Mackenzie Klinkhammer
Week 1 at Bowdle

Welcome to Bowdle, SD! The first week of the REHPS experience could not have started off any better. I had the opportunity to meet some amazing people in a few short days. 

The first day began by meeting Mary Turner, a woman that wears many hats in the community. She is the clinic manager at Bowdle Healthcare, and she also is our site coordinator. She also volunteers for the Bowdle Ambulance and is the wife of the local pharmacist. She gave us a tour to meet the clinic, hospital, and nursing home care providers. She is never short of a smile, and helping hand to Marissa and me. 

I also had the opportunity to round for the first time with Dr. Lechner and Wayne Washenberger, PA-C. Wayne is a great teacher and is very patient with everyone! Dr. Lechner is a walking encyclopedia because he has so many interesting facts about anything and everything! Dr. Lechner is in his last week at the facility because he is a full time hospitalist at the Watertown Hospital. The numerous nurses I have worked with at the facility have been nothing short of outstanding. They were so welcoming and willing to help me learn the ropes of the Pyxis machine. 

Most of my days have been spent with Doug Turner, the local pharmacy owner who doubles as the hospital pharmacist and doubles again as the nursing home consult pharmacist. To say he is a hardworking person is an understatement! He has taken on learning how to program the Pyxis over the past couple weeks, while still running his own store. This has been my first experience with a Pyxis machine, so it has been very interesting and challenging in a fun way. Doug also has a great support system back at the store, and I had the opportunity to work with them on Wednesday. The two technicians, Shawn and Tonya, are so welcoming and efficient. They do things without being asked to help alleviate the stress load for Doug. They are great resources for the relief pharmacists that work for Doug while he works at the hospital.  I also had the opportunity to do Med Reconciliations with Doug at the Nursing Home two nights during the week. It was a great way for me to use the information that I learned in school as we went through the charts. It also was a great opportunity for Doug to teach and challenge me. This was by far the best part of my week! 

The Bowdle Healthcare Community has such a great group of people that I cannot wait to spend my next three weeks learning more about rural health and the community, itself. The individuals of this community each have a unique story that makes you fall in love with the area because they show their passion for the hometown.

Week 2

I had the awesome opportunity to follow a physician for the first time. On Tuesday, Dr. Lechner started out by handing me a stethoscope and told me he wanted to understand what people were getting their medications for and how I could help someone in an emergency situation. He showed me how to listen for pneumonia in the lungs and for different arrhythmic heart beats. This was the first time I had ever heard an irregular heart rhythm. I cannot tell you what type it was, but it was an amazing opportunity to listen to a normal rhythm, my own, and then compare it to one of the patient’s. During the day, I also had the opportunity to listen to patient’s lungs that had pneumonia. Between each patient, Dr. Lechner would teach me the difference between common diagnoses. I also learned quite a bit about trivia. Dr. Lechner has a steel trap for a brain, and loves to teach. 

On Wednesday, I experienced another first by hanging out with Radiology. I gave my first ECG’s, and then followed the patient’s through with their appointments with Dr. Sidaway’s DNP, Amy Stevahn. It was very neat to see the holistic approach to the patient’s appointment. The afternoon was spent at Turner Drug. 

Thursday brought with it more first time experiences. I got to tour both Avera St. Luke’s and Sanford Aberdeen with Marissa. These two facilities are great assets to Aberdeen and the surrounding area. Marissa and I were both amazed with the size and amenities of each facility. To end our adventure in Aberdeen, Mary took Marissa and I to Storybook Land! It was honestly a very “magical” place because all my favorite childhood books were on display as large play sets. I had never been to Storybook land, so it was an awesome experience.  

