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Oppimispäiväkirja

Irina Saario g35028
Olena Mekh g35027
Diakonia-ammattikorkeakoulu
Diak, Oulu
Englanti ammatillinen, terveysala
Kesäopinnot 2017
I41sh
29.5 - 21.6.2017

Olemme päättäneet, että Irina tulee joka oppitunti minun luo ja opiskelemme Ammatillista englannin kesäkurssi yhdessä. Oppimispäiväkirjaa myös laadimme yhdessä jokaisen oppitunnin jälkeen.

Oppimispäivä 1,
29.5.2017
Oli mukava tutustua opettajaan ja kurssiin toteutussuunnitelmaan. Olen myös tutustunut Padlet-ohjelmaan ja oppinut käyttää sitä. Saimme kotitehtäväksi nauhoita kertomus itsestä ja laitta sitä Padletiin; laatia Power-Point esitys työpaikasta Suomen terveydenhuollossa, lukea opettajan Padletista artikkeli ”My future job” ja Suomen opiskelujärjestelmästä englanniksi. Saimme kotitehtäväksi myös laatia tyypillinen potilaan case Power-point muodossa ja valmistautua esiintyäkseen seuraavalla tapamisella.

Oppimispäivä 2,
31.5.2017
Opiskelimme paarina. Tuli luettu ja vastattu artikkelin alapuolella oleviin kysymyksen vuorottelen. Tuli mietiskelty ”Healthcare profession” tehtävän oikean käännöksen ja laitettu oma sanasto, josta oli puhuttu lisää oppitunnin jälkeen

Oppimispäivä 3,
5.6.2017
Taas opiskelimme AC:lla. Tuli esiintyä ”We are on the way to nursing job” ja ”Case of severe asthma” esitykset. Kuuntelimme muiden opiskelijoiden esityksiä, keskustelimme ammatillisesta sanastosta ja aiheesta. Saimme kotitehtäväksi laatia nursing prosedures/self care Power-point muodossa ja valmistautua esiintyäkseen keskiviikkona.

Oppimispäivä 4,
7.6.2017
Tuli esiintyä esityksen ”Postoperative self-care instructions”. Kuuntelimme muiden opiskelijoiden esityksiä, keskustelimme ammatillisesta sanastosta ja aiheesta. Keskustelimme opiskelukavereiden kanssa paarina opettajan Padletissa olevista aiheista mm katetroinnista, haavan hoidosta, EKG ja analyysien ottamisesta, potilaan kohtamisesta. Saimme kotitehtäväksi lukea anatomiasta ja ensiavusta opettajan Padletista ja valmistautua puhua aiheesta vapaakeskustelussa AC:lla

Oppimispäivä 5,
12.6.2017
Hienosti meni vapaakeskustelut paarin kanssa. Me pääsimme eli meidän paari pääsi paarikeskusteluun opiskelukaverin kanssa, joka asuu jo yli vuosi Kanadassa. Jarno on suomalainen ja meni puolison perässä pitkään työmatkaan Kanadaan viime elokuussa. Nopeasti ja kätevästi meni opettajan Padletista löytyvien materiaalin lukeminen ja tehtävien tekeminen, pääsimme myös mietiskellä ristikon ratkaisuun ja puhuimme myös englanniksi elämästä Kanadassa ja Oulussa.  Opiskelimme myös kehon osat englanniksi ja Welcoming the patient. Oppitunnin jälkeen surfailimme Oxford dictionary linkissä, yritimme ratkaista ristikon loppuun ja teimme läksyt.

Oppimispäivä 6,
14.62017
Tänään oli taas mukava ja antoisa harjoitella puhekieltä paarina. Minä meni olohuoneeseen ja Irina jäi keittiöön niin, että pääsemme opiskella paarissa muiden opiskelukavereiden kanssa. Minun paarina oli Jarno ja Irinan paarina oli Marianna. Olemme huomanneet, että paarikeskustelut sujuvat entistä helpompi ja mukavampi. Eli niitä paari keskusteluja ja puhekielen harjoitteluja toimii. Tänään huomasin, että muistan ja käytän keskustelussa paljon enemmän uutta ammatillista sanastosta, kuin se oli viime kerralla ja ihan itsestään palaa mieleen ennen vanhaa opittu sanasto. Niin, harjoitus tekee mestarin. = Practice makes perfect. Kaksi artikkelia ”Health bracelet” ja ”Sufficient sleep” tuli luettu ja vastaukset niihin tuli saatu niin nopeasti ja kätevästi, että ehdimme vielä jutella Jarnon kanssa omasta terveydestä. Samalla vauhdilla vuorotelen tuli tehty muut tehtävän, esimerkiksi, Health Discussion A ja B ja Personal Details ja niiden tekeminen ei tuntui yhtä raskaalta tai tylsä, päinvastoin, se oli tosi mielenkiintoista ja hauska. Aika hyvä treeni oli ennen suullista koetta. Saa nähdä mitä tulee kokeessa.

