Fra chili i Rom

Fra chili i Rom til smertevurdering af børns smerter på børneafdelingen i Holbæk.

Efteråret 2013 startede jeg på efteruddannelse i ”Implementering af kliniske retningslinjer”.

I denne forbindelse valgte jeg som opgave, at implementere ”Smertevurdering/ smertebehandling af børns smerter fra 6 års alderen”.

Det skulle vise sig, at blive en lang og udfordrende proces.
I flere måneder arbejdede jeg med ledelse af forandringsprocesser, diskurs og diskursanalyse, baseline undersøgelse og interessentanalyse i min opgave.


I forhold til smertevurdering af børn over 6 år, er der lavet evidens på, at en lineal med 6 ansigter er det bedste scoreredskab.

I børneafdelingen fandt jeg med lidt held en lineal med de 6 ansigter, resten var linealer med 1-10 skalaen.
I depotet kunne de kun levere linealer med 2 ansigter. Jeg kontaktede flere medicinalfirmaer, fordi jeg kunne huske, at de på et tidspunkt lavede dem som reklame. Dette var dog uden held, da de var sparet væk.
Underligt nok, når nu der lå krav om, at vi skal smertescore børn med smerter?

I uddannelsesforløbet var jeg så heldig, at tilbringe 5 feriedage i Rom med 3 dejlige piger. Vi vandrede Roms gader tynde imens vi nød de mange nye indtryk.
De mange cafeer, maden, vinen og ikke mindst solen gjorde os helt høje.
Når man rejser er det jo meningen at man skal slappe af fra sit arbejde, og jeg glemte da også alt om implementering og smertevurdering af børns smerter…NÆSTEN DA!

Det skulle vise sig, at jeg på forunderlig vis pludselig stod ansigt til ansigt med det jeg søgte i mit arbejde. Ansigter med forskellige udtryk der med sin enkelthed kan nå børns opmærksomhed og indlevelsesevne. Jeg var ikke en sekund i tvivl om, at her var noget, der kunne hjælpe syge børn med at udtrykke smerter på.
Ikke bare i Holbæk børneafdeling, men alle børn uanset nationalitet.

Ansigterne hang ved indgangen til den lille hyggelige chilibutik. I butikken havde man valgt at sætte ansigter på poserne, for at fortælle turister fra hele verden, hvor stærke de var.

Da jeg kom hjem, fortalte jeg min ledelse om min ide. Jeg fik lov til at indføre ansigterne i afdelingen som et projekt.
Herefter skrev jeg brev til Italien hvor jeg så ansigterne, for at spørge om jeg måtte bruge ansigterne / "Chilidrengene", som smertevurderingsredskab. Efter en tid kom jeg i kontakt med Rita fra chilibutikken. Jeg måtte jo være sikker på, at jeg ikke brugte noget, som var produktbeskyttet.
Rita synes at ideen var fantastisk og gav mig lov til at bruge dem.
Efter en tid kontaktede hun mig igen. Hun spurgte og jeg havde lyst til at mødes med hende og Paolo i København.
2 dage efter sad jeg i toget på vej mod hovedstaden. Jeg havde taget en god veninde med. Så var vi da to, hvis de kun talte italiensk. Hvordan skulle det ikke mon så gå?
Mødestedet var Hotel d’Angleterre kl. 16.00.

Jeg var ikke et øjeblik i tvivl da jeg så Rita og Paolo. Der var en ro og aura omkring dem da de stod der midt i Københavns mylder. Vores blikke fangede hurtigt hinanden og jeg fik de varmeste kindkys på italiensk maner. ”Buongiomo” Gitte. To skønne og hjertelige mennesker.
Det blev til to spændende timer i godt selskab.

Rita ejer en farm i Toscana hvor hun dyrker økologisk chili. Hun har altid været begejstret for chiliplanten. For mange år siden gik hun på kunstakademiet. Her formede hun chili som skulpturer. Herefter begyndte hun at lave malerier med chili, og ja! nu dyrker hun dem.
Paolo er uddannet journalist og er i dag anmelder på vine, mad og krydderier.

Ideen om at bruge chiliansigter kom, da hun i sine 3 forretninger skulle fortælle turister fra hele verden, hvor stærke de forskellige sorter er. Hun malede selv ansigterne og lagde dem på en skala.
At de kan bruges til børn, glædede Rita meget.
Med det formål, fik jeg rettigheden til at bruge hendes tegninger til syge børn med smerter.

Hvis jeg kommer i mål med mit projekt, og får tegningerne godkendt til brug, har jeg lovet Rita udgaven på italiensk.

