Country Profile Finland

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Country Profile – Finland

Subject matter

Country Information

Name

of full occupational

title of the target group

e.g. Health Care Assistant (HCA)

Licensed Practical Nurse (LPN)

Next to the licensed practical nurse, there exists also the group of employees being called care assistants. Care assistants have no official education, therefore they are not allowed to work with the occupational title. Many of the care assistants have studied parts of the practical nurse education. In Finland, it is permitted to do only some parts of the education with no final exam. Those who don’t complete the whole education, directly enter working life.

Regulation for Target

Group / Legal Aspects:

Regulation

Regulations below Registered Nurse! The following questions or categories should be specified separately:

1. Information relating to what is regulated (e.g. education, employment) no details of the content (e.g. single tasks or duties)!!!

2. Who regulates

3. Sources of regulation (e.g. laws or decrees) with their official names 4. History of regulation (if provided)

1. The licensed practical nurse’s education is regulated and a license to practice is required. [Survey 1/1.2] Moreover, the prerequisites for an authorisation depends on the applicant’s citizenship and where the applicant was initially trained. Due to the fact that there is a compulsory educational preparation for that occupational group and the qualification is recognized nationally, a person that has dropped the education cannot work as a licensed practical nurse. The compulsory educational preparation is called Vocational Qualification in Social and Health Care. In contrary, care assistants don't have an official education system. A care assistant may work even without authorisation from Valvira in similar fields as a licensed practical nurse, but he/she is not allowed to use the title licensed practical nurse. [Situation Statement].

2. The institution which authorises the regulation is the National Supervisory Authority for Welfare and Health (Valvira). 3. Sources for the regulation of the target group such as laws, decrees or edicts, codes of conduct:

a) Vocational Education and Training Act (630/1998) b) Vocational Education and Training Decree (811/1998)

c) Vocational Adult Education Act (631/1998); Vocational Adult Education Decree (812/1998) d) Curriculum:

http://www.oph.fi/download/137639_vocational_qualification_in_social_and_health_care_practical_nurse_2010.pdf

[Survey 2]

4. The regulation for the practical nurse dates back to 1987 and has been revised twice since then. The current valid form of training/education for practical nurses dates back to the year 2010.

Registration

1. Is there any?

1. Yes there is a compulsory registration for licensed practical nurses.

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2. What institution does it? registration body is the same as the licensing body) [Survey 1/1.2]

Governmental Supervisory

Control

Accountable to whom?

The National Supervisory Authority for Welfare and Health is the overall control institution. In each territory of a province the activities of health care professionals are guided and supervised by the competent Regional State Administrative Agency. [Survey 1/1.2]

Education:

Education objectives

(knowledge, competencies,

capacities, skills, future

rights and duties)

Education objectives of the qualification should be identified and communicated in English by the country experts without shortening of content (plain original text parts please) if available by an official curriculum or another source of

information. The project team can filter the text respective knowledge, competencies, capacities, skills, future rights and duties afterwards.

The completed vocational qualification in social and health care enables practical nurses to work with and for people. In order to master their professions’ core tasks which is to deal with the connections between the patient, his psychosocial and physical environment and the society, the key learning objectives of practical nurses are to know how to meet clients and patients of different ages and promote their health and well-being through their actions. In detail this means:

• That they can help and guide the client and patient, based on the client/patient’s resources, individually and equally in everyday situations,

• That they can guide the client and patient in maintaining his/her functional abilities, as well as in his/her regular lifestyle, e.g. nutrition, physical exercise and life management.

• Based on their knowledge, they can guide and support their clients and patients in applying for and using different welfare services and, when needed, they can refer their clients/patients to various peer support organisations.

Moreover, practical nurses can use their extensive social and health care competencies in different settings and in working with clients and patients with different cultural backgrounds, as well as with their families.

• The practical nurses’ extensive social and health care competencies enable them to move flexibly between different tasks in the field.

• In their work, they use more specialised skills in accordance with their study programme or specialisation.