Friday, Marissa and I had the opportunity to explore many areas of the facility. To start the day, we went and watched housekeeping do the laundry routine, then headed up to the nurses’ station to watch a Vancomycin dose start and a dressing change. Marissa and I then got called to help with a CT scan that lead to watching two more and three x-rays. I loved this opportunity because Marissa and Leslee, the Rad Tech, got to teach me so many new things when looking at the scans. Leslee then showed us some really cool images that she had done over the past year. Leslee just started her PA school this past week, so she was awesome to take the extra time to teach me. The remainder of my day was spent with the Pyxis and putting the order away in the pharmacy. 

Saturday was a day of adventure as well. Marissa and I went down to Hoven, about twenty miles away, to run a 5K. We were hauled three miles out of town in a horse trailer and then had to run, well in our case, walk, back to town. We told everyone back in Bowdle that we won! We were so grateful for Jamie, one of the housekeeping staff, for telling us about the race.  We then headed over to the Hoven Cathedral after the race. St. Anthony’s Catholic Church was so beautiful, and it blew our expectations out of the water. We spent the rest of the day exploring Bowdle. Later that evening, Marissa and I had the opportunity to ride along in a transfer to Aberdeen in our first Ambulance ride. 

Another week down and two more to go! So excited to see what else Bowdle has to bring! 

Week 3
Third time is a Charm!

The third week brought more adventure for Marissa and I. Monday was spent exploring new areas of healthcare. We had the opportunity to watch an ultrasound of a patient’s heart. The remainder of the morning was spent with Sandra, the facility’s Physical Therapist. She works with patients from birth to nursing home age, so she has a wide variety of patients. That afternoon, we got to go to the business office and watch all the extra work that happens behind the scenes. Before hanging up the towel for the day, Marissa and I got to assist in a very interesting ER visit. That evening, we went to the hospital’s board meeting/city council meeting. Since the Healthcare facility is owned by the city, the board is the city council. It was very interesting and informative to watch how the facility and city is run. Before heading to bed, we also got to watch a sleep study. It turned into a late night, but it was so fascinating to watch the set up and the simulations of different problems the tech could show us before the actual study started.  

Tuesday brought with it some luck. We went on a guided fishing trip with Sandra’s husband Pete! We caught our limit and some sun. Marissa and I even faced our fears and held our catches! To end the day, Wayne and Lynette took Marissa, Doug, Mary and I to Mina Lake’s restaurant Wakeside! It was a long day but a great break from the clinic! 

Wednesday turned into a great opportunity to check out a wound vac change with the nurses. It was very interesting for both Marissa and I because we had both worked with them in our past nursing home experiences, but never had witnessed a changing of the dressing. Mary and Doug then treated us to 3 Paws Restaurant in Roscoe for lunch! It is run by a chef that went to school in New York, and it was nothing short of impressive. He served homemade pizza that was to die for because the crust was beyond delicious! He also had delicious homemade oatmeal chocolate chip cookies for dessert! That afternoon, Marissa and I worked on our project, and then I worked the remainder of the day in the hospital pharmacy. I even got a run in that evening!

Thursday was a great day because I got to go on Home Health visits with Mel, the public health nurse. She is a very busy lady because she is also the school nurse for many of surrounding schools and does all the immunizations for the clinic. We made two visits, and both individuals loved having Mel come visit because she is so sweet and conversational. She sets up the pill boxes for week, takes vitals, and does an assessment of their overall well-being. Her patients look forward to her visit every week because she is someone that takes time to get to know them and check in on their lives. The remaining portion of my day, I worked on the return for Doug at the hospital pharmacy. Thankfully, I also got a run in that evening and a walk around town because the weather was beautiful!

Friday, I worked in the clinic organizing the supply closet. I also worked on all the outdates for the clinic and restocking those that were low. I also put the new order away for the pharmacy. With the new order, I finally got some meds that have been on back order! Experiencing drug shortages first hand this summer was a great eye opener to what we had talked about in school this past year. I revamped some of the antibiotic kits that I have been working on all summer. The remainder of the day, I spent finishing up Marissa’s and my project! That evening, Mary and Doug took Marissa, Austin, and me out for supper at the local steakhouse. Austin is my boyfriend, and he was traveling for work and drove through to meet everyone! Mary and Doug had to tease him about wanting me to buy the local pharmacy. It was a great meal spent with everyone! Many jokes were made about USD vs. SDSU since Marissa is a Coyote and Austin and I are diehard Jackrabbits. We ended up staying there for almost two hours just laughing and enjoying each other’s company! 

