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Report Kilkenny, Ireland 4SOT11YE

HyvaOlo -verkosto · Web viewThis is a journey report of our class on-the-job-learning period in Callan and Thomastown in Kilkenny, Ireland, 9.2.2013 - 10.3.2013. There are nine persons

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Kilkenny, Ireland

4SOT11YE

Sirja Vaara, Katri Elkki, Tania Hosio, Raita Ovaskainen ja Elisa Ovaskainen

Contents

1 Introduction3

2 Travelling, accommodation and other practical matters4

3 Practical training6

4 Interaction25

5 Reflection and tips to the people attending exchanges in the future25

1 Introduction

This is a journey report of our class on-the-job-learning period in Callan and Thomastown in Kilkenny, Ireland, 9.2.2013 - 10.3.2013. There are nine persons in our group and five of us left to do an on-the-job-learning period in Callan and Thomastown. Four persons of our class did their on-the-job-learning period in Rovaniemi in different placements. Our examination is partly in English and that is why we were able to have this experience.

We all have done our matriculation examination which why our practical nurse examination is a little bit shorter than usually. We started these studies in 12th September 2011 and we will graduate in 20th December 2013. We will specialize to nursing and care. At this moment we are doing study module of rehabilitation and that is why we are doing our on-the-job-learning period in a different kind of a rehabilitation placements. We already did our four and half week on-the-job-learning period in Finland which included a demonstration of occupational skills.

We were staying in three different host families in Kilkenny. In families we had a chance to upgrade our language skills and get to know to the Irish culture and cuisine. We were divided into three different rehabilitation placements. We were working seven hours/day, and we had 20 working days together. We had a chance to get to know to the Irish ways to do rehabilitation, their policies, customs and daily routines. In Ireland we found that in some of the rehabilitation placements were different kind of ways to take care of elderly people and hygiene than we have in Finland. Although in one placement there were plenty of activities for elderly people. We do not have so many activities for elderly people in Finland. In placements we were also able to upgrade our professional vocabulary.

Our exchange here in Ireland has received a lot of financial support from the project called Leonardo Da Vinci Mobility. The central goals of the project are: training future professionals with languages skills by offering mobility and practical training in the cultural area of the teaching language, support them in developing professional skills and preparedness for employment, motivating them to use and develop existing language skills and additional learning and especially provide them with the possibility to develop their patient guidance skills in English. In addition we shall proceed according to the ECVET-process in order to increase the transparency of studies and degrees. In our exchange the international partner was Language Xchange Ireland. We have done cultural trips as part of our exchange and also we have done guidance assignments.

2 Travelling, accommodation and other practical matters

We got the “to do list” from our teacher before the trip. We had already the European Health Insurance Card that we ordered to our first trip abroad, and the Criminal record certificate we did order from Legal Register Centre due to the last one was already too old. Flying tickets we got from school, we didn’t have to pay for those, although we had to buy our train tickets to Rovaniemi- Helsinki-Rovaniemi (around 80€ with VR’s student card). We had to have our passport, travel insurance and liability and legal expenses insurance (from school, Super, JHL, Tehy). We had (If wanted) to inform to Finnish ministry for foreign affairs the time we will be abroad, in case of emergency.

It took us 12 hours by train to travel to Helsinki, and after that we had to wait for our flight to take off, and we did take the flight to Frankfurt first and from there to Dublin we did leave at around 6.30 from Finland and we were in Dublin around 12.00(local time) and you should be prepared for any delays according to traveling. And In Dublin we had our contact person waiting for us, and from Dublin we did have a bus trip to Kilkenny (Thomastown and Callan). We either walked or our host family drove us to our working places. If you wanted you could take the train to Dublin or Kilkenny that cost like 20-30 euros to Dublin(return) and 10-15 euros to Kilkenny(return), and the trip lasted like 2 hours to Dublin and 15 minutes to Kilkenny. Also we had trips provided by the receiving organization, like the one in Dunmore Caves, and Hook’s Lighthouse (picture below) and Waterford.

We lived in family settings(Host familys), so we got breakfast, lunch and dinner from there, but everything else we like to ate, we needed to buy ourselves. School paid for the accommodation so we didn’t need to pay anything. Other expenses you needed to pay yourself.

Picture from Duplin

You worked five days a week, so you had weekends off and did whatever you wanted, but you must negotiated home coming times/dining times with your family. You should plan your free time carefully because it is very limited (Only three weekends all together).

