Sunday, May 4, 2014

Coming to the news on May 5th

I don't know if this will actually get seen by anyone in Norway early enough for them to see a live feed but tomorrow, Monday May 5th, NRK will air a news report on my on-going, now 3.5 year fight for authorization as a nurse and midwife in Norway.

The case will be aired on NRK radio, there will be two print versions available on nrk.no in both English and Norwegian, and a report will be on NRK evening news--first on the local Østnytt and hopefully on the national Dagsrevyen.

I will post links as soon as they are available.

In the meantime, our fingers are crossed.

Friday, March 7, 2014

The nursing/midwife saga update

My blogging efforts of late have been pathetic. But, to cut to the chase, I feel I need to update those curious on the details of my continued quest to work in Norway as a midwife. I apologize if this seems really disjointed (and not at all funny). I have written it several times over in the last few weeks as information evolves.

In mid-February (2014), I posted on Facebook that my final appeal for a nursing license had been denied. At that time, I thought that was true, and believed it was as black and white as “go start your education over again”. The actual decision, which we learned a few days later once it finally arrived in the mail, was that I must repeat 6 months of clinical training in geriatrics, home health care and psychiatric nursing. Then I can be authorized as a nurse. Then I must work for one year as a nurse in Norway. Then I can re-apply for the fourth time as a midwife. . . wait 6 months for a decision. . . perhaps need to appeal. . . .perhaps need to re-train 6-12 months, as was once originally recommended. . . and then 2-3 years down the road I might be able to work as a midwife. But, no guarantee. ‘Cause I’m not going to get that answer for another 1.5 years.

In May 2012, the appeals board had upheld the recommendationof SAK (the Norwegian authorization board) that I begin my entire nursing education from the beginning. They suggested I contact a nursing school and that perhaps I could get credit for a few of my American nursing courses.

That’s what we did. And what we found when contacting Norwegian nursing schools and nursing educators is that they were overwhelmingly supportive of my education and, after doing thorough reviews of my coursework and job experience, maintained that I did not need to repeat any nursing education. 

By September of 2013, with the help of an attorney, we finally managed to send in the following information to the appeals board, demanding that they do what is essentially an appeal of the original appeal (an omgjøringsbejæring), something that we didn’t know was an option until we actually spoke with an attorney.
*A four-page letter from a former dean of a local nursing program that explains how the number of credit hours I have earned as a nursing student in the United States actually exceeds the Norwegian hours. She points out that although I have fewer clinical hours than Norwegian, my 12 years of work experience can compensate for this.
*A letter from the fiery PhD-educated Norwegian nurse educator, stating the above as well.
*A letter from a third nursing college educator, stating that he agreed with the other two evaluations, and recommends that I become authorized as a nurse.
*A letter from a midwife who started the first and only master’s degree program for midwives in Norway, (of note: I have my master’s degree, nearly all midwifery programs in the US are master’s programs, and many are becoming doctoral programs), stating that my midwifery education and work experience is equal to a Norwegian, and she believes I should be authorized as a nurse and midwife.
*A letter from the regional office of the Norsk Sykepleierforbund (the Norwegian nurses union/professional organization) stating that they support my authorization as a nurse and midwife.
*A letter from the Norsk jordmorforbund (Norwegian midwife organization/union) supporting my authorization as a nurse and midwife.
*A letter from the Norsk jordmorforening (a second Norwegian midwife organization/union) supporting my authorization as a nurse and midwife.

In November, we heard that the appeals board would review my case in December, but they were first sending my paperwork to two new nurse educator/experts to review my application. They were not given any of the three letters from their fellow nurse educators to review, contradict, argue against, or agree with. We felt this was not a fair or complete evaluation, but there was nothing we could do, even with an attorney helping us out.

