A day with Randi Kræmmer Nielsen
Randi Kræmmer Nielsen is a medical doctor with specialist training in family medicine. She currently works as a full-time researcher at the Research Unit for General Practice in Aarhus, focusing on Advance Care Planning (ACP) in palliative care.
6:40: I'm woken up by my youngest daughter, aged 5, who is happy and chirpy this morning. She's already dressed and having breakfast. I take a shower and a cup of coffee to wake up. I help my other daughter, aged 7, pack her gym clothes and a backpack for a school trip. My two boys, aged 10 and 12, have a loud discussion about football and get ready to leave for school.
7:30: I set off with a girl in each hand to drop them off at school and nursery. The walk takes 10 minutes and is often the best time of day for me. We talk about what we're looking forward to today. The girls notice the sunrise, the leaves changing colour, and the neighbourhood cats. After dropping off the girls, I put on my headphones and listen to Genklang. I take the time to walk to work; it is a 35-minute trip from the southern part of Aarhus, through the city centre and up to Aarhus University, where the Research Unit for General Practice is located. Sometimes I listen to podcasts. Other times I use the walk to consider ideas for my project or to brainstorm solutions for a certain challenge in our setup.
8:20: The working day begins, and I start (as always) by answering emails and getting an overview of today’s to-do list. Today, I must prepare for pilot testing of my project, which is about Advance Care Planning (ACP). It's an approach to uncovering patient values and wishes for care and treatment during a life-threatening illness. I'm recruiting patients with lung cancer at the Department of Oncology at Aarhus University Hospital (AUH). If the patient agrees to participate, I will invite their general practitioner (GP) to conduct an ACP conversation with their patient. The hope is that the process will contribute to the patient's voice taking a stronger presence and that the relation to general practice will be strengthened in cases involving serious illness. I'm excited to see how it will be received. A lot needs to be done before the pilot test can begin: participant consent, questionnaires, information leaflets about the project to both patients and GPs, and supportive measures for ACP conversations in general practice. Today, I'm concentrating on finalising a conversation guide and a template to document the conversation. I write an email to our legal advisor to ask if we need to draw up a collaboration agreement between the research unit and AUH, from where I will recruit my patients.
10:00: Coffee break with my colleagues at the research unit. We are represented by many disciplines: doctors, medical students, anthropologists, sports science and public health graduates. This makes for some great discussions; both academic and not-so-academic. Today, we are discussing how a good work-life balance can be achieved.
10:15: I'm preparing a presentation for a group of palliative care doctors from Lund who collaborate with my supervisor from the Unit for Palliative Research at AUH. I'm going to talk for 20 minutes about my project. Then we'll hear about projects from Lund, including one focusing on early palliative care. The meeting will end with a discussion of future collaboration opportunities.
12:00: We have a lunch club, where we take turns serving lunch for our colleagues. It usually consists of open sandwiches, salads and a chocolate biscuit for dessert. Today, we discuss the annual meeting of the Danish College of General Practitioners, which took place last Friday.
12:30: I read through an email from PubMed. I've saved a search on ACP interventions in general practice that might be relevant for the systematic review I'm working on. I get an update once a month with new articles that match my search. I read through the abstracts, but I don't find anything relevant this time. However, I realise that the journal Palliative Medicine has a special issue on palliation in primary care. I save some of the articles in my reference programme and plan to read them later.
13:00: I book my hotel and train tickets to Copenhagen for next week. I'm going to Braget 2024, which is a health anthropology conference. This year’s theme is future healthcare and prioritisation seen from an anthropological perspective.
14:00: Many of us show up for the oral presentation made by Mogens Vestergaard on the report drawn up by the Danish Health Structure Reform Commission and the Danish government’s response. The meeting is organised by a research network for primary care and is attended by employees from both the Research Unit for General Practice and the Department of Public Health. There are many good questions and debates about the future of general practice and research opportunities. The discussions continue after the meeting on the way home.
15:45: I take the Light Rail and get off in the southern part of Aarhus to pick up my daughter at the after-school centre. We have about one hour together before her gymnastics class begins. I have brought a Moomin book in my bag, and I read it to her while she drinks juice and gets a little break.
17:00: My daughter is attending the gymnastics class, and I spend the waiting time reading a book. I'm reading ‘Being Mortal’ by Atul Gawande, which is half pleasure reading, half inspirational reading for my project. The book is about a surgeon's reflections on how we relate to our patients’ and our own mortality, and how we shift the focus from a good death to a good life, also at the end of life.
18:00: We go home. We are all tired; everybody has had a long day. My husband has made potato-leek soup for us, and my youngest daughter has prepared bread croutons. The children tell us about their day, and we talk about the autumn holidays starting in four days. We will spend our holiday in a cottage near the North Sea, and everyone is looking forward to it.
19:30: The children go to bed. We sing bedtime songs, get water and sing another song.
20:30: My husband reads out loud to us, while I am knitting and drinking tea. We are currently reading the Danish novel ‘On the Calculation of Volume’ by Solvej Balle, which is about a woman being trapped in 18 November. It is highly recommended.
21:45: It occurs to me that I need to prepare for tomorrow’s course ‘Responsible conduct of research’. I read through the programme and the teaching material.
22:30: I go to bed with my to-do list for tomorrow in my head. //
This article was originally published in Practicus no. 273 (pages 40-41) in December 2024.