3 Practical training

3.1 Mount Carmel House, Ireland, Callan

Description of the PT-place, daily schedule and activities

My on the job learning place was Mount Carmel House. It offers its services to low dependency residents over 65 years. It provides long-term and respite care for residents who are mainly capable of living independently and who require minimal assistance in a home-from home environment. In Mount Carmel House the total capacity is for 20 residents. There are 20 single bedrooms, and at the moment all bedrooms are in use.

There is also independent living accommodation on the grounds of Mount Carmel House and the occupants can avail of meals in the centre.

In Mount Carmel House, the day rhythm/daily routine was following:

7.30 am Breakfast

10.00 am Soup time

11.00 am mass

12.30 am Lunch/dinner

3.00 pm Teatime

5.00 pm Teatime

8.00 pm Teatime

There were a lot of activities in Mount Carmel House. There were following activities during the day: art and craft, playing cards, listening music, singing songs, playing bingo, playing ring game, do different kind of sport (dance, chair sport, bowling), etc.

Different personnel groups, personnel comparable to practical nurse and central duties

There were in Mount Carmel House different kind of workers: registered nurse, senior carer, care assistant and cook. Registered nurse was also the headmaster of the Mount Carmel House. In addition, there were hairdresser, sport leader and art and crafts leader. Sport leader and art and crafts leader visited once in a week. Hairdresser visited when needed.

In Ireland Registered nurse does pretty much the same things than registered nurse in Finland. But it is obviously clear that there are also differences. In Ireland there is no nurse like practical nurse in Finland. I think that Senior carer `s roles in Ireland and practical nurse`s roles in Finland are pretty much the same. In Care assistants took care of the resident`s nutrition, well-being and hygiene. They made food with cook, they cleaned resident`s rooms and washed their laundries. Sometimes, Registered nurse and senior carer did these previously jobs with other care assistants but they also have their own responsibilities like paperwork and leading things. Care assistants, registered nurse and senior carer also transported residents to the different places like doctor, shops, post and different happenings (dance happenings, bowling happenings etc.) Co-operation between different personnel groups was very open-minded and flowing.

The objectives according to the PT-period and their realization

The student is responsible for her learning and professional growth as follows:

· follows the schedules and working hours (I have followed every day the schedules and working hours)

· works being careful and reliable and respecting clients (I have been careful and reliable. I have respected different kind of residents)

· pays attention to co-operation and teamwork skills (I have payed attention to co-operation and teamwork skills, I have been polite and friendly for the stuff)

· asks the supervisor for support, guiding and feedback when needed (I have asked support, advices and guiding from my supervisor when I have needed that)

· is active and interested in work, working community and clients (I have been very interested in work. I have been interested in how work community works and what kind of residents there are in Mount Carmel House. I have played different games with residents and I have done a lot of exercise with them. I really enjoyed being in Mount Carmel House and I saw how residents enjoyed to living there too. They were happy.)

· prepares and participates in the feedback and evaluation discussions and fills the self- evaluation form (I have prepared and participated in the feedback and evaluation discussions. I also have filled the self-evaluation form)

· contacts the teacher and/supervisor in Kilkenny when needed (I have contacted the supervisor in Kilkenny when needed)

· does and returns the learning tasks/ written assignments (I have done my learning tasks and I will return all the forms with written assignments back to Finland)

Study counseling/tutoring

In Mount Carmel House the Study counseling/ tutoring has been quite good. All workers in Mount Carmel House were helpful, friendly and open-minded. During the work days we have discussed a lot about Finnish nursing and care and about Irish nursing and care. We have shared information about different ways to take care of residents. Although, If you want to learn something new during the on the job learning period you have to be very activate yourself and ask as many questions as you figure out. I have asked many questions, and it has helped me to get more information about the Irish culture and Irish way to take care of old people.

Occupational safety

Occupational safety is very important issue, and it comes out in the Mount Carmel House. In Mount Carmel House there are quite good hygiene. For example, they are cleaning every day resident`s rooms, and they use gloves in different kind of care situations. I was surprised that the hygiene was so good because the hygiene is not that good in every place in Ireland. In Mount Carmel House they use their own work clothes and work shoes. The atmosphere In Mount Carmel House was very good, and I think that is also one way to take care of workers and residents well-being in Mount Carmel House.

Methods and techniques of work, instruments and materials -comparing to the Finnish conventions

In Mount Carmel House there are a lot of happenings and stimulus for old people. For example, the following activities are arranged within the centre and Residents and Day care clients are encouraged to participate. However the participation is the choice of each individual.