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Olena Mekh g35027
20.6.2017

Story of 79-year-old lady from Rockland diagnosed with COPD highlights the growing concern about increased prevalence and incidence of COPD in Canadian women. Ann Silversides in her article “Short of breath: for Canadian women, COPD deaths surpass those from breast cancer” briefly reviews medical facts and preventive measures, stereotypes and scientific researches, methods of diagnosis and treatment, clinical prognosis and perspectives for patients with COPD.

According to the World Health Organization, chronic obstructive pulmonary disease (COPD) is expected to rise from 4th to the 3rd leading cause of death worldwide by 2030. Among Canadian women the number of deaths from COPD has already surpassed the number of those, who died from breast cancer. How can it be explained? Basically, the number of breast cancer survivals is growing due to improved treatment. On the other hand, COPD is still stays under-researched, poorly diagnosed and often goes untreated. COPD was traditionally considered as an old-white-male-smoker´s decease. According to researches mentioned in article, doctors often ignored spirometry test while diagnosing female patients. For that reason, usually women´s COPD is misdiagnosed as asthma. Furthermore, due to smaller size, women´s lungs are much more vulnerable to smoke and air pollution. Influence of hormones also increases inflammatory risk in women. Despite of constant decrease of smoking rates among the women since late 1960s, contemporary level of COPD in aging women reveals the consequences of so called World War II effect when number of women smokers were high.

As reported by Canadian Lung Association in 2009, COPD was becoming “a crucial women’s health issue”. Preventive measures and early diagnosis are crucial in treatment of COPD. According to a Canadian Institute of Health Information study patients with COPD have the highest rate of re-admissions to hospital. Dr. Anna Day, respirologist at Women’s College Hospital in Toronto admitted, that she has tried for the last 15 years to ring alarm bells and make people realize the danger of COPD. She noticed, that level of smokers´ another major risk -  lung cancer, also continue to grow among women in Canada.

Dr. Day and her colleagues are sure, that harmless and relatively cheap spirometry test routinely given to current and ex-smokers can detect airway obstructions on early stages, prevent COPD and save a lot of lives.

Please follow the link for the article “Short of breath: for Canadian women, COPD deaths surpass those from breast cancer” by Ann Silversides published on 12th of May 2014 on the website of Canadian Women´s Health Network.

http://www.cwhn.ca/en/networkmagazine/shortofbreath

Or use uploaded text below.

Short of breath: For Canadian women, COPD deaths surpass those from breast cancer

Publication Date:

Mon, 2014-05-12

By Ann Silversides

When Irene Donaldson became anxious about her persistent dry cough and the “terrible time” that she had breathing, her physician downplayed her concerns.

Donaldson had quit smoking 15 years earlier. Her doctor ordered a chest X-ray, which was clear.

“But I kept after her—and after her—and finally she referred me to a respirologist,” says Donaldson, 79, who lives in Rockland, a town of about 11,000 an hour’s drive east of Ottawa.

Donaldson, who was 75 at the time, waited six months for that appointment, at which she had a spirometry test and was diagnosed with chronic obstructive pulmonary disease (COPD), an umbrella term for emphysema and chronic bronchitis.

Spirometry is the standard test to confirm a COPD diagnosis; chest X-rays are “seldom diagnostic” for COPD, according to international guidelines.

Now the fourth leading cause of death worldwide, COPD is expected to climb to 3rd place by 2030, according to the World Health Organization.

Despite the burden that COPD places on sufferers—and on the health care system—researchers agree that this chronic disease is under-diagnosed and under-treated and, relative to other chronic conditions, underfunded and under-researched.

It will surprise many to learn that more Canadian women are expected to die from COPD this year than from breast cancer, continuing an existing trend. This underscores COPD’s low profile as a public health issue.

In fact, COPD overtook breast cancer as a cause of death for Canadian women in 2009, according to Statistics Canada figures, and since then COPD deaths have climbed while breast cancer deaths have fallen. (The latest figures, from 2011, show 5,342 deaths from COPD, 4,958 for breast cancer.)

Back in 2006, a Canadian Lung Association report pointed out that COPD was “becoming a crucial women’s health issue.”  Today it’s safe to say it is a women’s health issue. Taking Her Breath Away highlights the disturbing increase of COPD among women in the United States and was released just last year by the American Lung Association.

