Never More Strain on Hospital, Chief Physician Says

Emergency room

New rules took effect today at Iceland’s National University Hospital of Iceland due to increased strain and an outbreak of respiratory infections. Mask use is once again mandatory for outpatients and visitors, and visiting hours have been reduced. Chief Physician of the Infectious Diseases Ward Már Kristjánsson told RÚV it is “the most strain that we have ever seen the hospital under.”

Mandatory mask use

Mask use is mandatory in all interactions with patients as of today, January 4. Inpatients are not required to wear masks, but outpatients and their chaperones are required to do so. Visitors and others entering the hospital are also required to wear surgical masks. In departments where COVID-19 outbreaks occur, staff are required to wear fine particle (FFP2) masks.

Visiting hours have been shortened and will be between 4:30 and 7:30 PM on weekdays and 2:30-7:30 PM on weekends. The hospital recommends guests come one at a time and wash their hands upon entering the hospital.

Exceptions may be granted

Sibling visits to the children’s hospital are only permitted in consultation with the children’s ward staff. Exceptions to all of the new infection prevention regulations can be granted by department or shift managers.

Read more about the National Hospital’s persistent problem of patient flow.

Outlook Improves for Guðmundur Felix

guðmundur felix

Following four surgeries in the past week, Guðmundur Felix’s infections show signs of lessening. The operations seem to be cause for hope, with Guðmundur Felix stating that he expects to keep his arms.

“This isn’t completely finished, but there are indications that it’s heading in the right direction,” Guðmundur Felix stated to RÚV. “I have, at least temporarily, overcome this uncertainty.”

Read more: Guðmundur Felix May Lose His Arms A Second Time

Guðmundur Felix expressed his concern that he may lose his arms a second time last week, when an infection caused him and his medical team to suspect that his body had begun rejecting his arms. After losing both arms to a severe electric shock, his 2021 surgery was one of the world’s first double arm transplants.

His most recent symptoms included swelling in his arms, loosening fingernails, and spots on his arms that may have been an immune response. Following steroid injections under his fingernails, his condition did not improve much, and two weeks ago Guðmundur Felix noticed red spots that had formed on his hands.

Last week, the spots had multiplied significantly. Guðmundur Felix stated to RÚV that it was a clear indication of an allergic reaction. He sent a picture to his medical team, who brought him in for immediate treatment. At the hospital, his team determined that his body was rejecting his arm and began treatment immediately.

He was promptly placed on an aggressive regimen of steroids meant to suppress his immune system for some time. Guðmundur Felix received his last dose of these steroids last Friday. During the night, he woke up with pain in his elbow and noticed that his arm was swelling.

Because of this significant immune suppression, he contracted a serious infection in his arm. In order to ease the swelling, his arm was opened with an incision, which will be surgically narrowed in the coming days. His team expects that the incision can be fully closed in the coming week. Guðmundur Felix is undergoing surgery on Tuesday, where it will be examined. He then needs to be on antibiotics until May 20.

“The worst thing we can do is to do this too quickly. It’s possible that something small could be trapped inside and cause an infection,” he stated.

[visual-link-preview encoded=”eyJ0eXBlIjoiaW50ZXJuYWwiLCJwb3N0IjoxNTA2NjQsInBvc3RfbGFiZWwiOiJQb3N0IDE1MDY2NCAtIFRoZSBSaWdodCB0byBCZWFyIEFybXMiLCJ1cmwiOiIiLCJpbWFnZV9pZCI6MTUwNjY2LCJpbWFnZV91cmwiOiJodHRwczovL3d3dy5pY2VsYW5kcmV2aWV3LmNvbS93cC1jb250ZW50L3VwbG9hZHMvMjAyMi8xMC9Gb3JzaWRhLmpwZyIsInRpdGxlIjoiVGhlIFJpZ2h0IHRvIEJlYXIgQXJtcyIsInN1bW1hcnkiOiIiLCJ0ZW1wbGF0ZSI6InNwb3RsaWdodCJ9″]

 

Although it’s been a particularly difficult couple of weeks for Guðmundur Felix, he reiterated his gratitude for his family and all the support he has received from his fellow Icelanders.