• Practical nurses work systematically and flexibly in changing situations and they can make choices and decisions creatively. • They abide with the values of the field of social and health care.

• They are able to recognise, deal with and solve ethical problems in their work and comply with vocational ethics. • Practical nurses work in a responsible and fair manner, in accordance with their rights and obligations.

• They are primarily accountable for their work to the client, but also to the society.

Practical nurses maintain their vocational skills by staying updated with vocational developments, improving and consolidating their vocational expertise through further training or seeking admission to further studies.

Practical nurses look after their own ability to function and work, their occupational well-being and the constant development of

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Additionally, practical nurses encounter their clients holistically, humanely and tolerantly. They respect the ideology, values and experiences of their clients and patients.

• They pay close attention to client and patient safety, prevent accidents and work in a safe and ergonomically correct manner. • They can recognise threats of violence and its different forms (e.g. domestic violence) and they participate in the prevention of

violence and marginalisation.

Practical nurses have the skill to work in a client-based manner with disabled clients or patients (incl. people with impaired vision and/or sense of hearing), promote their functional abilities and guide them in the use of aid-devices and in the rehabilitation service system of the social and health care field. They participate in the promotion of health and in preventive mental health and substance abuse welfare work, as well as in the prevention of common diseases, both for individuals and communities.

• Another skill ist that they can exploit technology in their own field, including information technology. They are capable of embarking on entrepreneurship and working in networks and multicultural settings. They are capable of paying attention to the environmental and economical impact of their actions, and work in an economical and effective manner, not forgetting high quality.

• They comply with the principles of sustainable development in their work.

• They possess the skills of lifelong learning and are able to acquire and apply new information in their work and justify their decisions.

Practical nurses are able to work in multi-disciplinary and multi-cultural teams and projects.

• They can cooperate constructively with different vocational groups and communicate appropriately in different situations. • They exploit their vocational, interactive, human relations and negotiation skills, as well as their language proficiency at work. • They utilise peer support between client and patient groups and members of the work community.

Practical nurses pay attention to the aesthetic aspects of their working and living environment, as a factor which promotes wellbeing.

Training process and

duration

1. How is the training process designed in timely manner? 2. Is there full time or part time

education, also work-based learning?

1. The training is designed to last 3 years of full time study (120 Credits). In the first 2 years all participants have common classes and study the same courses. In year 3, students can choose out of 9 different elective courses for their major(further information will be provided in the curriculum). For instance one can either set a major in caring old people or working in rehabilitation. Practical nurses are even able to work in kindergardens and special schools due to their broad education. However, the majority works in hospitals and nursing homes caring for old people. Later on, one still has the chance to specialise in another field of work. So in case a person is tired of working in one of the major education fields, he/she has the opportunity to specialise in another field (e.g. youth care or kindergarden). [Survey 1/1.2]

2. The usual way is a full time education; an education in connection with a working contract is also possible – in this case it is part time education.

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Curriculum

1. Is there any curriculum? If yes, what is its content?

2. Does it cover theoretical as well as practical parts of education? 3. What is the relation between

practical and theoretical parts? 4. In what kinds of facilities does the

practical part take place?

1. There is an official curriculum. The National Board of Education has drawn up the national core curriculum. The education is designed in total about 3 years and it is divided into two parts [Situation Statement]

The first 2 years of the Vocational Qualification in Social and Health Care consists of 120 credits where participants learn: 1. Support and guidance

2. Nursing and care 3. Rehabilitation support

In the 3rd year, students can choose between 9 different elective vocational parts. 1. Emergency care (paramedics)

2. Rehabilitation

3. Childrens’ and youth care and education

4. Mental health and substance abuse welfare work 5. Nursing and care

6. Oral and dental care 7. Care for the disabled 8. Care for the elderly

9. Customer services and information management

2. The curriculum is subdivided into a practical and a theoretical part. The training includes a minimum of 29 credits of on-the-job learning in practice

3. The duration of the practical part of the education is half a year (29 credits). The goal is, that the practical education gives concrete knowledge to all parts of theoretical education for practical nurses. Places are mainly organized by the education institution, and the supervisors are also trained by the education institution. Students are not paid for the time of practical education, because they are still contracted as students.

