home. The first stop was a lovely elder couple whom had been married over 40 years. After a quick dressing change and some great advice for fish and chips in Glasgow, we then stopped by an independent elderly women who also needed a dressing change. Her home was filled with flowers and quite beautiful. The last house was rather emotional, as I learned about a disease process similar to multiple sclerosis called Progressive Supranuclear Palsy. This particular patient required around the clock care by his AMAZING wife (whom was a retired nurse). After checking on the patient, my nurse ensured that the wife herself was doing okay both physically and emotionally. It was a great learning experience, learning how the nurse handled multiple patients with very different needs was great to see. Her priority skills were top notch!
After a quick lunch, we presented our Service Learning Project about the soon coming baby boxes that the Scottish government is rolling out. Since my area of interest is in babies and children, I was very excited to investigate the baby box, it’s priority population and the benefits it could bring to families. The audience was mostly faculty members for the University of Stirling and they were impressed with the details of our presentation. After some last goodbyes to the amazing faculty here, we hurried off the get ready for Glasgow.
First stop in Glasgow- the gothic Glasgow cathedral stood tall right off of Cathedral St. The stain glass was amazing! Then we headed off to the many shops of Glasgow. I absolutely had to buy a cashmere scarf made in Edinburgh… so soft! We ended the quick city trip with a tasty dinner at Jamie Oliver’s Italian kitchen. Jamie’s even cut up Kelly’s pizza! 😉
July 6, 2017 Stirling
By Lauren Johnston
Rise and shine to get ready for day 2 of hospital clinicals at Fourth Valley Royal Hospital in Larbert. Energized on blood sausage, eggs, and an apple to go we meet our taxi and head to the hospital campus. We arrive at 9am and meet our practice education facilitator (PEF) who takes us to the locker rooms to change into our scrubs. Today we will be learning about the National Health Service (NHS) from the staff nurses in the wards!
As we step onto the unit, we see walls adorned with quality improvement posters, seeking to educate observers on the healthcare values embraced and implemented by the clinical team. The posters serve as great health promotion tools for patients being treated on the unit and for families helping to facilitate care at home. We observe daily operations, as nurses are responsible for the care of 8-10 patients per shift. We watch nurses conduct their morning assessments, taking vitals, performing visual inspections, and administering medications to their assigned patients. Interestingly, staff nurses use visual observations to conduct assessments. Listening to the heart and lungs is considered an advanced skill performed by providers. If a patient appears to be declining, a nurse practioner or doctor will be called to perform a more in depth assessment. As a student, I felt such assessment limitations for staff nurses, could delay interventions influential to patient outcomes. When documenting patient care, nurses use a written record, where nurses can observe trends in the patient’s status and see doctor’s notes with updates to patient care. Ideally, nurses attempt to round with the physician on their assigned patients. However, this practice may not always be feasible, making these written updates critical sources for communication.
After leaving the hospital, we return to our flat at University of Stirling, where we prepare for an evening of traditional Scottish dancing at our first ceilidh. Located in downtown Stirling, we are joined by international and Scottish students studying at the University to enjoy Gaelic folk music performed by a three-piece Scottish live band consisting of a fiddle, guitar, and accordion. Grab your partner and head to the dance floor to participate in indigenous Scottish dancing with instruction provided by the “caller” before each dance to learn the steps. Enjoy the food, fun and festivities, but can’t stay out too late…as we will be traveling throughout the community tomorrow with the district nurses!
Scotland 2017 Stirling
July 5, 2017
By Kelly Garvin
Today we visited Forth Valley Royal, the enormous new hospital serving the 285,000 residents of NHS Forth Valley. It has wide clean corridors and robots move things around for staff. Tina, our PEF, met us and delivered us to Debbie, who gave us an overview and tour of the OR, maternity, obstetrics, and NICU wards. There are 16 operating theaters. There is no cardiac cath lab, but they perform lots of orthopedic procedures.
Here, Norplant is a common form of birth control (the rod), and pregnant mums “get what they want” or develop their birth plan: be it a tub bath, squatting birth, or Cesarean section on demand. Midwives run the show, and consultants (doctors) are available if needed. Midwives can deliver most babies, even twins and breach. The “snowdrop” ward is for still births. Midwives care for the mums from 6-8 weeks gestation to 10 days post delivery, when the health visitor takes over for the first 5 years of life.
Forth Valley is able to handle most of the health care needs of the residents in the area. The doctors do not wear white coats or ties, but dress clothes. There is an emphasis on dementia-friendly signage throughout Forth Valley, so sitting rooms and toilets have pictures and contrasting colors on the doors. The walls are covered with QI posters and reminders to practice person-centred care. Mealtimes are important, and interruptions are kept to a minimum.
After clinicals, we changed and trekked up to Wallace Monument–that was a hike! From there, we walked up 246 stairs to ascend the tower. The view from the top was amazing, and the wind was cold. It was a great sight to see. So far, the weather is cooperating with us Floridians.