Getting a diagnosis

By the time that Donaldson was diagnosed with COPD, her condition was so severe that the specialist promptly arranged for her to be admitted to a 30-day in-patient pulmonary rehabilitation program in Ottawa.

While COPD cannot be cured, deterioration can be slowed down or even halted, and early diagnosis significantly improves outcomes. Donaldson needed a walker to get around when she entered the program, but after three weeks in rehab she folded up her walker and put it away.

________________________________________

With a (preferably early) early diagnosis of COPD, clinician scientist Pat Camp of the University of British Columbia advises that women should:

• be strongly encouraged to quit smoking. If they don’t quit, their health will decline much more rapidly.

• treat any chest infections aggressively with antibiotics and oral steroids to reduce inflammation. With COPD, infections rapidly get into the chest and, if untreated, patients end up in hospital with a “lung attack”.

• get the pneumonia vaccination and a flu shot.

• maintain physical activity—improving muscle strength and function means you put less load on your lungs, you don’t need as much oxygen.

________________________________________

The difficulty that Donaldson had getting her family doctor to take her concerns seriously is not uncommon. A 2011 British report, Reconsidering sex-based stereotypes of COPD, notes that COPD has “historically been considered a disease of older, white, male smokers” and that women with COPD present with somewhat different symptoms than men—more breathlessness and coughing, but less phlegm.

That report also cites an earlier (2001) study, in which researchers asked Canadian and American doctors to consider hypothetical cases of individuals—their gender was not revealed—with the symptoms of COPD.

The physicians diagnosed the female patients more often with asthma than with COPD. Only when shown the results of spirometry tests for the hypothetical patients did the doctors correctly diagnose the women—yet only 22 per cent of the doctors  “would have requested spirometry after the initial presentation,” the study reported.

Indeed, a recent study found that, when they do diagnose COPD, Ontario doctors typically do not bother to confirm their diagnosis. Only about 36 per cent of those diagnosed with COPD in the decade 2000 to 2010 had the confirmatory spirometry test.

COPD is not the only condition where gender bias may play a role in diagnosis and treatment. A study recently published in the CMAJ noted that women suffering from heart attacks are treated differently from male counterparts at emergency departments.

Spirometry should be “mandated as a quality improvement initiative” for patients at risk of COPD just like blood pressure screening for hypertension, says Dilshad Moosa, a respiratory therapist with the Ontario Lung Association who also manages education for health care providers for the Ontario Thoracic Society.

One way to help identify patients at risk of COPD is with a screening tool—a simple series of questions—developed by the Canadian Lung Association, she says.

Moosa has spent ten years educating Ontario doctors about lung health issues and says there is still a lack of knowledge among primary care providers about how to do quality spirometry tests and how to interpret them.

Meanwhile, the prevalence of COPD in Ontario (that is, the percentage of the population that is affected) increased by 64 per cent between 1996 and 2007, with more of the burden shifting from men to women, according to a recent Ontario study.

For both men and women between 35 and 80, the “lifetime risk” of a COPD diagnosis is double that of congestive heart failure and, for women, three or four times the risk of developing breast cancer, according to a 2011 a study by the Institute of Evaluative Sciences (ICES) published in the Lancet and based on Ontario data.

COPD accounts for the highest rate of hospital readmissions

The lack of attention to prevention and early diagnosis of COPD is particularly striking when costs to the health care system are considered.

For medical patients, COPD accounts for the highest rate of re-admissions to hospital in Canada. Almost one in five COPD patients was readmitted to hospital within 30 days, according to a Canadian Institute of Health Information study of the period 2010 to 2011.

Research from Ontario shows that the 11.8 per cent of the population over 35 with a diagnosis of COPD had rates of hospital, emergency and ambulatory visits that were 63 per cent, 85 per cent and 48 per cent higher than the rest of the population over a three-year period, according to a 2013 study from the Institute for Clinical Evaluative Sciences (ICES). Rates of long-term care and home care use were 58 per cent and 59 per cent higher.

Lead author Andrea Gershon explained the study did not provide a breakdown by gender of health care usage. “I think that would be a great topic for a future study,” she added.

Cigarette smoking accounts for about 90 per cent of cases of COPD—smoke inhalation damages upper airways and the lungs. The other 10 per cent of cases are caused by second hand smoke, air pollution, occupational exposure and a rare genetic disorder.

It’s true that smoking rates have fallen among women, from close to 40 per cent in 1965, to about 24 per cent in 2001 and 15 per cent in 2011. However, the rise in COPD diagnoses today represents the toll being paid today from the effects of the post WW2 rise in the number of women smokers.

