By Chris Edwards
Góðan dag! (G’Day in Icelandic)
You may be wondering how on earth I landed in a place so far away and so different from Australasia.
Well, having completed FACEM training in August last year, I was keen to pursue alternative experiences in Emergency Medicine. I had struggled with burnout on and off over the last few years of training, so I was keen to find something where I thought I could contribute a set of skills and go back to practicing clinical medicine without system frustrations like bed block and long waiting times. It just so happens that I found an advertisement on the ACEM weekly bulletin for a consultant emergency job in Akureyri, Iceland, and the rest – as they say – is history…
Akureyri is the Northern capital of Iceland. With a population of 20,000 and servicing an area of approximately 50,000 people, Akureyri houses the major hospital in the North.
I arrived in September 2018 and have had a blast, with a great team of nurses and doctors and manageable patient numbers. I´ve found great job satisfaction in being a source of education and training for the highly motivated nurses and doctors and being able to practice the clinical medicine I prefer – less tests, more repeat reviews, using the clinical acumen I worked hard to acquire and hone – it has really reinvigorated my passion for quality medical service.
Being the only formal emergency trained specialist in Akureyri also means I get the opportunity to attend clinical meetings of import. Recently I had the opportunity to visit Reykjavik for a meeting on stroke thrombectomy and was invited to tour the emergency department at Landspitali Hospital – the major hospital for Iceland. There I found that even though Iceland is more than 15 000 km away from Australia, predictably some of the challenges faced by the EDs here are exactly the same as “back home”.
Landspitali Emergency is a 42 bed Emergency Department in Reykjavik. They see approximately 75000 patients per year, with a roughly 20% admission rate. Paediatric non-trauma patients are seen at a separate paediatric emergency department at another campus.
The hard working staff encounter many of the same issues we find in Australasia; staffing, increasing demand, ageing population, crowding and of course bed block. During my visit there were eight patients in corridors with the longest stay being 47 hours.
As you may know, bed block is one of the factors that can lead to burnout in staff. Certainly for me, it was the main source of dissatisfaction with working in large Australian EDs. The regular ‘access alert´ announcement at 1000h every Monday and no visible response from the rest of the hospital slowly crushed my passion for the job. Like any workplace, repeatedly encountering the same issues day-to-day with no resolution or ability to affect the outcome is a source of frustration and helplessness amongst staff.
One way Landspitali Emergency has tried to support its staff is through the development of a meditation room. Complete with comfy sofa chairs, soothing sounds, yoga mats and even chimes – this haven away from the Emergency Department (it is situated adjacent but not within the Emergency Department) gives staff an opportunity to unwind and recharge during their shifts. I took the opportunity to check out this room and to take some photos during my tour. I must say when the door is closed and the lights are out, the comfy chair and gentle sounds immediately brought a sense of relaxation.
A translation of the sign in the meditation room:
This quiet room is a sanctuary in a hectic and demanding work environment.
It´s first and foremost, to enjoy and relax and hopefully a way to your inner calm.A few guidelines on how to use the room:
The quiet room is not for meetings/work
The quiet room is not for chatting
No food and drinks
Can use phone to play calming music but no games, chat, texting
Please tidy up after yourself when you have finished, leaving the room as it was when you found it (or even better)
That includes turning off the lights the scent lamp, fold blankets etc
Registration list will be in coffee room and you can put your name on the list and enjoy on your shift in collaboration with the in-charge
In the room are yoga mats, cushions, blankets, gong, scented lamps and two comfy chairs and more
In Akureyri Hospital, wellbeing almost appears to be automatic. Staff have regular social events, the hospital provides special event meals and events such as the hospital ball and departmental social events. Communication between specialities is largely friendly and patient focussed. Some of this is the inevitable result of a smaller hospital with less demand than a large hospital and some I suspect is due to the relaxed nature of Iceland in the North!
So why have I enjoyed my work in Iceland?
- I believe I have brought a set of skills that were required (I feel needed and appreciated)
- I have developed friendly and collegial relationships (I like the people I work with)
- I have been given opportunities to develop ideas outside of direct clinical contact (I have been allowed to pursue personal projects)
- I have re-experienced the satisfaction of increased time for patient contact and observational medicine (I´ve been able to say ‘I´m not sure, but let me see you again tomorrow before I order a CT´)
- The ED nurses convinced me to eat rotten shark (Worth it because I then made them try vegemite)
Before I leave, I´m hoping to make early progress on planning on utilisation of telemedicine technology to overcome the challenge of delivering Emergency care to the more remote areas of Iceland. It would be gratifying to leave somewhat of a legacy from my time here.
If anyone has any questions about Landspitali Emergency, Reykjavik they are always looking to recruit doctors interested in working in Iceland. You can contact Dr. Jon Magnus Kristjansson, ED Director at: firstname.lastname@example.org.
If you are interested in working in Akureyri Emergency, you can contact the Director of Emergency, Dr. Pálmi Óskarsson at: email@example.com
Chris Edwards (Phillipsson)