MEGAN’S BLOG – BACK TO STUDENTS

Parkston, South Dakota
Week 1
Beginning the REHPS program here in Parkston this week was exciting! I was finally able to meet Danielle, my student partner. We’ve had a lot of fun talking about each other’s program and getting to know our way around the facility and Parkston. The staff here has been very welcoming and we have had the chance to meet and talk to many people about his or her role here.

Our first day started off by going with Dr. Honke on rounds through the hospital. We also had the opportunity to watch a colonoscopy and an intrathecal injection. After listening to the doctor talk about disease states and having all of these new experiences I was definitely feeling a little overwhelmed! There is so much I don’t know about! I never thought I would be so excited to hear people talking about drugs, but it was finally something that I understood! The name fentanyl was actually giving me comfort and it was kind of an eerie feeling after dreading drug card tests for the last two years. ☺

On Tuesday morning we were able to learn more about the staff, facility, and town by attending meetings. We sat in on a meeting with the doctors and some nurses where they discussed issues with software, a review of the weekend, and things to come. Next we sat in on a meeting about construction that will be taking place soon to add on to the nursing home. Lastly, we sat in on a meeting to wrap-up a 5K walk the community held with the American Cancer Society. Later in the afternoon we helped set up for a Weight Watchers Meeting and spent some time prepping for a babysitting clinic that will be held this coming Wednesday.

Wednesday morning we found ourselves at Our Home with Dr. VanderPol. Our Home is a psychiatric residential treatment program. The program works with males and females between 12-18 years of age to help them learn healthier behavior, socialization, family relationships, and to stop alcohol and substance abuse. We sat in on treatment plans. During treatment plans the resident, his/her group leader, the psychiatrist, nurses, and a doctor all come together along with an optional parent/guardian via telephone to talk about the resident’s school work, counseling, health, and goals for the upcoming month. Danielle and I both enjoyed this experience and hope we have the chance to spend more time at Our Home. Later that evening we were invited to sit in on a committee meeting for the town’s 4th of July celebration. Danielle and I will be doing our community project at the celebration and will be discussing sun safety and the new FDA changes for sunscreen.

On Thursday morning I followed Dr. Wickersham to his appointments in the clinic. He was great to follow and always told me a little of the background of each patient. During the appointments he even quizzed me on a few drug topics. I didn’t have all of the answers, but it’s a great way to learn! Later in the afternoon Danielle and I sat down with Human Resources and learned about the job position and learned the history behind the facility here and how Avera came to be.

I finished the week by spending time with Dr. Honke again on Friday. We spent some time on rounds in the hospital and I sat in on another colonoscopy. After finishing up in the hospital we moved down to the clinic for a few appointments. I was able to see a few lab results and Dr. Honke was great at including me in the discussion.

As I get ready to start another week here I think that I am most excited to see how each department works with the others. I have been very impressed by the facility. It’s so neat to be in a place where the clinic, hospital, nursing home, physical therapy, and wellness center are all under the same roof. Another aspect that makes this facility unique is the rural area. It seems that everyone hear wears more than one hat and is happy to help wherever they can. It will be a great opportunity to see the effects and benefits of the whole healthcare team coming together to work towards patient health.

Week 2
Week two of our internship really flew by! On Monday we spent the morning and early afternoon in radiology. The technicians there were great and we were able to see a little bit of everything. The facility offers a wide scope of radiology including ultrasound, mammography, DEXA scans, CT scans, x-rays, and a traveling MRI bus. Later in the afternoon we helped the health information department organize old health records as they prepare to switch everything over to electronic medical records.

Tuesday morning was split between speech therapy and a summer reading program at the elementary school. We shadowed the speech therapist during a visit with a hospital patient who was thought to have suffered a stroke. She went through a checklist of questions and activities with the patient to see what kind of brain damage had been caused and to what area of the brain. After speech therapy we went to the elementary school to read with kids enrolled in a summer program. The program is used to help students retain reading skills and to improve them before the fall school year begins. During the afternoon we traveled to the Lake Andes clinic to shadow Dr. VanderPol. We were able to sit in on a new patients’ first appointment and two OB appointments. In the evening we had the opportunity to get a tour of the Simulation in Motion- South Dakota (SIMSD) bus. These buses travel all around SD to train EMS and ER teams to respond efficiently. When a team enters the bus they are given a scenario and then are videoed while they respond. The bus has adult, children, and baby/toddler simulators. The simulators are so life-like! They breathe, bleed, speak, yell, and sweat. Teams are able to do anything to them that they would do on a real patient. After responding to the situation the team watches the video and can talk about what went well and what should be changed. It was a really neat experience!

On Wednesday morning we went back to Our Home to sit in on more Treatment Plans with Dr. Boschee. It’s a really great experience to see each of the residents’ history and then to watch the whole health care team work together to benefit each one. The staff at Our Home work so well with the doctors at Avera.

Thursday I was finally able to get into the hospital pharmacy. I have never worked in a hospital pharmacy before so it was a great experience to learn more about the setting. The pharmacist showed me how she did billing as well as some of her other daily work. She also taught me about the Omnicell system. We went over how to re-stock it and spoke some about how she decided to organize it when she first began working at the hospital. She has a great relationship with the nurses, doctors, and other medical staff. Many of them floated in and out to ask questions and just to say hi.

