NYU Florence Rory Meyers

A common theme that I saw throughout the entire trip, that I could not go on without touching upon was the role of women. In Italy the woman is defined very differently. Given that it is such a Catholic country, I believe this has something to do with it, given that Virgin Mary is depicted in so many artistic pieces. At the Hospice we visited the nurse said that you need to be like a woman and be caring and motherly, but also like a man and be strong to be able to work in that particular environment. I found this very interesting because art is also a huge part of the culture in Italy, and in the art throughout all the years the depiction of men and women differ severely. When the children are photographed with the mother they are much more infant looking and dependent. When they are depicted with fathers or men they are unrealistically little men that are very muscular and holding up some sort of heavy object, or serving the man, or doing something that showed them as being very strong, but again not realistic. Breastfeeding is a big component of healthcare and it is something that very much seems to be normalized and expected in Italy where in the US it is often times deemed extremely inappropriate to breastfeed in public. In Italy we saw a woman trying to get her baby to latch while she was waiting for the salesman to come back with a pair of shoes for her to try on. No one batted an eye or gave a second look, and that is something that would never happen in the US. But why? It is something that is encouraged to promote the health of the infant and the mother, but yet something that is so shamed publicly. There are even several photos that exist of the Virgin Mary breastfeeding Baby Jesus. This is something that I believe needs to be more accepted in the US, it is a natural process and part of life that is encouraged from a healthcare perspective.

Looking around healthcare and nursing are everywhere and can be seen in so many places. Exploring the streets of Italy I saw so much that could mean such different things to different people, and to me I saw a lot that related to healthcare. These pictures are some examples of what I saw in street art. One reminded me of a blue bloater which is related to COPD and in Europe smoking is so prevalent among many ages. The second image shows a lot: the bones behind the flesh, surgical or pollution mask, human contact, exercise, the importance of reading and caring for people, and much more. The third picture I found interesting, and I think it is very much up for interpretation. To me I saw a faceless or mystery person that says STD; I saw this as a warning to protect yourself because you don't know based on appearance if someone has an STD or not.

To end this wonderful experience we took a trip to see Florence Nightingale's statue and of course the David! Florence Nightingale played an instrumental role in nursing and it is something that still has an impact on the nurses of today!

When we were in Sienna we went through this museum that was a Pilgrim Hall. It was a shelter but also a place in which the pilgrims could assess health care. There was also a small chapel in the basement of this now museum. On the way in there was a skull behind glass that read: "as you are I was also you: as I am you will also be you."

In the heart of Florence is Ospedale Santa Maria Nuova and it is the oldest operating hospital in the world. It was amazing to be able to see this hospital and how they took such an old building with original architecture and implemented the technology that it needed in order to be a fully functioning hospital in todays day and age. It is one of the only hospitals that has a church and this is because the hospital was built around the church. We also stopped in on the ICU floor and the wing was so colorful it instantly boosted your mood. The courtyard allowed for a lot of natural light into the building and inside there was even an art museum.

We went through the museum at Misericordia and were able to see the first ever ambulance! It was a basket that they used to put the patients in and carry them on their backs. It then progressed into carts wheeled by the medical personnel, and then eventually to something that could be attached to horseback. Now the ambulances are being electrically charged! This was such a great experience because it really highlighted how much of an impact technology has on healthcare, not only the ambulance but the tools, supplies, and systems used. The personnel that would respond to help the patients would wear these outfits with the full hoods to protect themselves from anything that was contagious.

We finished the day off in Empoli with a visit to a Residential Mental Health Facility. Here they had a program in which the guests stayed for a longer period of time, usually 6-8 months. They also had a day program in which guests could come for the day, and they came to the facility to socialize with other guests. They did performing arts, painting and drawing, swimming, cooking, and several other activities. In the residential facility the goal of the program is to help these guests to become fully functioning individuals who make a routine and are able to follow it. This is the first facility in which family involvement was not a big part of the treatment. Instead they want to learn about and how to work with their guests outside of their family as an individual. The place itself had a lot of art work around and built into the structure of the facility.

