Kelsey’s Blog

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Week 1 Wagner, South Dakota

I left for Wagner, SD early Monday morning.  I arrived and, believe it or not, I actually got lost in small town South Dakota.  In my GPS I had typed out “Third Street” instead of “3rd Street” so I was directed to a house in a residential area.  I thought I had the wrong address completely, so I drove to a gas station nearby and was just about to ask for directions, when I saw the sign for the hospital in my rear view mirror. So luckily I saved myself from a moment of embarrassment!

Once I got to the hospital, a nurse named Connie warmly greeted me, and then a few moments later I met my preceptor Lindsey.  Lindsey gave me a tour of the hospital and introduced me to my partner Kristin.  Kristin is a medical student from USD and I am grateful that I am able to work with her during my brief REHPS experience. After we toured the hospital, I was able to go to my room to unpack and get settled. Kristin and I are staying in a double hospital room. It is very nice and it’s convenient to stay in the hospital.  Once I was all set up in my room, I went back to shadow Lindsey and Connie for most of the afternoon.  Kristin and I were able to practice checking each other’s ears and eyes. We also were able to help irrigate a patient’s ears.  Later, Lindsey took me on a tour of Wagner.  I was able to see the town’s main street and their local pharmacy. Wagner is a very unique town.  It is located on the Yankton Sioux Reservation. Therefore, we are able to see a variety of people and even learn about another culture during our stay.

Later in the afternoon, Cheri, the REHPS coordinator, came to visit us.  She took us on a tour of some towns nearby. We went to see the Fort Randall dam, which is a very beautiful area! We also drove through Pickstown and saw the Marty Chapel in Marty, SD. Then we went out to eat at Two Spurs steak house in Wagner.

That evening, Kristin was on call for the ER.  She got a call about a patient who had come to the ER who had been stabbed in the chest.  She asked me if I wanted to tag along with her.  When we got there, the doctor had skyped in a doctor from Sioux Falls for help and a helicopter had been sent to bring the patient to Sioux Falls. In the meantime, the doctor inserted a chest pump into the patient’s lung because it was collapsing.  The situation was very intense, but the doctors and nurses handled the situation very well and soon the patient was stabilized and ready to go to the hospital in Sioux Falls.

During my second day in Wagner, I was able to shadow the physical therapists and a speech pathologist.  I was allowed to watch the patient’s appointments and how most of them are helped by the use of ultrasound technology. Then I also learned about common stretches and exercises the patient’s can do to strengthen their muscles again.

Shadowing the speech pathologist was very interesting.  We worked with a patient who had throat cancer previously.  Due to the radiation on his throat, the muscles were very weak and he needed help getting strength back in those muscles, so he could swallow properly again. The pathologist put a machine on the patient’s neck that sent electricity to his muscles.  This electricity acted as weights so the patient’s muscles had to work harder to swallow.  The electricity would keep getting stronger after a certain number of swallows.  Once the patient had to cough or clear his throat then they would stop for the day.

After we were finished working for the day, Kristin and I decided to go shopping for the afternoon.  We went to a cute, little clothing store on main street called Stacy’s expressions.  They had a wide variety of clothing and I even found a dress and shoes that were perfect for my cousin’s wedding that I attended this weekend.  Then we got supper at a local restaurant called Boom’s and even treated ourselves to some ice cream!

On my third day, I was able to spend some time in the hospital pharmacy.  I helped them check all of their medications to make sure none of them were expired.  Then I helped the pharmacist, Christina, load the Omnicell machine with medications.  The Omnicell machine allows nurses to retrieve medications for the patients in the hospital. After I finished helping in the pharmacy, I was able to attend Wagner’s Rotary Club with Lindsey.  Everyone there was so nice and welcoming! I was served a delicious lunch and we learned a lot about education and how it has changed over the years.  It was so wonderful to attend Rotary Club and see how passionate these community members were about their hometown.  These members are working hard for the betterment of their community and it is easy to see the joy it brings them by the way they so graciously serve those around them.