We finished our week by going to a nearby colony with Deb and Diane, two of the nurses. Three colonies actually came together for a Home Alone/CPR class for the children on the colonies. I had a great time helping the kids make age appropriate and health snacks. After talking about basic first aid we also went outside to play some games. It was a lot of fun teaching the kids new games and they even taught me a few new versions of tag! It was a great experience to learn more about the colonies and it was great to play around and laugh with the kids.

Week 3
Week three of our internship seemed to fly by! I began the week by spending Monday at the Medicine Shoppe. This was my first real experience at a rural pharmacy. The morning was busy so I helped out by filling prescriptions while the staff worked on deliveries, statements, and answering the phone. My memory was checked while filling prescriptions. The pharmacy is organized according to brand name whether the brand or generic is used. I can say that I used my drug card knowledge! I also learned about their software, billing, and the daily routine of small town pharmacy. It was a great experience and definitely made me think about rural pharmacy as a future career.

Tuesday morning began by watching in on a procedure with Dr. Boschee and Dr. Wickersham. Pharmacy is definitely the best option for me especially after watching sutures being put in! Following that I went to a Memory Clinic with Dr. VanderPol. The patient went through two tests with a nurse that went over memory, patterns, word association, etc. After the tests, Dr. VanderPol was confident that this patient does not have declining memory, but she will be coming back in six months for a re-evaluation. They use this clinic to catch Alzheimer’s early. Danielle and I spent Tuesday afternoon putting together our board for our community project.

We presented our community project, Summer Sun Safety, at the Parkston 4th of July celebration on Wednesday. We set up a booth on heat exhaustion, UV ray classification, and skin cancer. We also handed out brochures on sunscreen information and sunscreen samples. It was a hot day and the kids had a blast playing water games.

Thursday and Friday were spent in the nursing home and wellness center. We were able to sit in on a care conference in the nursing home on Thursday. The staff must perform a care conference on each resident every six months. During the care conference they talk about any differences in each resident such as health changes, social changes, or major events like falls. We helped during a water aerobics class on Friday morning in the wellness center. We met some more members of the community and learned a little about the specific requirements for arthritic aerobic classes.

Week 4
Our last week here in Parkston has come to an end. We started this week on Monday by spending some time in the lab. This was a really great experience. I was very impressed by the large, advanced lab they have here. One of the technicians sat down with me and discussed how they run certain tests and how new and improved technology has improved results while making it easier and faster too. I was very interested in seeing how they run antibiotic specificity tests. This knowledge really helps the providers make the best choices they can to return their patients to full health.

On Tuesday I went to Parkston Drug for another look at independent rural pharmacy. The pharmacist was very knowledgeable and taught me a lot of new things in the small amount of time I spent with him. We spoke about franchise opportunities, the ordering process, and daily independent pharmacy life. It has really increased my desire to someday serve a rural area in South Dakota. Later that evening we attended a group diabetic session. This is a new program they are trying to help improve the daily life of diabetics in the community. During the session a nurse, psychologist, dietician, and doctor were present to talk to the group about difficulties they face as diabetics and how to fix those problems. After the group talk each person had a brief physical and then was able to go and talk to the doctor privately about his or her diabetes. This will be happening monthly for six months. I thought this was a great way to improve diabetic education and will hopefully have an impact on all of the participants’ health.

On Wednesday we attended a nurse in-service. The presentation was on STEMI education for SD Mission: Lifeline. He spoke on the skills necessary to properly do a 12-Lead ECG on cardiac patients, how to properly read ECGs, and how to respond. South Dakota is the first state in the nation to have 100% participation of EMTs performing 12-leads and transmitting them to their local facility for interpretation before the patient even gets to the hospital. It’s saving time and lives. He gave an awesome overview of ECGs! The second presenter spoke about wound care and correct classification of ulcers. Finally, the last presenter for the day was a Pradaxa drug representative. It was fun to sit in on the last presenter as a pharmacy student. It was a unique experience because everyone in the hospital and clinic was involved. I was able to hear opinions and questions from the doctors and nurses and it was very educational.

Later in the afternoon, Julie treated us by taking us out to see the Amish. This was a new experience for both Danielle and me. After stopping at one home and talking to him about farming and their new life in South Dakota we were directed to another family’s home that make rugs and other goods to sell. While we were there Danielle even purchased a rug. He was very warm and inviting. He told us all about his family and how they make the rugs. He told us that he orders bales of material that come in every color. The colors have to be separated and then he gets ready to make a rug. He even let us watch as he started a new rug on his loom from the 1920’s.

Thursday was our final day in Parkston and our Celebration Day. Danielle and I put together a slideshow of our daily activities in Parkston and some pictures we took along the way. Many of the department heads and those that we had spent a lot of time with over the last four weeks were present and we enjoyed a nice meal from Schuvers. I would like to thank everyone in Parkston for the great experience! I still believe that I want to practice in a rural setting and hope to take some of the ideas and things I learned from my time in Parkston and apply it to another small town to improve the health and wellbeing of its community members.