During our trip to Empoli we visited a primary care facility. Primary care in Italy is a lot different than in the US. There is no such thing as a Nurse Practitioner or a Physician's Assistant in Italy, so everything is done by the Physician with help from the Nurses. The layout of this facility was in the shape of a circle, which made it very interesting to see how the whole place was divided up. In the back of the circle there were beds in which the health care team could sleep when they were on call because the facility was open 24 hours a day. This facility provides primary care for patients and also helps their patients see specialty doctors. It is very interesting because the patients rooms are stocked with everything that they might need, and the nurses offices are in patient rooms where the examinations take place. There is also a lot of art, particularly flowers that are displayed around the office. One other aspect that is very interesting is that they have a number system, similar to what we see in the US at a deli counter, that gives the order in which the patients will see the doctor.

After visiting the Dialysis Center, we took a trip to the Dialysis wing in the hospital in Pistoia. Here it was very different than the center, but also had some similarities. Within the hospital rooms there were aspects that were extremely colorful within the rooms, and the rooms had massive windows that looked out on the courtyard, still incorporating the importance of natural light. There was a room in which the healthcare providers meet with the families and it was a library, but something even more important also happened in that room. The healthcare providers would meet with a therapist to talk about what they go through, and help work through whatever is happening at that moment. This is extremely helpful, and is something that is lacked in the US. This care and work helps to prevent compassion fatigue in the healthcare workers, especially ones who work in such a difficult field. I really loved how there was the life cycle of a plant and there were trees, that could be looked at as the tree of life. This helped to normalize death and open up the conversation of it being a normal life process. There were also birds and butterflies on the wall and this reminded me of one of my favorite quotes: "just when the caterpillar thought the world was over, it became a butterfly..."

The more places we visit the more evident art and symbolism play a role in health and healing in Italy. We went to the dialysis center in Pistoia and right when you walk in there is an extremely colorful, almost overwhelming mosaic. This actually represents the blood flow throughout the kidney, and truly is beautiful but also has such important symbolism. The floor throughout part of the center is a mosaic that represents the night, and in the middle of the whole floor is a cross - again with a major center focus being religion. There is a garden, and massive amounts of natural light coming into the center where the patients are, really helping to boost the patients moods and making them not feel like they are trapped inside. In one of the gardens there is a copper pole which is the center of the garden, and this is important because copper represents good kidney health. From a birds eye view the building is actually in the shape of a kidney, and the middle is connected by this bridge which is a bridge to save one's self. The architecture and design play such a key aspect in this facility, and really give something to not only look at and enjoy, but also something to learn about that is very relevant.

Our last stop in Prato was to a Hospice. In the Hospice Center we had a great host, who really highlighted the importance about talking about death. This is an end of life treatment, and it is truly a time in which what ever the person needs or wants in that moment is given to them to ensure the best quality of life at the end of life. One of the nurses there really highlighted the importance of self care, especially as a healthcare provider working in a facility like this. He talked about how important it is to find your outlet in which you can look at death as a celebration of one's life and not as something that is so doomed and depressing. This building used to be an old orphanage and it has a beautiful view of the city. There is a family kitchen in which the families can come in and make and eat family dinner, they allow the patients pets to come in and stay with them, and they really make the care patient centered, so the person can leave this world feeling the best that they possibly can. The rooms themselves were very colorful, and the patients were able to decorate them how ever they pleased.

In the Nuovo Ospedale Di Prato, S. Stefano, there were several interesting aspects and elements that we do not see in the hospitals in the US. In the hospital the floor is lined with a non-slip piece that aligns with the colors on the signs, in which you follow to get to where you need to go within the hospital. There were also vending machines that distributed coffee and espresso, as well as some candy bars. Within the hospital there was also a full pharmacy that sold everything from chapstick and over the counter medication to shoes for healthcare providers. There was also a beauty salon that did hair and nails. This was an option for the patients, and if they could not get down to the salon then someone would go to their room and do their hair or their nails. This is something that is so small but yet can have such an impact on healing and helping those patients feel better about themselves. Throughout the visits and just being in Italy it became very evident how important religion is, and this hospital also provided a beautiful chapel for the patients, their families and visitors to access at anytime.