There’s not much conversation in the locker room at 6:30 a.m., as the six women change into the blue uniforms worn on the Intensive Care Unit. The handover from their overnight colleagues proceeds quietly — it was an uneventful night. But the day ahead? On the ICU, it’s impossible to know.

(Published: March 2015)

ICU head nurse Mandy Stockmann is busy handing out assignments. “When possible, we team up the less experienced people with the veterans,” she says. By any standard, Stockmann is a veteran: she has been heading the 67-member ICU nursing team at Fresenius Helios Hospital Bad Saarow, just east of Berlin, since she was 26.

Each member of the Bad Saarow ICU team is trained to deal with the life-threatening emergencies that can strike the ICU’s critically ill patients at any time. Many have just had major surgery or have advanced pneumonia. Others have suffered a serious heart attack or stroke, or devastating brain or internal injuries.

“We treat every patient like they were our own mother or father.”

Stockmann turns to hurry “downtown” — the English name the nurses have given the busy central corridor running between the ICU unit’s two wings, with their total of 36 beds. Downtown is where the doctors and nurses gather for their “morning rounds” to see the patients. The beeping of sophisticated medical equipment deployed throughout the ICU, along with the hoses, cables and flashing monitors — it can all seem daunting. For the ICU patients surrounded by — and often attached to — these life-saving machines, it is crucial that they sense the staff’s compassion, and special attention is given to treating them as gently and kindly as possible. “We treat every patient like they were our own mother or father,” says the head of the ICU, Dr. Uli-Ruediger Jahn.

“How was your night? Do you have any pain?” Jahn quietly asks a patient. During the morning visit he is highly focused, and expects the same from the staff. “This is the most important time of the day,” Jahn explains. “It’s the only time that the different specialist doctors all come together as a multi-disciplinary team. Everyone really has to listen closely.”

12:30 p.m.: Just after noon, the colleagues gather in Jahn’s office. Their faces etched in concentration, they examine the X-rays of patients as colleagues outside continue to closely monitor patients. The frequent checking of vital signs and medication levels, the carrying out of specially ordered tests such as lung endoscopies, as well as respiration therapy and the various measures needed to support patients’ circulatory systems: these are among the regular duties in the ICU workday.

“Interdisciplinary cooperation takes on a different level of significance in the ICU,” and the nursing staff is on the front line of care, says Dr. Stefan Wirtz, the hospital’s Chief Physician for Anesthesiology, Intensive Care Medicine, Emergency Care Medicine and Pain Therapy. After all, he points out, it is the nurses who spend the most time with the patients, watch over them day and night, and notice even the smallest changes in their condition. “You can only do medicine well when you work in friendly cooperation with your colleagues,” Wirtz adds. “That’s true for doctors and for the nursing staff.

5 p.m.: Another long day ends for Mandy Stockmann at 5 p.m., and she turns to the important business of properly winding down. “Symbolically, it’s important to leave all your private worries in your locker when you start your shift, and then put work problems or your concerns about the patients aside, along with your uniform, at the end of your day,” Stockmann explains. “And I really long for peace and quiet, so I turn the phone off for an hour when I get home.”

The night shift takes over at 10 p.m., with nurse Uwe Bogner as shift leader. This night soon sees him racing over to a nearby station to assist colleagues in helping a very heavy patient back into bed. Then word comes in that a planned emergency operation is being canceled because the patient is too weak, and all the equipment that the staff had brought out and set up for post-surgical care must now be put away. Other nurses, meanwhile, organize things for the day shift, while the physician on call attends to a patient who cannot come to rest; everyone knows that fear and anxiety do most of their visiting at night. The night shift is drawing to a close in the Bad Saarow ICU when Uwe Bogner approaches a patient to clear his throat of fluid that could obstruct breathing. The nurse knows the sedated patient will not be able to answer, but he takes a moment to speak to him all the same. “Good evening, Mr. K,” Bogner says softly. “Hope I didn’t startle you.”

6:30 a.m.: The unit is quiet. Three doors down, Uwe Bogner’s colleagues have arrived for the early shift and are quietly changing into their blue ICU uniforms.

