Reserapport - KI-student
Lärosäte: La Trobe University
Utbildningsprogram: Barnmorska
Utbytesprogram: INK
Termin: Vårtermin 16/17
Namn: Jenny Gerdin
E-postadress: jenny.gerdin@stud.ki.se

Innan avresa


First of all, I've always wanted to go to Australia! Secondly, having previous good experiences of studying abroad I felt drawn for another exchange. Thirdly, having the dream of working as a midwife in an English spoken country in the future, I decided to apply for the exchange.

 

Our midwifery course received information about offered exchange studies through a seminar held by representatives from the Midwifery International Committee (MINC) during the first semester. We were informed that Karolinska Institutet had collaboration with institutions in the Netherlands, Malawi, Australia and USA (Chicago). For more information, please visit the midwifery program’s international website: https://pingpong.ki.se/public/courseId/6225/lang-sv/publicPage.do?item=3891341. Since you apply for the exchange studies within the first two weeks during the second semester and given midwifery is a pretty intense education program, I recommend you to commence you application documents either during summer if you start the midwifery in January or in November if start midwifery in August.

 

I was thrilled knowing I was accepted for an exchange clinical placement in Melbourne, Australia! Even better was that I found out I was going with one of my best friends in my class. We arranged a meeting with the Midwifery Program’s international administrator five months before departure (December). She informed us about previous students’ preparations for their exchange studies; when to departure, where to look for a place to stay etc. We also arranged a meeting a few weeks later with Karolinska Institutets International administrative officer. She completed documents necessary for us to sign off before departure, e.g. Karolinska Institutets travel insurance and the grant from MINC.

 

Magdalena helped us getting in touch with the responsible staff at La Trobe University in Melbourne (the collaborative university). In late December we received an email from La Trobe that included a lot of information about which requirements were needed before departure. I’ve been trying to summarise these requirements in a list down below, just to facilitate for future students going to Melbourne and The Royal Women’s Hospital. There’s pretty much paper work, so make sure you start in time:

 

   Apply to La Trobe University

We didn’t have to apply to La Trobe University separately. According to our contact person in Melbourne at the university, the application in Sweden was enough.


   Vaccinations

         The following vaccinations were required from La Trobe University:

o   Diphteria, Tetanus, Pertussis (dTpa) (no more than 10 years old)

o   Hepatitis B (full course of 3 doses AND serology to confirm antibodies)

o   Hep A (full course)

o   Measles, Mumps, Rubella (MMR – Full course of 2 doses)

o   Varicella (Chickenpox) or serology confirming immunity

o   Poliomyelitis

o   Tuberculosis (QUANTIferon Gold or or Mantoux Skin Test (=PPD))

o   Influenza

 

All the above immunisation requirements are to be summarised and signed off by a doctor or Registered Nurse on the La Trobe Univeristy Immunisation and Health Record Form - http://www.latrobe.edu.au/__data/assets/pdf_file/0005/766148/Immunisation-form-version-17-11-2016.pdf. My advice is to let a doctor or Registered Nurse working where you’ve been vaccinated before to fill out this form, since they have the records in the computer. In order to fill out the form, it’s required that you have some documents from your childhood – contact your BVC or “Skolhälsovård” in order to receive these documents (for example when you received the Poliomyelitis and MMR-vaccinations). I went to City Akuten in Stockholm who helped me with everything. I’d recommend you to complete the vaccinations at least three months before departure. Please read “Economy” for detailed costs.


   Swedish police check

La Trobe Universiyt require a police check (valid from the year you are travelling). You can order it from this website for a cost of 185 Swedish kr: https://polisen.se/Service/Belastningsregistret-begar-utdrag/belastningsregistret-anvanda-utdraget-utomlands/


   Visa and passport

If you travel to Australia you must have a Visa. For a short exchange of five weeks it’s enough with a tourist Visa. It’s for free and is called Subclass 651 – you can apply online on this website: http://www.border.gov.au/Trav/Visa-1/651-. It took me one day to receive my Visa so this is a simple procedure. About your passport, make sure it’s valid at least six months after arriving home again.


   CPR

Your CPR-certificate must be up to date. I contacted my latest nursing job where I was still part time employed and I could take the course there. Once it’s up to date, make sure the responsible for the course print and sign a document saying you’ve taken the course. La Trobe Univeristy needs a copy of this signed document.


