YuYu 2015 China

Nursing student final clinical training in Peking Union Medical College Hospital, BeiJing China.

Category Archives: The EXPERIENCES

Finishing exchange (practical training) in BeiJing

Overall my experiences in Peking Union Medical College Hospital was wonderful! My goals and objectives were to experience and learn professional communication with patients, colleges and physicians, as well as improving my clinical skills.  After ten weeks of clinical training here in Beijing, I believe that I have reached my learning goals and objectives.

My recommendations:

If you are interested in performing your clinical training in Beijing; for non-Chinese speaking students I suggest you come during your first or second year of studying. The large amount of patients that you will be exposed to daily in the Chinese hospital will give you the opportunity to see and experience more and different types of medical conditions. In addition, the cultural differences between countries and especially in regards to Chinese family values give you more insight of the importance of professional communication and family nursing.  l especially recommend that Chinese speaking students perform their final clinical training in China during your last studying year. Having previous clinical skills and being able to understand the language helps you to have a general picture of being a nurse and will help you succeed in the Chinese hospital.

 

I strongly recommend this hospital to all of you if you are interested in seeing something different and the opportunity to see many patients in a short amount of time. However, your expectations and communication with your coordinator is essential for you to reach your objectives and goals. You need to communicate with your coordinator and tell them that you would like to follow one mentor and doing things when you can.

It was a valuable experience for me and I enjoyed it very much. Comparing Chinese nursing job and responsibility’s with other countries will help me in the future be more grateful and cherish my job in a western country.

Operating theater in PUMCH

Operating theaters in PUMCH is huge. There is one surgical building which consists of three floors as operating theaters. Forty-eight operating rooms are included in the surgical building, in which eight operating rooms are for emergency operations. Eighteen operating rooms are in the internal medicine department.

There are approximately 160 to 240 operations done here in PUMCH from Monday to Friday. Opportunities are available to see different types of surgeries, including cardiovascular, brain, orthopedics, gynecological, neurology, plastic surgeries etc. Robot assisted surgeries were started into practice here in PUMCH since last year. However, it is not yet available for students. 

I have two weeks practice opportunities here in the operating theater. Thus my goal of this experience is mainly focusing on understanding the systematic team work in the operating theater,  and size opportunities to see different types of surgeries.

Finished one month clinical training in the intensive care unit

Four weeks of clinical training in the intensive care unit was completed! My feelings to the nurses’ job there was “intensive”. I decided to have one nurse as my supervisor because it was easier to follow one person for the whole period and the trust relationship would built within time. Thus l could learn more and have more practice opportunities during my practice.

During the four weeks, l had only worked for three to four days a week and in total the working days was 13 days. However, the working hours was about 40 hours per week because each shift last from 12 to 13 hours. In the intensive care unit they only had day shift and night shift, and working hours was from 7:20- 20:00 and 19:20 -08:00 respectively. Lunch break and dinner break was included in the day shift, however there was no specific coffee break or meal break during night shift. I had one night shift every week, and after the night shift l felt that l would pass out! It was too busy most of the time, I got dehydrated and the working hours was too long making me exhausted!

The learning experiences there were most valuable for me because it was the most systematic learning. I had opportunities to write nursing interventions on the patient’s electrical medical history and gave oral report during the shift changing. In addition, l had communication opportunities with both  patient and their family members. It was great feelings to communicate with them, however, sometimes I feel it might be better if l do not know what is going on.

Different Working Uniforms from PUMCH

Here are some pictures of nursing uniforms from different department of PUMCH.

QQ Photo20150505133944Nursing uniform from Resuscitation Room. QQ Photo20150505133927

20150331_131241Nursing uniform with little hat from a normal ward.QQ Photo20150505133435

QQ Photo20150505133759Nursing uniform from surgical ICU department.20150424_224929

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PUMCH has three employee restaurants. This was a buffet lunch and price is  15 Yuan per person, (2.20-2.50 euros).

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This was the first couple of days when they did not have nursing uniforms, so I had the doctor’s uniform. There was another exchange student from Denmark who was also doing her practice in PUMCH.

 

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Intensive Care Unit, Day 1

Intensive care unit in Peking Union Medical College Hospital is divided into internal medicine ICU and surgical ICU. In addition, Surgical ICU consists of ward one, two and three. I will be continuing my clinical training at surgical ward two for the following four weeks.

Surgical ICU ward two consists of 18 patients’ beds, it is all small single rooms with glass window connected with each other. It is a closed ward, and the nursing station is placed in the middle of the ward like a rectangle. Two of the rooms are isolation room, and the air flow is reversed. Nurses and doctors are available 24 hours a day. One nurse and one doctor is assigned to be responsible for one patient to three patients depending on the situation of the patients. However, most of the time they help each other. In a way, it is good that they have good  team work spirit, but sometimes it might be too confusing especially if you do not know the care system here. Aseptic techniques are highly required and strict in ICU.

Nurses share the work as two shifts, whether day shifts or night shifts. Day shift is from 7:30 AM to 8:00 PM, and night shift is from 8 PM to 8 AM. Nurses work about three to four days a week and 12 hours per working shift. So if you work three days a week this week (36 hours), then you work four days a week next week (48 hours). Enjoy my practice here in ICU.

First Two Weeks in the Emergency Department

Time flies, two weeks practice in the emergency department has gone. As l have explained in the previous post, there are six wards at the emergency department, and l have been to all of the units for at least one day. Eventually l decided to stay at the resuscitation unit for the next two and half weeks, because this is the most unpredictable ward where l can practice quick nursing interventions and see something new.