· Art and craft

· Newspapers

· Crosswords

· Board Games

· Exercise to music

· Bingo

· Hairdressing

· Singing

· Dancing

There are also a lot of happening for old people in the city centre. There residents can meet other old people. In Finland we do not have as much activities for old people than here.

In Finland and In Ireland (in Mount Carmel House) the hygiene is good. Of course, there are a few differences. For example, In Finland we use more gloves, and in Ireland they are cleaning the rooms more often than we in Finland.

In Ireland the residents have same kind of rights (values) than residents have in Finland. For example in Mount Carmel House there were following rights: resident`s involvement and consultation, information and communication, consent, privacy, dignity, civil, political and religious rights.

In Ireland there are also care plans in use. Of course care plans were a bit different than we have in Finland. But the main point was the same. Also, In Ireland the care plan includes the most important information of the resident. It is important to read those care plans before you start to work.

In Mount Carmel House there was training for the staff. We also have training for the staff in Finland. In Finland and in Ireland, it is prominent to learn new things like methods and techniques of work regularly. When you update your information regularly, the residents gets better nursing and care.

Distinguishing characteristics that have to be considered when organizing the period and while working

Of course, every country and every culture has their own ways to do things. We have to respect different kinds of ways to do things in nursing and care. In Ireland nurses (registered nurse, senior carer, care assistants etc.) have different responsibilities in nursing and care than we might have in Finland. That is why you have to observe a lot of things before you start to work in different country.

In addition, you have to know that religion is very close to Irish people. And in Ireland the main religion is different than our main religion in Finland. You have to respect other people`s religion, and also your own religion.

Indeed, in Ireland nurses have a dress code. So, you have to dress up like them because of you are working in their own area.

To what kind of students and at which point of studies is the post suitable for considering the practical training for studies

My opinion is that student who is coming on the on the job learning in Ireland, should be very activate and self-imposed. She or he should have enough words to speak English but still you do not have to be great English speaker. The most important thing is that you have the courage to speak English! Communication skills and good social skills are also important. I think that exchange is suitable for every student and in every period of studies if the student have a lot of motivation to go abroad.

3.2 Strathmore Lodge Nursing Home, Ireland, Callan

Description of the PT-place, daily schedule and activities

Strathmore Lodge is elderly people`s nursing home in Ireland, in Callan, and it has been built in 2005. There are living 60 residents. There is downstairs and upstairs, in down there are 25 residents and up are 35 residents. There is working people from different countries like Ireland, India, Poland and Filipinos. Overall the number of staff is quite high. There is many different sifts to do for example morning, day, evening and night. There is also sifts between those sifts. Working day can be six, eight or 12 hours per day.

Daily schedule consists of handover which is first given nurse to nurse and after that nurse will give it to carers. After having handover carers start to give breakfasts to the residents. Residents are eating breakfasts in their own rooms in bed or round the table. Tea time is at 11 o’clock (11 am.) Lunch time is around 1 pm and after that they can have cup of tea. Supper is 5 pm. and it is served with tea and toast. Residents are eating in two different dining rooms (assist and by themselves) or in their own rooms.

Four times in a week there is an activity planner who plans the activities and keeps them. Activities can be reading the paper, watching TV, singing songs reading poetry, using senses like smell and touch. Once in a week there is Fit for Life- lesson where residents are doing some exercises with a trainer. There is two different session for those who are better shape and for those who are not so good shape. Residents can spend time in their rooms, in the corridor or in the nurse’s station. Also dayroom is available to time using.

Different personnel groups, personnel comparable to practical nurse and central duties

There are many different personnel groups in our work placement. Personnel groups are following:

· Director of Nursing

· Senior Nurse

· Nurse

· Senior Carer

· Carer and care assistant

· Kitchen staff

· domestic/house holding/laundry staff

· Activity planner (four time in the week, and multiple time at the day)

· Fit for Life and other trainers (once in a week)

· Chiropractics (once in a week)

· Hairdresser (once in a week)

· Psychiatric nurse, doctor (when needed)

· Priest (He keeps mass Sunday mornings and Tuesday evenings)

Care staff (senior carer, carers and care assistants) is taking care of resident’s personal hygiene, wellbeing and nutrition. They are not allowed to do any medication, or give insulin or take residents blood sugar. Nurses are taking care of resident’s medication, blood sugar, giving insulin and blood pressure measures. Nurse is also with the resident when doctor is visiting. In Ireland, they do not have practical nurses. I think that practical nurse`s work is somewhere in the middle of the care staff`s work and nurses work. Kitchen staff is looking after the dining rooms and make all the foods in the kitchen. They are also planning the menus. Domestic/House holding/ laundry staff are looking after the cleaning resident’s rooms, corridors, public toilets etc. And they are looking after also residents’ laundry to be washed and dried.

