SCANDINAVIA Does Scandinavia mean to In Geiranger, we saw many YOU the same things it meant an exchange age-old weatherbeaten farm to us before the 8th annual buildings with sod roofs. The AORN International Sym- of OR nursing drive along Lake Mjosa and posium? Fjords and moun- the peaceful Gudbransdal Val- tains? Blond hair and blue experience ley took us to Oslo where we eyes? Rolling farmlands and thousands of lakes? Cold weather? High taxes and a social welfare system? After spending three weeks there in September, we can say it is all those things and more. Many Scandinavians are dark-haired and brown-eyed. The Gulf Stream tempers the climate and keeps the coasts comparatively warm. Public medical care has the reputation of being unmatched anywhere in the world.

Arriving in Bergen, a Hanseatic city on Norway's west coast and gateway to the fjordland, the travelers saw a city sprinkled with visible proof of a medieval past rich in Viking lore. For six days, we traveled through the countryside that inspired composer Ed- vard Grieg -hairpin turns, breathtaking val- leys, and magnificent waterfalls. Towering cliffs rise in vertical grandeur from the water and we learned that the fjords are as deep as the land rising above them. Sogne Fjord, the longest and deepest in the world, has numerous waterfalls cascading over the mountainside rising 1,200 meters above the water.

A side trip to Briksdal Glacier afforded a view of part of the largest ice field in Europe. The group continued through Videseter Pass, across the Stryn glacier country to ascend the famous zigzag road to the Troll- stigen mountains.

jo;ned the main tour group. In Oslo, we took a sightseeing tour which

included the Royal Castle, Vigeland Park, and the University. Perhaps the most exciting was the Holmenkollen ski jump just a few miles outside of Oslo where the most famous as well as the oldest international ski-jumping event takes place in March each year.

To learn about health care delivery in Nor- way, we visited 12 area hospitals. The Norwegian Nurses Association hosted our visits and arranged for small groups to go to the operating rooms and talk with the nurses and the surgeons. The hospital visits lasted all morning and were followed by an after- noon seminar at the Grand Hotel for Ameri- can and Norwegian nurses. Three topics of primary concern to Norwegian nurses were presented by Marion Rustad, moderator.

1. Is there a diminishing interest in operating room nursing? 2. Are operating room technicians needed? 3. Nursing roles are expanding into the area of pre and postoperative nursing. Is this necessary? At round table discussions with two

English-speaking Norwegian nurses at each table, views were expressed, differences explored, and similarities noted.

We learned that an unusual program of

144 AORN Journal, January 1977, Val 25, No 1

cancer control and prevention is underway in Norway where cancer is the second cause of death.’Since 1932, with the establishment of a special cancer hospital (Norwegian Radium Hospital) several projects evolved culminat- ing in a union of different approaches to control, both in long-term and short-term plans of action. A Cancer Registry was founded in 1951. Statistics pertinent to cancer cases in the entire country are housed and handled by automated data pro- cessing in Oslo. Reporting of all cancer cases has been obligatory since 1952. One source of information has facilitated mean- ingful research to seek cures and plan action for cancer control and treatment.

Our next stop was in Helsinki, Finland, where we visited several hospitals. The nurses and physicians were anxious to dis- cuss operating room nursing and nursing in general. The dialogue afforded our members the opportunity to broaden their perspective about patient care and to relate the effect of social and ethnic customs and a government-controlled health system to that care. In Helsinki, because Finland has been almost constantly oppressed by other coun-

mass of rock using nature’s material as they were formed.

A smooth voyage across the Baltic Sea took us through the archipelago just east of Stockholm, a city of contrasts. The strongest impression is that of city and water welded together because the city is built on islands linked by bridges. There is the ultramodern section with glass and steel structures and pedestrian-only plazas in contrast to the cobblestone streets of Old Town.

During the train ride to Copenhagen, Den- mark, we took time to explore with each other what we had learned about medical care in Sweden. To only a small extent, medical care is the responsibility of the state; real control lies with the 23 County Councils and three municipalities. Pharmacies are state-owned. A small number of private prac- titioners and dentists exist. There are roughly 17 hospital beds per 1,000 population and about 7 places per 1,000 inhabitants in municipal homes for the aged. Sweden is divided into seven medical care regions, each with an average of just over 1 million inhabitants. The system was designed to avoid duplication of services. Mental hospi-

“Is there a diminishing interest in operating room nursing?” was one of the topics of mutual concern discussed by OR nurses from Norway and the USA.

tries, a desire to contribute something origi- nal has led to several contests for architects and sculptors to display to the world the feeling and mood of the Finns in art and in building construction. A sculpture in tribute to composer Jean Sibelius is a mammoth outdoor spectacle of aluminum pipe organ structures dominating a public park. Another winning design is a church carved into a

tals are no longer being built as psychiatric care is merged into the regular medical sys- tem. Nursing homes, on the other hand, have increased tremendously in recent years. There are few private hospitals. In certain fields, such as obstetrics and radiology, spe- cially trained nurses perform duties normally done by physicians in other countries. Assis- tant nurses have also taken over some of the

146 AORN Journal, January 1977, Val 25, No I

At the seminar in Oslo, Marion Rustad (center) of Norsk Sykepleierforbund (Norwegian Nurses Association), who moderated the discussion on concerns of Norwegian OR nurses, chats with AORN Executive Director Jerry G Peers, left, and Membership Chairman Caroline Rogers. (Photos: Norsk Sykepleietforbund)

duties formerly performed by registered nurses. Sweden has the lowest infant mortal- ity and childbirth mortality rate in the world. Average life expectancy is the worlds longest. Physician shortage and the inability to locate physicians in remote rural areas present the most serious problems. Medical goals in Sweden are to increase successes in the area of preventive medicine.

After leaving the train, a short ferry ride took us to Copenhagen, the largest city in Scandinavia. It is cosmopolitan and alive with vibrance and infectious gaiety. Sightseeing included “The mermaid,” the statue in the harbor symbolic of the tale by Hans Christian Andersen; several castles and historic sites reminiscent of the battles between the Danes and other Scandinavian countries in all the centuries before the 20th; and The Tivoli, a world-renowned pleasure park.

In all the hospitals visited in Copenhagen, the director of nursing, operating room supervisors, and operating room head nurses welcomed us warmly. We toured the surgical facilities in each hospital and partici- pated in question and answer sessions with nurses and physicians.

The last stop at a hospital was in Lund, Sweden, where we visited the hospital at the University of Lund. Perhaps the most unique feature was the “bed washing department.”

A huge section of one floor of the hospital was devoted to this mechanized washing system. Stripped beds were lifted to a con- veyor belt and passed through a wash and dry section. At the same time, the mattress and pillow were carried along a conveyor to the sterilizer compartment. The cycle re- quired eight minutes for the bed and one hour for the mattress and pillow. As the cycle finished, they were taken from the conveyor to a room where a staff made the bed with fresh linen. As much as possible, the patient keeps the same bed for his entire hospital stay. We found a tremendous similarity in our operating room nursing problems.

Their concerns for continuing education for the professional nurse, for maintaining a high level of education for the student of nursing, for expanding the role of the professional nurse, and for striving to achieve better pa- tient care were evident in the questions they asked .

AORN members attending the symposium can share their learning experiences with members of their chapters. Start planning now to be one of the group instrumental in enhancing the prestige of the professional nurse throughout the world by attending next year’s symposium in Central Europe.

Caroline Rogers, RN Director of membership

148 AORN Journal, January 1977, Vol25, No 1