History of physiotherapy at Landspítali 1967-2015

An adventure on a walk along a winding hospital path for 43 years Looking back at the Physical Therapy Department at the National Hospital in the spring of 2016

Evasion

In 1967, the undersigned returned from studying physiotherapy in Norway and took a job at the National Hospital (Lsh) together with Ásta Claessen who was also studying in the same program. In the physiotherapy program in Oslo, during those years, we also taught for the physical education teacher qualification, so we had the right to work as physical education teachers in Norway. The physiotherapy program in Oslo was connected to the University and the admission requirements were a matriculation examination and having worked in a hospital for at least 3 months. I got my hospital baptism at Ullevål Sykehus in Oslo as "krisehjelp". About 300 applied for the course and about 70 were accepted. It helped to be Icelandic! There was a lot of class division in Ullevål at that time. When the head of the department where I worked heard that I had gotten into the school, i.e. into this fine program that mainly doctors' children and Norwegian champions in sports got into, I was promoted a lot, for example I was allowed to drink coffee with the higher-ups.

There were very few physiotherapists in Iceland at that time, as all physiotherapy training had to be done abroad. Ásta and I were number 17 and 18 who registered with the Icelandic Physiotherapists Association when we started working at Landspítali in 1967. Sigurleif Hallgrímsdóttir was the first physiotherapist at Lsp, starting work there in 1930, i.e. shortly after the hospital began operating, which shows great foresight at the time.

National Hospital

I was so happy to get a job after completing my studies at such a fine institution as Lsp that I didn't even think about asking about salary. We, the few physiotherapists who worked there, didn't mind working longer than planned without getting paid overtime, we just finished what had to be done each time, it was so rewarding and fun at work . The work was varied and very interesting and we felt we had a lot to offer. Although we would have liked to know a lot more, we believed we could significantly improve the well-being and skills of patients and thereby hasten their discharge from the hospital. The physiotherapy facility was very small, two exercise benches and little equipment. A young doctor then took care of giving us sound waves to supplement his income! Soon after Ásta and I started working, the physiotherapy department got excellent, spacious and accessible premises in the basement. On February 18, 1969, a detailed article about the activities of the rehabilitation department of Landspítali was published in Morgunblaðið. It stated that 20 physiotherapists were employed throughout the country, of which 5 were at Lsp, namely Sigurleif Hallgrímsdóttir, Sigríður Gísladóttir, María Ragnarsdóttir, Unnur Guttormsdóttir and Kalla Malmquist, two positions were said to be vacant. The truth was that 5 physiotherapists were employed when the journalists arrived on site, in addition to this, there was one absentee, namely Svanhildur Elentínusdóttir, who had worked as a physiotherapist at the department since 1965, while Ásta Claessen, who was previously mentioned, had gone to the USA for postgraduate studies. The rehabilitation facility has been moved twice since then and is now in central premises at 14D, which is very close to the inpatient wards.

As a small example of the many fun things we do at LSP, we successfully danced with patients with Parkinson's disease. It was incredible to barely get them out of their wheelchairs, but when the music started, some of them literally floated with us as we danced around the exercise room.

There are many things to remember, I will mention an incident from the beginning of my career. I was training a man who had had his leg amputated. I thought the stump was rather irregular for a prosthetic leg sleeve, so I put on a rucksack and knocked on the door of Dr. Snorri Hallgrímsson, the chief physician. "Go to town," Snorri said when I shyly peeked in, he offered me a seat across from him. Then I began my speech with a shrill voice. I told him that in Norway the stumps had been wrapped in a special way with a certain elastic band to improve the shape and that I wanted to do the same. He looked at me for a long time and then said quickly, "You can try it, Karlína." I was surprised because I had rarely been called Karlína since I was accepted into school in Akureyri. It went well, the stump finally fit well in the sleeve and the prosthetic leg served its purpose. Prosthetic legs and sleeves have developed greatly since then, as have surgeries and physical therapy.

