FLORENCE NETWORK STUDENT BOARD NEWSLETTER

Newsletter VI June 2014

“MAKING YOUR VOICE HEARD IN EUROPE”

LETTER FROM THE EDITOR BY: KAROLINE HASLE EINANG

Hi, everybody! think of; please send them to us on our e- On behalf of the student board I am proud to intro- mail, [email protected], so that duce the 6th Florence Network newsletter, and our we can learn from it, and apply it next first as a new student board. This newsletter is full time. Please join the group Florence Net- of exiting reading, from information about the annu- work – Student board on Facebook, where al meeting in Ankara to travel-letter from a Eras- there will be more frequently updates mus-student! We would like to ask you to share about activities, information about what this newsletter with the other students at your the board is up to, and it is a great arena schools, so that we can be able to be “your voice in for all of us to communicate with each oth- Europe”. er, and take internationalisation to a new If any of you have either comment, complaints or level! compliments about the 22st annual meeting in An- kara, this newsletter or anything else you might Best regards, Karoline Hasle Einang, Newsletter editor.

Contents:

The new studentboard. 2

The new president 4

The annual meeting, Ankara, (By Karoline Hasle Einang.) 5

Why are there so few male nurses? (By Thom Dercksen.) 7

Erasmus-life in Porto, (By: Johanne Pereira Ribeiro) 10

Negative pressure wound therapy in comparison to standard wound care on chronic 11 wounds. (By Manuel Wiederkehr)

Bodywork of midwife-students (by: Sarah van Aken and Ines Neukom) 13 Page 2 FLORENCE NETWORK STUDENT BOARD NEWSLETTER

THE NEW STUDENTBOARD BY: THE NEW STUDENTBOARD

In the annual meeting in Ankara, a new studentboard was elected. We just want you to see our faces, amd learn a little about us, so that you all know who to contact, or ask about ANYTHIING. We would really like to give the former studentboard a huge “thank you” for all the hard work you have done, it is with both scare and delight that we now take over.

The Florence Network Student Board, both new and old! From the top left:: Ana Firme (Former boardmember, Portugal), Anton Gyllin (the new president, .), Ilona Bürklin (former boardmember, ), Madelén Snørteland (former boardmember, ), Florian van Garderen (new boardmember, The .), Richard Krakowczyk (former president, The Netherlands), Ines Neukom (new boardmember, Switzerland), Sarah van Aken (new boardmember, ) and Karoline Hasle Einang (new boardmember, Norway.) NEWSLETTER VI Page 3

THE NEW STUDENTBOARD

Sarah van Aken: Ines Neukom: Florian van Garderen: Let me short introduce myself, I’m Hi everyone! Sarah Van Aken, a very motivated Dearest second year midwiferystudent at Ka- I’m a 22 years old student midwife at the Zurich University of Applied readers I'd Ho Sint-Lieven Sint-Niklaas located in like to intro- Belgium. Sciences, Switzerland. I take much pleasure in being elected as a mem- duce myself First of all, I ber of the new student board – thank through the want to thank you at this point for your trust! I’m next couple all students highly motivated to work in a multicul- of lines. for the tural team, to create new ideas and Currently I election in to invest my time in such a good am a Ankara! I will thing as the Florence Network! second year do my best to nursing bring my I’m often described as an open- minded, heartily and wellorganised student at unique part the The as a member person. As I’m at the beginning of my Hague Uni- of the student studies I’ll bring some continuity to versity of board. In the Applied the student board. In the board I’m in board I’m in Sciences. I the position of the vice president and the function will fulfill the spot within the stu- I will do my best to support our presi- of the Academic Commitee. I will be a dentboard as regards the visibility dent Anton wherever I can! good representive for all the students, of the Florence Network for the Furthermore as a prospective with special attention for students upcoming two years. This will be midwifery. People often say that I’m a midwife it’s dear to my heart to be a a great opportunity to put some responsible and dynamic personality. good representative for all the stu- creativity into the group as well. I’m convinced that it’s important to dent midwives of the student board! Next to that I'd expand your world. Florence Network helps to build your skills as an inter- like to put some critical and cultural nurse or midwife. annalistic aspects in the orga- nization process. We are all diffe- I’ll be glad to see you next year in rent but I think we can comple- Copenhagen! It will be the third time I ment each other (in a good way) join the Florence Network with within the group. Therefore I want pleasure. to thank you again for electing/ Dear students, I’m looking forward to putting us together as the stu- answer any of your questions or con- dentboard we currently are! cerns.

Karoline Hasle Einang: Hi! I am a first year nursing-student from Vestfold university college in Norway. As a totally new member I am touched by being elected for the student board; thank you so much! In the student board I am responsible for this newsletter, and it is a lot of fun to be able to communicate with all of you, and maybe most of all; reading all your wonderful articles and letters. Please send them to us, so that your article might be published in the next newsletter.

