Homecare in Oslo

The residents in the public homecare nursing system are a high-risk group, and the Norwegian authorities have imposed very strict regulations in order to protect them.

Today, we interviewed Helen, a nurse from Norway (in order to protect her identity, we didn’t use her real name).

“I was traveling to Oslo, where I attend seminars regularly, as part of my further education in advanced nursing. One day, as I was on my way to class, we were suddenly informed that all the schools were closed. I walked down Karl-Johan – Oslo’s main walking street, which is always crowded with people – and it was completely empty. I thought, “Wow, this is creepy, I need to get home!” I talked with my boss, and we were told that we must be flexible now, and be prepared to work double shifts. I’ve been preparing for my final exam, which I can take from home, but now I might not be able to take it. I might have to work instead.” 

Helen is a community nurse in Norway. She works full-time in what is called “hjemmesykepleien” – a public homecare nursing system, where people with medical needs are cared for in their own homes. Meanwhile, she is also given paid leave to attend classes in order to advance her education. Helen wants to specialise in geriatric nursing, and she is passionate about her work. 

Now, since the Covid-19 pandemic reached Norway, Helen’s life has been burdened with uncertainty about what’s to come. While she considers herself one of the lucky ones, still being able to leave the house and go to work, the work that she is doing is getting more and more difficult. 

“A lot of the elderly people I care for have dementia. It’s always difficult to know whether or not they are eating, until you can see that their weight is dropping. Usually, when that happens, we send them to the day centre, where we know they will be fed and taken good care of. Now, all of the day centres are closed. Not just the day centres, but also the physiotherapists, the psychiatric home care service and other services for the elderly, are closed”. 

This is very difficult for some of the patients, especially those suffering from dementia, to understand. It’s also very difficult for them to understand why their families cannot come and visit them anymore. Meanwhile, the elderly residents who do understand what is going on are terribly afraid, and they do not have anyone to talk to. 

“I feel like I have to play the role of a psychologist all day long”.

The residents in the public homecare nursing system are a high-risk group, and the Norwegian authorities have imposed very strict regulations in order to protect them. One benefit is that they are automatically in at-home quarantine anyway, since most of them live by themselves and don’t get out of the house much. But Helen and her colleagues worry every day about the potential contagion they might be bringing into the houses of these vulnerable people. 

“We have procedures, but are they good enough?”

To make matters worse, a lot of health care personnel are themselves quarantined, and the ones who are left are pushed to their limit to provide the necessary services. Every day the nurses must assess which services are the most vital. Less vital services, such as showering, are, by necessity, neglected. “We recently had to stop offering this service, and we don’t know when they will be getting showers again”, Helen says. On a positive note, with such limited capacity of health care workers, a lot of elderly residents are suddenly discovering that there are many things they are able to do on their own, things that they used to think they needed help with, such as applying eyedrops. Maybe this is a time for some people to rediscover what they are capable of? 

“Everyone must stay inside now, all the time. I was very surprised about the extremely strict restrictions that were imposed, all of a sudden. Of course I understand why it is necessary. No one is immune to this new virus, so it’s very easy to get it”. 

It’s a hectic time to be a health care worker in Norway these days. The authorities have relaxed the national Working Environment Act, so that the workers can, and probably will be obliged to, work more overtime than what was previously allowed for. Helen worries about whether or not she will be able to take her exam, which she has been working towards for a long time. 

“I have always been an advocate for infection prevention. Now, all of a sudden, people start following the most basic procedures. Nobody gets past with rings or nail polish on my watch! Your wedding ring is not sterile, you know? It’s great that people are following these procedures – we must, in order to protect each other and ourselves. 

One good thing that might come out of it, as we also saw during the swine flu epidemic, is that people will be less sick overall. 

Learn how to show solidarity with people in your community. Share what you have with those who need it. Unless you work directly with sick people, you do not need face masks. We never use face masks to protect ourselves, but to protect others. Using a mask as a preventive measure is not recommended. You will only end up touching your face even more, and you will gather a lot of bacteria on your face as you breathe into the mask. Share what you have, wash your hands, and follow the advice of the health care authorities where you live.”

Helen knows that this is only the beginning. Worse than the outbreak itself, is the uncertainty that comes with it. How long will this last? How many will be affected? And what will be the consequences in the long run? 

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