My first job at the new City Hospital (BSP) was done while I was still working at LSP. BSP called and asked for the help of a physiotherapist to treat a patient with pneumonia. I took on the job together with Sigríður Gísladóttir, the head physiotherapist. It turned out that the man in question was a good man, a professor at the University of Iceland, and Sigríður and I took turns treating him. I am not going to describe the exact methods we used, but for fun, I can mention that I was loaned a pressure cooker to generate steam at his wits' end as I tilted him, tapped, vibrated, and shook him to get the viscous, unsightly mucus out. The blessed man got better and called us his life-giver, which we used to treat him. Much has changed in the treatment of pneumonia since then.

One spring day in 1969, Dr. Friðrik Einarsson came to me to talk about the new City Hospital. He looked at me with pleading eyes and said: “If I don’t get a physical therapist to work at City Hospital, I’ll stop fixing broken old women there”. This of course led me to work at Bsp for about 3 hours after working hours at Lsp on weekdays for about three months. I then applied for the advertised position of head physical therapist there and was hired on 1 September 1969. Guðlaug Sveinbjarnadóttir, a physical therapist, was available and filled the gap.

When I left a very good colleague at Lsp, I said goodbye with these words:

I have resigned from my position.

and applied to the City Council

honestly, little sleep

due to sadness.

Higher position and higher salary

that should be called a manager

but the soul is like a peeled bean

on a large desert!

City Hospital

I didn't have to worry about the changes because I was welcomed with open arms. In addition to Friðrik Einarsson, the chief physician of the surgical department, there were Sigurlín Gunnarsdóttir, the head of the department, Haukur Benediktsson, the managing director, and Dr. Óskar Þórðarson, the chief physician of the medical department. Physiotherapy reported directly to the managing director, so communication was not complicated. The first physiotherapist I hired to work with me at Bsp, Åsta Viken, is Norwegian and had previously worked for the Support Association for the Paralyzed and Disabled. She lives in Þrandheim and we are still on good terms.

Housing and registration

When I started working at Borgarspitali, there was no special premises ready for the operation, but it had already been decided that it would be housed on the 11th floor of a tower building. This gave me the opportunity to organize it and prepare equipment. Much training was done in hospital beds, in hospitals and in corridors, but it was important to have facilities for both portable and specialized, floor-mounted equipment that the patients could be moved to. Examples of equipment in a hall in a tower include a floor-mounted walker with a mirror, pulleys, arm wheels, an exercise bike and a wide exercise bench that made it possible to train a patient to move between a bench and a wheelchair, turn around and train in various ways. A special space had two adjustable treatment benches and tents around them, tubs with hot tubs and ice tubs, electrical equipment such as short waves, sound waves and a massage device (vibrator). There was a small room for writing and sipping coffee where the window box was slightly widened and made into a "desk". Reports and the progress of treatments were written there on cards that could be placed in a jacket pocket. The doctors were informed of the progress and they / medical scribes recorded our information in the medical records. An electric neck traction device (TruTrac) was stuffed into the corner of this box, otherwise we used a lot of manual traction. Ásta and I, who were studying together, were lucky enough to have as our main teacher one of the pioneers of "manual therapy" in Norway, Olav Evjenth. He later came to Iceland several times and held courses for physiotherapists.

Tower elevators were/are small and could only accommodate one wheelchair, and it was often difficult to get them in and out of the elevator, especially if the footrests had to be raised.

Staffing

Haukur Benediktsson, the managing director, and I agreed to offer a small scholarship to attract physiotherapists in exchange for them coming to work at Bsp for a minimum of 2 years. This was very successful and we managed to get top people to work who worked at the hospital for many years, even their entire working lives. When the premises were ready in the tower in 1970, I was able to hire first one and later another unskilled assistant who was a great asset, Ragnheiður Sigmundsdóttir and Björg Jónsdóttir jumped on the bandwagon. In particular, they helped transfer patients between inpatient wards and the physiotherapy department in the tower, as well as helping with various things related to treatment and exercise facilities. I have always thought a lot of our assistants and often called them the mainstays.

We hired quite a few foreign physiotherapists to work while it was not possible to study physiotherapy here at home. Most came from the Nordic countries, many from the Netherlands but also from Germany, one from the USA and one from South Africa to name a few. It was valuable to have these foreign employees who brought with them various knowledge and cultures. I often had foreigners for dinner on Christmas Eve and Christmas Day during those years. However, they were provided with accommodation by the hospital.