Page 4 FLORENCE NETWORK STUDENT BOARD NEWSLETTER

THE NEW PRESIDENT BY: ANTON GYLLIN

My name is Anton Gyllin, a 21 year old nurse wanted to take my drive to an internatio- student at the Swedish Red Cross University nal level thus the international dialogue is College in Stockholm. something I strongly believe in. My vision today is that in the future, as fully trai- The work we do in the Florence Network ned nurse, work in a long-term perspective, fo- is affecting our future occupation as nur- cusing on the child and their family, where I can ses and midwifes. The importance of join and promote a positive health and also pre- cooperation, being humble while doing so vent illness. I want to contribute my skills and and ambitiousness are watchwords that experience in an organization where I can de- well apply to me and that I always try to velop together with committed colleagues. live up to.

I am often told I have a great deal of drive and Seeing myself as a trustworthy and commitment. An example of this is how I, as Vice respectful with ease to create new good President, at the Red Cross Institute of Student relations makes me a good fit as Presi- Union, works drivingly to improve and optimize dent in this so important organization. I the training for current, but above all, future stu- often receive appreciation for my positive dents. I got the confidence by my fellow students attitude and have always been colorful in at my university college and works closely with my view of the world. the teaching staff and management at the uni- versity. I hope that I, together with my fellow

board members, will make difference in I have a strong belief in improving and the joining of European nurses and midwi- fes students. We all have to be the developing, so I will be happy to initiate changes. change we wish to see in the world. This I also why I applied to become President of the Student Board in the Florence Network. I NEWSLETTER VI Page 5

THE 22ND ANNUAL MEETING, ANKARA, TURKEY. BY: KAROLINE HASLE EINANG, NORWAY.

If I would like an opportunity to go to Turkey? Get an opportunity to meet nursing- and midwifery-students from all around Europe? An opportunity to work with internationalisation, to learn from each other, and to build bridges of shared knowledge and experience? Who could say no to this?

I have to admit; I did not know a lot midwife is in different countries. You can about the Florence Network prior to my read about this, in the brochure we made departure for Ankara. I only knew it was together in our student-meetings*. We an amazing opportunity that I had been also got an impression of the different smart enough to take. And it turned out countries in the food-tasting-party, it was even better! The welcome we got where all the students from the different was as warm as the Turkish night, and I countries brought traditional food and felt appreciated from the moment I step- drink that was for everyone to taste. We ped through the front door of the dormi- also used our student-meetings for tory. electing a new student board, and you can read about us, and our new president in this newsletter! This is an amazing op- Through the week we experienced a lot portunity and I wish again to thank you of what Turkey have to offer; whirling for your trust. Dervish show, music and dance therapy, different beautiful places in and around the city, and last but certainly not least; a lot of great conferences and workshops from talented lecturers from all across Europe! One of the things I found mostly interesting was visiting the Turgut Ozal university hospital, and see how hospitals in Turkey look like and function, seeing both the differences and the similarities to the hospitals in Norway.

As for us students, this was an amazing opportunity to make new friends, learn from each other, and share opinions and takes in both What a beautiful city. (Photo by Ana Firme.) nursing and midwifery. I found it fasci- nating to hear about the differences in the education, working conditions and generally how the life of a nurse or a

*You can find the brochure on the webpage and in the Facebook-page “Florence Network – student board”. Page 6 FLORENCE NETWORK STUDENT BOARD NEWSLETTER

THE 22ND ANNUAL MEETING, ANKARA, TURKEY.

BY: KAROLINE HASLE EINANG, NORWAY

The Florence Network and the an- I am looking forward to seeing some nual meetings are a platform for dia- of you again in the Copenhagen- log and exchange of lecturers, stu- meeting next spring, and also new, dents and teachers. This years mee- exited nurse- and midwifery- ting focused on the international students. Together we are the inter- dialog: “The key to improve quality nationalisation, the dialog and the of nursing/midwifery education and key to improved education and care. care”, which is one of the most im- portant things we do as an interna- tional organisation. This makes Eu- rope some way smaller; it makes the international dialog easier and more natural, because we are not divided as in where we are from – we are a community with the same goals; to improve the education and care. We might prefer different ways to get there, and that’s why the discus- sions, sharing and the dialog is a po- werful key.

The salt-lakes.

All dressed up for the galla-dinner that finished the annual meeting. Wonderful people, wonderful food, and wonderful dancing! Page 7 FLORENCE NETWORK STUDENT BOARD NEWSLETTER

WHY ARE THERE SO FEW MALE NURSES?