   Working with Children Check

We were told that once arriving to Australia we should complete a Working with children check (WCC) with the help from our contact at La Trobe University. Once in Melbourne, we were told that we wouldn’t be able to commence our clinical practise without this check (a requirement from the hospital). Unfortunately, before heading off we hadn’t received what sort of check this was or what was required in order to complete it. As a result we had know idea that we needed two Australian identification documents to complete the check. Neither knew the staff at the university this. Luckily, instead of WCC we could perform a police check on our orientation day at the hospital. But in the future, please ask the responsible at La Trobe if this WCC really is necessary, or if there’s enough doing a Police check at the hospital as we did (you get more information about this police check from the responsible at the hospital). For the police check there’s only Swedish identification documents necessary.

Ankomst och registrering

Since the flight was 22 hours and given the time difference (9 hours) we decided to arrive in Melbourne four days before introduction. We slept in a hotel at the airport the first night and took a taxi to our apartment the next day. We spent our first days in Melbourne as tourists, strolled in the city and explored the most visited tourist attractions (such as St Kilda Beach, Victoria Market and Yarra River).

 

On our fifth day we were invited to La Trobe University and we completed the final documents that were necessary before commencing the clinical placement. I felt really welcomed and left with an uplifting feeling. Website La Trobe University, Melbourne: http://www.latrobe.edu.au/

 

The next day we had an orientation day (full day) at The Royal Women’s Hospital with two of the midwives taking care of all students at the hospital, both local and international. There was a team of seven midwives (the CSM-team, Clinical Support Midwives) at the Women’s who exclusively were employed to organise students’ clinical placements. The day resulted in a lot of information about the hospital itself and its holistic and respectful approach towards the care of women and their health. The CSM-team also showed genuine interest in our personal goals and objectives and made us feel very welcome! I felt ready for the next day – the start of our clinical placement!

The Melbourne Star - View of Melbourne

Ekonomi

Down below is a list of expenses necessary for the exchange:

 

 

                         Swedish kronor

 

Flight tickets   9500 kr ToR

 

Living  Hotel the first night, 1400 kr/night

              Airbnb-apartment, 10 000 kr/person

 

Vaccinations  1000-2000 kr

La Trobe University Immunisation

and Health Record Form” – certificate, 550 kr.

 

Passport 385 kr

 

Swedish police check 185 kr

 

Insurance You receive this from KI

(KI has a agreement with Kammarkollegiet when

studying abroad)

 

Public Transport MyKiCard 8 AUS + minimum 4 AUS/travel

 


Grants INC: 4500 kr

“Vårdförbundets” travel grant: 3000 kr

“Samfonden barnmorskeförbundet”: 3000 kr

“Stockholm barnmorskestudenters stiftelse": 5000 kr

 

My expenses in Australia were quite the same as in Sweden, at least when it came to food and public transport. The currency didn’t differ much from Sweden. We had the nearest (and also one of the biggest in Melbourne city) supermarket located a three minutes’ walk from our apartment, which was really convenient. I would say that we held our costs pretty low thanks to buying and cooking all our meals except one or two times a week when we ate out.

Boende

We chose to rent an apartment through Airbnb (https://www.airbnb.se/) because we wanted to live by ourselves, not in a student dorm. Even though this chose probably was a bit more expensive than living in a dorm or renting a place to stay through La Trobe University (http://www.latrobe.edu.au/accommodation/off-campus and http://www.latrobe.edu.au/accommodation/contact) we could keep our costs down by walking (30 minutes) to the hospital each day instead of using public transport. We also saved money since we could walk to the supermarket instead of traveling by bus or any other transport.

Our Airbnb apartment in Melbourna

Studier allmänt

Midwife studies - Australia vs. Sweden and Karolinska Institutet

To start with, there are three ways of entering midwifery in Australia. First, there’s the combined nursing and midwifery program (four years). Secondly you’re able to enter midwifery if you’re a postgrad, i.e. as in Sweden. You’re already a registered nurse and enter midwifery for a year. Thirdly and at last there’s a straight midwifery program, quite newly introduced.

 

Seen through a student perspective, there are some differences worth to mention. For example, when you study midwifery in Sweden and at Karolinska Institutet you’re taught suturing, perform fetal scalp electrodes and also artificial rupture of membrane (e.g. with a amniohook). This isn’t included in the Australian midwifery education, which for us going to Australia meant we weren’t able to practise these skills at all. We weren’t allowed to perform them as student. In Australia these skills are learnt the first year as a midwife, but what I saw during my weeks in Melbourne it’s common doctors perform these skills in practise.