Interdisciplinary collaboration

There was particularly good cooperation in the hospital as a whole, great ambition and excellent management. The work of this new hospital was taking shape and there was great enthusiasm for doing everything professionally and in the best way for patients and staff. One specialized department opened after another and experts in the various fields hired themselves out. It was a fun and educational workplace with skilled and enthusiastic staff. I remember when Dr. Óskar Þórðarson invited me to hang out in the tower elevator. It was customary to greet that person and others.

There was a lot of social activity both within the departments and collectively. The annual cocktail party was very lively. It is worth mentioning that when the event was initially held in the new large hall of the hospital's children's home, the fun didn't end until the top management had slid down the large children's slide between floors.

Learning, profession and practice

Most of them studied physiotherapy in the Nordic countries, although a few went to the UK, Canada and elsewhere.

It was very encouraging how positive the doctors at the City Hospital were in general towards physiotherapists and trusted them well. They knew about physiotherapy from hospitals abroad where they had studied and worked. Physiotherapists mostly attended courses in the Nordic countries during these years and were in good contact with professional development where they had studied undergraduate studies and elsewhere. The Education Committee of the Icelandic Physiotherapists Association provided education in various fields and often had foreign lecturers and course leaders.

In the beginning, the physiotherapist's workweek was 36 hours like in the other Nordic countries and it was agreed that the same would apply here, as the work was both physically and mentally demanding. It was agreed that work clothes would be sportier than other hospital clothes, as physiotherapists were, among other things, crawling and kneeling while working in hospital beds and on the floor far and wide! One of my favorite "nurses" once called up to the tower and said: "Call, I have to get a physiotherapist or a lifter to me immediately". There was no lifter handy so I jumped into the job. Another funny example that explained the need for "sports uniforms" is the following incident. I was coming into a hospital corridor and saw a patient falling. I jumped under him and jumped under him - neither of us were hurt! I would like to mention another light example that shows that work did not leave a person's mind during these years. I was training an elderly man after an amputation. His doctor did not think it was necessary to order an artificial leg for him, believing that the man would not be able to use an artificial leg due to his poor skills and age. I managed to convince the doctor and now I made a real effort to get the blessed man on his feet. I succeeded, because I trained him day and night! I once woke up to the fact that I had been calling out, "straighten up, straighten up" and my husband woke me up with these words, "give him a straightener, give him a straightener." The old man got to his feet and walked around the block before he left. the hospital.

Grensásdeild Bsp - 1973

It was fun to participate in the development of the new rehabilitation department at Borgarspítali in Grensás. Ásgeir Erlendsson, a neurologist (who later also qualified as a rehabilitation physician), was appointed chief physician there, but Borgarspítali's physiotherapy department was to handle the department as well as other departments in the hospital. Cooperation with Ásgeir was very good.

I fought to get accommodation on the 1st floor for physiotherapy, which was successful, but many attempts had been made to shove us into the basement of the building, where the ceiling was far too low for physiotherapy. It was decided to lay carpet tiles where there was supposed to be a gym, but had been planned as a kitchen. It was so large that one would think that there should have been a cooking school there. Various ideas had been floated about how to use the building. This was probably the cheapest solution and the carpet lasted a long time (far too long!). At its best, there were a total of 60 rehabilitation beds at Grensás on two floors and later also a day ward. Physiotherapists "rotated" between the Grensás department and other departments of the hospital. To begin with, every 3 months, later every 6-12 months, and finally they settled in the departments that they were most interested in and began to specialize in certain professional areas. We temporarily hired Susan Novotny, a physiotherapist who worked with spinal cord injuries at Sunnås in Norway, which is a specialized institution for such rehabilitation, among other things. She brought with her good knowledge from there. At the same time, Sigrún Knútsdóttir went to work at Sunnås for about a year and has continued to develop rehabilitation in this field. For a while, I worked 50% at the emergency hospital and 50% at the Grensás department, trying to keep the hospital's physiotherapy in this way. It was not possible to get Icelandic occupational therapists to work, but we managed to hire German sisters, one came from work in Norway (Sunnås) and the other from Germany, Margret and Hildegard Demleiter. They are the hospital's first occupational therapists and worked in the Grensás Department. The Grensás Department took over the long-term care unit at the Health Protection Center and rotated physiotherapists there as well.