BY: THOM DERCKSEN, THE NETHERLANDS

So have you ever wondered, as a male nurse, of the hands of men. Nightingale even said that men why we are in the minority? From my own expe- were not suited for nursing. At that time there were rience I can tell that I was really one of the few still some men in nursing, but the number was very male students to start studying nursing. To be small (Stokowski, 2012). precise, I was one of twenty-five guys on a total

of 365 students attending the first year, so only Nursing schools for men were uncommon in the 7% of the students were male. United States. Men were expected to fight in WWI and not to serve as a nurses. This was seen as natural until the 1970s. In 1970 the American Nurses Asso- First, lets have a look at what the statistics say ciation finally gave in to the pressure and allowed about how many men there are compared to men to join (Mee, 2003). The number of men in- women in nursing. In the United States of Ameri- creased over time, but even today there are much ca, one of the biggest countries in the world, only more women. 7% of the total of registered nurses are male

(Stokowski, 2012). 10,6 % of the nurses in the United Kingdom is male. (Regan , 2012) In my So, what are the conventions and prejudices that ex- own country, the Netherlands, the latest statistics ist today? There are a lot of things why men do not say that 15% of the nurses are male (van Woer- choose to study nursing. For instance, less opportu- sum, 2013). Compared to China this number is nities and influences from family/friends are two big extremely high! Only 1% (21.000) nurses of the factors that play a roll according to LaRocco (2007). total of 2.18 million nurses are male (Xin, 2012) In the rest of Europe the percentages are around 5 Furthermore, society has a prejudice about how a -10%, with some exceptions such as Iceland male needs to behave and which role obligations (1%) and (21%). At the end of the article they have when it comes to choosing a job. This you’ll find more statistics. There is still one case might explain why few males decide to study nurs- I would like to mention, Saudi Arabia, because it ing (Goode, 1960). This prejudice takes on a variety has the highest number of male nurses, 32% and of forms. One of them is that it is “unmanly” to rising! (Regan , 2012) Rather shocking statistics, choose nursing as a job (Kelly, 1996). Current stu- if I may say so myself. Now that we have seen dents are also often seen as gay (Dyck, 2009). This some numbers, lets see why there are so less is of course not necessarily true. Furthermore, isola- male nurses. tion may be a factor in relation to the fact that nurs- ing is not seen as attractive to the male student. The male nurse student is permanently in a female envi- We will look at the changing conventions/ ronment and they express a desire to interact more prejudices surrounding the profession of nursing, often with ‘’male role models’’ (Kelly, 1996). In as well as the influence of cultural and historical addition, male nurses find it hard to demonstrate the aspects in general. History tells us that one of the concept of caring. This is because of the difference first nursing schools was settled in India (250 of caring between men and women. Male caring B.C.E) and that there were only men allowed. might be less touchy and more based on a friendship Also during the epidemic of the Black Death on- -like bond than female caring (Stott, 2007) ly men were helping the people and risking there (Paterson , 1996). lives. So the beginning of the history of nursing looked pretty good for us men. But in the 19th Century nursing really became a female profes- sion (van de Pol, 2014). Florence Nightingale is generally blamed for the “demise of men” in nursing. She believed that the organization and supervision of nursing care should be taken out NEWSLETTER VI Page 8

Male nurses find it difficult that there is always a suspicion surrounding the intimate touch. Male stu- dents and male nurses fear prejudices of sexual impropriety when caring for female patients (Paterson , 1996) (Patterson & Morin, 2002). Be- sides that, according to male students and male nurses also identified the following concerns re- lated to touch: ” the feminization of touch, the sexualisation of men’s touch, men's vulnerability to accusations of sexual misconduct and the fail- ure of nursing education to provide male students with strategies for dealing with intimate touch and protecting themselves from false accusa- tions” (Harding, 2008).

A lot of countries and organisations call for more diversity in nursing. The American Assembly for Men has set a goal of 20% male enrolment in the U.S.A. nursing programs by the year 2020. (MacWilliams, Schmidt, & Bleich, 2013) India and China are also asking for more male nurses. (Regan , 2012) The lack of male nurses negative- ly affects the health in the U.S.A. according to the Sullivan Commission on Diversity in the Healthcare Workforce (2004). Most female nurses are also hap- py with male nurses on their department, since they are psychically stronger and are a good addition to the hospital. (van de Pol, 2014). So guys, what are you waiting for?!

Source: (Regan , 2012) Page 9 FLORENCE NETWORK STUDENT BOARD NEWSLETTER

WHY ARE THERE SO FEW MALE NURSES? BY: THOM DERCKSEN

SOURCES: maternal-child clinical rotation: the male student nurse Dyck, J. (2009). Nursing instructors’ and male experience . Nurse Education (41), 266-72. nursing students’ perceptions of undergraduate, classroom nursing education. Nurse Education Today (29), 649-53. Regan , H. (2012, May 5). Male Nurses Worldwide. Retrieved June 9, 2014, from Realmanswork: http://

realmanswork.wordpress.com/2012/05/05/male-nurses Goode, W. (1960). A theory of role strain . American -worldwide/ Sociological Review (25), 483-96.