Dr. Uli-Ruediger Jahn has assumed the position of Chief Physician for Anesthesiology, Intensive and Emergency Medicine and Pain Therapy at HELIOS Hospital Uelzen, in northern Germany. The Intensive Care Unit and the clinic for Anesthesiology and Pain Therapy have since become separate specialist departments within HELIOS Hospital Bad Saarow. Dr. Stefan Wirtz is Chief Physician, and Ali Allam is Senior Consultant, in the Intensive Care Unit.

Her first look at Germany on that long-ago morning was not very encouraging. “Everything here looks so gray and dismal,” Florence de Peralta remembers thinking as she landed in Frankfurt back in February 1972. The young nurse was used to the warm temperatures of her native Philippines, not the cold winters of western Europe. But she had taken a decision to pursue a new life, so she got off the plane and started building it.

(Published: August 2015)

Forty-four years later, de Peralta, now 67 and recently retired from HELIOS Hospital Hünfeld, can look back on a successful career at the hospital and the founding and raising of a family in Germany. She’s glad she came, and that she stayed, even if it wasn’t always easy.

When Florence de Peralta arrived along with five other young Philippine nurses assigned to the hospital in Hünfeld, a town of 16,000 people some 100 kilometers (60 miles) north of Frankfurt, Germany was far less multicultural than it is today. The six nurses only came because of an intergovernmental agreement that nurses from the Philippines would work in Germany to help overcome a serious nursing shortage. In total, some 3,000 Philippine nurses came between 1969 and 1973. Thousands of nurses from India and Korea were also recruited during those years.

Today, advance preparation – especially language training – is customary for newcomers to Germany, but in Florence de Peralta’s day it wasn’t thought necessary. She arrived not knowing a word of German but was still expected to start right away at the hospital, “where we communicated with hand signals,” and take language lessons later.

She soon got used to her new country, though, with the help of colleagues and many friendly local people, including some families who helped her settle in and find her way around. “I was given a very warm welcome everywhere, both from the people in Hünfeld and from the colleagues and patients in the hospital,” Florence de Peralta recalls.

Still, Hünfeld is a small town, de Peralta was away from family and friends and living in a country with a very different culture. At times, homesickness was hard to shake. Then, at a gathering of the German-Philippine Association in Mainz, just west of Frankfurt, she bumped into Arsenio, whom she had known before taking her training back home. “He wouldn’t let me go,” she jokes of the man who would become her husband and with whom she has two children, Florian and Jennifer. She and Arsenio even worked together for a time in the Hünfeld hospital.

Florence de Peralta enters retirement with mixed feelings – sorry to say goodbye to work that has given her so much satisfaction, but grateful for the memories, the friends and colleagues, not to mention the many happy years of family life. “Nursing has brought me a lot of pleasure and joy,” Florence de Peralta says. “Having some understanding and sympathy for ill people and looking after them – that has always been my passion.” And for Florence and Arsenio de Peralta, there is still a lot to look forward to – including a long trip back to the country they left behind all those years ago for their new home in Germany.

“I would like some sardines, please.” The words are spoken softly by the little patient. She opens her eyes slowly, still visibly weakened by the disease raging inside her. She is 6 years old, lives in Liberia, and is critically ill with Ebola.

(Published: June 2015)

The girl looks carefully at the woman standing beside her bed: Sonja Stihler is clad from head to foot in a protective suit. Stihler’s gaze rests on the little girl and, as she comes closer, her suit rustles. She bends protectively over her patient and begins to measure vital signs, and then to administer medications.

Stihler spent six weeks with the humanitarian organization Doctors Without Borders in Foya, a town in Liberia’s north. She comes from Ludwigshafen, Germany, where she works as a medical assistant for NephroCare, a subsidiary of Fresenius Medical Care, caring for patients with chronic kidney disease who depend on life-sustaining dialysis treatment. To enable her to help the people of Liberia in the fight against Ebola, NephroCare granted Stihler a leave of absence for the duration of her stay in the West African nation. Stihler had worked for Doctors Without Borders once before, in 2011. On that occasion she spent six months in Iraq, helping to set up a dialysis clinic.

“Helping people in crisis situations is important, and also very rewarding.”

“It was all worth it to experience moments like that,” Sonja Stihler said warmly, as she reflected on the little girl in Liberia. Initially, the girl’s condition had continually worsened – so much so that the doctors had not expected her to survive. The morning she woke up hungry and asked for sardines marked the beginning of an incredible turnaround. Her condition had improved noticeably. At last, she was responding to treatment. A few days later the girl was discharged. She was healed.