Day four, I was able to shadow in the radiology department.  There I was able to observe many x-rays and CAT scans being performed.  I saw a wide variety of images, anywhere from knees to abdomens.  It was very interesting and I was amazed at how far technology has come.  The images were so clear and vivid and it was very easy to see the bones and other body parts. Later in the afternoon, Kristin and I were able to test our hearing by doing a hearing exam.  Luckily, we both have normal hearing! Then we headed to James Drug, the local retail pharmacy.  Here we met Deanna and Patty, who are both pharmacists.  They taught us about their store and how it was a family business.  They showed us how their store was set up and even let us fill some prescriptions.

Once I finished up on Thursday, I had to head home.  My cousin got married this weekend to a beautiful woman named Meghana.  Meghana is from India, so I was blessed to be able to partake in some traditional celebratory events on Friday prior to the wedding. The wedding was held on Saturday at our family’s farm and some Indian traditions were also mixed into the ceremony.  It was a beautiful wedding and I am so fortunate to have been able to experience some of the traditions of my new cousin-in-law’s culture. Also, one of my professors from pharmacy school was the Hindu priest for the ceremony!  I am so excited to welcome her into our family.  She has been a wonderful addition for the past 11 years, and I am glad they are finally officially married, so we get to keep her!

As I finish this blog entry, I am packing up and getting ready to leave home to venture back to Wagner for the last two weeks of my experience.  I am excited to see what the next two weeks bring and I am thankful for this experience thus far!

Week 2
On Sunday Kristin and I drove to Valley Pump, a local café, for dinner.  It was very good! Then later that evening, Kristin and I went and visited with Dr. Szilagy. She taught us how to write prescriptions, write an admit report, and how to do sutures.  She was so kind and such a great teacher. I am very grateful for the time she spent with us!

On Monday, I followed Dr. Qazi in the clinic. There I was able to observe a few patient appointments. Most of the patients I saw were just coming in for their normal check ups with no serious problems. After we were done for the day, Kristin and I went exploring out in the community.  We decided to drive over to Lake Andes and on the way there, a pheasant almost flew right into the windshield! Once we got to Lake Andes, we drove around the town and then we decided to drive along the lake out to the Wildlife Refuge.  It was beautiful! However, Kristin and I were only wearing sandals so we decided we would come back sometime next week with sneakers to go hiking. Then we drove to the Fort Randall Dam and explored parts of the State Park in the area, also very scenic!

On Tuesday, I was able to shadow at the Good Samaritan Nursing Home. First when I arrived, I talked with the manager about the history of the nursing home.  She also discussed the costs of running a nursing home and about the reimbursement they receive from Medicare and Medicaid. Unfortunately, most years they are not breaking even, so they host many fundraisers throughout the year to help cover expenses. Then I was able to tour the facility.  After that, I followed one of the nurses while she distributed the medications to the residents. Then I was able to talk to Annie, an RN, about Medicare and Medicaid so I could get a better understanding of those organizations. Then later in the afternoon, I followed Martha, an RN, while she checked the residents’ blood sugar levels and administered insulin. After we were done working for the day, Kristin and I decided to venture to Platte, SD.  My friend Rose is in the REHPS program also and she is staying in Platte, so we went to visit her. When we got there she gave us a tour of the town and then we ate at a local restaurant called Shorty’s.  It was good and they gave me so many fries! Calling it a mountain of fries just might be an understatement. Then we went to the City Park and relived our childhood by playing on the playground equipment.  It was a great evening and I’m so glad we were able to experience another rural community in South Dakota and, of course, hang out with Rose!

On Wednesday, I was able to help Christina, a pharmacist, in the hospital’s pharmacy.  Christina only comes to the hospital for a couple hours each morning and then she works at James’ Drug for the rest of the day.  At the hospital, I helped her put the order away and fill the Omnicell machine. Then when we were finished in the pharmacy, I went back over to the clinic for the rest of the day. I was able to see some interesting appointments. They included: an umbilical hernia, a punch biopsy, and a knee injury with a possible ACL and meniscus tear. So I learned a lot!

