Rebecca Donaldson
Faulkton Experience
Week 1
Day 1:
My first day at Faulkton Area Medical Center was filled with a variety of rural medicine aspects. The providers and staff were very welcoming! At the start of the day, Nathan and I participated in rounds with 3 providers. I learned the difference between acute and swing bed in their hospital setting. I was then able to shadow one of the providers by watching them conduct appointments with patients. Throughout the day I was able to see the process of before, during and after each clinical appointment. This allowed me to be exposed to the medical and doctor role in the health profession. During the afternoon, Nathan and I attended a Quality of Life meeting at City Hall. I enjoyed seeing the variety of people involved because it showed how different people and professions care about the quality of life in Faulkton. Jill from DSS was at the meeting and explained adult care services that were available to the town. Unfortunately, Faulk County does not have home health care or hospice available to individuals. I learned how challenging this can be when there is an older adult in the community who needs these services. Many community members recognize this need and are wanting to bring these services to Faulkton. I could relate to this compassion because of my morals and code of ethics as a social worker. In the evening, Cheri took us to Dot T Steakhouse. The restaurant was very welcoming and the food was delicious! We also explored the town and saw different areas like the city park, the court house and Lake Faulkton. The first day was a great experience and I look forward to what the upcoming days will bring!

Day 2:
Today, Nathan and I had the chance to visit 3 colonies in Faulk county. Melissa, a RN with Community Health, allowed Nathan and I to tag along while she administered vaccinations to various children on the colonies. We visited Thunderbird, Blumengard, and Brentwood colonies. I found this experience eye opening to the different culture these Hutterite colonies have. The individuals we met were friendly and welcoming!

On the second day, I have already been able to see how social work incorporates into the hospital setting. While talking with different providers and members of the town, I was able to see some of the social service strengths and barriers. As a social work student, I was excited to see how dedicated and passionate many of the hospital staff and providers are about providing all the necessary resources to their patients. Although Faulkton does not have a hospice facility, public transportation, and limited nursing home beds, both the providers and patients are optimistic about finding a solution. This experience will help me in my future profession! In the evening, I took a walk around the town to better acquaint myself.

Day 3:
Today was a busy day learning the different dynamics incorporated in Faulkton’s nursing home. The nursing home is connected to FAMC which is convenient for providers to do exams on the client’s staying there. In the morning I shadowed a provider who conducted routine exams. I witnessed just how important kindness and caring is to provide services to this population. Many of the residents were happy to talk with the provider and I about how they have been doing. Nathan and I met with Heather at FACM Support Services. She explained billing, accounts receivable, coding and transcriptions. These services are done in a separate building from the hospital. I was able to hear some dictations from providers and hear the vast difference in how providers dictate. As a social worker, I do not know the next time I will have the experience of transcribing a dictation, but I now know firsthand how difficult it can be. I tried typing while listening to a dictation and was not able to keep up! In the afternoon I shadowed Dr. B again in the nursing home. He explained the various prescriptions the residents are on related to dementia, Alzheimer’s, depression and anxiety. This knowledge will help me provide exceptional service as an MSW!

Day 4:
Today I was able to fully dive into my profession! I traveled with Cathy Holsing- LCSW-PIP, who works with Avera Home Hospice as well as Northeastern Mental Health. Cathy works with any patient that might be in swing bed in the hospital and require mental health services. We traveled to Ipswich, about 30 miles North of Faulkton, to visit with two hospice patients. I witnessed the important role Cathy plays in working with each patient as well as the partnering nursing home. Hospice requires an interdisciplinary team including social workers to provide the highest care for the patient. Cathy and I then drove to Aberdeen for a social work meeting. Cathy explained how social workers in different Avera Home locations come together once a month to offer support to one another. It is important when working in any field that you have support and are able to talk with other professionals. I adored being able to talk and listen to the various experiences these social workers have had with rural social work. Medicare plays a large role in social work services and this was discussed during the meeting. We also listened to a personality disorders tape. Avera Home will be putting on a grief program that I will have the privilege of participating in a couple weeks. I was able to hear the discussion about the program and look forward to seeing it in action! During the afternoon I sat in with Cathy as she made bereavement phone calls. She explained the benefits of these calls. I also learned about another resource available in Sioux Falls. As a social worker, we can never have too many resources known to us! I look forward to working with Cathy in the upcoming weeks and gain additional knowledge of the role she plays in a rural setting.