People who smoke have two major respiratory risks—lung cancer and COPD—notes Dr. Anna Day, respirologist at Women’s College Hospital in Toronto. Lung cancer is the leading cause of death from cancer in Canada and, disturbingly, lung cancer diagnoses continue to climb among women even as they fall among men.

Having one does not preclude the other, but the risk of COPD is independent of that of lung cancer, says Dr. Day.

Among Canadian women, smoking rates are highest among those in the lowest income brackets. It is notable that for both men and women, COPD rates are higher among those who live in rural areas and those with lower incomes, according to research from the Institute of Clinical Evaluative Sciences in Ontario.

These facts, together with an element of ageism—the risk of COPD increases steeply at 60 years of age—could well contribute to the relative neglect that the disease has suffered in terms of research dollars and public profile.

Certainly, it is clear that the neglect of COPD as a chronic disease is related to the stigma attached to smoking, together with a degree of victim blaming. “Yeah, yeah, you hear that: ‘You smoked, you deserve it.’ I even got that from my family,” says Donaldson.

However, smoking is an addiction, notes Day, and unfortunately “many doctors think you can’t do much about it.”

Day, whose rallying cry focuses on prevention and early diagnosis, says she has felt like “a sole voice in the wilderness” as she has tried for the past 15 years to raise the alarm about women’s risk of COPD.

Disturbingly, she says that people can lose up to 50 per cent of their lung function and still not show symptoms of COPD.  Day and her colleagues at WCH advocate that, at age 40 to 45, current smokers— or those with a history of smoking—should routinely be given a spirometry test.

The test, which is the only way to confirm a COPD diagnosis, can detect small airway obstruction, indicating COPD in early stages. Now, however, most people aren’t diagnosed until their COPD is moderate or severe.

Much attention has recently focused on screening tests like mammography, and the risk that they can lead to unnecessary and sometimes harmful invasive procedures. In contrast, the simple and relatively inexpensive spirometry test, when it confirms a diagnosis of COPD, paves the way for non-invasive steps that can improve health.

“A lot of doctors think they don’t need the test to diagnose COPD and then can just treat,” says Pat Camp, an assistant professor and clinician scientist in the department of physical therapy at the University of British Columbia. They would never think that about another chronic condition like hypertension, she adds.

Efforts at prevention and early diagnosis must, as Day argues, be stepped up. But for those who already have COPD, the merry-go-round of emergency ward visits and hospital admissions that are characteristic of a COPD diagnosis, can be significantly reduced with different approaches to caring for people with COPD. One example is the INSPIRED program in Halifax, Nova Scotia that stresses emotional and community-based support.

Donaldson, who smoked for 40 years before she quit, is in that respect typical of the patients for whom Camp provides pulmonary rehabilitation. COPD takes a long time to develop and most of her patients have smoked for 30 or 40 years, she says.

Camp, who has conducted research into women and COPD, nonetheless says such research is still “in its infancy.” Still, there is evidence that women are more vulnerable to the effects of smoking, likely due to factors such as their smaller size (and lung capacity) and the impact of hormones and inflammatory response.

Internationally, women who regularly tend open fires for cooking food are vulnerable to developing COPD because of their exposure to the smoke, Camp points out.

Donaldson now travels twice a week to Ottawa to join 15 others for a group program of exercise and support for their COPD. “I can now do 20 minutes on a treadmill …and last summer I went outside for a 20 minute walk,” she enthuses. “It improves your life.”

Donaldson has also improved the lives of others. She says her condition “scared the living daylights” out of her family, and led her children and their spouses to quit smoking. “Now they’ve all quit except one grandson, who is 33 years old.”

Oh yes, and after that problem she had convincing her family physician to take her concerns seriously? A new clinic opened up in town and she switched doctors.

Ann Silversides is an independent journalist and author who specializes in health policy.

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A few words about me

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Task 3
- Hello, Mrs Saario, my name is Olena Mekh. I am a nursing student and I´ll be taking care of you today. How are you feeling?
- Hi. Thanks, I feel myself much better than yesterday. I was a little dizzy in the morning, but now it is gone.
- That’s good. Light dizziness could be caused by preoperative medication, you´ve got before surgery. It is quite normal. Let me check your blood pressure.
- Yes, of course.
- Please roll up your sleeve I´ll put a cuff on your right hand. I would ask you to make yourself comfortable, relax and avoid talking for a while.
- Ok. Your blood pressure is normal. Did you feel any need to use your asthma medication today?
- No! It´s amazing. I even forgot about that! I breathed today as if I were young again. No wheezing, no oppression. Nothing like that!
- Great. I need to check your temperature also. I will check it from your ear.
- You are welcome
- Ok. Here it is 37.1C
- Is there anything to worry about?
- No, it is normal to have a temperature a little bit higher after an operation like yours!
- Yes, I'm so glad everything went well
- That’s great. I need to go now, but if you need please use the buzzer. See you soon
- See you. Thank you

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Asthma patient after surgery

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About me

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Answers by Olena Mekh

PROFILE

1. Before I moved to Finland 4 years ago, I worked in Ukrainian mass media. By now, mostly because of high demands to language skills I cannot go on with my previous occupation in Finland. That is why I am studying nursery in Oulu.

