Week 1 at Canton
My first week in Canton is over, and I cannot believe how fast the time has gone. Here’s a recap of Week One:

Monday was our first day in Canton. Chet and I met Scott, the CEO, at Canton Inwood Memorial Hospital, and started off the day with a hospital tour. The hospital is finishing up a beautiful remodel, and during the tour, Scott discussed the changes from the old hospital layout and the new one and the reasons behind them. We then sat in on a department head meeting over the lunch hour, where we not only met the heads of various departments at the hospital, but got a glimpse of the decision-making process. To cap off the day, Scott took us on a tour of Canton and introduced us to Pastor Steve. Steve and his wife, Kathy, graciously opened their home to us for the next four weeks, which is fantastic!

Tuesday was my first full day at the hospital, which I spent in the lab. I started off the day with some phlebotomy, where I hit the ground running. I got to draw my first patient, which was a bit nerve-wracking, but fun. I spent the remainder of the day getting down the flow of the lab. This included learning about the instruments used, what tests are run, and how duties are split between the techs. I got to see phlebotomy done on a 19 day old infant. I learned that it is very important to do the job as  quickly and efficiently as possible, and also how to attend to nervous family members. This is the first time I have I have spent time in a functioning lab, and it was great to bridge the academics I have been studying with its real world application.

Wednesday morning was spent in the laboratory, where I spent time running samples on the instruments, performing other testing, along with phlebotomy. When using instruments, quality control is very important, and today I observed how quality control testing on the chemistry analyzer and the urinalysis machine is done along with microbiology QC. I also observed phlebotomy done in a 4 year old child, which I had never seen before. In the afternoon, I shadowed an orthopedic specialist. I observed everything from arthritic necks, rotator cuff injuries, knee and foot injuries and their subsequent treatments, mainly with steroid injections.

Thursday we met with a behavioral health specialist, but unfortunately her patients did not allow us to observe the therapy sessions, which is totally understandable. We did get a chance to hear a bit about her profession, which was interesting.

Friday I arrived at the hospital at 6:00 AM for the early shift in the lab. It was a great opportunity to see more of the quality control aspects of laboratory work. I also spent time learning more about microbiology done in Canton’s lab, which was less instrumentation and more hands on. We got called to the ER, where I observed an arterial draw along with arterial blood gas testing. Not only was it informative to see the arterial draw, but I saw just how seamless the different departments of the hospital work together in a crisis situation.

The first week was a great experience, both inside and outside the hospital. Outside of the rotations, we met with the local Rotary club on Tuesday for lunch, where I met more community leaders. I took a beautiful drive around the country roads in the area, where I saw an amazing house built right into the side of a hill. If it had a round door, I might of thought I was in the Shire. Everyone I have met has been so friendly, it has been a great start to my month here. I am excited to see what next week will bring.

Week 2
As week two in Canton is coming to a close, here is a recap of this previous week’s activities:

Monday:
Today, we spent the day at Keystone Treatment Center. Keystone Treatment Center is a residential and outpatient rehabilitation center specializing in treatment for adults and adolescents struggling with alcohol, drug, and gambling issues and is based on the 12 step program. There is a weekly family session that takes place on Monday and Tuesday, where patient’s families come to visit and partake in therapy sessions both with and without the patients. Today, we sat in on family sessions without the patients. We listened to the individual stories of each family, which took place during the morning session. In the afternoon, the counselor discussed two common issues with families of addicts: enabling and setting healthy boundaries. We also listened to two speakers discuss their past struggles with addiction. It was a fascinating day and a great learning experience, and I am so glad that Keystone opened their doors to us. I have a better understanding of not only the process of the center itself, but of addiction in general.

Tuesday:
First, in the morning, we got to see an echocardiogram with a bubble study. We were able to see the ultrasound technologist perform the echo done both with and without the bubble contrast. I was unable to differentiate between the two, but the speed that the ultrasound tech took the measurements was impressive. Later in the morning, we watched two colonoscopies. Both Chet and I were able to operate the scope and camera for a moment, which I was definitely not very good at. The camera controls set up was similar to a video game controller. I definitely should have played more video games as a child. It was a great experience- I am excited to see more next week.

For lunch, we sat in on a Rotary club meeting, where we listened to president of the Canton Car Club talk about the club and about the annual car show in Canton every year. We also were able to visit with Rotary members and learn more about the organization and what they do in the community.

In the afternoon, we spend some time in physical therapy where I saw a patient dealing with chronic pain and another nearing the end of shoulder rehab. I was able to try out some of the different therapy tools- a lot of them were really fun!