A day after the deadline for the new nurse experts to turn in their evaluations to the appeals board, one of them asked to see the “reading list” (essentially the syllabi) from my nursing classes at St. Olaf. This is despite the fact that she had detailed descriptions of every prerequisite class and every nursing class I took at St. Olaf. Needless to say, getting ahold of syllabi from 1995-97 was nearly impossible. The nursing department at St. Olaf bent over backwards trying to locate these, but were only able to find one

In mid-January we finally received the two reviews from appeals board’s experts. The first was completely in agreement with our four—that while Norwegian and American nursing education programs are different in their approach, if one looks at the entire content and the final result, combined with a decade of work experience—I should be granted authorization. The second evaluation—from the nurse educator who wanted the syllabi—focused on the number of hours that differed in our clinical training, and felt that if I did 24 weeks of supervised clinical training in geriatrics, home-health care and psychiatric nursing I could be authorized as a nurse.

The appeals board said they could not give any weight to the four evaluations that we had submitted, as they were “privately engaged” (even though they were supported by one of their own independent evaluations). And so they focused entirely on the evaluation that recommended I repeat 24 weeks of clinical training, and additionally took phrases out of context from the more favorable evaluation and used them to support the less favorable evaluation.  


The TV journalist who originally reported on my case back in November 2012 has been hot on this case. The nurses who wrote the independent positive evaluation have been interviewed, the midwives in charge of the midwife organizations and midwife education programs have been interviewed, as well as some of the members of the appeals board. Our house was full of four journalists a few days ago—TV journalist, print journalist for the online version, and two camera people—still and film, interviewing Erik and me, and capturing the darling American children speaking English and Norwegian. But I digress. . . The questions are, how can an appeals board of lawyers and judges, not one with an educational background, an only one nurse, feel that they are more qualified to evaluate a foreign nursing education than 6-10 nursing professionals? And how can they give so much weight to the most negative evaluation over the other 4-5 that are in agreement with one another?  

Erik and I don't know exactly where this is going. The report will likely air within the next few weeks, and it appears that it will be going national (writing that makes me sick to my stomach). Officially, we don't have any recourse in regards to the appeal aside from a lawsuit, which would cost us somewhere around $18,000 and another 9 months of waiting. That is not going to happen. But, there are enough very angry and powerful nursing professionals out there that, well, who knows what will happen. I am not alone in this fight--these nursing professionals are not fighting for my case alone--there have been dozens of other American-educated nurses turned away because of SAK's inability and unwillingness to recognize and understand the American credit system and acknowledge that there are other countries in the world that can adequately educated a nurse. What this case means for me, and for my fellow RNs. . . .? Only time will tell. 

And hopefully not too much time. To say that I am sick of waiting is the understatement of the century. I need a paycheck, like, yesterday. Those lawyer bills aren't going to pay themselves. 

Thursday, March 6, 2014

An American's guide to napping your baby outdoors in the winter in Norway*

*Alternate title (according to my sister-in-law): "How to Raise a Viking"


Step 1
 Locate a pile of wool and fleece. 





Step Two
Locate a sleepy baby. 
Make sure he is dressed in a wool onesie (aka "body") and wool tights. 
Yes, even if baby is a boy baby, dress baby in tights. 
According to Norwegian folklore, it is of utmost importance that wool be the closest layer to the skin.
Fleece elf booties complete the look.




 Step Three
Dress the sleepy baby in a wool sweater and fleece overalls.




 Step Four
Dress baby in a wool hat that ties under his chin and 
a painstakingly knit over-sized wool bunting that is too cute for words.
Binky is optional.




Step Five
Wrap baby in a wool blanket. 
You now have a burrito baby.




Step Six
Place the burrito baby in a baby-sized sleeping baby.
Most Norwegian mothers will insist on a down bag.
Our baby has survived with fleece and polyfil. 




Step Seven
Baby is sleepy and ready for a nap!
(Trust me).




Step Eight
Place baby into the dark and cozy confines of his stroller.
Baby should lie on a stroller liner made of. . . 
you guessed it! Fleece and wool. 
Cover the baby burrito/sleeping unit with a windproof-fleece-lined cover.

 



Step Nine
If is is snowing/raining/sleeting, you may opt to cover your stroller with a rain cover. 
Ours has the zippers open for good air circulation. 
Take note of the baby monitor located in the basket under the stroller.
This ensures that the baby's happy gurgles of delight are heard once he awakens in several hours.



Note:
It seems that the general consensus is that babies not sleep outdoors in temperatures that are below -10C/10F. 

