Krankheit 1: Schlaganfall

 SCHLAGANFALL

-akute Durchblutungstörung des Gehirns.    

 

Risikofaktoren: (BUSFARB)

Bluthochdruck

Übergewicht

Stress

Fehlernährung

Alkohol

Rauchen

Bewegungsmangel

 

Hauptformen:

1.Ischämischer Insult – weißer Infarkt

Ursachen: (SATE)

Stenosen der Hirnarterien

Arteriosklerose der Hirnarterien

Thrombus

Embolie

 

TIA (Transitorische Ischämische Attacke) – mini Schlaganfall

-gilt als Vorbote(Frühwarnzeichen) des Ischämischen Apoplex.

-Symptome bilden sich scnell wieder zurück (<24Stunde Symptomatik)

Symptome: (SOTOSS)

Schwindel

Ohrgeräusche

Taubheitsgefühle

Ohnmacht(Synkopen)

Sprachstörung

Sehstörung

 

2. Hämorrhagischer Insult – roter Infarkt

- verurscaht wenn die Blutgefäße des Gehirns swach oder anormal sind oder unter ungewöhnlichen Druck stehen

 

Ursache: (AGA)

Aneurysmen

Gehirntumore

Arterielle Hypertonie

 

Symptome sind abhängig von der Lokalisation und Ausprägung des Gefäßverschluss.

*Neurologische Ausfälle werden immer kontralateral sichtbar, da sich motorische und sensible Nervenbahnen kreuzen.

Symptome: (HESUS)

Halbseitiger Lähmung

Eingeschränkten Sprachverständnis

Sprachstörungen

Übelkeit

Sehstörungen

 

Neglect Syndrom (Aufmerksamkeitstörung)

-Bei Schlaganfällen,die die linke Seite lähmen, tritt oft eine Vernachläßigung von Reizen der linken Körper- und Raumhälfte auf. Informationen auf dieser Seite werden aufgenommen, jedocht nicht verarbeitet.

Ziel: Immer die Aufmerksamkeit des Patienten auf die betroffene Seite zu lenken.

Diagnostik:

CT

EKG

Labor (Krea,PTT,Gerinnung)

 

Therapie

Vitalzeichen Kontrolle

Gabe von Sauerstoff

Systemische Lyse Therepie – wird zur Auflösung von Blutgerinnsel eingesetzt. (nur nach Anchluss der intracerebral Blutung!)

Thrombozytenaggregaionshemmer/ Antikoagulant

Operative Behandlung

Rehabilitative Behandlung (Physiotherapie, Logopädie)

 

Bobath Konzept (nach Berta und Karl Bobath) – ganzheitlicher Ansatz zur Behandlung von neurologischen Störungen. Die betroffene Seite immer in Alltagsbewegungen einbeziehen, um sie in ihren Bewegungen mit die normale Seite in Einklang zu bringen.

Ziel: Förderung der normalen Bewegung und Wahrnehmung des eigenen Körpers.

 

Komplikationen:

Dekubitusgefahr

Obstipationgefahr

Kontrakturgefahr

Sturzgefahr

Selbstpflegedefizit

 

Pflege: (LAAN)

Lagerung

Anleitung bei den ATLs

Aktivierende Pflege (Hilfe zur Selbsthilfe)

Neglect beachten

 

Kommunikation: (FAEE)

Freundlich aber bestimmt

Ängste besprechen

Empathie spenden

Erklärung nicht alleine aufzustehen

 

Mündliche Prüfung (Kenntnisprüfung)

Nursing is a broad subject. Guys, you don’t need to review everything. Just focus on certain diseases that is commonly tackled during the oral exam. You only have limited time to prepare, so focus on the important points. If you are still in the Philippines and is still waiting for your deployment, I would suggest to start reviewing about these diseases so that it would be easier for you when you arrive here in Germany already.

What are the common diseases discussed during our Preparation course which they say are the ones which comes out during the exam too?

1.Demenz

2.Schlaganfall (Click to read more)

3.Dysphagie

4.Parkinson

6.Pneumonie

7.Arthrose

8.Osteoporose

9. COPD

10.Hypertonie

11.DM

12.MRSA

13.Magengeschwür

14.Darmkrebs

15.Fraktur

16.Koronare Herzkrankheit

17.Herzinfarkt

18.Herzinsuffizienz

 

So, what do I need to discuss about these diseases?

