My Word!

Ward managers - do they need qualifications or training?

2010-02-05T11:04:00.006+01:00

Today I would like to introduce you to another participant in my intensive course this week.

My name is Cora, I'm a nurse and nursing teacher and I'm working currently at the Department of Continuing Education in a little hospital in the south of Germany. I'm responsible for the ward manager course, which has 720 hours and lasts about 16 weeks.
Times are changing very fast and the conditions in our health care system, too. For future ward managers the tension between economics (controlling costs) and ethics (e.g. sufficient conditions for the staff, satisfactory conditions for patients to get better again etc.) will get worse. I need to adapt the course to these changes and I'm thinking about the difference between the two words qualifying (Qualifizieren) and education or training (Bildung). Does a qualification (in terms of getting tools, like how to write a duty roster or knowledge of labour law etc.) covers sufficiently the daily requirements of a future ward manager or do they need more "training" in terms of developing their own personality. I think it`s not sufficiently enough to put, for example, conflict management in the timetable without other skills like networking, coaching (and being coached) or willingness to learn.
The ability to reflect on oneself while exchanging in an intensive way with other ward managers or deputy ward managers will maybe be one of the "key competences" to react properly to the (sometimes daily) changes taking place in hospitals and nursing homes. But the training of these soft skills is more difficult, needs more time and is more expensive; the current timetable and conditions surrounding the training program are very limited, so this will be my personal challenge: finding a balance between economics and ethics to find a good way to train future ward managers who can stand the daily demands for longer than just a few years.

Two more nurses on the way to London

2010-02-04T15:22:00.003+01:00

This week I am teaching a 5-day intensive course in Nursing English in Frankfurt. There are 7 nurses in the group, two of them are planning to start work in London this spring. I will let them introduce themselves to you.

Hi, our names are Bianca and Franziska. At the moment we're working in a hospital in east germany on an IMC (Intermediate Care) and ICU ward. Since August 2009 we have planned to go to England. We read an article in a special newspaper for nurses and there we found out that there`s an agency who supports nurses who want to go to Great Britain. We gave a phone call to the agency and the contact there sent us some information about that.
In January 2010 we had an appointment for two interviews in London. We were very excited when we travelled to London because we didn`t know what they expected from us in the interviews. They were very nice to us and tried to take away our fears. But that didn't work very well because we were absolutely nervous. One day later our agent called us and congratulated us on our new posts in England. We were very suprised and happy that our dream of going to England will come true. And now we`re planning the move to London. Keep your fingers crossed for us.

EnglishPracticeReflection in Frankfurt

2010-01-27T18:12:00.006+01:00

For a number of years a group of nurses in the Rhein-Main area who participated in one of my Nursing English courses at some point have met to continue to speak English, discuss nursing topics, and share experiences. The group meets once a month in a session called "English*Practice*Reflection". The name of this meeting means that we practice English, and that we reflect on nursing practice. We want to use this blog to introduce you to the members of this group and to give them a chance to get more experience in writing English for a larger audience.

Let me introduce you to Doris:

I have participated in medical English courses more than 20 years. It started out with a weekend course, when I was working at a paediatric practice. At school I learned English in an old-fashioned way, and what we learned there didn't have much to do with speaking English in reality, so I first had to learn a lot of vocabulary and practise speaking in that course.
Then we lost contact over some years, and met again at a week-long course in English for nurses in my hospital, which is a large one in the Rhein-Main area. I work there as a children´s nurse. The course was really helpful, but we pointed out, that it was necessary to keep in practise with English. So Yvonne started these monthly meetings. Here we talk about our work, and often had some papers to work on in the group. We learn new vocabulary, pronounciation and so on.
I find this really helpful, because sometimes you have no English-speaking patients for weeks, and forget a lot ;).-
For example, some days ago on my late shift I had parents who had to admit their 18-month-old girl after an eye accident - they understood a little German, but spoke only English. I had to show them the ward, their room, and speak with them about the treatment which the girl will would receive. The parents told me that they were really glad to have an English-speaking person in this horrible situation. Without practising English once a month, this would have been much harder for me. So I really appreciate these meetings.

And now here is Marianne:

Hello, I met Yvonne at the English course for Professors and Adjunct teachers at a University of Applied Science in Hessia. The main topic of this course was Social Work. I'm a nursing and health scientist and asked for a special course with nursing topics. So Yvonne invited me to join the "English*Practice*Reflection" group and I started this course in 2007. I met a lot of nurses with different special competencies in nursing. During our meetings we talk about our experiences at work and some of our daily problems. We have to speak in English so it is a good practice for learning new vocabulary and training our pronounciation.
At the moment I'm teaching in a nursing school and I'm writing a course book for a further education program for nurses.
This is my first post in Yvonne's blog and I hope somebody will read it.

more news from Julia in London

2009-08-03T18:03:00.004+02:00

Julia wrote me a couple of months ago to tell me of her plans - I forgot to post this then, and would like to share it with you now. Julia did some traveling for a couple of months and then planned to work in the NHS to get some experience there. I hope she will write to let us know what her impressions are.

London itself is a very interesting city. I enjoy living here. But my husband and I have decided that England won´t be the right place for growing up a family. Actually, that´s the reason for leaving London. At work I can not see the financial crisis, maybe because the HCA Gruop is a private company and our patients are arriving from all over the world.

Otherwise, Agency Nurses are telling me that the condition for NHS Nurses is getting worse. Their talks reminds me of the situation back home in Germany. I have not written it in my report, but a lot of the western nurses are going further to the USA, Australia or Canada (like I am planning to do). And a large number of nurses are from India and Pakistan. It makes me sad to see that the nursing standard becomes worse, because a lot of them are not very well
trained.

Another German nurse in London (3)

2009-04-03T19:05:00.002+02:00

Here is the third part of Julia's report.

Training to enhance Competency and working hours differences

Because of the Nursing Council, my manager is obliged to offer me a special amount of courses every year. I find it very nice, because I am able to choose from a lot of verities. The attended time is counted as working time. And like this, I am able to qualify myself in the field which I want to. So far I can mention it, it seems to be a little bit more professional organized than as back home in Germany.

In my point of view, the most beneficial advantage are the working hours. On the ICU, I care one patient for 12 hours from 8am to 8.30pm, or during the night shift from 8pm until 8.30am. Only one patient! My weekly total amount of working hours are 37.5. But because of the twelve hours shift, I am working just three till four days in a week. During my spare time, I am allowed to work as a Bank Nurse. This means, I am working self employed for the hospital and get extra paid for a shift. Like this, I can increase my salary up to my own capacity.

I see myself being very fortunate that I got the possibility to work here. It is just one step before the next one. It is a wonderful experience. I am pleased to see that nursing seems to be a profession which is respected. Back home, I saw a lot of nurses leaving their job because they were simply over worked. In Germany, the hospitals try to cut their costs, and mostly they are cutting the nursing staffs. It makes me very sad, because how we can establish our profession if we do not have time to show what we can? And how beneficial we are to cure the patient?

Another German nurse in London (2)

2009-04-03T19:01:00.001+02:00

Here is the second part of Julia's report.

Beginning Days with Multinational Staff

When I began to work, my colleague were very helpful. It was not very difficult for me to get integrated, because almost everybody in the ward is coming from abroad. London itself is a very international city. There are only two nurses from the UK in our whole ward and all the others are from Australia, USA, Canada, New Zealand, India, Philippines, Pakistan, Sri Lanka and some from Europe too. This creates a very exciting working environment. It is interesting to see how differently we all focus at our work. For example, nurses from the US focus highly in medical skills and the Canadian nurses are more focused on a supportive role to balance the deficits of the patient. Like this, we learn a lot from each other.

In the beginning, I carried a small red diary with me all the time. I used to write down all the expressions and abbreviation which I did not know. And the English people like abbreviations! For example FBC means Full Blood Count and SOB Shortness of Breath. Every evening I have written in my diary a small summary about what was new for me on that day and the difficulties I had faced. Like that, I started very fast to work independently and I got familiar with all the different kind of documentation. Furthermore, I could reflect my work and could see the weakness I needed to improve.

The different names of the drugs seemed to be the highest barrier for me. But this problem got solved. Lots of drugs are made in Germany and the package of the drugs were very helpful. Mostly, it was easier to read the drugs name than to listen it. The English pronunciation was really strange in the beginning. And I remember standing with a colleague in front of the drug cupboard. She taught me all the pronunciations, and on the end we were just laughing about this strange English way.

Another German nurse in London (1)

2009-04-03T18:50:00.007+02:00

Level of difficulty: intermediate

I received an email this week from a nurse who attended one of my intensive English courses a little more than a year ago. Shortly after the course she got a job in London. In this email she reports on some of her experiences there.

Hello,
My name is Julia and since September 2008 I am working in London as a Registered Nurse. Before I start to write about my experiences in England, I would like to tell a little bit about my nursing career.

In 2006 after completion of three years nursing school, I attended the German Nursing Exam “Gesundheits- und Krankenpflegerin”. Afterwards, I travelled for seven months in Asia where I used my skills on a volunteer basis to everyone who was in need. During my travel, I decided to learn more about nursing skills in the English speaking western world. With this decision, I came back to Germany. During this time, I came in contact with Kate from med-jobs. Kate was very helpful, and said honestly, that I need to gain more working experiences before I can think to work in England. That’s why I started to work in an ICU for one and a half year in Germany.

Nursing English

During the registration process, I attended the course “Communication with Patients” with Yvonne Ford in Frankfurt. I will not forget those five days. The class was during the summer time and she tried to give us students the best working environment as she could. She taught lovely the basic English skills of nursing. During the class we had very interesting discourses about essential nursing skills and personalities. I studied during these days the new vocabularies very deeply. When I look back, I realize that this course was very helpful for me to get started in my new work place. Yvonne prepared me also for the interview and her judging mind supported me very well.

Registration Process and Interview

In spring 2008, I contacted Kate again. The registration took almost two months and all worked superbly out. She helped in many different ways and arranged two interviews for me. On my 26th birthday in July 2008, I had an interview for a position as a staff nurse on a cardio surgical ICU in London. And two days after I arrived home, I got a positive result! It was a very exciting time.