More than 6,000 kilometers (3,800 miles) separate Ludwigshafen and Foya. Sonja Stihler’s route into the Ebola zone first took her to Belgium, where a team from Doctors Without Borders conducted intensive training – including extensive safety instruction – to prepare the volunteers. Two days later, the journey continued, to Liberia.

“The daily routine was very demanding,” Stihler admitted. “Exposure to this highly infectious disease required a great deal of self-control from all of us.” Ebola viruses are transmitted from person to person by body fluids. Those infected first suffer flu-like symptoms such as high fever, a cough, painful limbs, diarrhea and vomiting. Later symptoms include skin rashes, shortness of breath, and bleeding – both internally and externally. The disease is usually fatal.

Almost 10,000 people, more than 4,000 in Liberia alone, have died from Ebola since the outbreak at the onset of 2014, according to the World Health Organization. Many infected people, however, have been saved thanks to the commitment of the numerous volunteers. And, fortunately, the number of new infections in West Africa has begun to decline. In Liberia, the last Ebola case was reported in March. This is a big success, one in which Sonja Stihler played a part.

As she was about to return to Germany, she got a big shock. On the way to check in at the airport in Monrovia, Liberia’s capital city, fever was detected during a routine temperature check: Ebola was suspected, and Doctors Without Borders immediately placed her in quarantine. After weeks of caring for others, now she was experiencing what it was like to be a patient. “The uncertainty before the blood tests arrived was really terrible. Nonetheless, I don’t regret my time in Liberia,” recounted Sonja Stihler. She was very lucky: The first blood test was negative, and the second one 48 hours later confirmed the fever was not caused by Ebola. After a few days’ delay, she was able to fly home. As a safety precaution, her temperature was taken twice daily for three weeks following her return; it remained within the normal range.

“I was very happy that my family, my friends and also my colleagues at work so readily accepted me back in Germany. Luckily there were no irrational fears just because I had been in an Ebola zone,” Stihler said. “I received so much support and positive feedback from the people around me, it was very moving.”

Asked whether she could envision another trip to a crisis region, Stihler had a clear answer. “Of course,” she said. “Helping people in crisis situations is important, and also very rewarding.”

Cover photo: istockphoto© IlonaBudzbon

Usually it’s the intern who has all the questions, but Fresenius Medical Care employees had a few of their own when Kim Bui showed up for her internship. After all, it’s not every day that you work beside an Olympic gymnast.

(Published: August 2015)

Bui has been a member of the German national gymnastics team since 2003. A bronze medalist at the 2011 European championships, she competed at the 2012 Summer Olympics in London and hopes to compete at next year’s Summer Olympics in Rio de Janeiro.

Bui, 26, came to Fresenius in April under a special internship aimed at supporting young competitive athletes, who face particular challenges when trying to enter the job market. It was set up in cooperation with Deutsche Sporthilfe, a foundation that supports athletes.

“The biggest challenge in finding a job is my lack of work experience,” said Bui, a student in Technical Biology at the University of Stuttgart. “Because of all the training and competitions, I haven’t had the time or the chance to do internships and get practical experience. And it takes longer to complete my studies. That’s why I often fall through the cracks.”

“The biggest challenge in finding a job is my lack of work experience.”

“Fresenius completely understands that alongside my work I am still pursuing my sport, and I am extremely grateful for that,” she added. “The internship is in the precise area of the economy where I hope to start working after I graduate.”

At Fresenius Medical Care, Kim Bui was assigned to a team responsible for the international marketing of all products related to apheresis therapy. That is a blood purification process in which substances that are making people ill are removed from the blood. She said she felt like a full member of the team, and learned a lot by assisting in a product launch.

“I think it’s great that I can be involved with a product that is going to help ill people,” she said. After the internship ended, Kim Bui was able to return to more intensive gymnastics training but then suffered a knee injury. Her focus now is on regaining her fitness as quickly as possible: The qualifications for the Rio Olympics will be held this autumn, and she is determined to take part in the world’s biggest sporting event once again.

Good luck, Kim, from everyone at Fresenius!