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Wessington Springs, South Dakota
Week 1

REHPS To-Do List:

  1. Experience something new every day
  2. Take part in as many of the community activities as possible
  3. Never let there be a dull moment

Wessington Springs was not what I expected. On the surface, it looks just like any small South Dakota community—a large number of older houses, a couple quaint little shops and cafes on Main Street, and a small city park with a pool and baseball diamond. But what you can’t see as you drive into town is just how proud these people are to call Wessington Springs their home.

Ashley and I met up with Kristi on a Tuesday morning and she showed us around the hospital, clinic, independent living apartments, and nursing home where we met the extremely friendly staff. After that, we drove around town and she introduced us to the pride and joy of Wessington Springs, Sweet Grass Coffee Shop. (Apparently, they have the best monster cookies around, so that may have to be my “new thing” one of these days…). We had lunch with Kassy and Cheri with the Springs Area Community Club and by the end of the day, I think we were introduced to half of the town!

Wednesday was our first full day in the clinic. We went to report in the morning where we discussed care plans for a hospital inpatient and were updated on her status. After report, I took off for Plankinton with Dr. Orstad. We saw a couple OB patients, one of whom didn’t realize that her water broke that morning. Dr. Orstad taught me about the three tests you do to check if someone’s water broke. (My new thing that day: seeing amniotic fluid under the microscope for a ferning test!) We were happy to tell her that she was in labor and needed to go to the hospital! After seeing a few more patients, we headed back to Wessington Springs. That afternoon, the clinic, proved to be just as exciting as the morning. We had a variety of patients come into the clinic, one even needing a wound debridement (also a new experience!).

Thursday was the 4th of July. The whole town was abuzz with excitement!  Ashley and I helped out with the 5K Walk-Run which was a fundraiser for a local cancer assistance group. After the walk we went back to the hospital for a while only to find a child had come to the ER with a broken arm. We were able to enjoy the parade and went to the fire station to watch the water fight. A good friend of mine from Alpena invited us over for a cookout that night and we had a blast! We made it back to Springs in time for the fireworks, which was a great way to top off the 4th.

Friday, I spent the morning with Dr. Belz. He is great with his patients and was great about teaching me all sorts of things! I was excited to get to use my pharmacy knowledge to answer some of the patients’ questions about their medications and help Dr. Belz locate the drug and vaccination information he was looking for. That afternoon was quiet in the clinic, so I ventured over to Thorton Drug to help them with controlled substance inventory. I worked in a retail pharmacy for about 7 years, so I felt comfortable just jumping in helping out. My new thing that day was going to the drive-in movies in Mitchell with my friend from Alpena! I can finally cross that off my bucket list!

Week 2

After an exciting holiday weekend at the hospital, I started Monday in the clinic with Dr. Dean. We had a good number of your everyday patients with ear infections, strep throats, and routine check-ups. Dr. Dean got a referral from one of the outlying clinics to cast a broken leg! When the patient arrived at the clinic, we discovered he knew very little English. I have encountered patients with language barriers before, so it was very interesting to see how other health care providers communicate with non-English speakers. Ashley and I also spent part of the evening rearranging the hospital pharmacy to make it more user-friendly for the nurses! We helped the staff from Thorton create a spreadsheet of locations for the drugs so the nurses don’t have to spend hours searching for one thing.

Tuesday and Wednesday, I was in the clinic with Dr. Lim. We again saw many sore throats and physicals, but we also did get the opportunity to care for a burn patient. I really enjoyed learning about what makes a burn treatable in a clinic setting versus an acute burn unit setting. I also met one of the drug reps who frequents the clinic. I have talked with many drug reps in my time in a retail pharmacy, so it was interesting to see hear the “pitches” from a prescriber’s perspective. On Wednesday, Ashley and I went over to the senior center and offered free blood pressure checks. I also spent some time at Thorton Drug that day learning a little more about the 340B program. 340B is a federal program that gives prescription discounts to financially eligible patients. The way pharmacies are involved in 340B was very confusing to me, but Melanie did her best  to further help me understand.

On Thursday, I was working with Dr. Belz in the clinic. The day’s schedule started out light, but ended up progressing to quite a steady day. We discussed smoking cessation with a patient, and I was more than happy to add in counseling points about the different non-prescription methods available. I watched him remove some stitches from one patient, and put some in another! There were also a few walk-in patients: one with recurring seizures and another with all the classic symptoms of appendicitis, so that got pretty exciting! Ashley and I spent the evening relaxing at Shakespeare Garden listening to a local band perform some of their favorite songs. My Friday was spent in the clinic with Dr. Orstad. I learned a lot about the provider’s point of view on pain management.

