Abbie J’s Blog  Back to 2013 Students

Week 1
Redfield, South Dakota

My first week in Redfield has been packed with new experiences! After our tour of the hospital and introductions to most of the hospital and clinic staff, we began our week shadowing the physician’s assistants and doctors in the Redfield clinic. During the first appointment I observed I found myself passed out in the hallway. What a first impression I must have made! Needless to say I quickly bonded with the nurse that caught me as I fell. I had never passed out before that day and it just HAD to happen within the first hour of a professional experience. We determined that I was simply dehydrated and became a bit overheated in the exam room. The rest of the week I shadowed the PA-C’s Ron Wren, Andi Rische, and Dr. Owens. The most interesting case from the week was a rare case of gas gangrene in a non-diabetic female. We also had the opportunity to visit with a 94 year old retired doctor, Dr. Perry. He had many interesting stories to tell about his time as a family doctor in the Redfield-Aberdeen area. Doc Perry also was suffering from post-polio atrophy of his forearms and wrists due to a bout with polio as a young boy. He explained to us that this would probably be the only time that we would see this in a living human.   

This week I have been trying to discover as much of the town as possible. Tuesday night we attended a baseball game at the baseball complex and later played catch on the heli-pad at the hospital so I could prove my softball abilities. Wednesday and Friday we were invited to Dr. Owens’ farm for a chance to get out of the town and check out the country life of Spink county. Friday morning we decided to make a pit stop at the local bakery to pick up some homemade donuts. The nurses had insisted we check the place out. They were right! My donuts were gone before the end of our 5 minute drive back to the hospital. I will definitely be making a visit there again. Overall, I would say our first week has been great! I’m looking forward to next week!

Week 2
This week was jam packed with new experiences! Monday I was able to hang out at Randall’s Pharmacy, which is attached to the Redfield Clinic. I was impressed with the user-friendly computer system they utilize. 

On Tuesday, I wandered just down the hall from my room to the physical therapy wing. I enjoyed talking with the patients during their appointments. It was interesting to see how a patient’s compliance to their exercise routine determines their success with their treatment. I could relate to the frustration of non-compliant patients because I feel the same sort of frustrations when the patients at the pharmacy are not compliant to their medication regimens. I was also fortunate to go on two home health visits with the staff physical therapist, Cathy. On one particular home visit we assessed the patients’s ability to successfully complete their ADLs (activities of daily living) by rating their range of motion and speed of going from point A to point B. 

Wednesday was a busy day in the hospital as I followed Ron Wren, PA-C. We had to admit at least three patients so I was well versed in the process of admission by the end of the day. We also had many ER calls in the afternoon. One case in particular was a patient who had had a seizure earlier in the day. I learned how to test the importance of checking the seizure medication levels in the blood to determine if their seizure activity is adequately controlled. I also was able to review which medications can lower the seizure threshold in the body. 

Thursday I bounced back and forth from the clinic to the hospital with Dr. Owens. For lunch we walked over the the Eastern Star long-term care facility to attend a quality assurance meeting. The staff who attended the meeting were great at explaining the hierarchy of leadership within the facility and what each position was in charge of. The meeting was a great teaching tool to help me understand and appreciate how the inner workings of a nursing home/assisted living are conducted.

On Friday, Kevin and I went on pre-rounds in the hospital before Dr. Owens arrived. This allowed us to be become more comfortable talking with patients and practicing the skills that we had learned from Dr. Owens up to this point. In mid-morning I spent a couple of hours back in Randall’s Pharmacy and returned back to the clinic after lunch. The most interesting case of the day was helping to diagnose a supracondrylar humerus fracture in a young child. We had to construct a custom splint for the arm until the patient could be seen by an orthopedic specialist. Dr. Owens demonstrated, on me, the art of custom splint making to the weekend doctor.