Several times over the years we have had to fight for the existence of the Rehabilitation Department at Grensás. When the City Hospital was overcrowded, it was often ignored. We have always managed, with persistence, to convince those involved of the importance of the department for the patients and also for the operation of the emergency hospital.

Swimming pool at Grensásdeild inaugurated in 1985

We soon began to fight for a training pool at Grensás Department, which we believed would greatly improve the training opportunities for the patients. It was not until important political leaders who were listened to got to know the operation firsthand and also the great initiative that we carried the department's patients to the parliamentary platform that we managed to get funding for the pool. Sigrún and Ásgeir and I sat in meetings with architects and building contractors who took into account what we had to offer. For fun, we can mention that we prepared small mock-ups of wheelchairs and ambulances in the right proportions. We showed them the swimming pool drawing, which went well because we succeeded in demonstrating the need for more space where there was a shortage. A magnificent and very good training pool was built despite great obstacles and difficulties for the building contractors. The best north of the Alps, we always said. Yes, all's well that ends well, as they say (I recently heard that something was going wrong with this wonderful swimming pool).

New premises and remote departments

When the construction of the B-wing of the hospital, which was intended for older people, was completed, there was a lot of "smearing" about the 1st floor. With perseverance and good support from the hospital's management, we managed to get a large part of the 1st floor for physical and occupational therapy in 1986, where the activities are still housed. By then, Jóhannes Pálmason had become managing director and supported us well, like his predecessor. It was high time to move out of the tower, both because the space was far too small and it was very difficult to get patients between wards. The tower elevator was starting to become unsafe for ambulance transport, always stopping too low, too high, even between floors, and it was impossible to offer patients such a dangerous journey. The new training space was/is very good, bright and accessible.

It should be noted here that the City Hospital's Physical Therapy provided services to the day unit of the psychiatric ward at Hvítabandi, for a time at Arnarholt, the emergency department branch at the maternity hospital and the geriatric ward in Hafnarbúðir. The undersigned also volunteered several times at Landakot when there was a need for physical therapists. Later, the palliative care department and Kleppur were added to this list Bsp/ SHR /LHS

Committee work and staff services

Physiotherapists have been active in the hospital's social and organizational work, three have been chairmen of the staff council (Kalla Malmquist, Sigrún Knútsdóttir and Guðlaug Pálsdóttir) and two of the council's representatives have been on the board of the Reykjavík City Hospital (KM and SK). Physiotherapists have provided services to patients in all departments as well as to staff. Staff physiotherapists have carried out preventive work through education and training to combat occupational diseases. Physiotherapists have also offered fitness classes for staff at the end of the working day for years. The undersigned served for several years on the Ethics Committee of the Bsp.

Speaking of sitting on committees, the Mountain Women (a group of physiotherapists who studied abroad before physiotherapy was taught in Iceland) who performed at many of FÍSÞ's annual festivals included the following:

(song: Kalli á Hóli)

Who sits on committees and leads them boldly?

She Call, Call, Call, Call at Borgó

Who appears on television and breaks down?

She Call, Call, Call, Call at Borgó

Who is the best here in the Nordic region?

Who walks around town very out of their mind?

and then doesn't know me or you at all?

But she's Calling. Which Calling? Oh she's Calling

Now, she's calling. Yes, she's calling, calling, calling, calling Borgó!

(Unnur Gutt)

Sports

Physiotherapists participated in the Nordic Hospital Games several times on behalf of the hospital and sent a volleyball team that always won medals. Of course, we thought the gold medal was our favorite! Physiotherapists were also in key positions in the women's handball team at the same games, which also always won medals.

