79. Holland – världens renaste land

Tre läkare. Ett samtal. Ingen ordning. Ronden_logo

253 reaktion på “79. Holland – världens renaste land

  1. Hej, är sjuksköterska och älskar verkligen er podd! Har precis lyssnat på avsnittet om Holland, hygien och telefonrådgivning och reagerade på några saker som ni pratade om.
    1) Vårdhygienen, ja det är ett kapitel för sig och det är rätt märkligt att höra att man satsar så hårt på städning i ett PCI-lab när det på vårdavdelningarna på många håll idag slarvas otroligt mycket med städningen. Vet att för ca 10 år sen när jag började jobba som ssk så kunde städningen av den vårdavdelning jag jobbade på ta upp mot 3-4 timmar; idag får den inte lov att ta mer än max 2 timmar enligt en f.d kollega som jag pratade med nyligen och där vi av någon outgrundlig anledning kom in just på ämnet städning, först i största allmänhet och sen just på t ex vårdavdelningar, i väntrum o likn miljöer. Hur rent och välstädat kan det bli på 14 patientsalar, 16 toaletter, 2 ssk-exp, 1 sekr-exp, ett personalrum, en skölj, ett par förråd och en gemensam patientmatsal bli på 2 timmar när det tidigare tagit minst 3, oftast 4 timmar….?? Och så florerar MRSA/ESBL o likn, för att inte tala om vinterkräksjukan…. ??

    2) Telefonrådgivning, ja det är en svår konst, oavsett om du sitter på 1177 eller på någon vårdcentral. Visst har man riktlinjer att följa, googla t ex på triagehandboken region Skåne så hittar ni en väldigt bra guide. Sen har 1177 en guide som de följer, likaså de som svarar på SOS Alarm när någon ringer 112. Sen brukar jag själv faktiskt ofta använda mig av Internetmedicin och slå fram den ”diagnos” som patienten upplever sig ha (ofta säger ju en patient som ringer till telefonrådgivningen på sin vårdcentral att ”jag har nog fått magsår” eller ”jag har fått ryggskott” och då kan man via Internetmedicin dels se lite om olika tänkbara differentialdiagnoser som det kan röra sig om, men också bra beskrivningar av symtomen som man kan ställa frågorna om och på det kan man komma ganska långt. ICD.nu’s lathundar ger också bra hjälp, t ex Canadian C-Spine Rule som hjälp för bedömning av nacksmärtor. (har faktiskt hittat en allvarlig nackskada per telefon just genom att be pat göra de olika rörelserna försiktigt och berätta för mig vad hon upplevde; hon fick en akuttid och rtg visade en skada!) Generellt kan man väl dock säga att som sjuksköterska bör man inte vara allt för ny inom yrket för att sitta i telefonrådgivning, man behöver ha en hel del erfarenhet med sig i bagaget för att hitta de där nålarna i höstacken som verkligen är allvar och som måste få läkarvård omgående/akut. Kul att höra Märits reaktion då hon satt i telefonrådgivningen, det gäller verkligen att inte få allt för mycket ångest… Hälsningar Gertrud, leg ssk

  2. Först: Stort tack för mycket glädje och ett härligt resesällskap på väg till både läkarutbildning och första jobbet, ni inspirerar och förmänskligar.
    Sedan: Vilket underbart sätt att fira kvinnodagen, genom att stänga av kvinnans mikrofon.
    Hejja er!

  3. Hej! Tack för ännu ett bra avsnitt, alltid lika bra! Jag är inte läkare men är väldigt intresserad studera till det. Det hade varit kul att höra era reflektioner kring att omskola sig i äldre dagar (30-40 år). Är yrket såpass intressant och givande att det är värt det? Kanske kan bli ett kort inslag i podden 🙂
    Trevlig helg!

  4. Hejhej!
    Ni är fantastiska på att få mig att vakna till på väg till jobbet (som allmänspecialist ). Jag gillar verkligen hur ni stöter o blöter allt det det innebär att vara läkare och människa. Nu känns det som att det är dags för ett nytt avsnitt. Om ni vill.

    En utmaning på vårdcentralen är patienter med hälsoångest. De är inte många, men frekventa. Jag tror vi på vårdcentralen har lika många sätt att hantera dem som antalet sk mångsökare. Hur tänker ni?
    Kram på torsdagen
    Karolina

    • Hej Karolina! Vad kul att du gillar Ronden. Och extra kul med en allmänläkare. Vi är dåliga på att ta upp ert perspektiv. Vill verkligen få med en gäst. Bra ämne om hälsoångest. Ska kolla med de andra. Trevlig helg! /Christian

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