Ebay for nurses ?!

2008-03-30T13:45:00.005+02:00

Level of difficulty: lower intermediate

In the USA there is a shortage of nurses. The reasons for this are complex. However, the shortage means that new ideas are being developed to deal with the problem.

One idea is a website (http://www.nurseauction.com/) that allows nurses who want to work to put their details online. Hospitals who need a nurse can get in contact with them. Nurses can sell their time for one shift or more. They decide how much they want to earn - and the hospital or health care institution can accept their price if they need a nurse urgently. The website is free for nurses.

Some hospitals have their own internal auction programs: if a nurse is needed, the hospital puts the information on their website. If it is a shift that no one wants to work (for example, Christmas Day) then the nurse can demand high pay. The hospital will give the work to the nurse who makes the lowest bid (of course, the nurse has to be qualified for the work area.) If not many people make a bid, then the nurse has a good chance of getting higher than average pay.

These strategies will not deal with the shortage of nurses, but will allow nurses to choose better working conditions.

Working in London, Irina's report, part 3

2008-03-07T14:52:00.000+01:00

Level of difficulty: intermediate

This is the third and last part of Irina's report.

Another big difference is the documentation. In this hospital group there is a special US computer programme where they document everything. This programme is very hard to learn because it is very compact and sometimes complicated. But as soon as you know how it works it is ok. The documentation of everything needs a very long time. I thought in Germany we have too much documentation, but this is a lot more.

I also had difficulties in the beginning with understanding handovers, because there are a lot of foreign nurses who have different English accents and they use a lot of abbreviations which I didn’t know. And of course the medical English is very difficult, though written is much easier than spoken due to the pronounciation.

Besides all these problems in the beginning ( which is quite normal ) I’m very happy to work here. My new team has been very supportive and friendly, they helped me a lot going through all of this because a lot of them went through this by themselves. They were all very understanding.

Now I can work on my own and I am a lot more confident, though I still have a lot to learn and a lot of questions. It is sometimes busy at work but I don’t have the kind of stress I had in Germany and it is much better to work 12 hours. The salary is also a lot more than back home. Though London is very expensive, I can live a very good life and even save a lot of money.

As a summary I can say that I enjoy being a nurse again and it is great to live in London!!!

Working in London - Irina's report, part 2

2008-03-07T14:00:00.005+01:00

Level of difficulty: intermediate

This is part 2 of Irina's report.

I want to tell you about my job now. I’m working in a private hospital, which is one of 6 American hospitals in London and which has a very good reputation. So there are a lot of foreign people who come there to be treated. I’m working there on the neurosurgical ward with about 20 patients. Each nurse has about 4-5 patients to look after.

There is no A&E department (emergency room), so there are mostly planned admissions. The sister in charge is there for problems with patients; she also allocates patients to a nurse, knows which room the admissions come to and which nurse will admit them.

I work 12 hour shifts which I like very much because I only have to work 13 days and therefore have a lot of days off to recover.

For me the first weeks of work were very difficult. Sometimes I felt that I’d never done nursing before. It is very different from how I used to work in Germany. For example nurses here do things that I’ve never done before. They do ECGs, remove clips and drains, give i.v. injections and blood transfusions; sometimes they take blood or put in cannulaes.

There are a lot of further training program where I have to go to learn everything. Also the equipment they use at this hospital was unfamiliar. But the training courses help me to get used to everything, also to get to know all of the hospital policies.

Giving medications is very different here and also very strict. Medications are prepared when they are given; the nurse who prepares the medication has to give it and also watches the patient take it. All infusions, injections and controlled drugs have to be signed by two nurses before they can be given.

Finding a job in London - Irina's report, part 1

2008-03-05T13:29:00.004+01:00

Level of this article: intermediate

Irina B. took part in a course in my Centre in the fall of 2007. She was preparing for a job in London. I asked her to write me after she found her job. In this part of her report she describes what she did to get the job.

Finding a job in the UK wasn’t really that difficult. It is best to try to find something with an agency because they will help you with all the paperwork.

My agency was called Med-jobs (www.med-jobs.de) and Kate was always very helpful. You just have to fill out a form for them and write a CV and they will tell you exactly what you need for the registration with the NMC ( nursing and midwifery council ). You don’t have to pay for the agency and you don’t have to translate anything because all of that will be done by the agency. So you just have to send everything to Med-jobs, they will inform the NMC and then you have to wait ( which was the worst part for me because I’m very impatient ). I received my NMC pin with which I am allowed to work in the UK after about 2 months.

Kate called me then after about half a month later to tell me that I have an appointment for an interview. I had to fly to London for the interview. It was a good atmosphere during the interview, so I wasn’t nervous at all. They were very nice to me and it was more like a chat.

They wanted to know, where I worked before, how many patients my ward had, how long I’ve been a nurse, what I like about being a nurse, how I would handle difficult patients, how I would try to communicate with a patient who doesn’t speak English, if I would give a prescribed medication which I know is wrong, positive and negative points on me, why I chose England.

After two days they told me that I have the job and a month later I started work there. Everything was arranged by the agency.

All of that didn‘t cost a lot of money. About 500 Euro with NMC registration, flight and hotel to interview. The most expensive was when I started work because I first received salary after I worked one month. So I had to live on my savings a whole month in London which is very expensive.

Living Will

2007-10-07T17:31:00.000+02:00

Level of this article: intermediate

The term living will, called a "Patienten Verfügung" in German, refers to a written statement made by a person concerning their wishes for the period leading up to the end of their life. Another term that is often used is "advance directive." The term "last will and testament" refers to the legal document that is opened after the death of a person in which the inheritance of the person is distributed.

A person may be chosen to hold "medical power of attorney" - that person is responsible for staying in communication with the health care professionals to be sure that the patient's wishes are respected. The person who takes over this role is called the patient representative or surrogate.

This role implies a relationship of deep trust between the patient and his or her representative.

The most important medical advances

2007-03-16T14:12:00.000+01:00

English level of this article: advanced

What do you think has made the biggest difference in health care in the last years? Here are a few suggestions.

antibiotics
contraceptives
anesthesia
hospitals
clean water
vaccinations

Here are some statements for an article that was published in the UK at the beginning of this year. Do the results surprise you?

Sanitation rated the greatest medical advance in 150 years
Sarah Boseley, health editorFriday January 19, 2007
The Guardian

Sanitation is the greatest medical milestone of the last century and a half, acccording to a poll carried out by the British Medical Journal.

Sanitation was the clear winner among 15 milestones shortlisted by readers of the journal, including the development of vaccines, which has safeguarded many children's lives, and the invention of the contraceptive pill, which was a contributory factor to significant social change.

The winner was chosen by more than 11,000 members of the public around the world (...) The competition was to mark the relaunch of the BMJ and all the innovations had to have taken place since it was first published in 1840.

Sanitation was the undisputed winner, with 1,795 votes, over antibiotics in second place with 1,642 votes, and anaesthesia which took third place with 1,574.

(...) It is difficult now to calculate the cut in deaths attributable to improved sanitation in the 19th century, but it is possible to see the effects in the developing world wherever clean drinking water and sewerage are introduced. One major review showed deaths and damage in children from diarrhoeal diseases were reduced by about a fifth.

One of the professors who was interviewed drew three conclusions.

1) you do not have to know all about disease causation to intervene effectively.
2) environmental improvements, such as the provision of clean water, can be more effective than trying to persuade individuals to change their behaviour.
3) interventions that help all the people may be more effective than those aimed at particular groups

Work AND Family? How?!

2007-02-26T12:39:00.000+01:00

Level of this article is: upper-intermediate

Is it possible to have a family if you are working? The term "work-life balance" means having time and energy for both - not neglecting your children or personal needs because you are working so much, and not neglecting your work because of family or personal problems.

At the beginning of February 2007 the results of a survey on work-life balance which was carried out by the Equal Opportunities Commission in England were published. More than 2,000 people were interviewed.

Here are some of the results:

- 82% of people say it is difficult for parents to balance work and home life. More than seven in ten believe the situation will be worse, not better, in ten years' time.

- 96% think it is hard for other carers to combine their role with work. More than eight in ten think the next decade will only see the challenge become harder.

The chairperson of the Commission, Jenny Watson, said that "a serious breakdown in family and community life" will take place if changes are not made to support families. She called for "more opportunities for women and men to decide how to share caring and working responsibilities between themselves." She also said "more women are needed in positions of power" so they can make decisions that will support families.

According to the survey, almost two-thirds of the public believe the world of work should change to suit the needs of families rather than the other way round. Spending time with the family or finding time for key relationships is the biggest concern in daily life for both men and women, ahead of money, health, work and local safety.

Ms Watson also said: "The social revolution is an unfinished revolution. Family life has changed dramatically in the last generation (...) it feels as if the world has changed but society has failed to keep up."

These problems are "hot issues" in Germany as well as in the UK - more nursery schools for children, money for parents who stay at home with their children, part-time jobs for fathers and for mothers, the low birth rate in Germany. All these topics are being discussed today.

"Speak up when you are down"

2007-02-24T14:56:00.000+01:00

Level of this article: upper-intermediate

In English there are many verbs that are formed using a verb along with a preposition - the title of this article "Speak up when you are down" is using this kind of verb form to make its point.

Speak up means letting your voice be heard, speaking loud enough so that people can hear you.

To be down means being depressed. So the title of the article could be re-phrased as "tell somewhen when you feel depressed".

"Speak up when you are down" is the slogan for a public education campaign in the USA to let people know about the risks of depression about the birth of a baby. This link gives information about the program in the state of New Jersey.

http://www.state.nj.us/health/fhs/ppd/home.shtml

This kind of depression is called "post-partum depression" or PPD. Often women feel ashamed to admit that they are not happy and so they do not tell anyone.

About PPD

Postpartum depression (PPD) is treatable, but many people do not know the facts. They wait too long to get help, or never seek treatment.