2. Actually, the way a human body works was always interesting to me. After my 30th birthday I started to wonder why peers not always look and feel the same good. So, I´ve began digging to find out what is the true and what is the false about all that numerous statements I´ve read in health magazines. Due to my profession, I don´t believe mass media pretty much.  So, idea to choose healthcare, as an object of my own investigation was obvious to me. After moving to Finland, that idea makes me merge my hobby and my future profession. I hope, that besides getting a good job, someday I´ll get the secret how to live longer, feel better and avoid illnesses.

3. I am good in listening people and have some communication skills. I know for sure what means Stress Management. I am responsible and usually do think critically. Besides, I have an ability to notice the smallest details. I love to help people. I am patient and dedicated to a work I do.

4. Both Ukrainian and Russian languages are my native. Long time ago, when I was a student, I used my English to earn some extra money as translator/interpreter. And, of course, I speak already Finnish. As for me, language should be used daily, otherwise skills are slightly fading. While working though this book It would be great to refresh my writing skills.

5. I love reading and travelling.

STUDIES

6. After completing Diakonia University of Applied Sciences I will get a Batchelor´s Degree and become an officially registered healthcare professional, in other words, nurse.

7. I like my studies. It´s great, that we are having a lot of practical trainings. While we are a first year students, it is a bit difficult to talk about cons.

8. For better chances for communication it should be as much common, as possible. The wide use of Latin language makes this task easier.

FUTURE

9. I am supposed to graduate in 2020. After graduation, I hope to get a job and work within professional skills somewhere in the hospital. In nearest future, I am going to study, in longer perspective – work.

10. I don´t have much work experience in healthcare field. At least, I am sure, that I like to work with people.

11. I did not think yet about postgraduate study, but if I feel the call to study more, of course, I will continue study.

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Answers by Irina Saario

PROFILE

1. I live in Finland already more than 20 years. I am married and have two kids. Now I study in Diak University of Applied Sciences in Oulu.

2. I like to take care of another people and it is interesting to me to learn about diseases and health disorders, human anatomy, healthcare and different methodic, which helps to improve health.

3. I am careful, patient, flexible and responsible. I like to learn new things.

4. I speak Russian, Finnish and English. Agree with Olena, that language should be used, otherwise it will be forgotten. This course helps me to remember it better and learn new things.

5. I like reading and gardening.

STUDIES

6. After graduating from Diakonia University of Applied Sciences I will get a Batchelor´s Degree and become an officially registered healthcare professional or nurse.

7. I like to study, espessially anatomia and practical trainings. I didnot noticed any cons by now.

8. It is great, that all relative professions has latina as common language.

FUTURE

9. I will graduate at 2020. After that I would like to get a job in Raahe and use my professional skills.

10. Before entering nurse school, I worked as a teacher´s assistant, but decided to try myself also in healthcare.

11. I would probably not apply for postgraduate study.

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We hope, it is correct :)
Best wishes,
Irina&Olena

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Vocabulary:

geriatric ward - geriatrinen osasto
physiotherapist - fysioterapeutti
physician - lääkäri
review - katsaus
admit - päästää
occasion - tapahtuma
charting - kartoitus
reporting - raportointi
wound care -haavahoito
syringe - ruisku
refer - osoittaa, opastaa
suffer - kärsiä
persistent wheezing - jatkuva pihinä
adequate - sopiva
treatment - hoito, kohtelu
hospitalization - sairaalahoito
evaluation - arviointi
reveal - paljastaa
tumour - kasvain
pathological - patologinen
conclude - johtaa
decrease - laskea, vähentää
hematocrit - hematokriitti
blood count - verenkuva
leukocyte - valkosolu, leukosyytti
erythrocyte - punasolu, erytrosyytti
spirometry - keuhkojen toimintakoe, spirometria
require - edellyttää, vaatia
confirmation - vahvistus, varmennus
recurrence - toistuminen, uusiutuminen

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As for me, Lifeline by Sanoma pro is also pretty good