 

The midwifery education in Sweden demands that a student before graduation completes at least 50 births (with a maximum of five cesarean sections) and taking care of at least another 50 women. In Australia the students need 30 normal vaginal births (i.e. no instrumental deliveries or cesarean sections) and another ten complicated deliveries, e.g. these ending with forceps.

Kurser under utbytet

Kurser motsvarande termin 3 på KI

Sexual, reproductive and perinatal health III 15 hp

We had one contact person on La Trobe University, the partner university, and also a contact person at the hospital we were allocated to (The Royal Women’s Hospital). You’ll get all this information from the international coordinators at Karolinska Institutet once accepted for the exchange. Everyone was really helpful, answered all our questions and looked forward to our visit.

 

I did five weeks (7,5 hp) clinical placement in Melbourne: three weeks in birth centre and two weeks in postnatal. The exchange was doable during the final course – Sexual, reproductive and perinatal health 15 hp. Once back in Sweden I had another four weeks left, only in birth centre. Thus, you complete your final evaluation of achievement of intended learning outcomes concerning postpartum care abroad. Before leaving Melbourne I also had a “mid-evaluation” of my achievements of intended outcomes in the birth centre. This helped me to know what to focus on once I was back in Sweden.

Birth centre

Firstly, I strongly recommend you to write a “inlärningsplan” before the exchange (like one you did before your first clinical placement in the second semester) and forward this to the responsible at the hospital you’re about to be allocated to. Write down what your placement goals and objectives are. Add if there’re any specific skills you want to cover during your placement. The earlier you can forward this document, the earlier you can get feedback and rewrite if necessary. We got little to no information from Karolinska Institutet about the hospital’s routines and rules concerning what students are allowed to do on clinical placement before heading off and therefore had expectations what to achieve abroad that weren’t possible to achieve.

 

-   A student midwife isn’t allowed to suture

-   A student midwife isn’t allowed to put a fetal scalp electrode on

-   A student midwife isn’t allowed to do a artificial rupture of membrane (amniotomy)

 

Three weeks in birth centre is a pretty short amount of time. I think that if I’d known more about what to face once abroad, I would’ve been better prepared and had in a better way seized my exchange there. Nevertheless, I learnt a lot on my exchange! I improved my communication skills with other professions, I gained confidence in my self and in my in my profession since the only way to communicate was in English, I improved my abdominal palpation skills and palpating contractions. Additionally, I had the opportunity to be continuously present in the delivery room to a greater extent than I’d experienced in Sweden. This thanks to their one-to-one care once a woman is in labour. The Royal Women’s hospital is a level three hospital, meaning it’s a high risk hospital. Consequently you improve your knowledge about complicated deliveries, force you to always think one step ahead.

 

You work three shift; morning (7-15.30), evening (13.30-22), and night shift (21-7.30). You’re allocated to different midwives each shift. They don’t know that you’re from Sweden, what year your in, what your goals are etc. You need to repeat this to every midwife. They expect you to take responsible for your own learning, take initiative and telling what and when you wish to do something. If I’d known this before we came there, I think I would have had better chances being more hands-on than I actually was.

 

There’s this team of midwives (CSM-team) that I wrote about above (“Arrival”) who make sure to follow your progress and work. They come to the ward and have a chat with you and really want to make sure that you feel like you’re improving and also feel welcome. Almost everyday there’s this debrief session together with the CSM-team and the Australian student midwives allocated at the same hospital. You get to describe what you’ve been through during the day and once y’all finished, you discuss one particular case. I looked forward to these debrief sessions because I felt they helped me improve my English communication skills, you could ask questions about different choices made by midwives, doctors etc. It got me questioning my own learning and why I choose to act in a certain way in a certain situation.

 

Postnatal ward

Out of five weeks we were two weeks in the postnatal ward. As in birth centre we were allocated to different midwives each shift. Although, since the midwives rotate through birth centre and postnatal ward, we were sometimes lucky ending up with a midwife we’d met in birth centre. I learnt a lot in postnatal, especially about breast feeding. The Royal Women’s have a breast feeding service located adjacent to the postnatal ward. The staff working at the service were lactation consultants, experts on breast feeding, and worked close with the midwives and families on the ward. I got a lot of handy tips that I’ll benefit from in the future! In addition, since the Royal Women’s is a high risk hospital, the postnatal care could be complicated (e.g. women and newborns with diabetes, infections, preeclampsia, breast feeding issues). Giving that I was in a low-risk postnatal centre back in Sweden during my second semester (only women with uncomplicated deliveries), I felt I developed and learnt a lot in Australia!