There are about twenty-one beds at the resuscitation unit, and all of them have monitors, oxygen and other emergency equipment. Patients who are admitted in the resuscitation unit are mostly suffering from severe infections, pulmonary diseases, cancers, severe cardiovascular diseases including transit ischemic attack, myocardial infarction and other life threatening diseases. Sometimes there might be emergency events. Some of the clients are in coma or unconscious when they arrive. They may come from home with their family members, transfer from other hospitals, or come with paramedics with ambulance.

Nurses are classified into four levels, from the lowest level one to the highest level four. Their level is qualified by the examinations and working experiences. The nurses with higher level are mainly responsible for the medication and nurses with lower level are mainly responsible for morning nursing care, including urinary catheter, oral, and nursing care for the tracheotomy etc. The nurse helpers are responsible for bedding changing, and other basic nursing care. Doctors visit patients from bed to bed every morning and they are available at the nursing station 24 hours. Patients have their family members outside at the corridor 24 hours every day, they are there for signing the treatment agreement if needed, communicating with physicians and buying food, drinks and other daily necessaries (tissue paper, towels, wet paper, etc.) for their patients.

The hospital system here in China is different for Finland, patients’ medical documentation in China is mostly paper copies and in Finland it is all electronic.   The nurses use the paper forms to record patients’ vital signs and fluid balance. When the patient’s condition gets more stable, or certain diseases get confirmed then they may be transferred to the Intensive Care Unit, or to the specific wards such as internal medicine or cardiac unit etc. In general, it is a great place to learn and I am grateful as well as appreciate my time here at the resuscitation unit.

 

Orientation Day and First Day at the Emergency Department

Orientation Day

My first day was mainly focused on orientation, introduction, figure out timetable, welcome dinner and how to get around in the hospital. PUMCH is big, NO, actually it is HUGE. The total construction area is approximately 530,000 square meters. The tutors and teachers are amazingly thoughtful, they come to take me from my apartment to the hospital to get me uniform and showed me around in the history of museum exhibition building of PUMCH, other departments, wards, and cafeterias. My apartment is 10 minutes away from the hospital by walking.

 

First Day at the Emergency Department

Busy! Busy! Busy!  There were about 300 patients at the “triage nursing working station” of emergency department from 12 am  until 5 pm. Don’t be surprises! They have approximately 450 patients everyday on average. They consider that under 400 patients are not too busy and sometimes the number may reach up to 600. The emergency department is 24 hours available for their clients.

The emergency department has six units, including triage, resuscitation unit, emergency intensive care unit , emergency of international department, ward, and observing room. The triage nursing working station has two nurses working there take basic vital signs (BP, O2, Temperature) and ask the some basic information (reason to come to the hospital, pain, location of pain, medication) , and they are responsible for designating patients to the correct doctors. It is a not so organized, however, they are amazingly efficient.

There were all types of patients with different emergency needs or non-emergency needs. It was an amazing day for me as a student to see how everything works. I will be placed in six units for a day for the first week and choose two units for staying for my following two weeks.

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The history exhibition of PUMCH. Founded in 1921 by Rockefeller Foundation.

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The nursing uniform. Ms: Ying Liu

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One area of the historical museum.

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The model of PUMCH. As you can see, the whole block is the hospital area.

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Welcome dinner HaiDiLao Hotpot with other colleges.

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The half spicy and half non-spicy hot pot.

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Delicious vegetables and fruits.

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Time to eat! It was DELICIOUS!

 

All the nurses,and teachers are extremely friendly and kind to me. I am  enjoying here so far.

 

one week before departure (March, 2015)

It is now less than a week before my departure. I am getting excited and nervous at the same time. I am nervous about my professional language use or vocabulary. I might have trouble communicating with colleges and patients in a professional manner because some of the professional medical words in Chinese are not familiar to me.

Cheer up YuYu!:D How bad is going to be? My Chinese should be a little better than my Finnish. LOL 😀 The funniest thing is that I am a Chinese citizen doing my practice in China BUT I am representing as a Finnish student.(Because I am a student from Finnish university)

I contacted my international coordinator through email, it seems that everything is getting ready for me. A nice apartment near the hospital which is located in the center of BeiJing is prepared for me with internet. My timetable of first week is planned and scheduled. Everything is planned as I wished for. My final clinical training will be four-hundred hours in ten weeks. So far it is scheduled as three weeks in Emergency Room, three weeks in Intensive Care Unit and last four weeks in the Operating Theater. The coordinator of the host institution is very thoughtful, since she puts the first three days as my observation days in three departments, which gives me a general idea of my practice for the entire ten weeks.

I hope that I will learn as much as possible during this ten weeks and will continue share my experiences here.
Attached below is my first week timetable:

Finnish student clinical observation schedule in 2015
Student Name You Chen
School Jyvaskyla University of Applied Sciences
Hospital Peking Union Medical College Hospital
Period Mar.23rd — May. 29th (6 days’ work per week)
Date Time Contents Place Liaison person
3-23 (W1) 19:55PM Landing, Meet at the airport, Accommodation Beijige Dormitory
3-24 (W2) 9:30AM Orientation (brief introduction of the hospital, east campus of the hospital, hospital exhabition hall, the plan of the clinical practice, etc.) Check in. Department of Nursing Guo Na
3-24 (W2) 6PM Welcome dinner
3-25 (W3)– 4-11 (W6) 8:00AM–5:00PM Clinical Observation-Emergency Room North Building Shi Donglei 3w
4-13 (W1)– 5-2(W6) 8:00AM–5:00PM Clinical Observation-Intensive Care Unit ICU ward 2 Li Zunzhu 3w
5-4 (W1)– 5-29 (W5) 8:00AM–5:00PM Clinical Observation-Operating Theater Surgical Building Qiuju Cui 4w
Check out,Farewell Dinner Department of Nursing

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