PPD is serious. Feelings of depression or sadness may cause a new mom to feel confused and alone. By learning to recognize and understand PPD, a woman can seek support from her family and get medical help. Husbands, partners, friends, and family members can help in the process. Often, they recognize there is a problem even before the woman herself.

Postpartum depression affects one in every 8 to 10 women. It usually occurs within the first year after childbirth, miscarriage or stillbirth. PPD is not a character flaw or sign of personal weakness. It does not mean that there is anything wrong with your ability to be a mother. The symptoms of PPD range from mild blues to severe depression. The depression may be mild, moderate, or severe.

treatable - kann behandelt werden

childbirth - Geburt

miscarriage - Fehlgeburt

stillbirth - Totgeburt

Breaking the silence

2007-01-15T12:39:00.000+01:00

Level of this article: advanced

In December 2006 the Guardian newspaper in London published an article written by Dr. Alison Leary in which she says that nurses should speak out about their work - tell patients, families, people in other health professions, politicians and the public about WHAT they do and WHY they do it.

I feel that this article is an important one and so I want to quote a longer section of the article. Maybe this will encourage nurses in German to speak up about their work, too.

Nurses don't talk about their knowledge and professionalism, says Dr Alison Leary. Maybe it's time they broke their silence
Monday December 11, 2006 SocietyGuardian.co.uk
---------- ------------

In the UK press reports "of nurses not feeding patients or not providing "basic" care because they are too busy taking doctors' jobs are commonplace. But what is the response from the largest professional group in the NHS to these criticisms? Silence.

Nursing is a secretive occupation. People think they know what nurses do (...) Nurses keeping their professional attributes a secret has lead to the public misinterpreting and eventually devaluing the work of nursing and of caring in general.

In the press, there seems to be an obsession with wiping bottoms or being "too posh to wash", so let's start there. This "basic" (the word should be fundamental) care is often thought of as unskilled work that anyone can do. But think about it. How would you feel about dealing with a stranger in such an intimate way? A stranger who is so humiliated at his or her inability to control their own bodily functions that they weep? Then imagine having to care for him or her and 29 other patients with only two colleagues to help you. This takes skill and professionalism. It's not only the skills of the physical task that are important but also the ability to provide the associated psychological care (...)

So why the secrecy? Why don't nurses shout their worth from the rooftops? A lot of the reasons are to do with the socialisation of nurses into the profession, particularly in the past. Consider the words of Florence Nightingale: nursing is woman's work and "...should be done quietly and in private". Not a surprising attitude in the 19th century (...)

Nursing alleviates suffering. This can be physical suffering (...) but nurses also deal with the psychological, social and spiritual suffering inherent to the experience of living and dying. Nurses also save lives. A recent study showed that higher levels of qualified nurses mean lower death rates. This is because nurses continuously "rescue" patients from disease, from the consequences of treatment and occasionally from practitioners in medicine itself (particularly the inexperienced ones).

What about taking doctors jobs? That's like saying an electrician is taking a librarian's job. Nursing is not a competitor to medicine; it's a different profession (...)

If you were a patient with a chronic disease such as diabetes, would you rather see a junior doctor at the start of his or her career who will be around for six months at most or a nurse with years of experience and a PhD in the subject who will help you manage your care in the long term?

Nurses don't tend to shout about their experience and education. But it's time to break the silence.

·Dr Alison Leary is a registered nurse and Macmillan lecturer in oncology at University College London hospital foundation trust.

press reports - Medienberichte
commonplace - gewöhnlich
silence - Schweigen
occupation - Beruf
attributes - Qualitäten
devalue- abwerten
wiping bottoms - Hintern putzen
too posh to wash - zu fein um ein Patient zu baden
fundamental - grundlegend, unabdingbar
humiliated - erniedrigt
weep - weinen
to shout from the rooftops - vom Dach rufen
alleviate suffering -Leiden lindern
inherent - beinhaltet in, ein Bestandteil von
rescue - retten
to break the silence - das Schweigen brechen

Breastfeeding - it's okay!

2006-11-02T12:07:00.000+01:00

Level of this article: intermediate

In the USA a few weeks ago, a mother who was breastfeeding her child in an airplane, while waiting for take-off, was forced to leave the plane when she refused to stop feeding her child.

This event produced a protest across the country - breastfeeding mothers went to airports to breastfeed in public.

The airline issued an apology.

But why does breastfeeding in public cause such outrage? The female breast is used in public advertising for all sorts of products, from skin care creams to cars. But to see a mother's breast because she is breastfeeding? - That can't be allowed in public! is the opinion some people have.

In France this fall there were a number of events which were organised to take a stand against the taboo on nursing in public. “The Big Breastfeed” is part of an international campaign organised by UNICEF and the World Health Organisation to promote breastfeeding as a newborn's best defence against diarrhoea and respiratory infection.

In the UK there has been an initiative called "the breastfeeding welcome:” shops, restaurants and other business across Wales putting stickers in the window to identify welcoming places for nursing mothers. There is also a growing chain of drop-in centres known as “baby cafes” which are specifically aimed at women who are breastfeeding.

How do you feel about this question? If you would like to make a comment you can send me an email: Yvonne.Ford@cchc.de

Vocabulary

breastfeeding - Stillen, das Kind die Brust geben
issue an apology - ein Entschuldigung aussprechen
outrage - Entrüstung
advertising - Werben
nursing - Stillen
newborn - Neugeborene
defence - Verteidigung
stickers - Aufkleber
welcoming places - offene, begrüßende Orte
aimed at - gezielt ansprechen

Less nurses = more patient deaths

2006-10-31T16:59:00.000+01:00

Level of this article: upper-intermediate

One of the ways of reducing hospital costs is to cut the number of nurses. Recently large hospitals in Germany have announced that they will fire nurses (as well as some doctors and other staff) in order to save money.

What does this mean for patients? Of course, it means waiting longer for an appointment or waiting longer for care once a patient gets to the hospital.

But this study, part of the International Hospital Outcomes Study, shows patients develop complications, have to be re-admitted to the hospital or even die when ratios between patients and nurses is high (for example, when one nurse has to care for 12 - 16 patients). The British study was based on 120,000 patient records in 30 different hospitals, with over 4000 nurses.

In my opinion, this information should reach politicians and hospital managers in Germany. AND, German citizens should know that reducing the numbers of nurses in hospitals puts them at risk!

Nursing Shortages boosts death rates
http://news.bbc.co.uk/2/hi/health/6077690.stm

Nursing shortages are linked to an increase in patient death rates, a study of English hospitals has found.

Scientists discovered mortality was 26% higher for the hospitals with the worst staffing levels compared with those with more nurses per patient (...)

The Royal College of Nursing said the study, published in the International Journal of Nursing Studies, showed it was essential to retain nursing posts (...)

They found the patient-to-nurse ratios varied from 6.9 to 14.3 across the trusts. And patients in the hospitals where nurses had the highest workloads were more likely to suffer complications and/or die than those in hospitals with better staffing ratios.

The researchers also discovered the nurses caring for the most patients were 71% more likely to suffer "burn out", and 91% more likely to be unsatisfied with their jobs compared with the nurses with a lighter workload.

Here is the report in the German magazine "Spiegel."
http://www.spiegel.de/wissenschaft/mensch/0,1518,444319,00.html

Family members may be unreliable translators in hospital

2006-10-18T11:20:00.000+02:00

Level of this article: intermediate

This article reports that the state of New York in the USA has passed legislation that requires all hospitals to provide skilled translators for patients who do not speak English.

What this means is that hospitals can no longer allow family members to translate - they have to offer someone who is able to speak the patient's language as well as English. The patient can choose NOT to accept the hospital translator but the hospital has to offer someone first.

Why has this decision been made? There is evidence that family members, especially children, are not able to translate safely and accurately for the patient. Important information may be lost and the patient may be at risk.

I'd like to see this kind of legislation in Germany!

New York State Hospitals Require Translators For Patients With Limited English Proficiency
19 Sep 2006

New York state on Wednesday began requiring that all hospitals provide skilled translators for patients, "amid fears that family members can be unreliable translators for non-English-speaking patients," AP/Long Island Newsday reports. There are no state or federal standards for what a "skilled" interpreter is, according to AP/Newsday.

Most hospitals will rely on volunteers, bilingual staff members and telephone translation services to fulfill the requirement, according to Adam Gurvitch, director of health advocacy at the New York Immigration Coalition. (...)

Under the new regulations, patients still can choose to use their children or a relative to translate but only after they refuse hospitals' translators. According to the new regulations, children younger than age 16 will not be able to act as an interpreter. (...)

legislation - ein Gesetz
to require - erforderlich sein
to provide - bereitstellen
translator - Übersetzer
proficiency - Sprachkenntnisse
amid - inmitten
unreliable - unzuverlässig
to rely on - sich auf etwas verlassen
refuse - ablehnen
interpreter - Dolmetscher

Jargon - does it hide more than it reveals?

2006-10-11T12:05:00.000+02:00

Jargon can be heard everywhere we turn these days - hospital management promises "Quality- and Risk- Management" at the same time that the number of nurses and doctors are being reduced. Disease-management and evidence-based medicine suggest that patients will get the best of care - but do these phrases really point to new realities in health care?

The article below says that jargon often hides the truth from the public. Jargon is a shared language of people who work in the same field - and is a sort of short-cut to communication. But when jargon is used with people outside the field it cuts them off from knowledge and understanding.

Healthcare jargon means that patients don't understand their diagnosis or their treatment. Management jargon excludes the participation of the staff.

Jargon is sometimes like the "emperor's new clothes" - in reality, there isn't anything new to report. The effect is that patients lose trust in their carers and and staff lose trust in their managers.

SocietyGuardian.co.uk Society Guardian David Walker: Public managers risk alienating people by retreating into jargon

"We all use jargon ... (however) Abbreviation can include people in, as well as exclude (...)

The problem isn't coining a new word or using a noun as a verb - that's how language grows. It's whether, in retreating to a private language, holders of public offices cease to be understood by the people they work for (...)