4. In principal, all kind of facilities, which have working places for practical nurses, can also be places for the practical education for this group. The education institutions are obliged to offer their students enough places for practical education.

Examination

1. State examination, officially recognized or internally organized examination?

2. Practical, written or oral examination?

1. The examination is officially organized and recognized. There is an officially prescribed examination in the valid Decree on Vocational Education and Training. Due to this assessment scale, students receive their grades in terms of a qualification certificate. Next to the official examination, there also exists the possibility to drop the education and enter work life immediately without the occupational title of a licensed practical nurse. This group works as care assistants and is not registered as licensed practical nurses.

2. The examination has a written part (thesis), a practical part by a skills demonstration (usually at the places of the student’s practical training) and an oral part. Competence is being assessed by using the assessment methods which suit the study methods and support the student’s learning process. The students must have an opportunity to show their competences in various ways and also to assess

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their competence themselves.

Skills in vocational modules are assessed using a skills demonstration and other ways of assessing competences. A skills demonstration is used to assess the competence determined in vocational skills requirements as widely as possible but at least what the qualification requirements state. If necessary, other forms of competence assessment supplements the competence necessitated by skills requirements. The education provider decides on the other methods to assess competence in its assessment implementation plan. The students’ mentors are responsible for that assessment and have received a special training in assessment methods.

Funding of the education

How is the training funded:

a) public funding (eg taxes, national bodies)

b) private funding (eg insurances, private employers)

c) self-funding (eg personal monies) or d) mixed funding source (please specify)

The education of practical nurses is publicly funded, when the trainees are in the role of students. Another possibility is to conduct the education employee with a special contract in which the education is included. In this case the trainee is paid by the employer (the pay is about 15 % less than that of a graduated practical nurse), but the theoretical training of the practical nurse education is still funded publicly then. Trainees of the second ‘model’ typically have already a lower degree of education and longer working experience.

Field of Operation:

Areas of Employment

1. Areas of employment respective

occupational areas should be listed here and may be differentiated according to caring for

patients/clients in their own homes, community settings,

nursing/residential care homes and hospital settings.

2. General development regarding the areas of employment and the “care market”.

1. Practical nurses work in the fields of nursing, care, education and rehabilitation in the social and health care sector. Currently, the major part of practical nurses works in the public sector and is employed by municipalities. In the future, more will be working for private services or as self-employed professionals. [Survey 1/1.2] More concretely, the licensed practical nurses are working at health centers, hospitals, retirement homes, service centers, private homes and in private health care and social services. [Survey 2]

2. In the future, the range of workplaces offered to that occupational group will even rise. Caused by the fact that thousands of health care workers will retire in the near future, new employees are needed to ensure the availability of health care services. Another fact is that the ageing population and the need for social and health care services will increase. The proportion of care for the elderly will increase and diversify to a significant extent. There will be also a need for lifting the retirement age. Well-being at work will play a more important role. [Situation Statement]

Tasks and duties

The tasks and duties can be subject to regulation, but don`t have to be. They should be described here in detail and be set in relation to the areas of employment if they differ respectively.

Duties of the target group employees:

• know how to guide patients or clients in issues relating to nutrition, healthy lifestyles and maintenance of functional capacity; • know how to provide pharmaceutical care;

• promote individual patients’ or clients’ interaction with their environment and in activities of daily living; • be able to work ergonomically and in compliance with the principles of business operations and sustainability;

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• be able to function proactively, co-operatively and in a quality-conscious and service-oriented manner; • know how to make diverse use of information technology in their work;

• be able to assume responsibility for their own work, assess their own work performance and develop their vocational skills; • be able to manage work-related interactive situations in one foreign language and both national languages [Survey 2] A broad list of skills, competences and tasks is also provided in the country profile’s sector “educational objectives”.