The objectives according to the PT-period and their realization

The student is responsible for her learning and professional growth as follows:

-follows the schedules and working hours (I have followed every day the schedules and working hours. I have been on time at the work every day.)

-works being careful and reliable and respecting clients/residents (I have been very carefully and reliable. I have also respected different kind of elderly people and different staff in the working placement. Especially the religion is big thing here in Ireland)

-pays attention to co-operation and teamwork skills (I have pay attention to co-operation and teamwork skills. I have been helping to use hoist with carer. I have been also polite and friendly for the staff, residents and resident relatives.)

-asks the supervisor for support, guiding and feedback when needed (I have asked support and guiding from nurse/carer when I have needed that and when I felt that I need help for something to do)

-is active and interested in work, working community and clients (I have been very interested in work and what kind of duties everyone has in the nursing home. I have been interested how work community works and what kind of activities there are in nursing home for the elderly people (e.g. reading the paper, playing bingo and having different kind of exercises.)

-prepares and participates in the feedback and evaluation discussions and fills the self- evaluation form (I have prepared and participated in the feedback and evaluation discussions. I also have filled the self-evaluation form and recorded the evaluation conversation.)

-contacts the teacher and/supervisor in Ireland when needed (I have contacted the teacher when I had some questions for her)

-does and returns the learning tasks/ written assignments (I have done my learning diary, guidance task and other written assignments. I will return all the forms and papers with written assignments when I’m back to school in Finland.)

Study counseling/tutoring

I didn’t have one and only supervisor in the Strathmore Lodge because I was almost every day with different nurses and carers. Also staff was changing daily. I found out that there is so many different ways to take care of elderly people in my placement. All staff and residents was really nice to me and they did help me if it was needed.

Occupational safety

I had fire safety tour in the placement. We went through what to do in case of fire. There are fire doors and many exits to go out. In the front yard is fire assembly point where to go. In the corridors there are fire extinguisher and hammer to break down the window. In bathrooms there is emergency string. Also in every residents room is call bell to residents use. Some of the residents wear a security bell in their wrestle and it will give the information for the staff if the person lives out of the building.

Methods and techniques of work, instruments and materials -comparing to the Finnish conventions

In the placement there was lot of help equipment to use for helping residents and workers.

· hoist (stand assist and lifting) and different size of slings

· walking frame

· walking stick

· different kind of wheelchairs

· lifting belt

· in toilet higher sitting equipment

· electric beds and different kind of matters in beds

· weight measure chair

· blood pressure measure machine

· help equipment for eating and drinking

· railings in the wall

· rotation board

· lift between the floors (it is used to taking residents up and down)

In Strathmore Lodge in Ireland hygiene is not that good than in Finland but it is better than Northern Ireland. Staff doesn’t use gloves so often than in Finland. In my placement there is used a lot of different help equipment and I think that in really good thing. Plastic cups which are used to given medicines to residents are reused again. Night staff does the sterilization.

During the day carer’s and nurse are filling in a different kind of forms abut residents who need to be watch out better. Those forms are following:

· Check Sheet (for certain people, to check where they are in every 15 minutes)

· Daily Fluid Chart (intake and output)

· Weight Chart monthly/weekly

· 2/4 hrly Turning and Oral Hygiene chart

· Daily Allocation Record

· Shower Chart

· Bowel Chart (marked BO or BNO)

In the work placement there is a folder from every resident. Folder includes 5 sections and in the sections there are more titles. The sections and titles are following:

· Resident I.D sheet

· Pre-assessment

· Daily nursing records

· Care plans 1 – 12

· Risk assessments

· Monthly assessments

· MDT

· Weights

· Falls

· Key Worker

· Miscellaneous

Distinguishing characteristics that have to be considered when organizing the period and while working

I think it is important that students who goes to exchange understand that there is so many different ways to do care work. Like in Ireland taken care of elderly people is different than in Finland. Still, there is also similar ways to work and things that staff is doing. Like being with the elderly people daily and giving time to them. Students have to respect workers, residents and their relatives and also working methods. Discussing about work methods and differences are very important so you handle different kind of situations.