 

Each midwife cares for four families on shift. Giving it’s a high risk hospital, the work load is pretty high and intense. My opinion is that the Australian postnatal focuses much on the parents’ ability taking care of their newborn with a mindset to give them as much information and advice as possible before sent home from hospital, whilst the Swedish care expects the parents telling when and what help they need before going home with their child. 

Språk och kultur

We had the advantage going abroad to an English spoken country. Thus, I didn’t experience any difficulties being understood and to understand the daily spoken language. Although, the English language used at the hospital sometimes felt like a whole new language! I wasn’t used to all the medical terms, nor the least to speak this sort of medical language. Fortunately, it was much easier to understand than to speak and this helped me develop my speaking skills. I felt that it was much easier expressing myself towards the end of our placement than in the beginning. My advice is though to read as much articles as possible and also English literature to be familiar with the language. I really think this will benefit you during the exchange!

 

One of the things I loved the most about Australia, experienced both at the hospital during the clinical placement and on the leisure, was the kindness and respectfulness towards each other. Everyone was helpful and had a kind approach to each other. For the majority of my time there I didn’t experience any hard feelings or harsh tension at all. My experience is that the Australians have a pretty laid back attitude, but not in a way that can be perceived as nonchalant. They just seem to have a common-sense-type-of-way looking at life.

Fritid och sociala aktivteter

During our five weeks in Melbourne there weren’t any social activities we knew of for the exchange students. Nevertheless, we met Australian students at the debrief sessions at the end of each shift and could organise meet ups by ourselves. One student invited us to a car tour outside of Melbourne where we couldn’t travel by bus – we walked the well-known Kokoda Memorial Walk (“1000 steps”) together (http://www.visitmelbourne.com/regions/Yarra-Valley-and-Dandenong-Ranges/Things-to-do/Outdoor-activities/Walking-and-hiking/Kokoda-Memorial-Walk.aspx).

Melbourne feels like a city with everything! One the one hand you have a big city with an intense out life, on the other hand there’s this calm and welcoming family city with green parks that welcome you for a picnic. The Melbourne Museum is well worth a visit – built quite recently it’s a modern museum, but at the same time presents the Australians origin and nature (https://museumvictoria.com.au/melbournemuseum). While in Melbourne I’d recommend you to visit Phillip Island (https://www.visitphillipisland.com/) where you get to see the world’s smallest penguins – called little penguins. Their height is 30-40 cm and they weigh about one kilogram each. We went with a tourist bus since it’s two hours drive there and found it really convenient. A must-to-visit-place while in Melbourne is the Queen Victoria Market (http://www.qvm.com.au/). It has everything and is definitely the right spot to buy all your souvenirs and gifts to friends and family.

Finally I’d like to highlight the food in Melbourne! I don’t think I’ve ever had such good food-related experiences! Giving we were on a budget, we went out for dinner once/twice per week. Two of my favourite restaurants were Longrain and Da Guido. Don’t think I’ve ever had better Asian or Italian food before. Next time I visit Australia and Melbourne I’ll have a special budget just to be able to eat out every night!

Phillip Island

Sammanfattning

Going to Australia meant I got to see and gather experiences I never would have got if I’d stayed in Sweden! I think the experience of being forced communicating, being a student in unfamiliar contexts, and sometimes uncomfortable situations, did benefit me once coming back to the final weeks in birth centre in Sweden. I feel I gained trust in myself and that I felt braver and more confident taking own initiative. I developed my critical thinking in a way I wouldn’t have done if I’d stayed home.

 

A part of me is sorry for not being as hands-on as in Sweden. Nevertheless, I imagine this feeling partly exist because I had set up expectations and goals before going based on my experiences in Sweden and what I so far knew students were allowed to perform. Therefore, my advice to future student midwives studying abroad is to travel with an open mind, seek as much information that’s possible from Australian contact persons, and also feel free to contact me if there’s any questions! Once home again when chatting with co-students, I didn’t feel as I’d missed out on much. My feeling was that we shared the same thoughts of, fears towards and insecurities in our new profession. My Melbourne-experience was an eye opener, I absolutely don’t regret going!   

Melbourne by night. Yarra River.