Management - private and public - scores high on the bullshit scale. Leadership, strategy, modernisation, governance, community, innovation, partnership, accountability, customers ... these are all among the words that become fashionable, so everyone starts using them, often without pausing to ask whether they mean much. (...)

More involvement by people in their government has to start with speaking to them in language they get."

David Walker is the editor of the Guardian's Public magazine.

shared - geteilte
"Emperor's new clothes" - des Kaisers neue Kleider
abbreviation - Abkürzungen
include - einschliessen
exclude - ausschliessen
to coin a word - ein Begriff neu erfinden
bullshit scale - Blodsinnskala
fashionable - modisch, in Mode kommen
to pause - innehalten
involvement - Beteiligung
to get - begreifen, verstehen

Nurses have difficulty balancing work and family life

2006-09-26T08:44:00.000+02:00

Results of a new study that was carried out in the USA show that nurses say that their work causes problems with family and personal life.

Many of you who work in hospitals will nod your heads and say "what is new about this? I could have told you that!!"

What is new is that there are reliable statistics to show that this problem is real. 50% of registered nurses say they experience work-family conflict!

And, since there is already a shortage of nurses in many countries, this research shows that changes need to be made so that it is easier to find a balance between work and family life. Otherwise, people will not be interested in becoming nurses and the care of patients will suffer.

Work-family Conflict Common Among Registered Nurses, Study Shows

In a national survey of registered nurses, half reported chronic interference of work with their home lives, such as being unable to spend the time they wanted with their families, according to researchers from Wake Forest University School of Medicine and colleagues.

"Work-family conflict has significant implications for nurses in terms of personal health, their ability to provide quality care and for the nursing profession itself," said Joseph Grzywacz, Ph.D., an associate professor of family and community medicine and lead author on the study, reported in the current issue of Research in Nursing & Health.

The study is the first to provide reliable estimates of how frequently work-family conflict occurs among nurses. Work-family conflict refers to situations in which the demands and responsibilities of work and family roles are incompatible in some respect. It can occur in both directions. For example, family can interfere with work if a worker is distracted by marital problems or a sick child. And, work can interfere with family when work schedules make it impossible to attend family functions or complete household chores.

Work-family conflict can exacerbate the current nursing shortage by discouraging people from entering the profession or prompting them to change careers, Grzywacz said. In addition, work-family conflict is associated with lower job satisfaction, fatigue, burnout, and emotional distress or depressive symptoms, according to research. "Work-family conflict has the potential to undermine nurses' ability to provide high-quality care," Grzywacz said.

results - Ergebnisse
reliable - zuverlässig
shortage - Mangel
suffer - leidet
interference - Störung
significant implications - bedeutsame Auswirkungen
estimates - Einschätzung
occur - findet statt
incompatible - unvereinbar
family functions - Familienereignisse
household chores - Hausarbeit
exacerbate - verschärfen, verschlimmern

Is childhood at risk?

2006-09-15T14:28:00.000+02:00

You probably know the word "junk food" - it refers to food that can be bought in fast-food restaurants that has very little nutritional value. And only a short time later, you are hungry again.

But what about the term "junk culture" - what could this mean?

In September 110 professionals who deal with children sent a letter asking the British government to protect "real" childhood so that children can develop into healthy adults. Junk culture includes junk food, overuse of computer games and television, high pressure to compete at school.

What would be healthy childhood? The professionals say children need real, nutritious food, time to play outside in the fresh air, attention from adults who are interested in teaching and caring for children, and real experiences with animals, people and learning.

EducationGuardian.co.uk News crumb Junk culture killing childhood, experts warn: "Junk culture killing childhood, experts warn

Helen Mooney
Tuesday September 12, 2006
EducationGuardian.co.uk

"British children are being 'poisoned' by a culture of processed food, computer games and over-competitive education, a group of academics and authors claimed today.

In an open letter to the Daily Telegraph, 110 teachers, psychologists and children's authors have called on the government to prevent the death of childhood.

The authors of the letter (...) warn that children need to develop as human beings.

'Since children's brains are still developing, they cannot adjust as full-grown adults can, to the effects of ever more rapid technological and cultural change,' the letter says.

'They still need what developing human beings have always needed, including real food (as opposed to 'junk'), real play (as opposed to sedentary, screen-based entertainment), first-hand experience of the world they live in and regular interaction with the real-life significant adults in their lives,' they write."

nutritional value - Nährwert
protect - schützen
overuse -übermäßiger Gebrauch
pressure - Druck
compete - wetteifern
attention - Aufmerksamkeit
academics - Lehrkräfte
prevent - verhindern, vorbeugen
adjust - anpassen, sich einstellen auf etwas
sedentary - sitzend
significant - bedeutend, wichtige Person

Elders re-live war experiences

2006-08-09T12:19:00.000+02:00

The author of this article, Christopher Manthorp, is a nurse for elderly people in England. He is reflecting on the war in the Middle East and remembers his own experiences with older people he has cared for.

He says that many older people who become demented re-live the traumatic experiences that had during war. Of course, in Europe, this usually means World War I and II. However, many immigrants to countries in Europe have experienced war and displacement in other places around the world. Experiences in hospitals and elders' homes may trigger memories of these frightening experiences. Sensitive nursing or social care may help these persons to cope with their memories better.

SocietyGuardian.co.uk Comment Christopher Manthorp: It's isn't just the young who are wounded by wars: "In times of war, there is always a focus on how children suffer, but older people suffer at least as much. Children, if they are spared, have an almost unlimited potential for picking themselves up and starting again. Older people, on the other hand, are less mentally and physically resilient. They are more tied into their familiar surroundings, losing more when their reference points are destroyed and family networks smashed to pieces. They may find a temporary focus in saving possessions or helping relatives, but they pick themselves up after the immediate crisis to find that they have lost a lot more.
Of course, the misery caused by war isn't a competitive area, or one where it is proper to generalise much. It scars everybody. People talk about it less now, but when I started looking after older people 30 years ago, our own wars were a topic that surfaced regularly."

re-live - erneut durchleben
immigrants - Einwanderer, Migranten
trigger - auslösen
sensitive - sensible
suffer - leiden unter
at least - mindestens
spared - haben überlebt
unlimited - unbegrenzt
resilient - widerstandsfähig
reference points - Bezugspunkte (Orte, Personen)
smashed - zerstört
scars, to scar - Narben lassen

Giving "homegrown" nurses first chance

2006-07-04T17:44:00.000+02:00

Do you know the word homegrown? It is an adjective that developed from the phrase "to grow something at home." When this phrase was created, it referred to growing vegetables in your home garden.

In this article "homegrown" is used to describe nurses who were born in the UK (or in Europe) and received their training there.

Just a couple of years ago, the UK (as well as the USA and Australia) were criticized for drawing nurses away from countries in Africa and other parts of the world in order to fill the vacant positions in their hospitals. Now, because nursing positions have been cut in order to save money, nurses who just finished nursing school in the UK are not finding jobs. So a new regulation will limit the number of young foreign nurses who can come into the UK - to give the homegrown nurses a better chance at getting a job.

"Workforce planning" is a term that describes the process of thinking ahead about how many people will be needed in a profession in the future - and how many should be trained.

Something seems to be wrong with the workforce planning in nursing - not only in the UK!!

Foreign nurses barred in attempt to help homegrown candidates Sarah Hall, health correspondent
Tuesday July 4, 2006
http://society.guardian.co.uk/health/story/0,,1812083,00.html

Thousands of international nurses are to be banned from working in the UK to improve the chances of homegrown candidates getting a job, the government announced yesterday. The vast majority of overseas nurses will no longer be able to get work permits unless NHS trusts can prove they are unable to fill the posts with candidates trained in the European Economic Area or the UK.

International nurses now working in Britain will be unaffected by the rule changes, which come in on August 7, as will those applying for specialised areas such as intensive care in which there are shortages. But newly qualified nurses and those with up to two years' experience will be banned from applying. The move is thought to affect up to 10,000 candidates. Last year 12,670 overseas nurses entered Britain, most at the junior level. (...)

The Royal College of Nursing accused the government of scapegoating international nurses because of the £1.3bn NHS deficit. "International nurses have always been there for the UK in times of need and it beggars belief they are now being made scapegoats for the deficits crisis," said its general secretary, Beverly Malone. "More than 150,000 nurses are due to retire in the next five to 10 years and we will not replace them all with homegrown nurses alone."

Vocabulary

homegrown - selbstgezogen, im eigenen Land entstanden
candidates - Bewerber
to bar, barred - sperren, ausschliessen
to ban, banned - verbieten, untersagen
vast majority - grosse Mehrheit
to scapegoat - jemandem als Sündenbock zu nutzen
it beggars belief - es ist schier unvorstellbar
to retire - in Ruhestand zu gehen

No jobs for nurses??

2006-07-03T09:30:00.000+02:00

Over the last years England has been importing nurses from foreign countries to meet the nursing shortage they have. Ads for jobs are placed in German nursing magazines.

But at the end of June nursing schools in England reported that only 20% of nursing students who are finishing their training have been offered a job.

Why? The costs of healthcare in the UK are so high that cutbacks are necessary. This means that hospitals are closing beds, and are not hiring new staff.

Frustrated new nurse graduates will have to look for other work. And the nursing shortages will increase. The number of patients who need care is not dropping.

This story sounds familiar. I taught a course in a nursing school in Frankfurt two year ago. The students were in the final months of their course and only two or three had a job offer. All the others were afraid they would have to go on unemployment after they finished nursing school.

http://society.guardian.co.uk/health/news/0,,1809133,00.html

"Four out of five graduate nurses 'face unemployment"

Nursing shortages saw the number of students expand dramatically in the 1990s as hospitals were forced to recruit overseas to meet workforce targets.

The demand for qualified nursing staff has traditionally guaranteed students a job once they qualify after three years of study.

But evidence from 20 universities in England... showed more than 80% of nursing students are finishing their training without a post lined up, up from 30% last year.