“I have a wonderful wife, a wonderful mother, daughters and friends. That’s invaluable when you’re dealing with a situation like this,” he said.

 

Guðmundur Felix May Lose His Arms A Second Time

guðmundur felix

Guðmundur Felix, an Icelander famous for being the recipient of one of the world’s first-ever double arm transplants, may be in danger of losing his arms for a second time.

While working as an electronics engineer in 1998, Guðmundur Felix received a high-voltage shock while working on power lines. Suffering an 8 metre [26 foot] fall, he broke his back and fractured his neck and ribs. Following a period of unconsciousness, he awoke to find that his arms had been amputated.

In January 2021, however, he was one of the first people in the world to receive a double-arm transplant. He currently lives in Lyon in France, where he has found a medical team that specialises in such operations.

Read more: Guðmundur Felix Talks About His Arm Transplant

Now, unfortunately, he may be in danger of losing his arms again.

Guðmundur Felix’s full statement can be found below on social media.

 

Approximately a year and a half after his surgery, his body may be rejecting his arms. Guðmundur Felix began noticing tell-tale signs of the rejection recently, which included red spots on his arms and fingernails falling out.

Generally, such rejections of transplanted limbs occur sooner after the surgery, but late rejections are not unheard of.

In his statement, he also said that he is currently on a strong regimen of steroids that acts as a “bomb” on his immune system, which may suppress his body’s rejection of the limb.

 

Which languages are required to work as a nurse in Iceland?

Nurses Hospital Landsspítalinn við Hringbraut

For some years now, there has been a shortage in healthcare professionals in Iceland. In fact, despite the relatively high standard of public healthcare, Iceland has some of the lowest ratios of nurses and general practitioners to the population in Europe, meaning that working in healthcare in Iceland is a high-demand field.

Partially in response to these staffing shortages, previous requirements to speak Icelandic have been lifted in the last years. There are, however, some things to keep in mind.

The Icelandic Directorate of Health issues licenses to practice as a registered nurse in Iceland. On the application for applicants who have studied in an EEA country or Switzerland there is no specific requirement regarding language requirements. However, the applications are only available in Icelandic and English on their website. Applicants who have studied in countries outside the EEA or Switzerland are required to submit a course syllabus, or a detailed description of the classes concerned, in Icelandic and English.

In addition to that, individual employers can require job applicants to speak Icelandic. It varies between hospitals and institutions. If you have specific questions, it’s best to refer them to the employer in question.

If you are interested in a career in healthcare in Iceland. you may find the following resources helpful:

National Hospital Nurse Charged with Manslaughter

Landspítali national hospital

A nurse in the psychiatric ward of Landsspítali has been charged with manslaughter and crimes committed during public employment.

The nurse is accused of having culpably caused the death of a psychiatric patient by force-feeding them. The victim in question is said to be a woman in her fifties. It is alleged that the nurse force-fed her liquid food to the point of choking.

Anna Barbara Andradóttir, prosecutor at the district attorney’s office, confirmed this in a recent statement to RÚV.

The accused is a woman in her sixties, who had previously worked in department 33C at Landsspítali. The charges were brought against her about two weeks ago.

The case was first made known August of last year. Source report that the investigation has been wide in scope, with some 20 witnesses in total called to give an account.

The case is scheduled to be heard in court this January.

 

 

How can I practice as a doctor in Iceland?

healthcare jobs iceland

Iceland is a great place to live and work. And unfortunately for those in the medical field in Iceland, but fortunately for those in the field eyeing Iceland as a new home, there is a healthcare shortage in Iceland.

If you are looking for a healthcare job in Iceland, then you’re in luck, because it’s a very in-demand field.

For the most part, the process is just like any other profession. You will still need to comply to all the relevant regulations regarding work visas for individuals outside of EU/EEA nations (see “General Information” below).

What’s most important for medical professionals looking for employment in Iceland will be recognition of your degree and any other specific professional qualifications you have. You can read about these in detail at “Regulation on the Recognition of Professional Qualifications” below.