Sunday, August 4, 2013

Sleep

Three days before Henrik was born in late February, an article appeared in Norway’s Aftenposten newspaper; the headline read Norsk uskikk at spedbarn skal sove ute. The Norwegian bad habit that newborns should sleep outside.

It was a well-timed article, as I was well aware of the Norwegian, or perhaps more accurately the Scandinavian habit (as an article with similar theme appeared on the BBC around that same time about babies in Sweden) of babies taking their daily naps outside in their strollers, no matter what the weather.

Outside? you ask. But isn't it cold in Norway, like, 11 and a half months out of the year? 

Why yes, it is, but that doesn't seem to stop anyone. In fact, there are written recommendations from pediatric health offices stating that it is acceptable for babies to sleep outside until it is -10C (or 14F)!

Napping out in a stroller, bundled up in layers of wool and downy sleeping bags, is one of the few Norwegian habits that Greta did not adapt particularly well to upon our move here when she was 2. 5 years old and she began at the barnehage. It was too different and she was too curious—she kept peeking out of the stroller to see what the other kids were doing. Greta was a Champion Napper until this point, and we felt like had really gotten the nap thing nailed first time around. Naturally, I was both a little resistant and, I admit, defensive, against the thought of having to a) adjust my parenting habits which had served us quite well with baby #1 and b) make me and my baby somehow more “Norwegian”.

Uhh, Emily? you say. There is no one forcing you to have Henrik sleep outside. The worst that could happen is that the Norwegian Nap Police won't come and award you with Integrated Foreign Mother of the Year, right? 

True, but. . . that's a really cool award! Seriously, though. . .  once Henrik begins barnehage, which he will likely do around one year of age, he will be taking his naps outside in his stroller with all the other one-year olds. So, there is an incentive to train him to sleep outside now when he is young, otherwise it could be difficult once he is older. We had even bought a new stroller for baby #2 that could better accommodate a napping child because we knew this child would be napping outdoors.

But appearance of this article just days before Henrik’s birth only added to my mixed feelings on the subject, and also justified some of my resistance. The article quoted a number of Norwegian parents and barnehage employees who talk about how healthy it is and how soundly babies sleep outside. “It has never occurred to me that it was anything other than healthy than to sleep outside,” said one mother. “The fresh air is healthy. And she likes her stroller,” said another.

But apparently a number of utenlandsk  (foreign) parents are asking the doctors and barnehage leaders why it is so healthy to sleep outside, and in this article Norwegian pediatric leaders are admitting, yeah. . . we actually don’t have any studies proving this is more healthy than sleeping indoors. One doctor in particular was “very skeptical” that babies should sleep out, especially in the cold. “I think it’s an odd Norwegian habit, or actually bad habit, that infants should sleep outside, even in the winter.” He continues and says he gave a talk in Buenos Aires several years ago and told that a “certain percent” of Norwegian SIDS deaths happen while the babies sleep in their stollers in the winter.

While alarming, this did not come as a surprise to me, and in fact confirmed a concern that I have had, as Norwegians are very fond of piling puffy dyner – down comforters—on and around their sleeping infants in the stroller, very much against all the anti-SIDS recommendations we have in the US. It is not uncommon to see babies buried under a thick down comforter even in the middle of the summer. Unfortunately, the article did not pursue this point at all, which I found very frustrating, since the SIDS rate is something that I have wondered about.  Instead the doctor continued that the bad habit must be a kind of misdirected belief in “hardening” or toughening up the babies by breathing in cold air, but that there really isn’t any research or studies to back up any of these long-held beliefs.

One barnehage leader was questioned by a foreign parent about the whys of outside naps, she responded that there is less danger for spreading infection between the children when they are all sleeping outside (again—not documented or studied, just a “belief”). But a belief that I can see some truth in. Interestingly enough, the sleeping outside habit is so well institutionalized in Norwegian culture that there probably aren’t any barnehages that could accommodate all of their infant and toddlers sleeping inside—the barnehages are simply not built with that need in mind.