Gail Adams, head of nursing at Unison, said it was "immoral and unethical" to allow people to devote years to training and then face an acute employment shortage.

It was also a disgraceful waste of taxpayers' money, she said."It takes around £50,000 to train a nurse and to see this money wasted is a disgrace."

The report concluded not only that present students were facing disappointment, but that news of the shortages could hit future recruitment and cause early drop-outs.

Ms Adams said: "Student nurses are frustrated, angry and disillusioned because of the difficulties they face finding jobs as deficits bite. It is clear that the Department of Health has failed to forward plan, or we would not be in this dire situation.

What kind of message does this send out to people thinking of taking up nursing in the future?

There is an overall shortage of nurses across the NHS; these cut backs are a short-term, short-sighted solution."

Vocabulary
nursing shortages = Pflegenotstand
evidence = Bericht, Information
post lined up = eine Stelle angeboten zu haben
Union = ein Gewerkschaft in der UK
disgraceful = beschämend, schrecklich
drop-outs = Studien- oder Schulabbrecher
bite = greifen, spürbar werden
dire = düster, schlimm
short-sighted = kurzsichtig, nicht voraus-denkend

Depression is expensive!

2006-07-02T15:03:00.000+02:00

Depression costs money - not just for doctor's visits, medication and therapy, but it has a high cost for the national economy. Depressed people may not be able to work and may have to stay at home or even be in a hospital.

A report which was published in England at the end of April says that mental illness is a bigger social problem than unemployment. (Of course, unemployment may be one cause of depression.)

But in the Uk there are not enough psychotherapists, so most patients only get medication. Drugs alone are not as successful in treating depression as psychotherapy. The report challenged the government of the UK to set up training programmes for more therapists and to offer more treatment centres.

Offering psychotherapy would be cheaper than having patients suffer from untreated depression.

http://society.guardian.co.uk/socialcare/news/0,,1763540,00.html

Depression, anxiety and other forms of mental illness have taken over from unemployment as the greatest social problem in the UK, a health economist warns today.
Richard Layard, who is advising the government on mental health, advocates a network of 250 centres across the country to offer psychological therapies - instead of the drugs widely handed out by doctors in the absence of sufficient therapists.

Around 15% of the population suffers from depression or anxiety, says Lord Layard, emeritus professor at the Centre for Economic Performance of the London School of Economics. The economic cost in terms of lost productivity is huge ... "There are now more than 1 million mentally ill people receiving incapacity benefits - more than the total number of unemployed people receiving unemployment benefits," he writes in the British Medical Journal.

"Yet if you have one of these often crippling conditions you are unlikely to get any specialist help at all. You can see your GP, but he or she is unlikely to prescribe any treatment other than drugs." (...)

Only 4% of all those with depression and anxiety disorders received psychological therapy in the past year, Lord Layard says. Yet the "talking" therapies are popular with patients who often do not want drugs (...)

He estimates that around 800,000 patients a year would require cognitive behaviour therapy. That means the country needs an extra 10,000 therapists (...)

Vocabulary
anxiety = Angst
to advocate = befürworten
emeritus = in Ruhestand
lost productivity= Produktivitätsverlust
incapacity benefits = Erwerbsunfähigkeitsrente
crippling condition = lähmende Zustand
GP = niedergelassener Arzt (Hausarzt)
prescribe = verordnen
disorder = Störung
cognitive behaviour therapy = (kognitive) Verhaltenstherapie

Taking a break!

2006-06-10T09:00:00.000+02:00

Have you noticed that the last entry in this weblog was in March?! I took a break from writing my weblog because I was "up to my ears" in teaching and making a study trip to the USA.

I will be back with more new words and comments in July. By then the soccer cup will be over and life will settle down in Germany again. We'll see how far the German team gets!

Up to my ears is a colloquial expression in America - it means that you have so much work to do that you are nearly drowning in it.
Drowning = ertrinken

2006-03-06T17:11:00.000+01:00

This is what corriboard looks like.

Creative Design Project - a portable bed for homeless people

2006-03-06T15:42:00.000+01:00

In the UK there is an expression for people who have no homes and have to sleep outside or in abandoned buildings: sleeping rough. In this context the word rough means improvised, without comfort. This article reports on a project idea developed by a design student in England that would make sleeping in the rough just a little bit more comfortable.

28 November, 2005

An award-winning design student at the Sheffield Hallam University swapped style for substance in the hope of helping hundreds of homeless people across the UK sleep sounder this winter.

Tom Goodfellow, who has just completed a degree in product design at Sheffield Hallam University, has designed a portable, plastic fold-up bed made of corriboard and bubble wrap, called Sleeping (Less) Rough. Held together with a network of straps and string, the bed’s design provides a thermal barrier from the cold and a comfortable sleeping surface.

The 23 year old hopes the lightweight, 1kg bed will help the estimated 500 people who sleep outside in UK streets, alleyways or subways each night (...)

Tom said:

“There is a critical shortage of hostel beds for the homeless. I wanted to take a risk and challenge the traditional approach to design by creating something that stimulates thought and raises awareness of some important issues.

“There are always going to be homeless people, but this is something that could make their lives a bit more comfortable.”

(...)
Tom is spearheading a new generation of designers with a social conscience with his latest project, which has already earned him recognition as one of the country’s rising design stars.

sleeping rough - draußen schlafen, "Platte machen"
swapped - (ein)tauschen
substance - Inhalt, sinnvoll
sounder - besser, tiefer
corriboard - doppel-seitiges Material aus Plastik mit Luftkammern in der Mitte
bubble wrap - plastik Verpackungsmaterial aus Luft gefüllte Kämmern
straps - Bänder
barrier - Schutzwall
critical shortage - akuten Mangel
raises awareness - Bewußtmachung (einer Problem)
spearheading - leitende Rolle spielen
social conscience - soziales Gewissen

Who cares for the carers children?

2006-01-24T09:30:00.000+01:00

This article discusses the impact of the shortage of people who want to work in the caring professions in the western nations: not enough nurses and doctors, not enough childcare workers, not enough home help - so people from poor countries are often imported to do this work.

But who cares for the children of the people who emigrate? Who cares for patients in the hospitals in their home country?

At this time there are shortages in nurses and doctors in the UK, Australia and the USA. In Germany there seem to be enough nurses at the moment, but carers for patients at home often come from east European countries.

How long will it take until Germany also experiences nursing shortages again. And shortages in doctors? Many German doctors are already leaving to work in the UK or Australia.

The crisis in the caring professions will certainly continue over the coming years. Finding a fair way to solve this crisis is a great challenge.

SocietyGuardian.co.uk Comment Madeleine Bunting: Importing our carers adds up to emotional imperialism: "The solution in the west is to outsource care - pay someone else to do it - and that is often provided by migrant female labour from the developing world. So the care gap of the west is resolved at the cost of exacerbating the care gap of the developing world. It's bad enough when a woman has to leave her children alone to go to work in a factory for 12 hours a day; it's even worse when she has to get on a plane and leave her children behind for years at a time, using some of her pay to cover the cost of a maid substitute.

It's a form of asset-stripping - though this time the asset is not oil or diamonds but care. Alongside economic inequality emerges the inequality of care. It's what the American academic Arlie Russell Hochschild describes as the 'care drain', as young women move to richer countries to care for the young, sick and elderly. The scale of this care drain is projected to grow dramatically; by 2020 the US alone will be able to absorb the entire world's supply of nurses, a demand in part generated by an increasingly elderly population.

For the first time in history, half of all migrants are women. In some countries, such as the Philippines, Sri Lanka and Thailand, women make up the majority of all migration. For many of them it is the need to earn money so they can care for their own children that forces them to leave; the average age of migrant women entering the US is 29, an age by which most of them have had children..."

impact - Einfluss
shortage - Notstand, z.B. Pflegenotstand
emigrate - auswandern
outsource - nach Außen lagern
resolve - ein Problem lösen
exacerbating - verschlectern, verschlimmern
care gap - Kluft zwischen nötige Pflege und das Personal die es durchführen könnte
maid substitute - Haushaltshilfe als Mutterersatz
asset-stripping - Ressourcen wegnehmen
scale - die Dimensionen
care drain - Abfließen, Weggehen von Personen die pflegen
generated - verursacht, ausgelöst durch

How expensive are cheap clothes?

2006-01-23T09:00:00.000+01:00

When we shop for clothes, we are happy to find what we want for a price that we can pay. We are especially happy if the price is lower than we expected - just 30 or 40 Euros for a new pullover, a sweater or a jacket.

A recent article in the Guardian newspaper in England commented on the real price of these clothes - the price that the workers who produced them pay:

the clothes are produced in China, Rumania or other low-wage countries
the workers are often women
they usually work long hours
they are paid very low wages for each piece they produce, so they work under constant pressure to work quickly
if they are sick they have no earnings (and no health care insurance)
if their children are sick they can't afford to stay at home with them
their very small children may be at home alone or with an older sister or brother

SocietyGuardian.co.uk Comment Madeleine Bunting: Importing our carers adds up to emotional imperialism: "The piles of cheap clothing on our high streets come with a high price tag. We know about the low pay and poor working conditions of those producing these garments, as described in the work of writers such as Naomi Klein. What we know much less about is the impact of those working conditions on the workers' families. The next time you pick up an elaborately stitched jacket or pair of shoes, ask yourself where the seamstress's children were when she was hunched over her sewing machine."

low-wage - Billiglohn
price tag - Preiszettel
garments - Kleidungsstücke
impact - Einfluss
elaborately - aufwendig
stitched - Stickerei
seamstress - Näherin
hunched over - übergebeugt

Children should not translate for their parents

2006-01-19T17:45:00.000+01:00

What do you do when you have to care for patients who do not speak German? You need information about your patients, and they need information from you! Is there someone who can translate? Another health professional? A care worker or cleaner on the ward? A member of the family, maybe even the child of the patient?

Last fall California began to discuss new legislation that would ban child translators. Children do not understand enough about anatomy and physiology to be able to describe symptoms exactly. Children may make mistakes in translating information about diagnoses and treatments - these mistakes could be very serious.