Wednesday:
Today I travelled to Inwood, Iowa for clinic in the morning. Inwood is a small town about 8 miles east of Canton. The first two patients reminded me of my time in podiatry school a few years ago. I saw a foot injury with X-rays, and a patient who needed their toenails cut due to onychomycosis, both of which I have had previous experience with. I also got see my first OB appointment.

Over the lunch hour, Chet and I met with the Inwood Kiwanis Club, where we were the guest speakers. After visiting with club members and learning about what Kiwanis is and what club members do, we were able to talk with the members about the REHPS program and about our chosen professions. I was a little nervous about public speaking, but it went well and they were a great audience!

In the afternoon, we spent time in the hospital clinic shadowing a PA. I got to see many clinic patients while learning more about the PA profession.

Thursday:
Thursday morning was spent in the lab where I am feeling more and more comfortable. We did instrumentation QC, morning phlebotomy, and microbiology. I played patient for Chet, who tried his hand at phlebotomy. He did really good- got blood the first time!

After a short break (and delicious personal pizzas from the cafeteria), we returned in the afternoon to shadow a cardiologist. I got to see multiple patients including yearly check-ups, pre-ops, and I got to hear a heart murmur. We were also able to watch two exercise stress tests, which was a first for me. It definitely made me want to keep an eye on my own heart health, because stress tests do not look like fun.

Friday, Saturday, and Sunday:
The clinic was closed on Friday due to the holiday, and is closed on Saturday and Sunday as well. I am on call in the lab this weekend, and the call schedule for the lab is from 6-9 AM to set up and run QC on instrumentation, along with any inpatient draws if needed. After that, we are called in if ER patients need lab work done. This weekend I saw a handful of ER patients, including a pediatric seizure patient, and a patient with diabetic complications. I drew my first inpatient, and also drew from the back of the hand for the first time, and it was my first time on call.

On Saturday afternoon, my husband (Joe) and basset hound (Bleeker) came to visit. After giving them a tour of Canton, we spent the afternoon hiking at Newton Hills State Park and at Lake Lakota. Afterwards, we had a late lunch at a local city park, and enjoyed a beautiful afternoon in Canton.

It is hard to believe that I am half way done with this experience. Everyone I have met so far has been so welcoming and nice. Canton really is a great town! I have seen so much already, but I am excited to see more in the next two weeks. Bring on Week 3!

Week 3

I cannot believe that I am finishing up my third week in Canton already.  It is so crazy how fast time flies. Here’s a recap of Week 3:

Monday:

Today I spent the day at Keystone Treatment Center.  Keystone is a residential and outpatient rehabilitation center specializing in treatment for adults and adolescents struggling with alcohol, drug, and gambling issues and is based on the 12 step program.  In the morning, we joined the patients and families for a half-hour medical discussion given by one of the staff physicians, followed by a half-hour spiritual discussion given by a local spiritual leader. Afterwards, we met with another staff physician and shadowed her for the remainder of the day as she saw patients.  We discussed addiction medicine, along with how to effectively communicate with patients struggling with addictions during a history and physical. I think this was a valuable experience. There are so many people struggling with addiction, it would be naive to think that I will not encounter addicted individuals in my professional career.

Tuesday:

Today was also spent at Keystone, and I got to see the second day of the family sessions that I attended last week. We started the day off listening to a medical discussion given by the physician we shadowed on Monday. She touched on orthopedic injuries in addiction medicine, and it was a fascinating topic. I was unaware of how the two medical specialties overlapped. Afterwards we sat in on the second portion of family sessions, which is the day when the patients join the families for group. I am so grateful that Keystone allowed us to witness the second day of the family sessions. There were tears shed and a lot of emotions, and it was a powerful experience.

Wednesday:

Inwood, Iowa was the destination today. In the morning, we shadowed at the Inwood clinic.  It was a busier morning than last week, and we saw a lot of patients (and a lot of pediatric patients). I got to see an infant wellness check, along with pediatric physicals. It was interesting to see the differences in the history and physical between pediatric and adult patients.

In the afternoon, we shadowed the same physician at Fellowship Village, a nursing facility attached to the clinic. We saw a lot of the residents for their periodic medical wellness visits. I found it very interesting that the physicians at Canton-Inwood Hospital are also medical directors of nursing facilities in the area. I was unaware of all of the roles that rural physicians played until I started this rotation. It may seem that the rural life isn’t very busy, but from what I have seen, these doctors are very busy indeed!