For a general practitioner, it should be enough to hold an MD or equivalent degree from an accredited institution. But for more specialized fields, you will want to begin your job hunt long before relocating to Iceland. Here you can view all of the current vacancies at the National University Hospital. For more specific questions on qualifications and employment in Iceland’s medical field, you will also want to contact the clinic or hospital you intend to work at directly. Especially for in-demand roles, they will also be able to help you navigate the process of having your medical qualifications recognized in Iceland.

Admission to medical school in Iceland requires a Bachelor’s degree. In order to obtain a medical license, candidates must complete a course of 180 ECTS credits over three years, in addition to a 12-month residency program. Medical candidates in Iceland will then take the NBME Clinical Sciences Comprehensive Examination.

Another common question we receive about practising as a medical professional in Iceland is whether there is an equivalent of a Physician’s Associate in Iceland. The short answer is no, but nurses do have a slightly wider range of responsibilities in Iceland. For example, nurses in Iceland are able to prescribe contraception. However, according to the National Hospital, laws governing prescriptions are currently under review, and this may change in the future.

Useful Links

Dramatic Helicopter Maneuvering Saves Life

TF-GRÓ Icelandic Coast Guard Helicopter

An Icelandic coast guard helicopter likely saved a man’s life last Friday when it flew backwards for five kilometres to Ísafjörður.

The dramatic manoeuvre was needed because of weather conditions in Ísafjörður, and doctors at the National Hospital of Iceland say that the helicopter crew’s decisive action likely saved the man’s life.

This story was first reported by Vísir.

Rough conditions

Conditions were extreme in Ísafjörður when the call for help came to Iceland’s coast guard last Friday, with wind ranging between 35 to 40 m/s, and little to no visibility.

Andri Jóhannesson, helicopter pilot in the coast guard, stated that the mission was one of the most difficult he had been a part of in his 15-year career.

Andri stated to Vísir that when the crew arrived in the Westfjords, wind conditions were so bad that it was not possible to fly straight into Ísafjörður like usual.

With a strong north-northwest wind, it would have been extremely dangerous to fly into the fjord, but nevertheless, the crew tried twice to fly into the fjord at a low altitude. However, the zero-visibility conditions made this impossible.

A hard decision

After these failed attempts, the crew was forced to make a roadside landing in order to assess the situation further.

When the crew took stock of the situation, it was clear that they were running low on fuel. The crew had flown in a stiff headwind all the way from Reykjavík, and the multiple attempts at entering the fjord had forced them to spend more time in the air than they had planned.

The crew would not be able to make it to Bolungarvík, a village near Ísafjörur, and the location of the patient. The crew would be forced to land in Ísafjörður to refuel and pick up the patient there.

Flying with their nose in the wind

Given the conditions, the crew realised they would not be able to fly the usual way, with the wind at their back, as it would be impossible to turn the helicopter to land in Ísafjörður. The decision was made to instead fly with “their nose in the wind,” that is, backwards, for a total of five kilometres.

This, however, was not the end of the drama. Given the low visibility, flight mechanic Árni Freyr had to lead the way. With the back of the helicopter open, Árni directed the final approach of the helicopter. In a harness and partially hanging out of the helicopter, Árni led the crew like this for some 20 minutes.

Upon landing in Ísafjörður and taking on the patient, the helicopter was forced to perform a “hot refuelling,” in which the engine stays on. Given the harsh winds, it may have been impossible to start the rotors again if the engine was turned off during the refuelling process.

A life saved

The patient, who had suffered a heart attack, was immediately sent into surgery upon arrival in Reykjavík, and doctors claim he would have died without the crew’s bravery.

The story, dramatic as it is, highlights the critical role played by emergency services in Iceland. Many remote parts of Iceland become largely inaccessible during the winter. Often, there is only one rescue helicopter on call, and there have been calls to increase funding to the coast guard and search and rescue services.

 

 

Ármúli Clinic Reaches Multibillion Agreement for Expansion

healthcare iceland ármúli clinic

Ármúli Clinic, a private healthcare provider, has recently concluded a multibillion ISK deal with real estate developer Reitir to expand services, reports Stundin.

Having secured a 20-year lease, the project aims to convert the clinic into a hospital over the next two years, with a large expansion in bed space and services provided.