Day 5:
I couldn’t believe Friday was already here! I feel this past week has flown by at FAMC. It has been great getting to know everyone at the hospital as well as the citizens of the community. Today, I visited the Dentist in town. I witnessed a teeth cleaning, and partial filling and root canal. I understand the importance of dental hygiene but was exposed to a variety of important aspects to be aware of. The dental hygienist explained the importance of finding any abscess in the mouth and ensure they are fixed before they travel up into the brain. This was a great learning experience and something I had not witnessed before! In the afternoon, I visited the local drug store and shadowed the pharmacists. Trisha, the pharmacist, provided a lot of knowledge about insurance approvals, refills, and authorizations needed for prescriptions. Because they are the only pharmacy in the town, besides the one for the hospital, they see a large amount of clients from surrounding areas. Trisha explained how other hospitals like Aberdeen might have their clients fill prescriptions at their location for convenience to the patient. I asked several questions about insurance approvals, specifics on narcotics and controlled drugs, and Medicare/Medicaid rules. Trisha was amazing at answering my questions and was knowledgeable in all of these areas. Insurance companies, Medicare and Medicaid can play a large role in the social work profession. In the evening, I ate at the Burger Shack located in Faulkton. This small, homey burger joint is a delightful restaurant in the area! The staff was wonderful and the community cannot say enough amazing things about the Burger Shack!

The Weekend:
Saturday morning, Nathan and I volunteered with Bountiful Baskets. Faulkton participates in this co-op program where community members can have fresh fruits and vegetables available to them. The individual goes online, orders their basket and any additional items and then picks it up at the designated spot and time. We helped with unloading the truck, distributing all of the food into the correct boxes and helping citizens carry items to their car. I enjoyed seeing the various individuals who volunteered as well as the members who participate in this program. A community member was kind and gave Nathan and I one of her baskets so we could experience firsthand the benefits of having the fresh fruits and vegetables! I also traveled to Aberdeen in the afternoon. On this rainy day I was able to visit a few unique shops and boutiques as well as the mall. Sunday was filled with studying and then attending the Faulkton Carousel opening. The town offered hot dogs, lemonade and ice cream to the citizens who attended. The carousel was in full swing and many children (as well as adults!) were enjoying the ride! It was great to see how the community comes together to enjoy a town feature as well as each other’s company. Everyone has been wonderful to talk with and interested in the role I currently play in the town. I hope to experience more community activities in the next two weeks!

Week 2
Monday:
To start off the week, it was Memorial Day and we did not have to go into the hospital today. However, we did get a call in the morning from the on call provider to come in and see a unique patient. I was able to talk with the family about community services they utilize as well as the hospital care received. Faulkton is a critical access hospital but does not perform surgeries. Their role is to stabilize the patient and if necessary transport them to a larger facility that can serve their needs. The providers have to be very knowledgeable in a vast variety of areas and know when FAMC can handle the patient’s situation or if they need to be transferred to another hospital before things get to a point were FAMC can no longer provide what is needed. I have seen how FAMC does an incredible job of working with patients and ensuring they receive the best care possible! For the afternoon I traveled to Aberdeen again to visit Storybook Land. Many providers and community members highly recommended going so I checked it out! It was fun and unique. I loved seeing all the childhood stories I grew up with!

Tuesday:
To start off the day, Nathan and I observed an abdominal ultrasound. The technician performing the ultrasound would describe different items he was seeing or looking for. I enjoyed being able to first hand see the different areas and organs the machine takes pictures of. To finish off the morning I shadowed a provider while she saw clients in the clinic. Each appointment has been different and unique. Jessica, a Certified Nurse Practitioner, has done a phenomenal job of explaining everything that takes place in each appointment to me. She willingly answers all of my questions. This has been a great way to not only gain more knowledge in the health profession but to see how this knowledge will help me in being a strong social worker. In the afternoon, Nathan, Nathan’s girlfriend, and I had a tour at the Pickler Mansion. The Pickler Mansion was another popular landmark that the community encouraged us to visit. I got a glimpse into the past and learned various historical facts about John Pickler and his family. There were A LOT of facts and information and I was very impressed with our tour guide who made the information easy to follow. The community takes pride in this monument and I think that is an important to understand how many rural communities have special gems hidden in their community that they are proud of! In the evening, we had dinner with Cathy and her family on their farm. It was wonderful to be able to sit, eat and get to know a family who was enthusiastic about having us in the community. Their kind hearts and welcoming arms made me feel like I was also part of the Faulkton community! In addition to enjoying the families company, I had the opportunity to bottle feed a calf and hold baby chickens!