1.Bedeutung

2.Ursache/Risikofaktoren

3.Symptome

4.Komplikationen

5.Diagnostik

6.Medikamente (Bemerkungen und Nebenwirkungen)

7.Behandlung (medikamentöse und nicht medikamentöse)

8.Beobachtungen (Ernährung, Fl üssigkeitszufuhr, Lagerung)

Aside from the diseases mentioned above, they will also ask you about other topics because sometimes the patient has two diagnosis or he has other symptoms. You will be asked topics about:

Hygiene

Infektion

Wunde

Schmerzen

Rechts

Ethik,

Kommunikation

Beratung

Arzneimittel

Versicherungen

Nadelstich Verletzungen

Sturz               

Inkontinez

Isolation

Dokumentation

PEG

Freiheitsentziehende Maßnahmen          

Fieber

Like what I’ve mentioned from my previous post, it was easy if it is only in English guys. So, the challenge here is that you need to memorize the terminologies and vocabularies in German. If you are not familiar with the disease or maybe you have forgotten about it already, learn it first in English so that it will be easier for you when you study it in German. And in case the examiner will ask you something, you can still answer it because you have really understood it by heart.

Your presentation doesn’t need to be long. Define the disease in a short sentence. Prove them that you know the disease well and that you can explain it in your own words. Be confident. Keep in mind, we are Filipino nurses. We have learned those things during our college years. We did it and you can too!

Kenntnisprüfung bestanden!

When I passed the B2 exam in the Philippines, I felt very happy and was very excited to fly in Germany. So, the time came and yes, Hallo Deutschland it is. The next day when I arrived, I need to attend the online class in preparation for my knowledge exam (Kenntnisprüfung). The Vorbereitungskurs or course preparation will be 6 hours twice a week for one a half month. So, it would be two days online class and three days hospital duty.

During the first day of my online class, I was shocked because the lecturer was hard to understand. I thought I am already good in German after having my B2 Certificate but I was wrong. It was as if, I was back to A1. But still, I tried to integrate myself on the language. We need to study about nursing and after, will have an exam. The exam will be oral and practical exam. The oral exam is like a presentation of a case study and the second part is like a return demo in the Philippines where in you need to prove you are skilled enough to be recognized as a nurse here.

There comes the day of the exam. By the way, we had our oral exam first and the practical exam will be three weeks after. We had our oral exam in Campus Buch in Berlin last December 2020. You will be called one by one and will sit in front of two examiners. So, once your name is called, you will choose on one of the flipped papers on the table. Each paper is about a case and you need to discuss about it. Then you will be asked questions by the examiner about the situation or they could also ask you about general questions about nursing here in Germany. After the exam, they did not tell us if we passed it. On my experience, they told me that they were very satisfied on my answers and that I did well. It isn’t a guarantee that I passed the exam but I am so happy to hear those from them.

Meanwhile during the practical exam, you will choose a patient and you will present about his case. This includes his personal details, diagnosis, medications, treatment and also the nursing care plan which is needed to be done. So, basically you will do everything for the patient that day. Afterwards, the examiner from the campus you are enrolled in and your mentor (Praxisanleiter) in the hospital will evaluate your performance. They will then call you and tell you the result right away.

For me, it was a very stressful exam. It was very basic in English but auf Deutsch everything is complicated. And it is indeed stressful to adjust at work, at a new environment, missing your family, braving the cold weather while preparing for the exam. Most of the time we don’t have enough sleep because we really need to review. But thank God, we made it! There is nothing impossible if you put you heart to something. Stay focus and reach for your goal. And of course, always pray because up to this time God still does wonders and miracles!

 

 

I got a Perfect Score in Schreiben!

I never thought that I would get a triple B2 score on my Pflege exam nor have I imagined that I will get a perfect score on writing. I remember how simple my writing that time was. There was nothing special on it. I used simple verbs and it was basically plain writing. I must say, I have done better ones during our mock exams. But yes, I scored 20!

So, before anything else, let us first discuss how do they score your writing. It is based on four important criteria: Content related adequacy, Communicative composition, Correctness and Vocabulary. Each criterion can be scored 5 points maximum which sums it up to 20 points for a perfect score.  Getting a score of 15-20 is equivalent to B2 level, 7-14points is equivalent to B1 level and 6points below means under B1 level.