Stokowski, L. A. (2012, August 16). Just Call Us Harding, T. (2008). Suspect touch: a problem for Nurses: Men in Nursing. Retrieved June 9, 2014, from men in nursing. Nursing Journal: Tai Tokerau Medscape Multispecialty: http://www.medscape.com/ Wananga (12), 28-34. viewarticle/768914_1

Kelly, N. (1996). The experience of being a male Stott, A. (2007). Exploring factors affecting attrition of student nurse. Nurs Education (35), 170-4. male students from an undergraduate nursing course: a qualitative study. Nurse Education Today (27), 325- 32. LaRocco, S. (2007). A grounded theory study of socializing men into nursing. Mens Stud. , 15 (2), 120-9. Sullivan Commission on Diversity in the Healthcare Workforce. (2004). Missing persons: minorities in the health professions. Washington, DC: Sullivan MacWilliams, B. R., Schmidt, B., & Bleich, M. (2013, January). Men in Nursing. Retrieved June 9, 2014, Commission on Diversity in the Healthcare Workforce. from American Journal of Nursing: http:// journals.lww.com/ajnonline/Fulltext/2013/01000/ Men_in_Nursing.26.aspx van de Pol, R. (2014, Febuary 25). 4 vooroordelen over mannelijke verpleegkundigen. Retrieved Juni 9, 2014, from Nursing: http://www.nursing.nl/Verpleegkundigen/ Mee, L. C. (2003). Looking fore more than a few Achtergrond/2014/2/4-vooroordelen-over-mannelijke- good men. Nursing 2009 , 8-96. verpleegkundigen-1469758W/

Minority Nurse. (2013). Nursing Statistics. Retrieved van Woersum, Y. (2013, Febuary 5). Steeds meer June 9, 2014, from Minority Nurse: http:// mannen kiezen voor HBO verpleegkunde . Retrieved www.minoritynurse.com/minority-nursing-statistics June 9, 2014, from Nationale onderwijs gids: http:// www.nationaleonderwijsgids.nl/hbo/nieuws/15721- steeds-meer-mannen-kiezen-voor-hbo- verpleegkunde.html Paterson , B. (1996). Learning to care: gender issues for male nursing students. Can J Nurs Res. (28), 25-29. Xin, Z. (2012, May 3). China faces difficulty hiring male nurses. Retrieved June 9, 2014, from China Daily: http://www.chinadaily.com.cn/bizchina/2012-05/03/ Patterson, B., & Morin, K. (2002). Perceptions of the content_15198248.htm

Page 10 FLORENCE NETWORK STUDENT BOARD NEWSLETTER

“managed” sixty births on their own – at home and in ERASMUS-LIFE IN PORTO,hospitals. PORTUGAL. The Netherlands. If I hear the name of this country, WhereasBY: JOHANNE the majority PEREIRA of pregnant RIBEIRO women in the first thing I think about is Home Birth. And I don’t Switzerland see their gynecologist first, Dutch mothers-