All in all, my 2nd week in Wessington Springs was quite interesting. This week has shown me that the most wonderful thing about rural health care is the variety. There is a common misconception about rural health care being only about ear infections, colds, and hypertension. The rural health care providers have to be very knowledgeable in many fields because they have to be ready to treat whoever comes in the door or know who to refer the patients to if they need  a more specialized level of care.

Week 3
I began my third week in Wessington Springs with Dr. Orstad in the clinic. We mostly saw patients for physicals and different types of infections, but the most interesting thing was discussing birth control use. We haven’t learned a whole lot about birth control pills in pharmacy school, so I was very eager to learn how providers decide which type of birth control to give a patient.

Tuesday, I worked in both the Wessington Springs clinic and the Woonsocket Clinic with Dr. Dean. We also visited the Woonsocket nursing home to see some patients. We had some great conversations about adult immunizations and mammograms. I learned a lot about treating chronic kidney disease and even got to help him figure out the sodium content of a patient’s medications. That’s not something people normally worry about, but with kidney disease, patients have to be extremely careful about how much sodium they consume each day. I also got to watch Dr. Dean remove a basal cell carcinoma!

Wednesday, I spent the morning in the clinic with Dr. Belz. During the afternoon, Jessica and I finished rearranging the hospital pharmacy and completed biennial controlled substance inventory. Later that evening, Ashley and I headed down to the ER to watch Dr. Lim put staples into a patient’s head. I had always wondered how they did that!

On Thursday, I spent the day at Thorton Drug with Jessica. That afternoon, Ashley and I participated in the water aerobics class at the city pool and presented our community project on women’s health to the class. We finished off our evening with supper and a concert at Shakespeare Garden.

Friday, I was with Dr. Orstad. She and I went to report, did rounds at the hospital and nursing home, and treated an ER patient – all before 10 a.m.! The busy day tapered off to a calm afternoon, which was a great way to end the week.

Week 4
My last week in Wessington Springs flew by. Monday, I had the opportunity to visit some home healthcare patients with Donna. It was a great experience to see the types of things she does to help these people continue to live semi-independently. I was able to help her set up medication reminder boxes for her patients, answer their medication questions, and give them reminders about side effects to monitor for. That afternoon, Ashley and I sat down with Dr. Dean and got a lot of our questions answered about Medicare and the new Affordable Care Act. Dr. Dean was part of a Medicare Advisory Counsel and proved to be an excellent resource for us.

Tuesday, I helped the folks at Thorton Drug finish setting up nursing home medications for the week. Wednesday, I had the opportunity to observe a few of Dr. Christopherson’s appointments. He is a psychiatrist and does a fair amount of telemedicine with outreach facilities. It was quite interesting to experience a telemedicine appointment. Telemedicine really is a great way to expand the reach of services to extremely rural areas, especially to patients who may not have the ability to travel even 30 miles to the nearest clinic for their appointment. That afternoon, I spent time with Dr. Orstad. The most interesting part of our afternoon was discussing pessaries with one of her patients. It was the first time I had ever heard of or saw one! That night, Dr. Orstad kindly invited Ashley and I over for dinner. We had a wonderful time with her family and it was great to have a home-cooked meal.

Thursday, I spent the morning in the hospital lab. Linda taught me all about their quality control procedures, their hematology tests, chemistry tests, blood banking procedures, and showed me how they perform PT and PTT. She also showed me how they do bacterial identification and sensitivity testing. We had talked a bit about it in school, but it was really cool to see the cards that they use to perform the testing and what they look like after the tests are completed. That afternoon, I spent time in the clinic with Dr. Dean. On Friday, I spent the day at Thorton Drug counseling patients and helping to fill prescriptions.

It is crazy to think that the month of July has gone by so fast. In the past 4 weeks, I have gotten to learn from some amazing health care professionals, met some incredible people, and had fun doing it. The town of Wessington Springs may not have all the bells and whistles of places like Sioux Falls or Rapid City, but it truly is a great little town. The people are all incredibly friendly and they have some wonderful little restaurants and activities to keep people busy. Thank you to everyone in Wessington Springs, especially the folks at Weskota Memorial Hospital, Horizon Healthcare, and Thorton Drug for making my REHPS experience everything I thought it would be and more.