On Thursday, I shadowed in the clinic during the morning. While there, I was able to help with administering allergy shots. Then Kristin and I were able to go on hospital rounds with Dr. Pinter. We were able to visit patients that had pneumonia, urosepsis, and a hip replacement. Then for the second half of the day I was able to help out at James’ Drug. There I was able to help fill prescriptions, learn how to run their computer system, and even ran the cash register. Later that night, Kristin and I were able to visit some patients in the ER. We saw patients with new onset atrial fibrillation, strep throat, and a baby with an infected feeding tube.

On Friday, Lindsey, our preceptor, had the day off so Kristin and I were able to sleep in after a late night in the ER. Then we went to shadow Connie, a nurse, in the clinic for a little while and saw a patient with strep throat and one with pneumonia. Then we followed Dr. Bushell in the ER.  We were able to help out with a patient who had orthostatic hypotension.  Dr. Bushell was a great teacher for us also. He explained each patient case to us and made sure we understood all of the main points.  I was also very thankful for the time he dedicated to teaching us new things.

Saturday morning arrived early, since Kristin and I volunteered at the Fort Randall Dam 5k Run and Walk. The Wagner Area Wellness Consortium hosted this event.  Connie, the nurse at Wagner Community Clinic, is the secretary of the consortium and she invited us to come volunteer with her.  It was a beautiful morning and we were able to stand on the route and guide the runners and walkers and encourage them. After the race, I headed for home to visit my family for Father’s Day.  I am blessed with an amazing family.  They are all so supportive and loving and I am continually grateful for them.  This weekend however, I was especially thankful for my dad and grandpa.  They have been such great role models to me.  They have shown me love and support throughout my life and they also display kindness and patience, which I really admire.

Now, I am back in Wagner ready to finish my last week of the REHPS program.  I cannot believe how quickly the time has gone by. Kristin and I are becoming great friends and I have had so much fun getting to know her throughout this experience. I am excited for what the rest of this week holds!

 Week 3/4
The last week of the REHPS program came and went very quickly! Even so, I was still able to learn some more and have a few more fun experiences. I was able to observe more patient appointments, some of which included: an elderly man with extreme toe pain, a patient with nausea and vomiting who had been unable to eat over the weekend, a patient with anxiety, and I even was allowed to administer my first shot! We had a patient come in who was receiving allergy shots for the summer. The previous week I was able to observe how to administer the shots and now this week, I was able to administer one myself.  I was very excited to be given this opportunity, because this coming school year we will be learning how to administer flu shots, so it was nice to get some practice in beforehand.

Later on, Kristin and I were able to finish up the last of our interviews for our community project.  While we were in Wagner, Kristin and I conducted eight key informant interviews to help get a better understanding of what the community needs as far as fitness and healthy foods go. From our information, we gathered that the community cares about their health very much and they want to take measures to improve their wellness as a whole.  As a health professions student, it was very encouraging to see efforts community members have taken for the betterment of their community’s health as a whole. Wagner offers two gym facilities, a zumba class, an ideal health store, a walking path around their lake, and hosts many 5ks and health fairs through out the year! Once we finished all of our interviews, Kristin and I were able to sit down and write a paper summarizing what we had learned.  It was very interesting to see all of the key informants varying opinions.  We also decided to get supper from Valley Pump one last time, because it is so delicious!

Later in the week, our friend Rose (the REHPS student from Platte) came to visit us to see what Wagner was like.  She met us at the hospital, so we first gave her a quick tour of the facility and our room. Then we gave her a tour of town, the housing complexes, and the Wagner Lake. After that, we drove out to Fort Randall Casino for supper. The casino is up on a hill overlooking the Fort Randall dam and the river, so it was very beautiful.  We each had a great supper, which was followed by complimentary ice cream! After dinner, we drove to Marty to see the chapel. Unfortunately, all of the doors were locked so we were not able to see the inside, but we walked around the campus instead. I hope I can go back and see the inside of the Marty Chapel sometime, because I have heard from many about how beautiful it is.

Our week ended with a final presentation and lunch with our mentors that advised us throughout the experience. I am so thankful for my time in Wagner. I learned so much about rural health, rural communities, different cultures because of their involvement with the Tribal communities, and so much more. I feel very privileged to have been able to take part in this experience, and I even made a great friend along the way!