How nurses nurse in Israel

Published: 08 December 2011

Jayne Etches was off to the holy land late last year on a fact-finding missing.

Middle Eastern culture has fascinated me since I was at school so I was very excited (and a bit apprehensive!) when I found out I had been awarded the community nursing representative place on a trip to Israel.

Jointly funded by the Israeli Ministry of Health and the Israeli Government, the trip was a fact-finding mission, with the aim of examining and comparing health care provision in Israel.

The whole visit was amazing. Not only to experience Middle Eastern culture, but also to spend time with different nurses from the UK. My colleagues included directors of nursing, a nurse consultant in cancer care, nurse lecturers and the Department of Health Informatics Lead – all of them so enthusiastic and eager to share their knowledge and experiences.

Sightseeing then down to work

The visit started with a five hour tour of Old Jerusalem, visiting sites of interest to Jewish, Muslim and Christian faiths. I could have done with a 4D camera to capture everything. I remember a walk through the Garden of Gethsemane, the smell of jasmine and spices, the sound of the Muslim call to prayer and the hot hot sun.

 It was fascinating to see Israeli primary care in action. IT is the backbone of health care provision - for example, telemonitoring for med prompts. This involves an electronic dossette used with pressure pads which alerts a central hub if meds are not taken. They can use Skype in wound assessments, gaining opinions of an endocrinologist, a vascular surgeon and dermatologist to view wounds remotely and thus replace costly OPA.

Open all hours

Video conferencing is used to discuss patients. Out-of-hours care can be provided from the nurse’s home so there are low overheads and thus more staff. Internet forums are used to provide Q&As for all types of care.

The Israelis have a very structured approach to chronic disease management, which is a 24 hour access from a specialist nurse. This is available via a multidisciplinary team regional call centre with centralised records and daily monitoring of parameters.

Training is via e-learning and a Medical Simulation Unit, a suite that uses real equipment and scenarios for students. These are recorded and played back to the students who are to be assessed so they can reflect on and then discuss the scenario.

Some things we do better

Health care in Israel is not funded through a national insurance system, but instead through a choice of three insurance companies so not all the facilities on show were available to all.

I learned so much, but I took so much to them as well. Nurses in Israel appear to have little autonomy, and they were impressed by our decision making ability and use of clinical skills.

 All in all it was a great trip – a once in a life time opportunity.

 Jayne Etches is a clinical lead for district nursing in Stockport.