Wednesday:
Today, I attended Women in Agriculture Day. This all day conference is held once a year and targets the women who are involved in the community and agriculture. I was able to meet more community members and explain the REHPS program as well as the social work profession. The speaker I found the most pertinent to my profession and the program was Erin from Avera who talked about the Cancer Navigation program. She described the different barriers there can be living in a rural community while having cancer. She also stated how the program can be a support for not only the individual who has cancer but for family, friends or anyone who is impacted by cancer. This is a wonderful resource not only for those living rural but anyone across the state. The conference allowed me to see different women from different professions coming together because they know the importance of agriculture. A quote I took away today was “Everyone is involved in the rural community, not just farmers”. This includes the hospital, providers and social workers.

Thursday:
On Thursday morning, I accompanied Cathy, LCSW-PIP, to perform mental health assessments in the community. Cathy explained to me how living in a smaller community meant that confidentiality was extremely important. Everyone knows everyone! After the assessments I was able to debrief with Cathy and she answered all of my questions. She explained how there are goals set for each patient but depending on age, many of the sessions are life review. It is important to meet each client where they are at. In the elderly population, often times the role of the therapist is to provide support through listening and provide validation. Also when working with a client, the social worker needs to assess if the concern is medical or mental. If they are on any medications, are they on the right ones? Is the dose too high or too low? Are the symptoms a side effect of the medication? Because of these questions, it is important to be working with the doctor, nurses and other disciplines to ensure the best care is given to the patient. The REHPS program is giving me strong exposure to working with an interdisciplinary team that will benefit me as a social worker in any area. In the afternoon, I was able to visit the “Out of School Time” Program available in Faulkton. The teacher and children were very welcoming! I went to the park with the children for recreation time and participated in a nutritional activity with them. All the kids were willing to learn and participate in learning about blueberries. The program did a fantastic job of getting the children excited about healthy foods! I also learned how the program offers a wide range of educational and healthy activities. This experience allowed me to see another great part of the Faulkton community!

Friday:
I spent the day in Pierre with Cathy. I shadowed Cathy as she completed various hospice visits. We went to both nursing homes as well as visited patients living in their homes. These visits provided me the opportunity to learn how hospice also incorporates an interdisciplinary team. There is a MD director, social worker, RN, an aide and chaplain all working together with each patient. There were times that a patient would ask a question and if Cathy was not able to answer, she reassured the patient that a member of the team would be able to. In my experience with social work, I have often heard how social workers working in a rural area drive constantly and do not have any time to chart. Cathy explained how although there is a lot of driving involved due to the area of service being broad, charting is a priority that needs to have time made for it. Medicare encourages charting to be done during “visit” time which means completing charting right after seeing the patient. I also learned how family dynamics can play a large part in caregiving as well as depression. When working in hospice, the whole family is involved in the process and it is just as important to take care of the family as it is the patient.

The Weekend:
On Saturday, I spent some time studying and enjoying the wonderful weather! In the evening, I went and saw a movie at the Faulkton Lyric Theater. The theater shows a movie at 8pm on Friday, Saturday and Sundays during the summer. They pick one movie per week. This week it was Alvin and the Chipmunks. The owner of the theater recognized me as a REHPS student and told me my admission was free! Many community members have commented how they enjoy the idea of the program and that I’m in their town experiencing what they have to offer.

On Sunday I attended a fundraising event the town was having for the FCCLA (Family, Career and Community Leaders of America). I watched teams of all ages play kickball. This was another great opportunity I had to talk with different members of the community about the REHPS program and also about social work. I had a delicious pork loin sandwich dinner. The way the town gathered and supported the youth in the community was inspiring! Many families and individuals came out to provide emotional and financial support. This was a great example of how a small community can have a large impact! I am in awe of how I only have one more week in Faulkton but am excited to see what this coming week has to offer!

