Thursday 2 April

We have now had a state of emergency at the health center for 3 weeks. I am happy that the Norwegian Directorate of Health came up with new guidelines for how we should work during this period. We usually have 15 regular contacts with children before they start school. They are followed up with vaccinations, weight, nutrition, motor development and upbringing environment. Now it has been reduced to only vaccinations and follow-up of newborns after they return home from hospital. That is now there are 5 permanent contacts to be followed up. We will also follow up families who have additional challenges.

We work so that some days we are at home with a home office to minimize infection in the working environment. Then the others are on duty and take care of the consultations at the health centre. This is only the beginning and I will have to settle for working elsewhere such as in nursing homes or other institutions in the municipality if the need arises. Some of my colleagues are on the information phone for the population in the municipality - the so-called "Corona phone", and they work with infection tracking.

Our professional group has had the experience of strengthening our original role as prevention and infection control workers during this period. Health nurse - before Health nurse, has worked with infection control work and vaccination work for decades, with a long historical background. It will be exciting to see what kind of role we get when, hopefully, a vaccine against Covid-19 is developed.

I find myself doing an important job of maintaining contact with newborns and their families and not least maintaining the child vaccination programme. It must absolutely be the first priority and keep the child population healthy from the diseases we vaccinate against. I think e.g. on polio, which caused fear in the 50s and which left many with accompanying symptoms and illness afterwards. Whooping cough is also a disease that spreads quickly. We also have measles which requires a high herd immunity in order not to spread.

We forget that we are so lucky and to be almost free from such diseases today, when we have an effective vaccination system with reporting and a government overview of vaccination coverage in the population. Perhaps we take it for granted? But now we get to feel on our bodies being threatened by something we don't see, but which we know is dangerous. We have no remedy for that. Wonder if we will get this thing with vaccines back into consciousness after this? In any case, I notice at the health center now that the parents are happy that they can now come and get the vaccine at the recommended time and that it has not been postponed because of the situation we are in.

Friday 3 April

I am at home because cold. Normally I would have been able to go to work with mild symptoms, but now it is strict and I cannot go to work until I have been symptom-free for a day. I work a bit in the home office and have gained access to the municipality's website and records system. It feels strange to work from home as work is usually so present with children laughing and crying, playing, talking to parents and commitment. I miss that.

So far today, I have followed the e-mail where we have been presented with the duty plans for Easter. We plan, cancel and send out new hours with information about the infection control measures at the health centre. A mother calls and wants advice on diet as the groups we usually have which deal with this topic have been cancelled. She greatly appreciates being able to receive guidance on the phone. I know with a little useful even if I'm at home.

Tuesday 14 April

Today we are back in full swing. Since it has been closed for Easter, we have many visitors today. We organize ourselves so that we have a person in the waiting room who makes sure that the "queue" runs smoothly from the doctor to us and that they are not left waiting in the same room. We have many 6 week old babies today since the doctor is here and this is the only doctor contact that is maintained in the changed guidelines.

Wednesday 15 April

We have just finished a small morning meeting (with plenty of distance) before today's tasks await. Today there are more people in home offices and there are therefore fewer people at work. We are looking forward to tomorrow's information from the Norwegian Directorate of Health on the new guidelines that schools and nurseries must comply with when it comes to their reopening. It is conceivable that this will have consequences for our operation and that we can return to a more normal health center program with certain precautions. We plan week by week and send out messages to parents about changed attendance times, infection prevention measures when they arrive and if they have questions or concerns, they can call us. I have already received signals that several parents are worried about whether they should dare to send their children to kindergarten and they are also waiting for what measures will be implemented. There will probably be a number of questions afterwards from parents that we must be ready to answer.

Monday 20 April

On Friday, there was a recommendation from the Directorate of Health regarding the restoration of normal activity at the health centre, in the school health service and maternity care. The school health nurses are going back to the schools and we at the health center will follow the normal health center programme. Our challenge will be to have a large enough distance in the waiting room, cleaning between each user and at the same time be able to have as many consultations as usual. In addition, we have had reduced operations for several weeks and we have many children who have not had their health checked by a doctor or health nurse. These are still pending. There is no mention of how we will get up to date with this in the new recommendations. The dilemma is to have few people in the premises for infection control reasons, but ideally to have full operation. Today, we have tried to imagine how we are going to solve this going forward and how we are going to achieve practical implementation. The guide for those who have one-to-one consultations such as physiotherapists gives us good information, but it requires time and space. During the week, we expect to have a plan for implementation, but there is still much that is uncertain.

Tuesday 21 April

We are awaiting word from the crisis management in the municipality as to when we can start approximately normal operations again. For the time being, we are doing as in previous weeks and have vaccinations and other necessary follow-up. I know that it is demanding not to have a clarified work situation and not to know exactly what is happening from week to week. In a way, it is a comfort that most people feel this way in their everyday working life and I notice that the parents we are in contact with have a great understanding of the measures we have put in place.

Wednesday 22 April

The municipal kindergartens in Tønsberg municipality opened yesterday. I experience a generally positive attitude towards this both in the local media and among parents here. We stand behind the health authorities' recommendation to send the children to nursery school and school and that this is safe with the measures that have been put in place.

Thursday 23 April

The National Group for Health Nurses in NSF is streaming live on Facebook today and talking about the new recommendations that came on Friday. Many useful questions were answered there. It was clarified that the recommendations are indicative as it is up to each individual municipality to see what kind of capacity they have to resume full operations. We in Tønsberg will get an answer tomorrow from the crisis management about how our municipality will solve this.

Friday 24 April

We have received the go-ahead from crisis management in the municipality to resume operations in accordance with the Directorate of Health's recommendations. We will continue to refrain from having group offers and home visits.

Monday 27 April

We are back to a more active operation at the health centre. There is now more activity here as we will try to bring back some of the controls we were unable to take from 12 March when operations were reduced to a minimum. There are good guidelines for what should be prioritized and there are quite a few children who are going in for a doctor's check-up here. We start with the youngest first. We have now got the infection prevention measures in place to welcome more people and have started contacting those who will come to us. This takes a lot of time. At the same time, it is very nice to know that we are more up and running again. Parents have started to send their children back to kindergartens and today is the first day at school for those in grades 1-4. class. I have the impression that the parents are a little relieved that they can return to a more normal everyday life, while at the same time expressing excitement for what will happen next.

Tuesday 28 April

Today I am thinking about creativity. From a routine working day, we see new sides in colleagues who come up with good creative solutions and can see details of how we can solve new challenges. It will be valuable to take with you when everyday work is normalized sometime in the future. There is now a decrease in activity on the Koronaltelefonen at the weekend and weekdays. Maybe people are starting to relax and adjust to a new "normal everyday life"? I can get that impression from the people I talk to here.