When Henrik was about 6 weeks old in the beginning of April and the weather was still in the 30s F, I attended a postpartum group at the health center. The group was lead by a helsesøster—kind of a pediatric community health nurse—to answer questions we might have. I had taken Henrik out on walks in his buggy, having dutifully dressed him in a layer of wool long underwear and bundled inside a baby sleeping bag, and he did seem to sleep quite well. I had occasionally let him finish off a nap on our porch if we finished a walk and he was still sleeping, but quite nervously. But I had not grown comfortable with the idea intentionally putting him outside to sleep, so I finally asked, “Soooo. . . I’m not Norwegian. (eyebrows raise around the room, curious looks abound). I’m not used to having my baby sleep outside in the cold. Or when it’s warm! I never dressed my daughter in wool until she was nearly 3 years old. What do you dress your baby in when it’s outside? How do you know it’s warm enough?”

And at first, they seemed rather surprised: where does your baby nap if not in its stroller? What do you dress them in if not wool? Seriously! And not surprisingly, the answers were basically what I expected: dress them in wool (ahh Norwegians and their love of wool) and the sound advice of check to see if they are warm. Duh. The helsesøster laughed,  “Did that help?” she asked. Not exactly, but at least I felt like I wasn’t doing anything wrong.

So, don’t leave me in suspense, you say. Where does Henrik take his naps?

As the weather warmed this spring, I became more comfortable with leaving him on our porch in his buggy after a walk and allowing him to finish off a nap, with a baby monitor in the side pocket, within full view of my kitchen and living room window, and safely in our back yard. It wasn’t until about 6 weeks ago, in a moment of this-kid-won’t-stay-asleep-and-he’s-driving-me-crazy frustration, that I tossed him into his buggy where he laid calmly and quietly awake for half an hour, then put himself to sleep and proceeded to sleep for another hour and a half. Later that afternoon, I started his nap in the buggy. He slept for 3 hours.


He’s been sleeping outside ever since.




Monday, July 29, 2013

Now that's customer service



I am not alone in saying that Norway is not exactly known for its customer service. Norwegians themselves even admit this. No local grocery store offers to bag your groceries and certainly would never offer a very pregnant woman if they could help her push a heavy grocery cart through the icy, snowy, uneven parking lot or even lift her heavy bags into the cart. Ask me: never happened. Nor does a cashier even bother to push the button to assemble my groceries in a smaller pile at the end of the grocery conveyer belt when I have a small infant strapped to my chest, making it nearly impossible to stretch across the counter and grab those few remaining items that are out of reach. The cashiers instead sit and stare, or better yet, get up and walk away.

So I was shocked to see the following parking sign at the Norwegian Outlet mall that we stopped at on our recent trip to Sweden.

Special designated parking spots for families with young children! How novel! How helpful! How very customer friendly!











But the Norwegian Outlet malls took customer service to a level that I have not even seen in America.

They have special designated parking spots for their headless, wheelchair bound customers.

Now that's customer service.

Yeah, Norway!

Thursday, July 18, 2013

America's Newest Citizen


 Much to the surprise of many, Henrik is not granted Norwegian citizenship just because he was born in Norway. Norway does not have Jus soli (italics used to highlight Latin and not Norwegian this time, and meaning right of birthplace) unlike the United States. He is, however, an American citizen, due to Jus Sanguinis (right of blood), since Erik and I are American citizens. But, since he wasn't born in the United States, the actual documentation of  his American citizenship was not a straightforward case.

We had to apply for a "consular report of birth abroad" through the American Embassy in Oslo, along with an application for his American passport (necessarily to travel with, even for an infant), and his American social security number. This required that Erik and I make a trip together--along with Henrik, and of course, Greta--to the Embassy in Oslo to apply for these in person, along with a stack of supporting documentation proving Erik and I are who we say we are: our own birth certificates, original marriage certificate, 5+ years of school records (proving we actually lived in the United States), Henrik's Norwegian birth certificate, our own passports (along with Greta's passport, simply so she could enter the Embassy along with us), and the three separate applications for the birth abroad certificate, social security and passport. And then pay about $200.

But for all of this to happen we first had to have Henrik's Norwegian birth certificate in our hands. We applied for this online a few weeks after he was born. On the website, we had to fill in his first, middle and last name. These names must be on a list of approved names, and if it's not, you must apply for the name and explain your reasons for choosing this name. My Norwegian friend Karianne said that her name--40 years ago--was not on the list! This is something that perhaps the United States should consider, in order to stop people from naming their kids Lemonjello, Se7en, and Neveah Legna (Heaven Angel backwards). Don't get me started on stupid people picking stupid baby names. Oh wait, you already did. . .