Week 3/4
Monday:
I’m still processing how this is my last week in Faulkton! On Monday, I drove up to Aberdeen again to attend a Grief and Loss program put on by the social workers with Avera at Home Hospice. Cathy, who I have been working with the last couple weeks, was one of the social workers putting on the program. The program is open to the public and for anyone who has experienced a loss of a family member or friend. I learned that they provide three different programs throughout the year focusing on different topics associated with grief. During this time I witnessed individuals who had a safe place to talk about their emotions and be able to connect with others who are experiencing similar things. It is important to recognize that taking care of the family is important when providing services to the client. I felt this program allowed many individuals to not feel alone with their grief and to have a safe outlet to express it. In the afternoon, I talked with a provider about the HPV vaccination and what they have seen as far as clients having the vaccination done. The provider informed me that they recommend the vaccination to the target age group and many do partake in the vaccine. FAMC does not perform child vaccinations, the county health nurse does, but the providers do give select vaccinations and HPV can be one. The hospital has a good partnership with community health to ensure children are receiving their vaccinations. During the evening Cathy invited me to her families farm again and I was able to experience more of what living on a farm would be like!

Tuesday:
In in the morning, I had the opportunity to watch part of a colonoscopy. I also was able to see a echocardiogram performed. Today, Nathan and I gave our presentation to the providers as well as community members. I was both surprised and happy that many of the individuals we had worked with the last couple weeks came to hear about our experiences. It was a wonderful experience to share what I have learned both educationally as well as in the community. Many of the individuals in attendance expressed how thankful they were that we participated in the program. Some also discussed how in a rural setting, working together is all they know and working in an interdisciplinary team is essential. The group also had a great discussion on the HPV vaccination and what people are seeing in their community relating to this vaccination’s statistics. I gained even more knowledge in this area by hearing what everyone had to say! I shadowed the pharmacist at the community drug store again for a few hours. I was able to see the meth check system as well as learn about the inspections that are completed by the Board of Pharmacy. I finished out the day by shadowing providers. I was able to look at several digital x-rays and ask more questions about diagnosis of various patients.

Wednesday:
I had the opportunity to shadow a provider again in the nursing home. Although the routine is the same each Wednesday, every patient is different and warrants a different experience. In the afternoon, I was in the Physical Therapy and Occupational Therapy department. I gained an understanding of the difference between the PT and OT roles and how they work together to provide the best care for the patient. There was a variety of patients that were seen and various exercises that were performed. The EStem machine was explained to me. This machine is used for muscle stimulation on the legs or arms. Many of the patients disclosed to me the reason they needed therapy and were very open about the progress or barriers with using PT and OT. I can see the importance of working closely with other disciplines to ensure the patient has the correct care at home and access to the necessary resources to make their therapy successful.

Thursday:
In the morning, Nathan and I visited Dr. Bode, the veterinarian in town. We were able to get a tour of his facility and learn about the different services he provides in the clinic and out on ranches and farms. That morning Dr. Bode was collecting specimen samples, evaluating and giving vaccinations to bulls who were getting prepared to go into pasture with the cows. Dr. Bode explained how ensuring the bulls were “good to go” was vital to the economical outcome of the calves being born. If a bull does not pass the specimen test, there is a high likelihood that they would not reproduce and this would not benefit the family trying to produce calves. I think it is important to understand the procedure and planning that goes in to make sure a farm or ranch is able to operate effectively. Ranching is a large part of the rural community and I feel this experience helped me to fully understand the importance ranching and agriculture has on the community as well as the world.

Friday:
Today is bitter sweet. Although I look forward to returning to my family and friends back home, I am going to miss the hospital and the amazing individuals I have had the pleasure of meeting! In the morning, I observed Dr. Westbrook, an anesthesiologist, perform pain injections in patients who need pain management. Dr. Westbook and her husband Percy fly to Faulkton, SD from Kentucky once a month to hold a two day pain management clinic. On day one, Percy sees patients for oral prescriptions and on day two, Dr. Westbrook gives injections to patients. I found it fascinating how the injections were done and how the one injection is supposed to relieve the patient of pain. During lunch, I was able to sit in on a Drug Rep presentation about a drug that is meant to relieve constipation in patients who are on narcotic pain medication. The drug rep talked about the product and provided the group with lunch. In the afternoon I shadowed a provider for the last time. I thanked a large majority of the individuals I worked with at the clinic but am not fully able to express my gratitude. The REHPS program gave me the opportunity to not only work with various individuals from different disciplines, but I was able to see how the social work profession can play a crucial role in the heath profession. I experienced the rural community first hand and have a grasp on the importance of rural health care. I hope to apply the knowledge and experiences I gained to my future profession as a social worker. Thank you to FAMC staff, providers, community members and the REHPS program for allowing me to grow and learn with you!