So, how do I usually write my Anamnesebericht or admission note?

1.Content is king. Make sure all details or ticked information on the Anamnesebogen or questionnaire is mentioned on your writing. Remember, it is one of the criteria mentioned above. So double check if you have included everything.

2.Watch out for the structure of your Writing. You can put a brief introduction about the patient for example her name,age and birthday as well as if she came to the hospital alone or with a relative. Then proceed to another paragraph with every topic you will write.  This way, it will be easier to understand your writing.

3.Forget not your grammar. Check for the tenses of your verb, your sentence order and also your spelling. Keep your eye on the umlauts, these are very important too. Put your comma after clauses. Kick verbs at the end of the sentences as needed and put verbs in second position for a normal sentence order.

4.You can use simple vocabularies but make sure not to repeat it. Look for synonyms of the words.

5.Write your Aufnahmebericht in 120-150 words if possible.

6. I usually start my paragraph with “Zum Punkt …. sei gesagt” or “Im Verhältnis zum Thema…. sei hervorgehoben”.

7.Use your adverbs to start your sentences or you can use these useful phrases (Redemittel).

- Ferner ist anzumerken, dass...

- Aus diesem Grund…

-Zu beachten ist jedoch, dass…

- Abgesehen davon…

- In dieser Hinsicht…

- Obendrein ist zu vermerken…

- Es sollte auch erwähnt werden, dass…

- Dies führte dazu…

- Des Weiteren ist zu berichten,dass…

- Letztendlich bleibt noch mitzuteilen…

 

How I passed my B2 Pflege Exam?

I took my b2 Pflege Exam last September 2020 in Intermed Ortigas, Manila. It was a two-day exam. First part was Hearing, Listening, Knowledge of the linguistic structure (Hören/Lesen/Sprachbau) and Writing. On the second day was the Speaking part. The exam started at 9a.m. in the morning. I think we finished at around lunchtime, can’t recall exactly how many hours did it take. After the first part, we had draw lots in order to know what time will be go back for the speaking part the next day. So, that is by partner. They allot an hour for a set of examinees for the speaking part. As far as I can r
emember, 20 minutes for the preparation before you take the hot seat. The speaking part is composed of three part which are Bildbeschreibung where in you will be given a picture to describe, Kurzvortrag where you need to present a topic(you can choose and write bullets already during the preparation time) and Diskussion where in you will discuss a topic with your partner.

1. Be early. I remember we were the first ones to arrive at the testing center that time.

2. Choose a comfortable seat. Some say sitting close to the speaker is of an advantage too.

3. Use the elimination technique. When you did not fully understand the question, remove the ones which is not a possible answer.

4. Use your instinct. Some questions have two possible answers, always go for your first choice.

5. Don’t look on the clock. Relax and take time to read the questions well. The time allotted is enough.

6. Some examinees finish the exam fast. Ignore them. This will surely put pressure on you. But stay focus. As long as the examiner did not tell you yet to pass the test sheet that means you still have time.

7. During the writing part, write your sentences legibly. 120-150 words would suffice. Watch out for your grammar because every mistake means minus points. Make it simple and direct.

8. For the speaking part, it is very important to be confident. Don’t be too anxious. Prove them you can express yourself and you can understand the German language.

9. Inhale and Exhale. This can help you lessen your anxiety. Don’t look at the examiners as villains, instead look at them as your mentors. They are very nice and considerate anyway.

10. Pray, Pray and Pray. Lift everything to God. He had seen all your sleepless nights, tears and knew what your heart desires. He will be with you. Trust His promises.

 

Are you thinking of pursuing a career in Germany?

So, you've heard that Germany is in need of nurses. Here are some of the common questions I am sure are in your mind right now. These are all based on my personal experience and may vary from that of other's.

 1.What are the requirements to apply in Germany?

- One must have a PRC License, Hospital Experience and Pass the B2 Exam.

2.Can I apply if my experience is private nurse or community health nurse?

- Yes, you can. They consider that as experience as well.

3.I don’t have any experience at all, can I apply?

- Yes! They accept nurses without experience and even fresh graduates too.

4. How long is the language course?

- It takes 6 to 8 months. On my experience, 3hours daily every weekdays.

5. How much is the language course?

- I paid almost 60K for the whole course. But there are lots of agencies now that offer free German course.