To what kind of students and at which point of studies is the post suitable for considering the practical training for studies

I think students who are going to exchange need to be activated and orientated to the trip. Also English skills need to good so you can understand what people are saying to you. It is also easier to yourself communicated with other when you know the language and professional terms. You need to have encouragement to use English skills. Also knowledge about the work you are going to do is good to have e.g. on-the-job learning period in Finland before going to aboard.

3.3 St. Columba’s Hospital, St. Patrick’s ward

St. Columba’s hospital is a public nursing home for elderly people. St Columba’s was originally opened as a workhouse under the auspices of the Board of Guardians in 1853 and its history includes providing care for homeless persons and single mothers. Since 1952 the premises had been utilised specifically for the care of older people in the region. St. Columba’s Hospital is managed by the Health Service Executive (HSE). The hospital is a large three-storey building accessed via a long landscaped driveway. There is 4 different wards: St. Joseph’s ward (Rehabilitation), St. Mary’s ward (Dementia), St. Patrick’s ward (long stay ward) and ST Bridget’s ward. Also the hospital has got a day care centre which offers services to the community and that is located in the grounds of the hospital. There is registered for a total of 78 beds, four of which are respite.

I was working in St. Patrick’s ward which is for a long time patient’s. My day started at 8 with a night nurses rapport, and after that the health care assistants (and me) went to wake up the patients, when the nurses still continued the rapport and conversation about the patients. After that there was a kitchen staff that gave the breakfast to the patients, and health care assistants (and me) helped with that and they fed the patients that needed assistance. After that we collected the china away and started to dress the patients and toileting them, and we get them into the day room, also at this time nurses gave the medicines and took the daily OBS (observes: blood pressure, pulse, saturation and temperatures. After that in Mondays and Thursdays there were a mass in the hospital’s chapel, the patients that could be walked or pushed in a wheelchair there went, and the others could watch the mass on TV (they had cameras on the chapel).

Chapel from St. Patrick’s ward

The patient’s lunch was at 1pm and we helped with that, also there were patients that needed feeding and assistance. After lunch we toilet the patients that needed to use toilet, and some of the patients, wanted to go to bed already. On approx 2pm-3pm there was activity time, it depends for the day what there is, could be singing or watching DVDs. Also there are staff that are looking after the activities, they normally came twice a week. They had for example some painting and trip to the garden. In evening shift there was dinner at 5pm, and after that there was some toileting and maybe activities, and then the health care staff started to put patient s back to bed, some of the patients went earlier than others, they were allowed to watch TV, and they had teatime at 8pm, after that all the patients went to bed. Night shift starts at 8.30pm and continues till 8am.

In the hospital there were nurses, and health care assistants, and doctor that came every day, and kitchen and laundry staff, and also cleaners. I was working mostly with the health care assistants, but I think it’s still not the same as the practical nurse, because they didn’t do any of the medical things. I also was with the nurses, and did thing with them too (medicines, OBS, writing etc).

The guiding was really poor, because the ward was so busy, the staff didn’t have the time to explain things properly, so you did have to ask things and just learn by watching what others are doing. Also it took ages to get the paperwork done.

Safety in the ward was really good, though it could have been better. It was an old house so the structure was bit hard to work with. But the safety was good otherwise, they did have training about the fire safety, and they had alarms in the beds and chairs for the patient’s that might fall. Also they had all the risk evaluations for all the patients, like how many nurses you needed to get the patient to toilet and what are the risks of falling etc.

The methods and techniques were pretty much the same, though they didn’t use computers at all, all the medicine lists and daily writings were done by hand, and I did think that was hard to read sometimes you couldn’t even tell what there was meant to read. But I think the other procedures were the same, although they used different tools than we use in Finland, but they worked as the same. Also the medicines might have the same usage and ingredients, but the name was different. The place suits practical nurses in their studies in nursing and care, but the problem about our stage of studies (rehabilitation support) was that there was place for just one student in St. Joseph’s ward (rehabilitation unit).

3.4 St. Columba’s Hospital, St. Joseph’s ward

Description of the PT-place, daily schedule and activities

St. Joseph’s ward is located to St. Columbas Hospital, Thomastown, Kilkenny. St. Joseph’s ward is a rehabilitation ward. There is physiotherapy and occupational therapy provided in the ward. The total capacity of the ward is 18 residents. The number of residents vary quite a much because there is always patients leaving the ward and new patients coming to the ward. The length of the rehabilitation periods can vary from two weeks to six months. Usually patients go to a physiotherapy twice a day. Occupational therapy was offered when needed.