Skills and competences

required / demanded by

workplace

In comparison to the description of educational objectives (certain knowledge, skills, competencies etc.) above here we concentrate on the actual demand / requirements of the workplace.

Most important skills needed:

• be able to function independently and as members of multidisciplinary networks

• know how to guide and assist clients and patients in an individual, equal and resource-driven manner; • know how to provide instruction on maintenance of functional capacity and healthy lifestyles [Survey 2] • act in a holistic, humane and tolerant manner in their work

A broad list of skills, competences and tasks is also provided in the country profile’s sector “educational objectives”. A further requirement to work as a licensed practical nurse in Finland is to have good language skills in one of the two official languages (Finnish and Swedish). All applicants need to study Finnish but only some of them need to show an official language certificate to Valvira. [Source:

http://www.valvira.fi/en/licensing/professional_practice_rights/licensed_practical_nurses]

Independence and

organization of work

Some of the practical consequences of regulatory issues can be described here. If the occupation is not regulated the organization of work and the dependence or independence in working may also follow general rules or conventions which should be described here. It is most important to state how the target group employees relate to registered nurses regarding the organization of their work and delegated tasks and responsibilities.

Practical nurses are registered, and their professional name “Practical nurse” is protected. They can work independently within the legal framework of their profession. This is especially the case in elderly care and outpatient nursing care (also known as mobile care). When practical nurses work together with registered nurses, registered nurses are the first line manager in the workgroup.

Labour market situation

Requirements for employment are

1. Currently, the healthcare sector offers more workplaces than there is skilled personnel, so the educated practical nurses generally get a job very easily.[Survey 1/1.2] Due to the fact that practical nurses get a wide basic study they are flexible and compatible in regard to

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“requirements for entry” and should be listed there!

The following issues should be differentiated here:

1. The situation of demand and offer (of labour)

2. Statistical numbers in relation to the labour market situation of that occupational group in focus a) Number of employed and

unemployment rate b) Number of examinations /

year c) Age pattern d) Gender distribution e) Average time spend in this

occupation f) Pay/Wage

the place of work and the subject area. Nevertheless, most Finnish employers hire only those who have been authorised by Valvira to use the occupational title of a LPN. In Finland, it is pursued that only registered nurses and practical nurses are employed in the healthcare sector. There are a few care assistants working in that field. The license authorities make sure that there aren’t a lot of different levels of nurses. Therefore, curriculums are very similar in every school and are strictly regulated.

2. Statistics about personnel in healthcare:

a) The unemployment rate is very low. In the countryside the unemployment rate is higher than in the urban area, but it is still only a few percentages. In 2008, the total unemployment rate for all social and health care professionals was about 2,4 %. In 2010, there were 28.500 practical nurses and 43.400 registered nurses employed by municipalities.

Time series of employment figures of practical nurses: 2002: 27.250, 2003: 33.587, 2004: 34.435, 2005: 36.762, 2006: 36.880, 2007: 38.502, 2008: 41.211, 2009: 69.038

[for further information: http://www.stakes.fi/EN/tilastot/statisticsbytopic/healthservices/personnel.htm] b) No information

c) The average age of all social and health care sector professional is 45 years (includes all kind of nurses, doctors etc.).In the occupational group, 23 % of the current employed practical nurses are over the age of 55 years [Survey 2]. The retirement age of the occupational group is between 63-68 years

d) 96% of the occupational group are females. e) No information

f) The target group employees earn about 30.000 euro/year (average gross salary per year).

EU-Mobility

1. Is there a lot of EU-mobility (incoming and leaving) of that occupational group in focus in the respective country?

2. What do the ones who enter require to be accepted?

1. In 2008, there were 3% foreigners by birth in all social and healthcare professions for further information:

http://www.oph.fi/info/recognition]

2. To get an acceptance the National Supervisory Authority for Welfare and Health may approve the applicant’s education and grant him/her the right to use the occupational title of a licensed practical nurse. After this, Valvira will add the applicant’s information to the Finnish Central Register of Health Care Professionals. [Survey 2]

There is a distinction between EU citizens and non EU citizens. EU citizens in particular do not need to show an official language certificate of Finnish to Valvira before they obtain the right to use the LPN title, whereas non EU citizens need to show an official language certificate of Finnish to Valvira before they are authorised to use the LPN title. The certificate has to make clear, that the applicant possesses at least satisfactory skills.