And translating for parents can be emotionally stressful for children - especially if they have to give their father or mother bad news.

But what are the alternatives? Are hospitals willing to spend money for interpreters? The costs could be very high. But the cost of mistakes is also very high.

Here is an example of the problems that can develop:

A Laotian mother could not speak English. She had many health problems so she took her son with her when she went to the doctor. The doctor diagnosed a prolapsed uterus. This was a result of giving birth to 14 children. The doctor prescribed medicine and her son translated how much she should take. After a few days, the woman felt so dizzy that she could not get out of bed. Her son had made a mistake in translation so she was taking too much medication. Fortunately, the error did not cause long-term harm but it is the kind of problem that California medical officials want to prevent.

California Seeks to Stop the Use of Child Medical Interpreters - New York Times: "MERCED, Calif., Oct. 29 (AP) -
"The use of children as medical interpreters is common in states like California with high immigrant populations. Yet studies have illustrated the potentially lethal consequences of faulty translations.

In November, California will hold public hearings about draft regulations that would prevent children from interpreting at private hospitals, physicians' offices or clinics. The rules would not apply in emergencies.

California would be the first state to pass such a wide-ranging prohibition...Experts say children lack the vocabulary and the emotional maturity to serve as effective interpreters. And two of every three mistranslations have clinical consequences, according to a 2003 study.

Child interpreters also shoulder a heavy emotional responsibility. They are privy to confidential information about their parents and can be the first family member to learn of a serious illness."

ban - untersagen
interpreter - Dolmetscher
lethal - tödlich
faulty - fehlerhaft
draft - Entwurf
regulations - gesetzliche Regulierung
wide-ranging - weit-reichend
maturity - Reife
mistranslations - fehlerhafte Übersetzungen
shoulder - hier als Verb, zu tragen
privy - eingeweiht

How do you deal with these problems? Does you hospital have a plan for such problems? Send me an email if you want to make a comment: Yvonne.Ford@cchc.de

Is smoking three or four cigarettes a day dangerous?

2006-01-11T21:40:00.000+01:00

Last fall the results of a report on the effects of smoking on health were published by the Norwegian National Health Institute. Does smoking only a few cigarettes a day raise the risk of illness? This report says YES!

Light smokers have much higher risk of developing heart disease and lung cancer, women's risk higher than men's:
If you are a keeping your smoking down to a minimum, say, under five cigarettes a day, you may not be protecting yourself from developing heart disease or lung cancer by as much as you think. If you smoke from one to five cigarettes a day you will be tripling your chances of dying from coronary artery disease (compared to someone who does not smoke).

The researchers found that the risk for women is greater than for men. Lung cancer risk for light smoking women is five times higher than a non-smoker, while for men it is three times higher.

This is according to research carried out at the Norwegian National Health Institute. Researchers studied the death rates of over 43,000 people for the period 1975-2002. The results were reported in September 2005.

Confusing communication

2005-12-15T12:24:00.000+01:00

A nurse in a Frankfurt hospital sent her comments to the article "Confusion about cancer" via email and asked that I post them here:

"The reason that patients fail to understand what doctors say is that doctors tend to use terms that keeps them in a distance, safe from emotions. The doctors terms are "right, but vague" and not "accurate". As a nurse I am used to being asked questions by patients after the visitation of the doctor (doctor's rounds) and I am used to "translating" what the doctor has said for the patient.

Instead of saying "the tumor is progressing", a doctor could say "the tumor is getting bigger" or "the tumor has started to spread into other organs". Describing the reality in these simple and clear words would frighten the patient. Being frightened is a reasonable feeling (reaction) to a "progressing tumor". But a frightened patient needs accompany and encouragement, that is what nurses do, but it seems to be a waste of time for doctors.

I would recommend that nurses should assist the doctor in the communication with the patient."

Not enough doctors - what can be done?

2005-11-19T20:30:00.000+01:00

In the United Kingdom there are not enough doctors, so patients often have to wait a long time to be seen. This can mean that illnesses get worse while the patient is waiting.

Now there is a plan to create a new medical profession to deal with the shortage of doctors. This new profession will be called "medical care practitioner (MCP)". The course of training will take only two years for people who have already have training in related fields, such as nurses, physiotherapists, chemists, etc. In this way, fully-trained doctors will have more time to focus on serious illness and health problems.

Will patients be "safe" in the care of these new professionals? The government says the MCPs will have rigorous training and will work under the continous supervision of doctors.

SocietyGuardian.co.uk Health New breed of medics 'will cut waiting times': "The new healthcare workers, known as medical care practitioners (MCPs), will have a similar role to junior doctors - and be supervised by senior doctors. But unlike doctors, who spend six years at medical school, they will be treating patients after just two years' training.

Ministers believe the new health professionals will help relieve the workload of hospital consultants and family doctors, allowing more patients to be treated more quickly.

Health minister Lord Warner said: 'By introducing new roles we are able to offer patients skilled practitioners who are able to manage the care of patients in primary and secondary care - freeing up GPs and hospital doctors to deal with more difficult cases.'

Science graduates, nurses or physiotherapists are expected to be among those likely to retrain as MCPs.

The Department of Health today published a curriculum framework for MCPs, outlining the standards they will have to meet before they can treat patients. MCPs would only be allowed to treat patients after 'rigorous additional training' and under the continuous supervision of physicians.

Tasks they could perform include

obtaining full medical histories (Anamnese erheben)
performing examinations such as breast checks (Vorsorgeuntersuchungen durchführen)
diagnosing, managing and treating illnesses such as depression, gout and eczema
requesting diagnostic tests such as heart monitoring (Untersuchungen anordnen)
interpreting the results of the tests they order (Auswertung von Untersuchungen)
giving patients advice on managing chronic conditions such as diabetes and angina pectoris

Vocabulary help:

relieve the workload - Arbeitspensum reduzieren
hospital consultants - Chefärzte, Oberärzte
family doctor - Hausarzt practitioner - Fachperson
GP - General Practitioner (Hausärzte)
retrain - eine Weiterbildung absolvieren
outlining - beschreiben, erläutern
rigorous - gründlich, strikt
physicians - Ärzte
supervision - Überwachung
gout - Gicht

Confusion about cancer

2005-11-19T17:53:00.000+01:00

Is "progress" good or bad?

If your doctor tells you, your tumour is progressing, does this mean that you are getting well?

This article reports on the results of a research study that show that patients often do not understand the language used by doctors and other health care professionals. Patients need to hear about their illness and the treatment options in clear, simple terms. And they need help learning how to ask questions and understand the answers they get.

News Item : CancerBACUP: "Every day in the UK, 740 people find out they have cancer but, according to new research revealed today, almost two thirds do not fully understand what their diagnosis means.

The 'Cancer Information Maze (Irrgarten) ' report, published jointly (in Zusammenarbeit) today by CancerBACUP, the Association of British Pharmaceutical Industries (ABPI) and Ask About Medicines, concludes that people who have cancer feel lost in a maze of information and are failing to understand their condition. One reason for their confusion is that they have poor understanding of medical terms and phrases commonly used in consultations (Arztgespräche). For example, only half of cancer patients know it is not good news if your doctor tells you that "the tumour is progressing" (...)

The survey also found that almost one in three people with cancer feel that cancer patients who are better informed get better care. However, nearly 4 out of 10 people with cancer don't feel they know what questions to ask their healthcare professional about their treatment.

Do you have ideas for giving patients more information in language they can understand? If so, send me an email (y.ford@gmx.de) and I will collect them and post them here on the weblog.

Reading and listening to English

2005-10-24T11:27:00.000+02:00

It is easier to speak English if you have the opportunity to hear English often. Many learners in my courses say they don't hear English often enough. This link takes you to a Canadian site where you can read a text and hear it at the same time. In the first issue of the newspaper there is a text on how to prepare for a doctor's visit. Perhaps this would interest those of you who work in healthcare.

The newspaper is called "The Learning Edge" - there are six editions of the newspaper to choose from. I hope you enjoy it!

http://www.thewclc.ca/edge/index.html

Why should a nurse get a flu shot?

2005-10-01T11:27:00.000+02:00

Are you going to get a flu shot (Spritze) this fall? Do you know why having a flu injection is a good idea?

Having a flu shot will not prevent colds during the winter, but it will prevent the more serious influenza infection. This is not only a protection for the person who gets the vaccination, but also for the patients that are being cared for. Nurses can pass infections to patients who are weak and may not be able to recover from the flu.

I found this report of a recent study on the website of the English nursing magazine Nursing Times (www.nursingtimes.net):

In a recent survey carried out in two Liverpool hospitals, less than 8 per cent of nurses and healthcare assistants said they had annual flu injections. 144 healthcare workers were interviewed. 29 per cent said they didn't feel they needed to be vaccinated (geimpft); 18 per cent were not aware of the vaccine (Impfstoff) and 11 per cent were concerned about the side effects.

"Vaccinating healthcare workers against flu can reduce staff sickness and winter pressures (Druck der, auf Grund Fehlzeiten von kranke Mitarbeiter, entsteht) as well as reducing deaths among frail (gebrechlich) older patients" says Dr Helen Canning, who carried out her research at the University of Liverpool.

"Our study found that the main reason for poor vaccine uptake was a basic lack of knowledge and understanding of the vaccine, especially regarding benefits and side-effects. Many of the respondents appeared to demonstrate general apathy towards the flu vaccination. Almost half of the respondents were either not aware of the vaccine or did not think they needed it. And only 10 per cent knew that the benefits of the vaccine included protecting patients against the serious complications of flu. "

Sick and alone - who can help?

2005-09-30T20:30:00.000+02:00

I found out this summer how much help I needed when I had my bicycle accident: I couldn't dress or undress without help, couldn't wash my hair alone, couldn't walk to the grocery shop, nor could I drive a car. It was too much effort to carry my clean laundry from the basement to my rooms on the 1st floor of the house I live in. I am lucky that two of my children live in Frankfurt - but both of them have jobs and couldn't be available all the time. I was also lucky to have close friends and acquaintances who volunteered to help.