think I am the only one thinking this. Me as a to-be already have their first appointment at the I midwiferyknew right student, away Ithat couldn’t I wanted wait to to go go to on the Annual aware midwife’s.of whether The I was path reaching leading from the therelearning is based on risk exchange the moment I heard about the objectivesselection. that the This normal risk screeninginternship is in a process which is possibilityMeeting and to dohear so. more The about international it. I mean, who hasn’t demanded. It was on my own initiative that I talked coordinator at the university had contacts all performed continuously by the midwife. All women start heard of the (in Europe incomparable) high rate of with my clinical supervisor at the ward about the around the world, but having family and their pregnancy care at low risk. If a risk situation home births in the Netherlands?! We were lucky objectives I had to reach and what was required of me friends in the north of Portugal, I decided to to becomedevelops, better gynecologists every day. I very are often involved needed or take to over stayenough in Europe to have and a midwiferyfollow the-student, Erasmus lecturers as evaluate my own practice to be aware of to what programme in Porto, Portugal. eventually. well as a gynecologist to tell us about different extent I had reached my objectives. This was quite However, there are also important issues the Dutch aspects regarding the Dutch system. What a demanding but very giving in the end, and was amongstObstetric other things System a isreason confronted for my with personal these days. The Mychance! clinical placement was the pulmonary development as well. It was not all work and ward at Hospital São João, a rather “heavy” perinatal death rate was around 8,9‰ in 2009. This is Maybe it is easier to understand what is so different profession though. The social part of Erasmus is also unit with 90% terminal cancer patients and and unique about the obstetric system in the a very takenimportant very one.seriously Porto and is intensea great researchcity for students on possible patients with tuberculosis in isolation. I was and it hasreasons a huge for thisstudent is carried network. out in Iorder met manyto change other this as excitedNetherlands to start if but I explain also worried the situation as to what in my own wascountry expected first. In ofSwitzerland, me. All worries around aside, 1800 babiesthe out peoplesoon on Erasmus as possible. from Adding all around to this the is world, the fact some that the staff was amazing and had an approach to of them whom, today one year after, are still very dear of 80 000 a year are born outside the hospital. That home birth has been slightly decreasing over the past life that made it an incredible experience. friends of mine. Porto is such a diverse city and there few years – this as well is being researched and makes around two percent. At the University of was always a party, an event, a dinner, a happening One of the huge differences between the or a tripconcepts to somewhere. to support change are being developed. nursingApplied profession Science we in areDenmark taught and the importancePortugal, of isphysiology the role of andthe nurse births in the without health or care with little Hearing about all this has encouraged me to look more system. In Portugal, the nursing field is much closely at the system I will be working in myself soon. intervention. The reality in internships at the During my Erasmus I made some fantastic memories, wider and more extensive because they met amazingBut it has people also and encouraged grew me to think about myself carryhospitals out tasks is though, that in that Denmark hardly any would of us be students handledhas seen by more a specialist. than three For in around me it meant20 births that where tremendouslyand my aprofessional great deal as views a person. and skills It is most from another I had the possibility to improve my definitely an unforgettable experience, one I a baby was born without intervention of any kind. perspective – not just what could be changed about the professional competences and technical would neversystem, wish but mostly,to have which been small without. things I can adapt into skills;The number furthermore, of children extending born in amy non practical-clinical setting knowledgein the Netherlands and capability has decreased a great over deal. the last few my professional thinking and also my everyday work. years but is still impressively fifteen times bigger When I went home, my fellow students asked questions which led to many interesting discussions Fromthan time the oneto time in SwitzerlandI came across (around procedures 30%). This thatnumber were iscarried probably out completely the reason, different why midwifery - about obstetric systems within Europe. I hope this is a than what I was used to. I then had to students in the Dutch System are taught and trained good basis for some more thinking and discussing and compare and consider why things were therefore a good basis for at least small changes carriedto be out independent the way they from were. an early Through stage this of their processeducation. of constant In Year two evaluation, and three my of skills their training, (which lead to bigger ones…) – that again shows me greatly developed and I thus became they are already taking the main responsibility for the importance of international exchange. What a capable of augmenting my actions. chance the Florence Network is! However,women during professional pregnancy, development birth and the was post notpartum theperiod. only thing At the I experienced. end of their During studies, my they have exchange I had complete responsibility for my own learning, which meant that I constantly had to be NEWSLETTER VI Page 11

NEGATIVE PRESSURE WOUND THERAPY IN COMPARISON TO STANDARD WOUND CARE ON CHRONIC WOUNDS – A LITERATURE RESEARCH ON PUBMED AND COCHRANE LIBRARY BY: MANUEL WIEDERKEHR, SWITZERLAND-

Introduction The Rehabilitation Clinic where I did my last internship provided the entire wound care by an internal wound management service. Nurses on the wards took care of small wounds healing through primary in- tention. On one of the weekend shifts, a patient’s negative pressure wound dressing began to leak. Unfor- tunately the wound management service isn’t available on weekends. The nurses weren’t familiar with this particular dressing due to a lack of practice. Therefore a temporary dressing had to be applied. As a result of this, a colleague and I asked ourselves whether there were any advantages of a negative pressure wound therapy that would justify the risk of a non-optimal wound therapy, based on the lack of practice the nurses have on the wards. We followed this question by doing a literature research as part of a 4th semester research module at the University of Applied Sciences in Bern, comparing negative pres- sure wound therapy (NPWT) with moist standard wound care (SWC).

Method Discussion A literature research on PubMed and Cochrane Li- The trials had a few important limitations. The brary was conducted. Three RCT’s and one Meta- Meta-Analysis assumed a publication bias. Addi- Analysis were selected, which compared NPWT tionally, 9 out of 10 trials had been sponsored by with SCW on chronic wounds, such as pressure companies producing NPWT systems. ulcers, infected wounds, pilonidal sinus, burns, skin Another major limitation was the population. The grafts and dehisced wounds. Diabetic wounds were RCT with the biggest population had 50 partici- excluded. pants. Furthermore, similar or clear inclusion cri- teria were not defined. According to the different application standards of NPWT and SWC used Results between the trials, the internal validity was re- Due to the findings, duced. Each trial performed the interventions on the decision was different types of chronic wounds and it was made to focus on therefore difficult to draw a comparison. two wound healing

parameters. Every trail showed a signif- Despite these major limitations, there was still a icantly better wound tenor that NPWT increases the effectiveness of healing process, the wound therapy on chronic wounds, compared regarding healing to SWC. Additionally, NPTW is more cost effec- time and reduction tive because less dressing changes are needed of wound size, with and patients can be discharged earlier since NPWT compared to wounds are healing faster. Moreover, patients SWC. Furthermore, experience fewer painful interventions on their in comparison with wound area. SWC, the Meta-