Rita har et stort hjerte til syge børn. Hun fortalte, at der lå et børnehospital i Toscana hvor hun en gang om året sponsorerede penge til. Pludselig gav det hele mening.
På mit skæve engelsk fik jeg sagt, at børnene på hospitalet i Toscana selvfølgelig også skulle have glæde af ideen. Den var Rita med på.

Jeg tager med glæde turen til Toscana for at introducere linealen på italiensk.
Jeg ved at jeg er mere end velkommen til at bo på farmen hvis jeg valgte at komme,
… og det gør jeg … med eller uden den italienske udgave af smertescore linealen.
I forbindelse med iværksættelsen af et børnevenligt smertescoreredskab, i børneafdelingen på Holbæk Sygehus.
Vil jeg gerne rette en stor tak til …
Karin De Neergaard & Annemi Lyng Frandsen

Sygeplejeske Gitte Larsen

From chili in Rome

From chili in Rome to pain assessment of children's pain in the children's ward in Holbæk.

In the fall of 2013, I started continuing education in "Implementation of clinical guidelines".

In this connection, I chose to implement "Pain assessment / pain management of children's pain from the age of 6".

It turned out to be a long and challenging process.
For months, I worked with leadership of change processes, discourse and discourse analysis, baseline research and stakeholder analysis in my assignment.


In relation to pain assessment of children over the age of 6, evidence has been made that a 6-face ruler is the best scoring tool.

In the children's section, I found with some luck a ruler with the 6 faces, the rest were rulers with the 1-10 scale.
In the depot, they could only provide rulers with 2 faces. I contacted several pharmaceutical companies because I remembered that at one point they made them as advertisements. However, this was unsuccessful as they were spared away.
Strangely enough, when is there a demand that we have to score pain children with pain?

In the course of education, I was lucky enough to spend 5 vacation days in Rome with 3 lovely girls. We wandered the streets of Rome while enjoying the many new impressions.
The many cafes, the food, the wine and not least the sun made us quite high.
When traveling, the intention is to relax from work, and I forgot all about the implementation and pain assessment of children's pain ... NEXT DA!

It turned out that, in a strange way, I suddenly came face to face with what I was looking for in my job. Faces with different expressions that, with their simplicity, can reach children's attention and empathy. I didn't doubt for a second that there was something that could help sick children express pain.
Not just in the Holbæk children's section, but all children regardless of nationality.

The faces hung at the entrance to the small cozy chili shop. The store had chosen to put faces on the bags, to tell tourists from all over the world how strong they were.

When I got home, I told my management about my idea. I was allowed to introduce the faces of the department as a project.
Then I wrote a letter to Italy where I saw the faces, asking if I could use the faces / "Chilean boys" as a pain assessment tool. After a while I came into contact with Rita from the chili shop. After all, I had to make sure I didn't use anything that was product protected.
Rita thought the idea was great and allowed me to use it.
After a while she contacted me again. She asked and I wanted to meet her and Paolo in Copenhagen.
Two days later I was on the train heading for the capital. I had brought a good friend. Then we were two, if they only spoke Italian. How could it not be so?
The meeting point was the Hotel d'Angleterre at. 16.00.

I didn't doubt for a moment when I saw Rita and Paolo. There was a calm and aura around them as they stood there in the midst of Copenhagen's crowds. Our eyes quickly caught each other and I got the warmest cheek kisses in Italian manners. "Buongiomo" Gitte. Two lovely and cordial people.
It turned into two exciting hours in good company.

Rita owns a farm in Tuscany where she grows organic chili. She has always been excited about the chili plant. Many years ago, she attended the art academy. Here she shaped chili as sculptures. After that, she started making paintings with chili, and yes! now she cultivates them.
Paolo is a trained journalist and is currently a reviewer on wines, food and spices.

The idea of ​​using Chilean faces came when she was going to tell tourists from all over the world how strong the different varieties are. She even painted the faces and placed them on a scale.
That they can be used for children, Rita was very pleased.
To that end, I was given the right to use her drawings for sick children with pain.

If I finish my project and get the drawings approved for use, I have promised the Rita edition in Italian.

Rita has a big heart for sick children. She said there was a children's hospital in Tuscany where she sponsored money once a year. Suddenly it all made sense.
In my crooked English, I was told that the children in the hospital in Tuscany should of course also benefit from the idea. It was Rita included.

I am happy to take the trip to Tuscany to introduce the ruler in Italian.
I know I'm more than welcome to stay at the farm if I choose to come,
… And I do… with or without the Italian version of the pain score ruler.
In connection with the launch of a child-friendly pain scoring tool, in the pediatric ward at Holbæk Hospital.
I would like to thank ...
Karin De Neergaard & Annemi Lyng Frandsen

Nurse Gitte Larsen