How did our educational tour to Croatia end?

On the last day, we talked to Mario Gazić, President of the Croatian Chamber of Nurses. The Croatian Chamber of Nurses admits medical professionals to work in nursing and maintains a register of nurses. Representatives of the Chamber are authorized to issue and confirm the license for nursing work, so membership is mandatory. The Chamber was established in 2013 and currently includes 38,500 nurses in Croatia.

The institution is also involved in defining professional standards and qualifications of nurses and regularly updates brochures of the professional qualifications of different nurses and the diagnoses they can make. Mario was happy to share these brochures with our participants. So, if you are interested to learn about their content – the full set is now available at the Chortkiv PHC team and on the Chamber website -> https://www.hkms.hr/ 

Палата займається також розробкою й втіленням стандартів, змісту та процедур БПР у Хорватії. Для продовження ліцензії на професійну діяльність хорватьські медсестри зобов’язані кожні шість років набирати принаймні 90 балів БПР (по 15 балів щорічно). Плани та активності БПР розписані для 21-ї області, а медсестри можуть відвідувати будь-які з них, незалежно від місця проживання чи практики. З часів пандемії COVID-19 доступними стали й онлайн-заходи БПР. Як кажуть хорватські медсестри: «Тільки лінивий не набере 15 балів щороку!» Якщо комусь таки вдалося набрати менш ніж 15 балів, Палата дає можливість заново скласти екзамен для продовження ліцензії.

The Chamber is also engaged in developing and implementing standards, content, and procedures of CPD in Croatia. In order to renew their professional license, Croatian nurses are required to gain at least 90 CPD points every six years (15 points annually). CPD plans and activities are scheduled for 21 regions, and nurses can attend any of them, regardless of their residence or practice. Since the COVID-19 pandemic, online CPD activities have also become available. As Croatian nurses say: “Only the lazy will not score 15 points yearly!” If someone still scored less than 15 points, the Chamber allows retaking the exam to renew the license.

We looked at the list of topics for discussion and were pleasantly surprised by their diversity. Here is just a short list:

• knowledge and attitude of medical workers and the general population to vaccination against COVID-19,
• breastfeeding,
• wound management,
• care for patients with dementia,
• prevention of medical errors,
• cardiopulmonary resuscitation procedures,
• stress and burnout,
• use of personal protective equipment to prevent infections, and much more.

Membership fees to the Chamber are 0.3% of the nurses’ salary. If a nurse is not employed, she does not pay a membership fee but does not terminate her membership. It is important that through membership in the Chamber, nurses feel protected.

The mission of the Chamber is to protect patients by ensuring nurses’ quality, responsible and ethical work. Therefore, representatives of the Chamber adhere to a specific code of ethics. If members violate the code’s provisions, the Chamber representatives can suspend or terminate the nursing license entirely.

In the afternoon we visited the Hrvatska liječnička komora. This is the Chamber of Physicians, which was established more than 100 years ago. Its activities are similar to those of the Chamber of Nurses: it also maintains a register of doctors, admission to the profession is through licensing, and much attention is paid to CPD and compliance with professional and ethical work standards.

In communication with the representatives of the Chamber of Physicians, we were impressed by how much attention they pay to nurses and with what gratitude they speak about their role and work: “Nurses in family medicine practice are the engine that drives about 70% of all work. Yes, they may have somewhat limited functions in MIS, they are the same as doctors, as equal members of the team”.

Currently, the Chamber unites about 20,000 doctors: 16,000 have an active practice, and three thousand are primary care doctors). Even though four medical universities in Croatia graduate 570 doctors annually, the country, like the rest of the world, needs more specialists in primary care. Only some of the graduates go to work in primary care.

In the medical Chamber, unlike the nursing chamber, there is a fixed membership fee of 17 euros per month. Doctors of retirement age can pay only 50% of the amount.

Finally, we created a space for reflection for Ukrainian participants. They discussed the experience gained in working on cases: managers, doctors, and nurses together thought about possible changes in the distribution of responsibilities of doctors and nurses in Ukrainian primary care, taking into account the Croatian experience. We are incredibly grateful to our Croatian colleagues for their exciting experience and new insights.

And during the fellow dinner, we were incredibly touched when Tatjana Prenđa Trupec read us a symbolic poem in Croatian about a small drop that forms the ocean. Don’t be lazy to go to the translator and translate these touching lines:

Dobriša Cesarić

Slap

Teče i teče, teče jedan slap;

Što u njem znači moja mala kap?

Gle, jedna duga u vodi se stvara,

I sja i dršće u hiljadu šara.

Taj san u slapu da bi mogo sjati,

I moja kaplja pomaže ga tkati

Taj san u slapu da bi mogo sjati,

I moja kaplja pomaže ga tkati