In a few weeks I could care for myself again - but what about patients who are seriously ill for months? In Germany it is possible to get help from a homecare nursing service, but when someone needs a lot of care, this isn't enough.

Also, it is not easy to learn to ask for help. Nurses, doctors and social workers who work with patients to prepare for their discharge (Entlassung) from hospital need to learn how to advise patients about managing their care at home. Discharge planning should begin early enough to give the patient time to get others involved in a care network.

This article gives information about the challenges of organizing care when the patient is alone, and about information that is available through internet and books.

Where to Get Help in Planning for Illness - New York Times

"To be ill and alone requires far more advanced planning than is required of those who live with their families. It is a predicament (schlimme Lage) poorly understood by health care providers (Pflegende, Ärzte usw.), who are likely to advise hiring (to hire, beschäftigen) a home health aid (Haushaltshilfe) or other professional.

That is certainly helpful, if there is a way to pay for it, but not a replacement for the support and companionship (Begleitung) of loved ones (Angehörige). An invaluable how-to (Selbsthilfe) book for those seeking to organize a broad-based caregiving network is 'Share the Care' by Cappy Capossela and Sheila Warnock (Fireside, 1995, 2004).

The book was inspired by Ms. Warnock's experience of caring, at different times, for two dying friends, one of them her co-author. In one of those instances, a therapist asked the terminally ill woman to assemble everyone she knew who might be of help in even the smallest way and together they developed a systematic way to parcel out (aufteilen) responsibilities. The book is a manual for replicating (to replicate, wiederholen) the success and satisfaction of that experience. Further information is available online at www.sharethecare.org.

Organizations that offer help to family members of sick people also serve friends in their support groups and other activities even if their literature refers only to kin (Familienmitglieder). A few organizations have been explicitly (ausdrucklich) welcoming to friends in recent years, changing their vocabulary accordingly. But even with that change, expect a caregiver support group to overwhelmingly (überwiegend) consist of family members who may, out of ignorance not malice (Böswilligkeit), express surprise that someone who is 'just a friend' has assumed such responsibility.

Check yourself!

2005-09-13T08:54:00.000+02:00

Here are the corrections of the mistakes in the sentences that were in the last posting.

1. She lives in an older's home.

Correction: She lives in an elder's home.

2. She's on the surgery station.

Correction: She's on the surgery ward.

3. I have been here since three weeks.

Correction: I have been here for three weeks.

4. I have some informations for you.

Correction: I have some information for you.

5. I want to give you some advices.

Correction: I want to give you some advice.

6. I will tell it the doctor.

Correction: I will tell the doctor.

7. She said me she was sick.

Correction: She told me she was sick.

8. He is short of hearing.

Correction: He is hard of hearing.

Another possible correction: He is short of breath.

9. He has a peacemaker.

Correction: He has a pacemaker.

10. I will to work mornings.

Correction: He wants to work morning.

How did you do? I hope you enjoyed testing your ability to catch and correct a mistake.

If you would like to improve your English skills, you might enjoy this website:

ESL Independent Study Lab

Find the mistakes!

2005-09-06T16:00:00.001+02:00

Would you like to test your ability to find mistakes in an English sentence?

Here are 10 opportunities to test yourself; all of these are sentences I wrote down while teaching. Each sentence has one mistake. I will post the corrections in a few days. I hope you enjoy the challenge!

1) She lives in an older's home.
2) She's on the surgery station.
3) I have been here since three weeks.
4) I have some informations for you.
5) I want to give you some advices.
6) I will tell it the doctor.
7) She said me she was sick.
8) He is short of hearing.
9) He has a peacemaker.
10) I will to work mornings.

Reaching for the stars

2005-08-25T13:45:00.000+02:00

In Germany there were 100,000 nurses (general nurses and nurses for the elderly) in the statistics for 2003. How many of those nurses are from non-German backgrounds? And how many top managers in health care do we have from non-German backgrounds?

I must admit I have looked for the statistics but was unable to find them. (If you know where I could find the data, please send me an email: yvonne.ford@cchc.de)

My impression (Eindruck) is that the number is low, compared with the percentage of residents in Germany who come from Turkey and other countries of Europe and abroad (Übersee)

In the UK there are programmes to encourage qualified health professionals to "reach for the stars" - that is, to aim for the top positions. Mentoring is one of the programmes. This article describes some of the results.

SocietyGuardian.co.uk Society Reaching for the stars: "But the proportion of black people and those from minority ethnic communities among the NHS's 1.3 million workforce has also risen - up from 11.5% last year to 14.1%. The increase in the representation of black people in the most senior posts is still only half that in the workforce as a whole.

Sharma highlights the positive. The Breaking Through development programme programme for black and minority ethnic would-be directors is, he says, a success, while more than 600 new mentoring arrangements are in place, on top of the 200-300 that already existed.

One of those who feels things are improving is Yvonne Coghill, who last year was mentored by Crisp, and who now works directly under chief nursing officer Chris Beasley. Race equality has 'stepped up a gear', she says, adding that when she left Crisp's office, 89 black and minority ethnic managers applied to be his next mentee. 'Amazing, absolutely amazing,' she says. 'They had PhDs, MBAs, the whole nine yards. Most were sitting around in middle management jobs.'
They are evidence of the potential there to be tapped, Coghill believes, and she urges more 'pushing from the top and pushing from the bottom' to maintain progress.

Janet Soo-Chung, chief executive at Sheffield South West primary care trust (PCT) and a member of the 1% club interviewed last year, sees more evidence of improvement. 'I think that the awareness of having diversity on the workforce and more senior black and minority ethnic managers is growing in the NHS, and is definitely increasing all the time. 'It's an issue that is here to stay.'"

Why don't people take the medicines they need?

2005-08-07T18:34:00.000+02:00

This interesting article was printed in the Guardian newspaper on July 12 and deals with a very important question: why do so many people refuse to take medicines that are prescribed for them, or stop taking medicines regularly?

Guardian Unlimited Special reports The medicine refuseniks: "Look in pretty much any bathroom cupboard and you will find a hoard of half-used or even untouched medicines. Many of us forget to take our pills, or don't finish a course of antibiotics. But we probably weren't that ill. The real surprise is that people taking life-saving medicines do the same. For example, 25% of transplant patients don't take their anti-rejection medicines as directed, with some stopping completely.
It is estimated that overall, anything between 30- 50% of prescription medicines are not taken as directed. Usually, patients take them in much reduced doses or intermittently, but 20% of medicines never even make it out of the packet. "

When patients refuse to take medications to treat a condition or to prevent health problems, the results are not just "private" but are also public since they affect the rising costs of health care. Complications have to be treated, sometimes with expensive hospital stays.

Patients give some of the following reasons for not taking their medicines:
- taking the medicine is too complex or inconvenient
- they are not convinced that they need to take the medicine when they don't feel ill at the moment
- they are afraid of the side-effects of the medicines
- they don't want to be "sick" but want to lead a "normal" life

The idea of "compliance" suggests that the doctor or nurse knows what is best for the patient and the patient should agree and obey. Today patients want to be involved in making decisions about their health and treatment; they want to be treated as a partner in their own health care.

It is important to listen to the patient to find out what their questions are and to help them understand why taking medications regularly is important. It will take more time at the beginning but will prevent costly complications.

An unplanned interuption

2005-07-31T14:14:00.000+02:00

It has been several weeks since I have made an entry into my weblog: in part, I have been busy teaching but the major incident was an accident I had on my bicycle.

I was on my way home from the post office on a sunny day in July and was driving over the streetcar tracks when I suddenly felt the front tire of my bike slide into the tracks. The bike twisted toward the left; I fell forward and fell into the handlebars (Lenker) . I could feel immediately that I had an injury in my lower abdomen. Then the bike and I fell to the ground; I fell backwards from the force and hit my head on the cobblestones (Kopfsteinpflaster).

Fortunately for me, I was wearing my bike helmet. I could hear the "crack" as the helmet took the force of the fall.

An ambulance was called to take me hospital. After examinations (Untersuchungen) I was admitted to the surgery ward (Chirurgiestation) where I stayed for a week.

My injuries: a torn ligament (Band) in my thumb (which had to be sutured (genäht) in a small operation), severe contusion (Prellung) in my left shoulder with immobility (Unbeweglichkeit) for several days (and slow recovery now with the help of physiotherapy (Krankengymnastik), a large hematoma in my abdomen that had to be removed surgically, as well as bruising (Blaueflecken) on other parts of my body.

It is amazing (erstaunlich) how much damage (Schäden) can occur in only a few seconds! I am grateful that no bones were broken and VERY grateful that I had my helmet on. Otherwise I would have had a concussion (Gehirnerschütterung) or perhaps even a fracture of the base of my skull (Schädelbasisbruch).

My message to you: wear a helmet when you are on a bike! In the last days many friends who cycle regularly have told me that their helmets have saved them on a number of occasions. You may feel that you look a little silly (lächerlich) at first but you'll soon get used to it. Be safe not sorry (Reue haben)!

Talking about the birds and the bees!

2005-06-08T14:44:00.000+02:00

In English there is an expression I heard when I was young that described telling young people about sex and conception: telling someone about "the birds and the bees." The phrase shows that parents tried to talk about nature because they felt awkward discussing human sexual needs and behaviour.

Many parents today still feel uneasy talking about sex to their children - and hope that schools, the media, or someone else will tell children and teenagers about sex and how to deal with it.

The UK has the highest rate of teenage pregnancies in Europe. This article makes suggestions about what parents and schools should do to respond to this problem.

SocietyGuardian.co.uk Society 'If we leave sex education to parents alone, many teenagers will suffer': "Sex and relationships education (SRE) may not be the whole answer, but it's certainly an important part of it. Young people still view school as the most important source of information on sexual health. Brook and others, including the government's independent advisory groups on teenage pregnancy and sexual health and HIV, want SRE to become a compulsory part of the curriculum.