Physiotherapy at the University of Iceland (HÍ) – vocational training/clinical teaching

It became clear that it would not be possible to get enough physiotherapists to work in the country unless it was possible to pursue undergraduate studies in the profession here. The Icelandic Physiotherapists Association fought for the program to be included in the University of Iceland, under the leadership of its chairman, Sigríður Gísladóttir. Many physiotherapists from Galway supported Sigríður in this fight, as did Haukur Þórðarson, a rehabilitation physician. Physiotherapists Mária Þorsteinsdóttir and Guðlauga Sveinbjarnadóttir should be mentioned in particular. They went to Canada, among other places, on behalf of the Ministry of Education and the Ministry of Health to study university studies in physiotherapy, where it was considered exemplary. The University of Manitoba subsequently sent an advisor to a committee in the Ministry of Education and later a teacher who initially taught the program for one year. In 1976, a four-year B.Sc. program began at the University of Iceland. and Ella Kolbrún Kristinsdóttir, who had just returned home after studying and teaching physiotherapy in the UK, was hired as program director. Subsequently, an agreement was reached between Bsp / physiotherapy and the University of Iceland for clinical studies at Bsp. as well as at Lsp. Several physiotherapists from Borgarspítal and Lsp also became part-time teachers at the University of Iceland.

Reykjavik Hospital (SHR)

City Hospital and Landakots Hospital were merged into Reykjavík Hospital in 1995. Opinions were divided about the whole process, and I particularly noticed that the staff at Landakots felt that they were being taken advantage of.

Landakot was now to be used for geriatric services with an emphasis on rehabilitation, and very good premises were prepared for physiotherapy and occupational therapy where the Chapel had previously been. The beautiful chapel windows are still there to show. It was very exciting to be able to participate in designing that training building with the hospital's architect, along with Jóhanna Óskarsdóttir and Jarþrúður Þórhallsdóttir, who had shared the position of chief physiotherapist at Landakot. Now the chief physiotherapist at Borgarspítali was also to oversee physiotherapy at Landakot. The result was that the chief physiotherapist of Landakot kept her position (Jóhanna/Jarþrúður, Bergþóra Baldursdóttir - Jóhanna), the chief physiotherapist of Borgarspítali became the chief physiotherapist (KM), another chief physiotherapist was hired at Borgarspítali (Sara Hafsteinsdóttir) and the assistant chief physiotherapist who worked at Grensás Department became the chief physiotherapist there (Sigrún Knútsdóttir), who was in turn the chief physiotherapist at the large facilities and the chief physiotherapist to take care of the joint operation of SHR physiotherapy. It should be noted that these chiefs all continued to work in the treatment of patients in their administrative positions and worked very well together and supported each other in the management and staffing of these four facilities.

I am not sure who the first physiotherapist was at Landakot, but I imagine that the German nuns hired a German physiotherapist to work there at one time. I am told that various physiotherapists, both foreign and Icelandic, have worked at Landakot temporarily in the past. However, I do know that Ingrid Grödum, our school sister Ásta Claessen from Oslo, came to Iceland after completing her studies in 1967, hired herself at Landakot and worked there for almost a year, and María Weixelbaumer worked there from 1970 to 1972.

Following Sigríður Gísladóttir, many physiotherapists have taken on the position of chief physiotherapist of Lsp at Hringbraut for varying lengths of time over the years. These include: Ásta Claessen, Unni Guttormsdóttir, Ella B Bjarnason, Lise Bertelsen, Bryndís Guðmundsdóttir, Guðnýja Jónsdóttir, Valgerði Gunnarsdóttir, Guðrún Sigurjónsdóttir and Örna Harðardóttir. Guðrún was for a time on the board of Lsp's staff council and on the committee on electronic medical records.

Landspítali University Hospital LSH

The merger continued and Reykjavík Hospital and Landspítali were merged in 2000. The Chief Physiotherapist (signed), was a representative from SHR and Guðrún Sigurjónsdóttir, Chief Physiotherapist, was a representative from LSH in a working group on rehabilitation that was assigned in May 1999 to make proposals for the scope and operational arrangements of rehabilitation services at LSH and SHR. During the group's tenure, the hospitals were merged, i.e. in 2000, and a service agreement for rehabilitation was concluded. Rehabilitation then became a separate field within LSH.

The Chief Physiotherapist of LSP (GS) became the Director of the Department together with Þórdís Ingólfsdóttir, a department nurse at Grensás, and Stefán Yngvason, a chief physician at Grensás. The Chief Physiotherapist of SHR (KM) became the Assistant Director of Training, etc., and this was a follow-up to the consultation with a working group on the strategy of the rehabilitation department, which produced a report, “Rehabilitation in the New Age” in November 2001. Bergþóra Baldursdóttir was the chairman of the working group. Arna Harðardóttir was appointed Chief Physiotherapist of LSH at Hringbraut. Arna later took maternity leave and the undersigned replaced her. When the Director of Training left to work outside the hospital (at the Ministry of Health), the undersigned was appointed Director of the Department in her place. Thus, the arrangement continued in harmony and with particularly good cooperation between the managers in physiotherapy who also worked on the treatment of patients as before.