Generally a licensed practical nurse who is a national of a EU country and received her/his diploma in an EU/EEA country can usually work automatically in all EU member states including Finland. In case the the applicant's education is different to the Finnish nursing education, Valvira gives commission to a Finnish training institution to evaluate the applicant's qualification. After evaluating, the applicant may or may not undertake some extra courses or further compensation measures in order to be able to work as an official

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licensed practical nurse. Compensation measures are defined as an aptitude test and an adaptation period. The aptitude test measures general nursing skills and the adaptation period describes the period of time one need to work under the supervision. This period is three years at the longest. After being evaluated the applicants send their application to Valvira and then receive a conditional recognition of the qualification. Attached to the documents there is a letter indicating which fields will be examined in the aptitude test or how long the length of the adaptation period is supposed to last. The applicant is free to choose between the test and the adaptation period. When one decides to work it is up to the applicant to look for a workplace, Valvira does not support him/her. The application process of an applicant trained outside an European country is managed differently. Valvira sends the diploma and other documents to a Finnish institution training licensed practical nurse`s. The institution will compare your education to a Finnish LPN education and may order further studies.

[Source for all paragraphs above: http://www.valvira.fi/en/licensing/professional_practice_rights/licensed_ practical_nurses]

Requirement for Entry

usually general education / minimum age

The students start after comprehensive school. So the students are between 16 and 20 years old. Furthermore, the students must have a 9-year elementary education to access the practical nurse training,. [survey 1 /1.2]

Further Education at the

same level of qualification

Horizontal Permeability

In Finland, one can also do only parts of the education and thus get no final exam. One can enter working life in that case, but one cannot use the title practical nurse. They may use the informal title care assistant then. [Situation Statement] They may work in similar fields like the practical nurse.

Connecting education with

higher levels of

qualification (general

nurse, BA, MA, PhD)

Vertical Permeability

Three-year trainings give general eligibility to apply for studies at universities and polytechnics. In order to enter bachelor studies to become a registered nurse, one needs 12 years of elementary school. Alternatively, the practical nurse training can also be counted as an admission requirement. From those who start the nursing education, about 20 % are practical nurses (in youngster education) and about 60 % are in adult education. Due to the fact that practical nurses can apply straight into nursing studies, there are no bridging courses. [Survey 2] If a former practical nurse starts to study at Bachelor level, it is possible to get accredited some of the practical courses of the vocational training from the practical nurse education.

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Description of the graphic: The Finnish education system consists of pre

general and vocational education, higher education and adult education. Higher education is provided by 16 academic universit universities of applied sciences. Source: Ministry of Education

Literature

Here all suggested literature regarding regulation, education and employment situation of the occupational group of the

• Statistics about personnel in • http://www.oph.fi/inf

• Curriculum:

http://www.oph.fi/download/137639_vocational_qualification_in_social_and_health_care_practical_nurse_2010.pdf

the graphic: The Finnish education system consists of pre-school education, comprehensive school, post general and vocational education, higher education and adult education. Higher education is provided by 16 academic universit

versities of applied sciences. Source: Ministry of Education

Statistics about personnel in healthcare: http://www.stakes.fi/EN/tilastot/statisticsbytopic/healthservices/personnel.htm http://www.oph.fi/info/recognition

Curriculum:

http://www.oph.fi/download/137639_vocational_qualification_in_social_and_health_care_practical_nurse_2010.pdf

school education, comprehensive school, post-comprehensive general and vocational education, higher education and adult education. Higher education is provided by 16 academic universities and 25

http://www.stakes.fi/EN/tilastot/statisticsbytopic/healthservices/personnel.htm

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respective country can be lined up and, if possible, supplemented by a short description of its content.

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