Veronica Forsythe is a nursing student from France who is completing her hospice clinical rotation with Rainbow. A Chicago native, she comes to us from Strasbourg, France, where she is in her third (and last) year at ISFE (L’Institut de formation en soins infirmiers des Hôpitaux Universitaires). Pamella Waickus-Dryier, BSN, MS, CHPN, has been Veronica’s mentor for her hospice education.
The Internship Program
During her five-week internship, Veronica has accompanied Pam on visits to patients’ homes and long term care facilities. She has also joined Pam in meetings with social workers and interdisciplinary team meetings. Veronica says she is “soaking up the medical atmosphere here in the U.S.”
Nursing in France
Because most hospitals are state-run, most nurses are considered employees of the state. Nurses can practice any specialty at any given time. In France there is no “higher education” for the nursing profession—all nurses hold the same three-year degree with no advanced practice degrees or PhD’s.
Similarities to the United States
Veronica says that the structure of the hospice care team is similar in both counties, which both include nurses and doctors. Additionally, the same types of hospice services are available to patients in America and France, including massage and other types of therapy.
Differences from the United States
According to Veronica, the hospice transition is more “official” in the United States than in France. In the United States several health and government agencies need to be notified of the patient’s status and approve hospice care.
In France, the transition is more subtle. Patients are not technically “admitted” to hospice. The team that cares for the patient assesses his or her status and then determines whether there needs to be a change in the care plan. Then, that same team continues to care for the patient, with a shift to comfort, rather than curative care.
Conversely, patient interaction is more formal in France than America. Veronica says that in France, nurses use professional speech and formal pronouns when addressing their patients, calling them “Mr.” and “Mrs.” Here, Veronica says, nurses are informal and personable with their patients, creating more of a “familiarity and a bond” between patients and their caregivers.
Veronica says that this personal touch makes for a more holistic approach towards caring for patients. Hospice teams in the U.S. are involved in more aspects of the patient’s life, such as getting to know family dynamics, and incorporating that into care.
The Impact of Culture on Patient Care
One of Pam and Veronica’s patients is Dominique, a French-American woman who has dementia. Dominique and Veronica have formed a very special bond. As her disease progresses, Dominique is reverting to speaking only French, her native language. Dominique is happy whenever Veronica visits because they can communicate, and she uses their visits as a time to “unload” everything that is on her mind.
Veronica plans on practicing nursing in France when she graduates in March 2017.