Rapid expansion

According to Sigurður Björnsson, the clinic’s current managing director, there has been significant growth in the last years and the clinic intends to expand operations further.

Currently, the clinic specializes in joint replacement surgeries, preventative breast surgeries, orthopedic surgery, and treatment for obesity and other metabolic problems.

The Ármúli clinic is also the only private clinic in Iceland with an inpatient unit.

In an interview with Stundin, Sigurður stated “once we have gone through this, we will truly be a real hospital in every way. There will be everything here that can be found in a normal hospital. We are tripling the space we are in.”

A 20-year lease

The clinic itself will not be investing in the construction. Instead, Reitir, owner of the Ármúli real estate, is expected to take on the necessary work of expanding the facilities. Some ISK 2.8 billion are expected to be invested in the clinic to make the necessary changes.

The project is currently slated to be completed in the second half of 2024, with an annual lease for the newly improved property at ISK 270 million. Over the period of the lease, this will represent at least ISK 5.4 billion in revenue for the real estate developer.

 

Patients Wait in Ambulances Due to Lack of Beds in ER

All of the beds in Landspítali’s emergency room at Fossvogur were full on Friday night, forcing patients to wait in ambulances until beds became available in the ER, RÚV reports.

According to the duty officer at the Metropolitan Fire Department, which also oversees capital-area ambulance transportation, it’s not unusual for patients to wait for a bed in the ER, although the duty officer was careful to say that Friday’s situation is not a common problem. Rather they stressed that paramedics provide patient care to those waiting to be admitted to the ER and room is always made for priority patients.

See Also: Mass Resignations at the University Hospital

Fourteen nurses resigned from the ER at the end of August, largely due to stress within the department.

According to Soffía Steingrímsdóttir, who was an ER nurse at the Landspítali for almost eight years, the resignations were “a long time coming. We’ve been trying to call attention to stressful work conditions and the threat to the safety of our patients for years now. Over these past two years, especially – when conditions have been unacceptable.”

At the time, hospital director Runólfur Pálsson said that hospital administrators would do everything in their power to reverse this trend. “The work conditions are extremely difficult. There’s a lot of stress, which means that people resign, which leads to staff shortages, which makes things even more difficult. It’s a vicious cycle that we’ve been trying to break.”

On Friday, nurse and assistant head of the ER Hildur Dís Kristjánsdóttir weighed in, saying the ER didn’t need to employ as many nurses as it previously did, as there are fewer patients being admitted on a regular basis.

As of September 1, the hospital’s stated goal is that no more than 20 patients should be in the ER at any one time.

Four Nurses Resign from Emergency Ward

Emergency room

Four nurses have resigned from their positions at the National Hospital’s Emergency Ward since yesterday, citing unacceptable working conditions and strain, RÚV reports. Ten other resignations took effect last March, and ER Department Head Helga Rósa Másdóttir says staffing shortages are already affecting the ward’s operations.

The emergency ward at Iceland’s National University Hospital has 30 beds. Nearly 100 patients were registered there yesterday, 33 of which should have been in other wards that could not admit them due to lack of space. Some patients waited over five hours for medical attention.

Such days have become the norm rather than the exception, according to Soffia Steingrímsdóttir, a nurse who resigned from the ER yesterday after seven years in the position. In a Facebook post, Soffia stated that she loves her job, but has given up hope that the situation at the ER will improve.

Cuts elsewhere impact emergency services

Helga Rósa told RÚV she is concerned it will be impossible to fully staff the ER this summer when many of its regular staff go on vacation. Staffing shortages are already affecting the department, which cannot utilise all of its space because it does not have enough staff to monitor the entire area. Helga says cuts elsewhere in the healthcare system come down on the ER, which ends up with patients on its hands that should be treated elsewhere but are turned away for lack of room.

Emergency ward staff have been vocal about the ward’s situation for years, stressing that staffing shortages and poor conditions put patients at risk. In 2019, a partial audit published by the Directorate of Health found neither lodging nor staffing conditions at the emergency ward fulfilled regulations and that the ward could not ensure patients’ rights regarding care. In the wake of the audit, the Director of Health recommended increasing staff at the ward, particularly nurses, as well as reviewing their wages and working conditions.