Analysis showed a significant reduction Considering the Evidence-Based-Practice-Model of wound size with of Rycroft-Malone (2004) NPWT especially shows NPWT in 5 out of 9 advantages in the areas “Research Evidence” trials and a signifi- and “Patients’ Preferences”. In order to increase cantly faster wound- the “Clinical Expertise” and to provide an optimal healing time was wound management. Nurses, even though they found in 4 out of 6 might be sceptical at first, should be trained in the trials. usage of negative pressure wound dressings. In conclusion, this leads to the suggestion that chronic wounds of appropriate size should be treated with NPWT. Page 12 FLORENCE NETWORK STUDENT BOARD NEWSLETTER

NEGATIVE PRESSURE WOUND THERAPY IN COMPARISON“managed” TO sixty S TANDARDbirths on their W OUNDown – atC AREhome and in ON CHRONIC WOUNDS – A LITERATURE RESEARCHhospitals. ON P UBMED AND COCHRANE LIBRARY BY: MANUEL WIEDERKEHR, SWITZERLAND. The Netherlands. If I hear the name of this country, Whereas the majority of pregnant women in SOURCES:the first thing I think about is Home Birth. And I don’t Switzerland see their gynecologist first, Dutch mothers- think I am the only one thinking this. Me as a to-be already have their first appointment at the De Laat,midwifery E. H., student,van den IBoogaard, couldn’t wait M. toH., go Spauwen, to the Annual P. H., van Kuppevelt,midwife’s. D. The H., pathvan leading from there is based on risk Goor, H., & Schoonhoven, L. (2011). Faster wound healingselection. with topical This risk screening is a process which is Meetingnegative and hearpressure more therapy about it.in Idifficult mean,- towho-heal hasn’t wounds: a prospective

heard of the (in Europe incomparable) high rate of performed continuously by the midwife. All women start randomized controlled trial. Annals of Plastic Surgery. Netherlands. home births in the Netherlands?! We were lucky their pregnancy care at low risk. If a risk situation

enough to have a midwifery-student, lecturers as develops, gynecologists are involved or take over Petkar, K. S., Dhanraj, P., Kingsly, P. M., Sreekar, H., Lakshmanarao, A., Lamba, S., eventually. well Zachariah, as a gynecologist J. R. (2011). to A tell prospective us about randomized different controlled trial comparing aspectsnegative regarding pressure the dressing Dutch and system. conventional What dressing a methodsHowever, on split there- are also important issues the Dutch thickness skin grafts in burned patients. Burns. India. chance! Obstetric System is confronted with these days. The

Maybe it is easier to understand what is so different perinatal death rate was around 8,9‰ in 2009. This is Suissa, D., Danino, A., & Nikolis, A. (2011). Negative-pressure therapytaken versusvery seriously and intense research on possible and standard unique wound about care: the obstetrica meta-analysis system of inrandomized the trials. Plastic and NetherlandsReconstructive if I explain Surgery. the Canada. situation in my own reasons for this is carried out in order to change this as country first. In Switzerland, around 1800 babies out soon as possible. Adding to this is the fact that the Tuncel,of 80 U., 000 Erkorkmaz, a year are U., born & Turan, outside A. (2013).the hospital. Clinical That evaluation homeof gauze birth-based has been slightly decreasing over the past negative pressure wound therapy in challenging wounds.few International years – Woundthis as well is being researched and makesJournal. around Turkey. two percent. At the University of Applied Science we are taught the importance of concepts to support change are being developed.

physiology and births without or with little Hearing about all this has encouraged me to look more Rycroft-Malone, J., Seers, K., Titchen, A., Harvey, G., Kitson, A., & McCormack, B. closely at the system I will be working in myself soon. intervention.(2004). What The counts reality as evidence in internships in evidence at the-based practice? Journal of hospitalsAdvanced is though, Nursing, that 47(1), hardly 81 any-90. of us students But it has also encouraged me to think about myself has seen more than three in around 20 births where and my professional views and skills from another a baby was born without intervention of any kind. perspective – not just what could be changed about the The number of children born in a non-clinical setting system, but mostly, which small things I can adapt into in the Netherlands has decreased over the last few my professional thinking and also my everyday work. years but is still impressively fifteen times bigger When I went home, my fellow students asked than the one in Switzerland (around 30%). This questions which led to many interesting discussions number is probably the reason, why midwifery- about obstetric systems within Europe. I hope this is a students in the Dutch System are taught and trained good basis for some more thinking and discussing and to be independent from an early stage of their therefore a good basis for at least small changes education. In Year two and three of their training, (which lead to bigger ones…) – that again shows me they are already taking the main responsibility for the importance of international exchange. What a women during pregnancy, birth and the post partum chance the Florence Network is! period. At the end of their studies, they have