Saturday I was enjoying a lazy day when I received a call from the hospital asking me to report to the ER. When I arrived I was informed that they had been alerted by the EMTs that a two car accident north of Redfield had occurred with up to seven patients affected. I began to silently panic because I had never been in a trauma situation before and had no idea how I could be of help as a pharmacy student. The entire process was very organized because of the awesome nursing staff. I was told I would be transcribing for the nurses as they did their assessments. Thankfully, the injuries were not as bad as we were all expecting and the outcomes of all seven patients look to be promising.

Halfway done with my time in Redfield. I have a feeling that these next two weeks are going to buzz by!

Week 3

This week has been even busier than the last!

Monday I followed Dr. Owens in the clinic and hospital and had an interesting conversation with Dr. Kleinberg about his thoughts on a boy who he suspected had Van Willebrand’s disorder–a rare hereditary disorder. Kevin and I also completed our community project. We set up a booth at the amateur baseball game to inform the community how to prevent West Nile. We handed out over 20 handouts and had about 25 people come and visit the booth. We received great feedback from those who stopped by! 

Tuesday I ran around the clinic’s “energizer bunny” Lyn Munce, PA-C. I assisted her in dressing a pressure ulcer and choosing medications to treat depression. We also worked with Andi Rische, NP and the nurses on a difficult case involving a young child. 

Wednesday I had the opportunity to meet the general surgeon that travels from Aberdeen, Dr. Iwerks. He allowed me to sit in on four colonoscopy procedures. I was definitely uncomfortable during this observation process but Dr. Iwerks was great at quizzing us about different GI diseases such as diverticulitis. I also had a great conversation with him about his preference on how his patients take their proton-pump inhibitor drugs. The information I gained from that conversation will help me when I counsel patients on the proper use of those medications. 

Thursday I was back with Lyn and ready for a busy day. She had a full schedule at the Redfield Clinic in the morning and then shipped off to the Doland Clinic after lunch. I loved my experience at the Doland Clinic! Lyn sent me on a mission to adjust a patient’s diabetes medications since their A1C was still very high. After examining the bottles I determined that the patient was non-compliant on one of their diabetes medications. When the patient was interviewed that was exactly the case! The very next patient was struggling with bouts of hypoglycemia. Lyn and I had a conversation with them about how to plan their meals and snacks to prevent the blood sugar crash without overeating. My experience at the Doland Clinic was one of my favorites so far.

Friday I was with Dr. Owens once again. He allowed me to go in before him and speak with the patient about their medications and symptoms before he entered the room. This helped me to practice determining a patient’s chief complaint. Later that night I drove about 30 miles to Orient to see a college friend of mine and enjoy a fish fry. I believe I ate my weight in walleye that night! The next day my parents came to visit and we took off to Aberdeen to eat and shop. I showed them around the town and later we stopped in at Terry’s for supper. 

I cannot believe there is only one week left!

Week 4

I cannot believe this is my last night in Redfield. I will miss the nursing staff and providers dearly. Well I’ll make this blog as short and sweet as I can. Monday I headed over to Eastern Star nursing home to help Spencer, the pharmacist at Randall’s, with the medication reviews for the patients.

Tuesday I had the privilege to visit the South Dakota Developmental Center. This facility is for those with mental disabilities who need assistance learning how to manage their daily lives. The staff did a fabulous job explaining the history of the facility and explaining their philosophy of teaching individuals with special needs.

Wednesday I had the opportunity to follow around the state’s trauma surveyors. They came to evaluate the ER and actual trauma cases to help better the trauma department. That afternoon we headed out to the James River and caught almost 30 catfish! Kevin caught the biggest fish weighing in at approximately 15 pounds!

Thursday we did our final presentation to the staff. It was difficult to express in words how grateful I am to have had this experience. That night we took Dr. Owen’s girls out to Cottonwood Lake to go tubing. 

Overall, this experience has taught me so much about myself and myself as a future health care professional. I have fallen in love with rural health care. I hope and pray that one day I can find myself working in a facility such as this, serving a rural community, and doing what I love.