The broader curriculum we advocate would start early and teach young people to talk about feelings and relationships. It would cover issues such as resisting peer-pressure to become sexually active and developing negotiation skills. Young people who have discussed condom use are more likely actually to use one, one reason why helping them to improve their communications skills matters.

Comprehensive SRE needs to be backed up with access to confidential sexual health services for young people. Research shows that this is instrumental in helping them delay having sex and encouraging them to use contraception when they do become sexually active.

Parents also need to be supported to discuss sex and relationships with their children from an early age. More openness at home and school will help counterbalance the media's confusing messages about sex. "

Children are getting too little exercise

2005-06-06T15:00:00.000+02:00

SocietyGuardian.co.uk Society 90% of children 'set to be couch potatoes'

When you were young, what did you do when school was out? I had to work on the farm my parents owned - milking cows and helping care for other animals. I also rode my bike (I was proud when I learned to ride with "no hands") and I played outside with my sisters and our neighbours.

But how about children today? Many do not play outside - society has changed so that some parents feel that outdoor play is not safe. But there are also many things for children to do inside, things which do not require children to move very much.

A term for people who sit for long periods watching TV is "couch potato" - a couch is another word for sofa, and the word potato refers to a vegetable. A person who is not being active is said to be "vegetating."

People who watch a lot of TV, or sit in front of the computer for many hours are not moving about, are not giving their bodies the exercise they need. And so the term "couch potato" was invented.

This article reports that only 10% of children in England are getting an hour of exercise each day. Take a look at the article to see what the consequences of this will be in the future.

The ethics of recruiting foreign staff for hospitals

2005-05-21T14:13:00.000+02:00

Currently in Germany there are too many nurses - many graduates of nursing schools are not able to find work. But this is not the case in the UK and in the USA. There is a great shortage of nurses and doctors so nurses (and doctors) from other countries are being recruited.

For German nurses and doctors who want to work in England or the USA this is good news. With good English skills, there are good chances to work in another country to gain experience and improve your professional skills.

But other countries are being seriously hurt by the loss of qualified staff - African countries, for example, need their health workers desperately. This article criticizes the recruitment efforts in the UK and in the USA that are causing suffering in other parts of the world.

"BMA's poaching crisis warning

John Carvel, social affairs editor
Wednesday May 11, 2005
The Guardian

Doctors' leaders last night accused Britain and the US of causing a medical emergency in the developing world by poaching healthcare workers from countries struggling to cope with the HIV/Aids epidemic.
The British Medical Association said lives were being lost because of severe shortages of healthcare workers in areas such as sub-Saharan Africa.

This isn't really a surprise, is it?!

2005-05-10T19:35:00.000+02:00

For many years I have organised professional exchange visits to hospitals in England. One of the things that German nurses were always surprised about was seeing nurses on public buses coming to work or going home at the end of their shifts - they were wearing their uniforms!

When we asked questions, we were always told that wearing uniforms on public transportation was not a problem, that nurses washed their uniforms at home, that studies didn't show a higher risk of infections. It was always hard for the German nurses to believe.

And, now - hospitals in England have significant problems with infections that are resistent to antibiotics. A recent article in the German newspaper "Die Zeit" said that 44% of germs in British hospitals are resistant to usual antibiotics. (In Germany the rate is also high - estimated to be about 20%. http://www.zeit.de/2005/17/M-MRSA)

Finding solutions has become a high priority for the Department of Health in Britain. Better cleaning services in hospitals, higher awareness of the importance of washing hands, AND places for changing uniforms in hospital are some of the proposals. This press release is from the Royal College of Nurses in England. I am sure that German nurses will not be surprised to hear what the General Secretary of the RCN has to say!

RCN: News & Press article: RCN calls for major reforms to combat MRSA: "General Secretary of the RCN, Dr Beverly Malone, said: 'There has been a terrific amount of work to highlight the importance of hand washing in combating MRSA. This commitment must not waver, but we also need to extend the debate and recognise the importance of other factors.'

These factors include ensuring the supply of sufficient clean uniforms for all healthcare staff, the provision of staff changing and laundry facilities and the availability of 24-hour cleaning teams.

Is it hard to live a healthy lifestyle?

2005-05-09T18:00:00.000+02:00

Reports that encourage people to choose a more healthy lifestyle often focus on four key areas:

- stopping smoking
- eating healthier food
- getting more physical exercise
- losing weight

In the USA a research study was recently carried out to find out how many people meet these four criteria for a healthy lifestyle. The link below takes you to the article which reports on telephone interviews with 153,000 adults in all 50 states of the USA. The research team wanted to find out how many adults manage to live a healthy lifestyle by achieving all four goals. The results showed that only 3% of the persons interviewed met the criteria for a healthy lifestyle!

How would you rate?

And me? Well, I have never smoked - so meeting that goal is easy for me. And, I have started going to the fitness centre more often, and riding my bicycle a bit more but I must confess I don't eat as many fruits and vegetables every day as I should and losing a few kilos would also be good for me. Fortunately, it's never too late to make lifestyle changes!

Relatively few US adults report having a healthy lifestyle:
Mathew J. Reeves, Ph.D., of Michigan State University, East Lansing, and Ann P. Rafferty, Ph.D., of the Michigan Department of Community Health, Lansing, analyzed data from the 2000 Behavioral Risk Factor Surveillance System, annual statewide random-dialed telephone surveys, to determine the prevalence of four healthy lifestyle characteristics (HLCs): nonsmoking; healthy weight; consuming five or more fruits and vegetables a day; and regular physical activity. The researchers combined these four characteristics to generate a single indicator for a healthy lifestyle, scored by the number of healthy lifestyle characteristics were followed. A healthy lifestyle would be defined as following all four.

Are childhood infections "healthy"?

2005-05-05T18:43:00.000+02:00

Young working parents often feel guilty about putting their baby in child care, especially in the first months of life. Relatives and friends may criticize them for not giving their child enough attention. In addition, the child picks up all sorts of infections from the other children in day care: colds, coughs, stomach viruses, and maybe even childhood diseases like chickenpox (in German this is "Windpocken") or German measles (Röteln).

This article suggests that getting such infections may help children to avoid developing serious illness later such as leukaemia and diabetes. That is good news for parents who must return to work or to school and have to put their baby in care for some time each week.

Day Care In Infancy Protects Against Childhood Leukaemia: 29 Apr 2005

Children who attend day care centres on a regular basis in the first few months of life are less likely to develop leukaemia than children who do not, finds a study published online by the British Medical Journal today.

Increasing levels of social activity outside the home were associated with consistent reductions in risk of acute lymphoblastic leukaemia (ALL). However, the greatest reduction in risk of ALL was seen in children who attended formal day care during the first three months of life (defined as attendance at a day nursery or nursery school at least once a week, or at least two half day sessions a week at a playgroup, mother and toddler group, or at a childminder with a minimum of four children attending).

Professional jargon blocks participation

2005-04-25T14:15:00.000+02:00

SocietyGuardian.co.uk Society Ethnic barrier: "Jargon used by professionals working in regeneration is preventing black and minority ethnic communities from having a say in how their neighbourhoods should be improved"

This quote is taken from an article written in 2001 in the Guardian newspaper in England. The article described an initiative that was being started to help citizens in a poor neighbourhood get involved in a regeneration project. The goal of the project was to improve housing, and improve the quality of life in the neighbourhood.

The initiative was called "Getting Engaged." Getting engaged in this context means getting involved, or taking part in community acition. The people they wanted to reach were black British citizens from African and Carribean countries, and people from other minority ethnic groups. This group is often referred to as "BME" - which means black and minority ethnic (groups, neighbourhoods, etc.).

The Getting Engaged initiative said that people who learned English as a second language can't understand the jargon used by government officials. This means that they do not feel they can get involved in the affairs of their neighbourhood. Clear English and clear strategies to reach isolated groups are needed.

The problem with jargon is also part of the difficulty of communicating with patients: lack of compliance is one of the results. (And even here, compliance is a word that is part of medical jargon!).

Too much English in German?

2005-04-13T13:50:00.000+02:00

Global German - FAZ.NET - FAZ Weekly: "The Association for the Cultivation of the German Language recently called on all public speakers to "avoid superfluous (colour added by Yvonne Ford) foreign words" in the future. A former state minister suggested introducing a "law for the protection of the German language." "

Do you know the word "superfluous?" In German it means überflüssig; in this context it suggests that use of an English word is not necessary since there is a German word that means the same thing.

Why are English expressions used in German so often? Does it make the speaker sound more up-to-date, more aware of international developments? Is saying the same thing in German old-fashioned?

Here are some words that have made their way into the language of health care in Germany:
primary nursing, care pathways, case management, diagnosis-related groups, pain management, trends, coaching, supervision, benchmarking, balanced scorecard, gender mainstreaming.

Do you think these words are superfluous? Can you think of German words that could replace them?

Health literacy

2005-03-23T08:17:00.000+01:00

Link to visit: http://www.askme3.org/pdfs/words_to_watch.pdf

Literacy is the word we use in English to describe the ability to read and write. The term "health literacy" means more than this: it means being able to understand health information - both in written and oral forms.

Many patients do not understand what doctors, nurses and others who work in health care tell them. Health care "jargon" or words that come from Latin or Greek can be confusing.

This link takes you to a website sponsored by the Partnership for Clear Health Communication. You will find a list of words that can be confusing, as well as alternative ways to say the same thing.

If you are learning English as a second language, this website can be very useful because you can learn both the professional vocabulary as well as the simpler words.

Welcome to My Word!

2005-03-13T15:44:00.000+01:00

Welcome to my new web log on communication in health care!

The title My Word! has several meanings:

1) it means that what I write are my reflections and ideas, my words.

2) it also refers to the meaning of words in health care, new words, translations.

3) the phrase is an English idiom that shows surprise - although this idiom is not used very often in spoken English these days, I think it is a good title for my weblog because I plan to share things with you that surprise and astonish me in health care communication.

I would be very pleased if you take time to write your comments on my postings, so that all of us who read and write on this log can enter into a dialogue.