So, interestingly enough, Henrik's middle name "David" was rejected as a "middle" name. In Norway, many people have two first names: Tor Kristian, Jon Gunnar, Mette Marit, Ann Kristin, and they use both names in everyday life. But what we consider to be the space for a "middle" name in the United States, is reserved for a last name--like the mother's maiden name--if the parents aren't doing the hyphenated last name thing. So, you could have, for example Tor Kristian Sandvik Hammarshaug. Or, Tor Kristian Sandvik Hammarshaug-Lien if the parents are hyphenating their names. Confusing, perhaps. But as a result, when we got Henrik's Norwegian birth certificate, it read that his first name is Henrik David with no middle name.

No biggie.

The birth certificate itself, however. . . . I'm sorry Norway, but it really made me laugh. It is perhaps the most unimpressive, unofficial-looking official document I have ever seen. It looked as if it was printed on regular printer paper, black and white, no raised ink seal, no watermark, no fancy flowery edging, just a single blue ink stamp at the bottom. I emailed an American friend of mine who has given birth to two babies in Norway, expressing my amusement over this underwhelming official document, and she responded that she had printed more official looking birth certificates from the internet for her cat's kittens than what Norway gives their kids.





Thankfully, the US pulled through when it came to providing us with an official looking document. Henrik's Consular Report of Birth Abroad certificate arrived in the mail last week, and a more over the top document it could not be. The contrast between the two certificates only make the situation more absurd: fancy watermarked paper with italics and impressive fonts, shiny raised gold seals, a shimmery 3D stripe of colorful stars (not kidding), eagles and tendrils and even the Declaration of Independence.

God Bless America. Our boy is officially American.

Wednesday, April 24, 2013

Will I ever write again???

Maybe, maybe not. . .

I've written some really great blog entries at 4am, while I'm awake and nursing Henrik. Too bad you can't read them, as they are only written in my head.

Many of my favorite "ex-pat" bloggers seem to have fallen off the wagon as well and months are going by without updates from them, so I know I'm not alone in struggling to sit down and pound out an entry for my loyal readers. I'd love to tell you my experiences with maternity care in Norway (mostly good, but sparten), my stabs at meeting other new Norwegian mothers and finding my BNFF (Best Norwegian Friend Forever (have chickened out a few times), my 5 year-old daughter whittling with a knife--an activity endorsed by her daycare, a 5-year old birthday party hosted by Pippi Longstocking, and my personal internal struggles over the sleep habits of babies in Norway, including that of my own newborn son (involving napping in a stroller outside). And other funny, light-hearted blog entries about garbage and recycling, the graduating high school students who dress up in red overalls every May, paint color choices for Norwegian homes, and the ubiquitousness of black station wagons. All of these you will some day get to read about, if only I had the time. . .


But, when I sit down to write, I never know if I'm going to have ten minutes or two hours, depending on the still unpredictable napping habits of one young Henrik. And my To Do list includes sorting through boxes of toddler girl clothes that I will now no longer need to hold on to, calling a Serbian nurse who is getting his decision from SAFH over-turned--but in the wrong way, doing my American taxes (yes, I know it's now April 24th), finishing Henrik's baby blanket, and, last but not least, sewing a pair of bunad bukser (Norway's national costume pants) for my dear friend's son, in time for Norway's national holiday on the 17th of May. And, I'll throw in for good measure, my average day includes being the sole source of nourishment for a small human being 24 hours a day, occasionally putting together an evening meal for my family, special laundry loads of poop-stained wool baby clothes, transporting to and from barnehage and also, last but not least, letting the dog in and out of the house TWENTY GAZILLION TIMES BEFORE NOON AND WIPING HER SANDY MUDDY FEET EVERY SINGLE TIME! (But honestly, who can fault her? It's springtime in Norway, and who doesn't want to be outside, soaking up the sunshine, only to realize 10 minutes later that it's really not as warm out as it looks. Even with a fur coat.)

On that note, goodnight. It's 10pm and someone will likely soon be crying out for a little boob time.