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EHECADI: A Practical Nurse's Journey in Person-Centred Support for Individuals with High Support Needs

For our latest interview for the EHECADI project, we sat down with Roosa, a practical nurse working at a daytime centre in Finland.

For our latest interview for the EHECADI project, we sat down with Roosa, a practical nurse working at a daytime centre that’s a part of Tukena. Tukena creates services across Finland, supporting more than 1800 customers, and employing over 900 professionals.

Roosa, who works as a practical nurse in a daytime centre, revealed what she has learned to be the most important element of her work – her connection to the persons with disabilities who use Tukena’s services. She shares with us her daily activities, and her experience in person centred support for individuals with high support needs.

We’d like to also acknowledge Petra Rantamäki, Development Director of Tukena Foundation, who acted as translator and thanks to who this interview was possible.

  • Our first question is, where do you work and was is your current role in your organisation?

Roosa: I work currently in a service from the Tukena, near Tampere.  It’s a daytime activity centre and I work in a group with people who have severe support needs. I’m a practical nurse by profession. With this, in our services, my role is to support those who are using our services. It’s not the same as an occupational therapist for example, it’s more like a coach or an assistant.

  • Day to day, what do you do in your role?

Roosa: My daily role is to support and help our customers in the daytime activities. It depends on what they do during the daytime, for example they could be practicing something with their hands, going outside to be in the community or listening to music - whatever is their individual plan as a daytime activity. If they need some practical nursing in their daily needs, I also help with that. Of course, mainly my role is to be there, present, to listen and communicate with the people who require our support.

  • I see. You mentioned you’re a practical nurse by profession, so I was wondering – is this the role you always saw yourself doing?

Roosa: Yes!

  • Perfect then! What were your exact studies?

Roose: Practical nursing. The practical nurse profession is very well known in Finland. For example, in our services we don’t have so many nurses, because people who use our services don’t necessarily need “nursing” so much, they need some other kind of support. So, many of the staff in our services has the profession of a practical nurse. The profession itself, when I was studying it, included how to support persons with support needs, how to communicate, how to listen and be present, and there was a part focused on medication. There was also the side of how to support people on nursing related issues, as well as supporting them in everyday needs, such as eating, personal hygiene, and so on. That’s the nursing part. But in the profession, itself, it’s sort of a balance between communication, being present, and understanding medication, since many of our service users also need that.

Do you think that your studies prepared you well for your job? What do you think they did well, or perhaps you would have liked to be a little bit different?

Roosa: What I’m about to say is quite common, and something we’ve heard a lot from people working in our services. It’s that the profession is quite focused on the nursing part, so the side of medication, daily nursing, hygiene and so on. However, in my work, it’s more about connecting with people, interacting, communicating and being close. Whilst my work, of course, includes also the more practical part of working, the balance is different than how it is taught. Most of my days are about interactions and understanding, that kind of support.

  • So, you feel the social and psychological part of your profession wasn’t sufficiently covered in your studies?

Roosa: Yes. It was more medical, although every day balance is not like that. That’s quite common. A lot of students are required to focus more on the medical part, leaving the human and social element behind.

  • What would you say are the biggest challenges, and biggest rewards in your line of work?

Roosa: One of the biggest challenges, is around working with people with high support needs. Since those with higher support needs don’t always communicate with speech or have a communication method that is easy to understand, there are communication difficulties. I have to interpret what a person needs or feels by gestures or facial expressions and that can be hard or challenging. The biggest plus is that my everyday work includes a lot of things that are very meaningful to people. I can help and support them in having a better life and I’m doing important work.

  • I understand. And that further goes into what you were saying before that the social and human touch of the job is not so well taught. The EHECADI project will work to develop a course for healthcare students to have a better understanding of societal needs and be able to increase their employability. What do you think students should be taught in their studies now, to equip them for delivering quality support in the coming years?

Roosa: If the students would jump into my shoes and go to work in my profession, I’d like to emphasise they would need an understanding and knowledge on how to be present, how to touch and approach people, how to really focus on one person at a time. How to look into somebody’s eyes, how to really listen, and how to really pay attention to the individual. We have this communication method that emphasises meaningful individual moments in everyday life. Because sometimes organisations and professionals constantly want to do something – plan structures and be very active, but for many people it’s actually more important to be present. Sometimes you don’t need to do anything or accomplish anything, you just need to be there for the person and listen to what they need, to what they want to say.

  • That’s beautiful, thank you so much for sharing that. We’ve come to my last question, which is: Is there something you realised is different once you started practicing your profession?

Roosa: What surprised me the most is mainly what I already said. When I started, I thought it was more that there are practices and activities, structures, and daily programs, but that’s not what it is. It’s more the connection between people. That’s what surprised me the most.