Page 13 FLORENCE NETWORK STUDENT BOARD NEWSLETTER

BODYWORK OF MIDWIFE STUDENTS “managed” sixty births on their own – at home and in BY: SARAH VAN ANKEN, BELGIUM AND INES NEUKOM, SWITZERLAND hospitals.

The Netherlands. If I hear the name of this country, Whereas the majority of pregnant women in Helene Gschwend Zurlinden, lector at the first thing I think about is Home Birth. And I don’t theirSwitzerland knowledge see their in gynecologist bodywork. first, RealisticDutch mothers - the Bern University of Applied Sciences, think I am the only one thinking this. Me as a situationsto-be already learned have their during first the appointment practice at the (Switzerland) started the workshop with lessonsmidwife’s. in Theschool path leadingare applied from there on is interns- based on risk anmidwifery exercise, student, so I couldn’t that wait we to go immediately to the Annual hip.selection. During This the risk whole screening time is of a processeducation which is knewMeeting what and thehear more workshop about it. wasI mean, all who about. hasn’t the students write a personal diary Weheard had of tothe massage (in Europe incomparable)our ischium high on rate one of performed continuously by the midwife. All women start where they reflect their experiences with side,home while births sitting in the on Netherlands?! a chair and We wereafter luckythe their pregnancy care at low risk. If a risk situation bodywork. They learn to recognize their massage we had to compare both sides. develops, gynecologists are involved or take over enough to have a midwifery-student, lecturers as own feelings, and name them, as well Surprisingly there was a difference! The eventually. well as a gynecologist to tell us about different as those of others. Hereby they point side with the massage felt a lot softer aspects regarding the Dutch system. What a theirHowever, attention there to are what also important happens issues in their the Dutch than the other! Bodywork – it’s about the chance! body.Obstetric To express System is somatic confronted situations with these days.be- The awareness of our own body, which is foreperinatal and afterdeath ratean interventionwas around 8,9‰ they in 2009. draw This is crucialMaybe forit is easier the workto understand as a what midwife. is so different “We somagrammstaken very seriously (look and intense at the research pictures on possible tendand to unique orientate about ourselves the obstetric outwards system in ins- the below). A somagramm represents the teadNetherlands of relying if I explain on our the interior”, situation in mentio- my own reasons for this is carried out in order to change this as physical condition in the form of nedcountry Helene first. InGschwend Switzerland, aroundZurlinden. 1800 babies out soon as possible. Adding to this is the fact that the drawings.home birth Athas thebeen sameslightly decreasing time also over thethe past At ofthe 80 000Bern a year University are born outside of Applied the hospital. Scien- That psycho-emotional state is visible. few years – this as well is being researched and cesmakes bodywork around two has percent. it’s fix At spacethe University in the of Furthermore the somagramm helps the schedule.Applied Science While we in arethe taught fist year the importancemany stu- of studentsconcepts toto support a more change sophisticated are being developed. body dentsphysiology experience and births the without lessons or with little as awareness.Hearing about all this has encouraged me to look more abstract,intervention. later The on, realityas it gets in internships practical at they the closely at the system I will be working in myself soon. canhospitals see what is though, advantages that hardly they any of have us students with But it has also encouraged me to think about myself has seen more than three in around 20 births where and my professional views and skills from another a baby was born without intervention of any kind. perspective – not just what could be changed about the The number of children born in a non-clinical setting system, but mostly, which small things I can adapt into in the Netherlands has decreased over the last few my professional thinking and also my everyday work. years but is still impressively fifteen times bigger When I went home, my fellow students asked than the one in Switzerland (around 30%). This questions which led to many interesting discussions number is probably the reason, why midwifery- about obstetric systems within Europe. I hope this is a students in the Dutch System are taught and trained good basis for some more thinking and discussing and to be independent from an early stage of their therefore a good basis for at least small changes education. In Year two and three of their training, (which lead to bigger ones…) – that again shows me they are already taking the main responsibility for the importance of international exchange. What a women during pregnancy, birth and the post partum chance the Florence Network is! period. At the end of their studies, they have