Daily schedule:

7:30 Breakfast

10:00 Souptime

13:00 Lunch

15:30 Teatime

17:00 Dinner

19:30 Teatime

Different personnel groups, personnel comparable to practical nurse and central duties

In St. Joseph’s ward there is many kind of workers. Registered nurses, care assistants, physiotherapists, occupational therapists and the kitchen staff. In St. Joseph’s ward registered nurses does same kind of tasks as nurses in Finland. In St. Joseph’s ward the nurses had quite much paperwork and patient assesments to do. The care assistants assists patients with their daily living activities and does the daily observations (blood pressure, temperature etc) but the care assistants does not give any medication. The care assistants does not either do assesments for the patients. The doctors round was once or twice a week.

Study counseling/tutoring

In St. Joseph’s ward tutoring was quite good. I did’nt have my own tutor though. There was couple of staff nurses I worked with, and they took me into consideration as a student. The staff of the ward is very friendly. I always got quiding and help when asked.

Occupational safety

The athmosphere in the ward was very good. The hygiene and aseptics were taken into consideration quite well. There was some differences between Finnish and Irish methods but the staff in St. Joseph’s ward is very aware about the importance of hand washing and desinfection.

Methods and techniques of work, instruments and materials -comparing to the Finnish conventions

The methods were very similar with the Finnish nursing methods. The staff was using ergonomic working methods. Working ethics were similar than in Finland. The staff treated all the patients with respect. Materials and instruments were quite similar than in Finland.

Distinguishing characteristics that have to be considered when organizing the period and while working

When training in a different country, you have to get to know the culture and habits and norms of the working place. In Ireland most of the people are Roman Catholics and the religion is very important especially for elderly people. You always have to take the new environment and its culture into consideration when working abroad.

To what kind of students and at which point of studies is the post suitable for considering the practical training for studies

I think St. Josephs is suitable for every student in healt care. There is working people with different occupational backround and it is good chance for students to get new point of views. In St. Joseph’s ward it is good for student to be hardworking, self-imposed and social.

4 Interaction

Our language skills and sufficiency developed well because we had to speak English every day all day. The speech was easy to understand because the dialect of the locals was easy to keep up with, even though they had some words and phrases in their dialect that we had not heard before.

All the language teaching and training happened at the interaction with locals and people from work placement. All the people loved to help us to learn the language and helped us if we did not remember how to finish a sentence or to say something particular. We also learned a lot of professional language from work, and that some words that we were taught at school are not used over there, that they had better synonyms that are commonly used.

We had trips organized for us to Dublin and to Dunmore cave, Hooks lighthouse and to Waterford. We went to Dublin couple of times. The first time was when we had just arrived to Ireland and we had to buy some clothing for work. Second time we organized the trip on our own because of a school task of culture. The trips to Dunmore cave, the lighthouse and to Waterford were combined into one whole day lasting trip.

Interaction with locals was easy, and Irish people were easy to get along with. Locals were very friendly and social. They said hello even they did not know us and some could just start to talk to us, which was nice. People were very keen to get to know us and they were very interested of our culture as well as they liked to tell us about their culture. We were staying with a host family so we got a good picture of normal every day Irish life.

5 Reflection and tips to the people attending exchanges in the future

In Ireland we learnt a lot of Irish ways to take care of elderly people in rehabilitation placements. We also learnt that in different cultures are different ways to take care of elderly people in rehabilitation. For example in Finland the hygiene is much better than here in Ireland. In Ireland hygiene is much better than in Northern Ireland. Here in some work placements there are a lot of activities for elderly people. We improved our professional English skills and also skills in rehabilitation. In work placements the workers are really friendly, helpful and polite.

When you are going to exchange take into consideration weather in that country. For example in Ireland winter time is really cold and houses are even colder. Sometimes there can be a lot of rain in Ireland in winter time. So, an umbrella and wellingtons might be needed. After all you need to take enough warm clothes with you.

In addition you need to be prepared that your host family can be anything so don't expect too much. You need to be able to respect different kind of habits and be flexible. Also you can prepare by taking some cash with you, because all shops doesn't take credit cards if the price of your shopping is to low. Traffic is also one thing you should take into consideration because it's here in Ireland contrary.

When you are going to go exchange the most important thing is that your attitude is right and you are open-minded. You will enjoy a lot of your trip if you are activated and you want to learn new things and you want new experiences. Don’t be afraid to use your English language. The more you speak the more you learn.

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