Helsinki nurses are busier than ever
Number of patients growing faster than personnel
Päivi Punkka-Hänninen
Beep beep! The demanding sound calls again. The board on the ceiling displays the code: H1PP5.
Nurse Aila Koivisto-Vilkko laughs when she is asked that the code means.
She knows. It is a young 20-year-old woman in room 1, who has had an appendectomy at 6:00 o'clock. She is brought from the recovery room to ward 41 at Meilahti Hospital - a unit specialised in intestinal conditions.
Nina Malm, who is more alert after her anaesthesia has worn off, wants more pain medicine, and would like the back of her bed to be raised slightly. From the other side of the curtain, Merja Lartamo asks for cough medicine.
Another nurse asks Koivisto-Vilkko to help her, so that they might get a 91-year-old patient into a better position. "Sometimes they keep us running", Koivisto-Vilkko laughs.
Koivisto-Vilkko and her colleagues have been kept busier than before in recent times, as a shortage of substitutes has placed a burden on regular staff. It is harder than before to get nurses to take on short-term jobs. In the summer, 250 of the 2,600 beds at the Helsinki University Central Hospital in Meilahti were closed because of a seasonal shortage of personnel. Supply and demand do not always link up in hospital care.
"We are always full, and the burden is very heavy", says the hospital's head physician Jorma Lauharanta.
Hanna Aschan, head of nursing, says that the number of staff members has not kept pace with the increase in the number of patients. There are more patients than ever, especially at out-patient clinics.
On the other hand, some patient beds are in corridors, and the number of patients exceeds the planned capacity of the hospital. This has not happened in ward 41. "Personnel has been gauged for 23 patients, so we will not take any more than that", says the ward's head nurse Maija Eskola-Pellikka.
The corridor of ward 41 measures 64 average steps taken by a medium-sized woman. According to a pedometer clicking in a nurse's pocket, the nurses' clogs and Birkenstocks hit the floor 8,000 times during a single shift.
The prevailing feeling in the ward is that of exhausting haste. There is no actual running among the 23 beds in the manner that is familiar from hospital television dramas, and the defibulator cart stays in its spot in the corridor next to the fire extinguisher.
However, when the IV of one patient is working again, another needs more pain medication. When there is finally a coffee break, the telephone rings again, and the code that appears on the wall of the coffee room sounds its alarm.
"Why are the incisions still bleeding? And why are there three of them", Malm asks, looking at her abdomen.
Nurse Koivisto-Vilkko assures her that sometimes incisions can bleed after surgery, and that in laparoscopic surgery, there are supposed to be three cuts: the ones on the side are for instruments.
"Sure - a crowbar and a hammer", says Lartamo, who is convalescing on the other side of the curtain.
In the bed on the other side of the room a woman continues to have nightmares. The nurse suspects that side effects of her pain medication might be the cause.
"This job involves so much more than the concrete procedures", she ponders.
If there were more personnel, there would be time for more conversation - for instance, about the fact that the surgery on the lady who was having nightmares revealed that her cancer - which had been the cause of a previous operation - had spread.
More drugs are prescribed for the physical pain, and for the psychological side, a psychiatrist's consultation is scheduled for the next morning.
"Considering the demands and stresses of the job, it's too small", says the former leader of a political party who is recovering from surgery, when asked about the basic salary of a nurse. It is slightly more than EUR 1,900 a month.
However, there is no complaining, nor are there any plans for a nurses' strike at ward 41.
"It would be difficult to arrange a strike in this field, because ethics require that patients must be cared for", notes head nurse Maija Eskola-Pellikka, whose 30-year career has included a couple of strikes. She admits that sometimes society trusts too much in the flexibility of care personnel.
The treatment guarantee system has added to the pressures of the job. In addition to setting minimum times for getting treatment, it is attracting more patients from the private sector to public health care.
The Helsinki University Central Hospital health care area is responsible for the specialised health care needs of more than one million residents of Helsinki, Espoo, Vantaa, Kerava, Kirkkonummi, and Kauniainen. The population of the municipalities can grow as much as three percent a year, notes head physician Jorma Lauharanta. Each year there are about 20,000 more potential patients, and the number of old people who need much treatment is growing.
Another factor is that patients from other parts of Finland come to the Helsinki for especially demanding types of treatment.
Nurse Aila Koivisto-Vilkko has about 20 years of experience. During that time, stress has increased, and the times that patients are treated have grown shorter. In spite of the pressures, the job is rewarding, when a patient begins to recover and gets to go home.
When a nurse's shift is over at 2:30 PM, Nina Malm, who had her surgery in the morning, is already walking in the halls, with her IV holder next to her.
The appendix patient went home the next day, and code H1PP5 gets a new face.
Helsingin Sanomat / First published in print 20.10.2006
PÄIVI PUNKKA-HÄNNINEN / Helsingin Sanomat
paivi.punkka-hanninen@hs.fi
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| 24.10.2006 - THIS WEEK |
 Helsinki nurses are busier than ever |
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