Page 14 FLORENCE NETWORK STUDENT BOARD NEWSLETTER

BODYWORK OF MIDWIFE STUDENTS “managed” sixty births on their own – at home and in BY: SARAH VAN ANKEN, BELGIUM AND INES NEUKOM, SWITZERLAND hospitals. Whereas the majority of pregnant women in TheThe lessonsNetherlands. are If I hear based the name on experiencesof this country, As a midwife you learn to develop Switzerland see their gynecologist first, Dutch mothers- ofthe the first midwives thing I think teachersabout is Home in Birth.the field. And I don’tBo- your own vision and you search what dyworkthink I amis not the onlyevidence one thinking based this. – Mebut asob- a to todo-be with already it. She have found their it first unfortunate appointment at the viouslymidwifery it student,works! I couldn’t wait to go to the Annual thatmidwife’s. there Thewas path sometimes leading from little there space is based on risk Meeting and hear more about it. I mean, who hasn’t forselection. exercises This during risk screening the internships. is a process which is

Toheard give of anthe idea(in Europe how incomparable)an application high inrate the of Asperformed a student continuously you grow by the in midwife.all this, All thewomen start practice could look like, there are two ot- more confidence you get in yourself, home births in the Netherlands?! We were lucky their pregnancy care at low risk. If a risk situation her somagramms. They show the soma- the more your dare instead of simply enough to have a midwifery-student, lecturers as develops, gynecologists are involved or take over tic and psycho-emotional condition be- addeventually. some more medication. These forewell and as a after gynecologist intervention to tell us of about a woman different are often unnecessary if you can sol- However, there are also important issues the Dutch whoaspects had regarding an unsuccessful the Dutch system. induction What of a ve the situation with your hands. labor.chance! Obstetric System is confronted with these days. The Maybe it is easier to understand what is so different Experimentationperinatal death rate is was the around message. 8,9‰ in 2009. This is Inand the uniqueend Ilona about Bürklin, the obstetric a third system year in stu- the Worktaken with very touchesseriously and not intense with words.research on possible dentNetherlands midwife if I at explain the the Bern situation University in my own of Afterreasons that for words this is carriedwill follow out in orderby them- to change this as Applied Sciences shared her expe- selves. People start talking with country first. In Switzerland, around 1800 babies out soon as possible. Adding to this is the fact that the riences she did with bodywork. She told trust, when they’re more relaxed. In- of 80 000 a year are born outside the hospital. That home birth has been slightly decreasing over the past that during the first lessons she was a stefewad yearsof sa y– inthisg ‘y aso u well ha v ise beingto br e researchedath and littlemakes skeptic around two about percent. all At the the University touchy of- like this or that’ just do this together. concepts to support change are being developed. feely.Applied The Science further we are she taught advanced the importance in the of Working with head, heart and hands studiesphysiology the andmore births she withoutlearned. or The with exer- little is Hearingwhat the about midwife all this has stands encouraged for. me to look more closely at the system I will be working in myself soon. cisesintervention. got more The reality concrete in internships and complex. at the But it has also encouraged me to think about myself hospitals is though, that hardly any of us students Source: Helene Zurlinden Gschwend, lector at has seen more than three in around 20 births where Bernand University my professional of Applied viewsSciences. and skills from another a baby was born without intervention of any kind. perspective – not just what could be changed about the The number of children born in a non-clinical setting system, but mostly, which small things I can adapt into in the Netherlands has decreased over the last few my professional thinking and also my everyday work. years but is still impressively fifteen times bigger When I went home, my fellow students asked than the one in Switzerland (around 30%). This questions which led to many interesting discussions number is probably the reason, why midwifery- about obstetric systems within Europe. I hope this is a students in the Dutch System are taught and trained good basis for some more thinking and discussing and to be independent from an early stage of their therefore a good basis for at least small changes education. In Year two and three of their training, (which lead to bigger ones…) – that again shows me they are already taking the main responsibility for the importance of international exchange. What a women during pregnancy, birth and the post partum chance the Florence Network is! period. At the end of their studies, they have NEWSLETTER VI Page 15

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The Florence Nursing and rope, stimulating research and countries. We work as a team Midwifery Network consists of developing common projects within the Florence Network, 37 universities and schools of and activities within SOCRA- promoting cooperation and higher education in 18 Europe- TES, ERASMUS and other pro- communication between stu- an countries and is one of Eu- grammes. dents and lecturers, ensuring rope’s oldest nursing and mid- The Network promotes the that the Network is visible in wifery networks. It´s main goals involvement of students, educa- universities and schools of high- include raising the profile of tors, practitioners and policy er education and encouraging European Nursing and Midwife- makers to ensure strong links international student exchange, ry, stimulating and organising between theory, strategy and as well as taking responsibility the exchange of lecturers and practice. The student board are for and contributing to the students, comparing and devel- a group of current nursing and achievement of exchange stu- oping new curricula in Nursing midwifery students, studying in dents’ learning outcomes. and Midwifery education in Eu- various different European