6. What is Allgemein and Pflege Exam? How much is the exam?

- Allgemein and Pflege Exam are B2 exams offered by TELC, which is a Testing Center. Allgemein is more of general German while Pflege is about nursing. The exam costs 10k.

7. How long will I need to wait for the exam result?

- It took more than a month for the result and certificate to be released.

8. What’s next after passing the exam?

- It normally depends on the agency. It could be translation of documents or setting for an embassy appointment. The waiting time also varies.

9. How much is the translation of documents?

- 10k.

10. How much did you pay for your visa?

- I think more or less 5k.

11. Did you pay for your plane ticket?

- My employer did.

12. What is partial and full recognition?

- Partial recognition means you will first work as a nursing assistant and will need to take exam before you can work as a registered nurse in Germany. Whereas, full recognition means you can work as a nurse once you arrived here in Germany.

13. How can I get full recognition? Will they base that on my work experience?

- No. It depends on the State you will be assigned at. Having many years of experience and even masters can’t guarantee a full recognition.

14. How much is your salary?

- Before recognition it was 2100+ euro and after passing the exam 2600+ euro gross  salary (night differentials as well as Sunday and holiday duties are not yet included)

15. What does gross salary means?

- That is the total salary without deductions.

16. How much is your net after deductions?

- 1600 as nurse assistant and 1900 as registered nurse. (night differentials as well as Sunday and holiday duties are not yet included)

17. How much do you pay for your Apartment?

- I live before in Berlin and I was paying 480euros every month. But I am working in a small city now in northern part of Germany and I pay 245euros all in.

18. How was the nurse licensure exam in Germany?

- You can have two options. One is the Kenntnisprüfung and the other is the Anpassungslehrgang. The former is composed of oral and practical exam while the latter will be like you will be assigned on different stations for certain period of time then you will then be evaluated.

19. How is the work in Germany different in the Philippines?

- In Germany, washing the patient is included in the daily tasks of nurses. The doctors do IV insertion and blood transfusion.

20. How much do you spend for your food monthly?

- Believe it or not, 100euros is enough including toiletries.

 

I will try to explain further on some of the things I mentioned here. If you have questions, don’t hesitate to comment below.

 

 

 

A nurse's Dream

Hello guys! Welcome to my blog. I am a nurse currently living and working Germany for almost 6 months now. I graduated BSN in a school in our province Pangasinan in 2008. Like many other nurses, I volunteered at hospitals to gain experience which I can eventually use going abroad. But during those time, I find it hard applying because most of the job offers abroad requires experience in special areas. That’s why I worked as a writer online. At first, I enjoyed what I am doing since everything is online, you’re at home and you will only allot few hours of your time. But later on, I knew I wanted to do something else. So, I tried applying for local jobs and luckily, I got hired in a manufacturing company in Pampanga. It was not related to my job but I enjoyed it somehow because the work is easy, sitting in front of a computer and doing some sort of administrative work. Almost two years later, I resigned and tried my luck of applying abroad again. I tried this student visa application in Canada but unfortunately, the application was denied. Because of my high hopes, I really got frustrated that time. So, I was thinking that time to go back working again online. As I was browsing on the web, I stumbled on this job hiring in Saudi Arabia. I thought of sending an application, then I was invited for an interview. So, to cut the story short, I flew in Saudi Arabia. I finished my contract for two years. After, I got married. A year later, I got pregnant and gave birth to my son. That time I was think of changing to another profession or still pursuing my career. So, since it is easier to stick to my profession, I went back to Saudi Arabia again. While working there, I felt how hard to be away from family is, since this time I already have a son. Homesickness is real. This time I knew what I really wanted, I wanted a work where we can settle as a family. So, there came Germany. There was this video from Triple Win Project in the Philippines telling the advantages of working in Germany. So, I researched well about it, I spent my day offs looking for agencies and schools near our hometown. I was fueled with determination right then. I want to go in Germany. I am so sure of that. So, while working in Saudi Arabia, I started learning the language. It is mentally draining at first but I always think of the benefits of living there that’s why I really pushed myself learning the language. My contract in Saudi Arabia is over. I flew back home and started my language course right after. After 8months of German course, I took the exam. Because of prayers and hard work, I passed the exam with good scores. Our agency processed everything. I had my embassy appointment and later on visa approval. I flew I Germany and yes, it was a dream come true. It wasn’t an easy journey but I can say that it is definitely worth it.