Week 4
The last week in Bowdle came sooner than we anticipated, and it kept us just as busy as the rest of the experience. Monday, we spent time adding final changes to our presentation, but dropping in on experiences that we had not had, including mammograms. Marissa and I had the cool opportunity to watch those. Mary asked us what we would like to do with our final week to make sure we got to see everything before we left.  Marissa taught me that afternoon how to intubate a manikin with the new equipment. I was what they call a “NOT” natural. In other words, in an emergency, do not look to me to be the hero, and call Marissa instead. ;)

Tuesday, was the day that sent us for a loop. We were supposed to give our presentation at 11:30 that day, so Mary gave us some free time to set everything up and get ready. However, an 11:15 ER visit that included a nail in a finger kept us on our toes and scrambling to make it to the presentation on time. Marissa almost had to mop me up off the floor as I watched them take the nail out. Let us just say, it is a good thing that I am going to be a pharmacist and not an ER doctor. The presentation went really well, and Cheri came and brought cake balls from Cakes by Monica in Vermillion. Yes, Cheri may have won the hearts of everyone present by that gesture. That afternoon, Marissa and I spend time with home health visits, and in the clinic and hospital.

Wednesday may have been my favorite day of the experience because I had the opportunity to hold FOUR babies. Marissa and I spent the day in the Public Health building with Mel for WIC. It was awesome! We weighed the babies, measured the head circumference, and recorded the height. While the moms and Mel would talk about different nutrition pieces and discuss what they wanted for items on the checks, I would hold the baby for the mom. Like I said, the best day because those babies were oh so adorable that it would just melt my heart. Mel also had me prick a couple of the new moms’ fingers to do Point of Care hemoglobin checks. Mel also gave some shots that day, so she showed me how to register those online. After WIC ended, I joined Marissa back in the clinic to meet with the final patients; one even included an injection that Marissa administered. It was very neat to watch her in action. That evening, Marissa and I went to the Turner’s to feast on our Walleye that we caught the week prior. We met one of their family friends and stayed until almost midnight laughing and reminiscing on the experience.

Thursday, I spent the entire day in Aberdeen with Winston. He is a pharmacist that is in charge of the informatics at Avera St. Luke’s. I had requested to shadow him because through all my work with Meditech and Pyxis, I wanted to meet the man who troubleshot any of my problems. He is truly a brilliant mind because he self-taught most of the work that he does. He is the “go to” man for all the hospitals in the area that use Avera’s system. He broke down each portion for me, and he made everything come full circle. I was so grateful for that experience because it will be so helpful for my future rotations in pharmacy school. That evening, Doug and Mary took Marissa and me to 3 Paws Baking Company in Roscoe for supper. Denis opened the store just for us that night and set up the table in the kitchen so we could watch everything. It was truly the most delicious food I have ever eaten. He did not have a plan coming into the evening, but just would pull things together as he went. He went to culinary school in New York, and he has had some amazing experiences that have sculpted him into the great chef he is today. It was the perfect ending to a great experience.

I took off for home on Friday morning because of the long drive, but saying goodbyes that morning was not easy. Each person truly touched my heart in ways they will never know. The facility took Marissa and me in and gave us an experience of a lifetime by exposing us to areas we would never get to see elsewhere. Each person took the time to make us feel special and to teach us. We could not ask for more because the whole premise of the experience was to learn and to expose us to the whole scope of rural healthcare. I cannot thank the Turners and the rest of the staff enough for everything, they truly are great!