Thursday:

This morning was spent in the lab in Canton. Right away in the morning, there was an ER patient followed by phlebotomy draws and microbiology. I got a chance to run the QC on some of the instruments myself. Later in the morning, I got a chance to shadow the laboratory director, where I got to see more of the administrative duties. This is something that we don’t cover a lot in our classes, so it was educational to get a glimpse into another aspect of laboratory work. In the afternoon, we met with a member of the Canton Chamber of Commerce to discuss topics related to our wellness project. I learned a lot about Canton’s current infrastructure, along with what their future plans are for the town. Canton already has great amenities for their residents as far as promoting healthy living, and I am impressed by their future plans.

Friday:

Friday morning began with a medical staff meeting. These meetings are held monthly, and involve the heads of the different departments. In the afternoon, I volunteered at the Canton-Inwood Area Health Foundation Golf Tournament. As I don’t golf, I chose to volunteer, which was a lot of fun. Along with volunteering, I rode around the golf course watching the tournament. It was a beautiful day for a tournament, and a great day to spend outdoors enjoying Canton.

I cannot believe that I will be starting my last week tomorrow. I have learned so much these last three weeks, and I am looking forward to what this last week will bring! Again, thank you to everyone who has made this experience such a great one! 

Week 4
Monday:
Today was spent in the lab. As the weeks have gone by, I am getting more and more familiar with the flow of the lab and the instrumentation. I know this will be a huge asset when I start my clinicals in the spring. I got to see a patient sample who had a cold agglutinin, both with and without being prewarmed, which is something that is seen occasionally in the lab, but was new to me. I was also able to see a pediatric draw on a 9 day old infant, and I also drew a ER patient! We had quite the busy day!

Tuesday:
Today Chet and I observed cataract surgery. It was an eye-opening experience! (Sorry, bad pun). It really was very interesting to watch. It amazes me how fast the procedure is, I expected it to be a much longer surgery. We were able to look through the special scope the surgeon uses and see the new lens in place. It is such a delicate surgery! I will say that my eyes wanted to water the whole time. This was an entirely new experience for me, and I am so grateful that I was able to witness it.

In the afternoon, we spent some time in respiratory therapy. They have a new hire who needed to practice some pulmonary function tests, and we gladly played the role of the patient. We did spirometry, and it was a bit tough to breath through the tube with a nose plug with healthy lungs…I can only imagine how hard it would be for someone with respiratory issues. It was a fun experience, and interesting to see the test from the perspective of the patient.

Wednesday:
I spend Wednesday morning in radiology. It was a bit of a slow morning and unfortunately there were not any patients, but I did get to visit with the radiology techs and hear more about what they do. Not every day is exciting in a rural environment. After radiology, we met with the Chamber of Commerce for their meeting. I got to see what the Chamber does, along with what upcoming events are happening in Canton!
In the afternoon, we shadowed an ophthalmologist that does outreach in Canton. This was the same doctor that we shadowed the day before in surgery. We saw post-op patients from the Tuesday, along with many patients with cataracts who were candidates for surgery. I had no idea that cataract surgery is the most commonly performed surgery in the country. I did get to see Botox injections and how to test for a possible blocked lacrimal duct. It was a very educational afternoon, as I have never shadowed an ophthalmologist before this experience.

Thursday and Friday:
Thursday, Chet and I met with Cheri and together we gave our final presentation to providers at the hospital. It was a great opportunity to show everyone what we did during our rotation along with thank everyone for a great experience. Thursday evening, my hosts asked me to dinner with them. We had a great time with great good and conversation- it was a wonderful evening.

On Friday, I shadowed a physician during rounds at Good Samaritan Center Nursing Home. I saw many patients, most of whom were being seen for regular bimonthly check-ups. I did see a patient who had frontal lobe dementia, and I was able to discuss the differences between this and more traditional forms of dementia in terms of onset and symptomatology.

I had such a great experience during my time in Canton. I got to spend time in a working lab, and gained valuable experience and knowledge that I know will help me with my future clinical rotations and my future career. I also got to experience different domains of healthcare, from shadowing physicians, to surgeries, to ancillary care, to specialized care. Not only did I see the different roles of healthcare in the hospital and clinic, but I got a glimpse into the different roles that the rural health care professional plays: from clinic, to hospital, to call, to outreach, rural healthcare is busier than I thought it would be.

After spending four weeks in Canton, I now have a newfound appreciation for rural healthcare and the healthcare professionals in Canton. Everyone I spent time with was so helpful and inviting. Thank you to everyone in Canton and the REHPS program for making this experience possible for me. I will go forward with a greater appreciation for the unique setting that is rural healthcare and I will utilize what I have learned in Canton in my future career.