Two physiotherapists have been on the board of the LSH staff association, Arna Harðardóttir as chairwoman and Hólmfríður Erlingsdóttir, secretary.

Postgraduate studies

The hospital's physiotherapists have been diligent in attending a variety of courses in the profession in Iceland and abroad, and we like to make sure that everyone has a few professional books and journals on their bedside table. But now the world is different and everyone is online! In addition to a variety of courses, conferences and world congresses, the undersigned attended a course in Management and Operations in Health Services at the University of Iceland (Institute for Continuing Education). It was very useful in my multifaceted work in physiotherapy, management and countless councils and committees within and outside the hospital, which often focused on physiotherapy and or holistic rehabilitation. Guðrún Sigurjónsdóttir was with me in this course and we worked on exciting projects together. Several LSH physiotherapists have received master's degrees, two have completed doctoral studies and two more are in the final stages. Several have also completed diploma studies in various fields and quite a few have received specialist recognition. Two physiotherapists have served on the LSH Ethics Committee, namely the undersigned and Ólöf Ámundadóttir.

Glens 

At the LSH annual festival in 1997, 10 physiotherapists, Taumlausar Teygjur, performed the musical "The Big Hospital" with music from Little Horror Shop under the direction of pianist and arranger Aðalheiður Þorsteinsdóttir, who arranged and played the music.

Steina Ólafsdóttir made a splash in a black continuum with a whip when she sang to the dentist's tune:

Tear off your stiffness

and I find myself in that profession

repair the joints

and get out of your torment and pain

When I go out to pull your leg

You weep as if you were in the flames of hell.

and even though the customer is not happy

I know that with his harp on a high cloud

Mom is proud of me.

Because I'm a coach, a complete failure

say eh, say oh, say oh and then shrug.

(Sun)

The musical made fun of the merger, the closure of departments, the roundabout, the flow, management and physiotherapy, a weak patient was followed between departments until he ended up at Landakot - "At Landakot the old people heal" - as was sung with emotion.

(Yes, a lot of things were done for fun!)

Finally

All LSH division managers were dismissed in 2009 and offered jobs in their respective fields, the number of divisions was reduced and a general manager was appointed for each operating division. Rehabilitation was placed under the supervision of Vilhelmína Haraldsdóttir, MD and general manager. Then the undersigned packed up and decided to retire at peace with God and man!

When this is recorded in March 2016, there are 76 physiotherapists employed at Sukrathið LSH in 65 full-time positions, 7 specialized workers in 6 full-time positions, 4 paramedics in 3.3 full-time positions and 5 secretaries in 3.6 full-time positions.

Ragnheiður Einarsdóttir, chief physiotherapist at Landspítali Hringbraut, is now the chief physiotherapist at LSH, with physiotherapy supervisors at each facility. LSH physiotherapists have added expertise in various areas. In addition to the above, two physiotherapists are also employed in the human resources department, Bergind Helgadóttir, staff physiotherapist, and Hólmfríður Erlendsdóttir, who is the chairman of the LSH safety committee and on the board of the staff association. In addition to them, Arna Harðardóttir works in the economics department, she is a project manager in the finance department and handles registration issues. She is the editor of the medical record and the quality manager of health information for the Director of Health. Kristín Gunda Vigfúsdóttir is a project manager in the quality and infection control department and is also involved in financial projects. She completed a postgraduate degree in health economics.

Quite a few physiotherapists have contributed to the drawings of the "ever-changing" new Landspítali since the initial signing, which refers to discussions about the size and location of the space for physiotherapy.

We are still waiting to see this long-awaited hospital built!



Hopefully, with this story I have succeeded in drawing attention to how active physiotherapists are and have been in the hospital's operations as a whole.

Call Signý Malmquist, physiotherapist, (chief physiotherapist, head physiotherapist, assistant to the director of the rehabilitation department, director of the rehabilitation department, retired).