Rebecca Jarratt
First Week at Sisseton
This week, Ashley and I were very busy in Sisseton! Starting on Tuesday morning, we were able to meet all of the staff members at Coteau Des Prairies (CDP) Hospital. Everyone was very welcoming and inviting to us. For lunch, Cheri took us to a local restaurant, The Cottage, and afterward, we drove out to the infamous Nicollet Tower. To our surprise, the tower was covered in caterpillars! Here is a photo from the top of the tower!

On Wednesday, we were able to attend a community meeting at the Aliive facility. Here, we listened as they spoke about plans to reduce the suicide rate, and to educate middle and high schoolers about the resources that are available to them. The community is also in the midst of opening a food pantry, and we were able to hear the plans and timeline involved with this project. After our meeting, we visited Kerri Peters at the local Indian Health Services (IHS), and toured the facility. It was very interesting to see the multitude of services available, and to learn about the process of billing and involvement with the Tribal Council. CDP works very closely with the IHS, and some providers work part time at both facilities.
For the remainder of the week, I spent my time following various providers at CDP. With Dr. Meadows, I got a glimpse of health care in the nursing home. We met with a few patients, and worked to sort through their medication lists. I also followed Dr. Staub as he split his time between the clinic and emergency department. I was surprised to see how busy his day was, as he raced back and forth between the two units. This aspect shows one of the major differences between rural and urban health care, as one provider has multiple responsibilities during one shift. With Dr. Staub, I also had my first experience of dictating for patient records!

During night and weekend hours, I was able to shadow Dr. Gallagher in the emergency department. We had some interesting cases come in, involving car accident patients and chest pain. I was very fortunate to take on a few patients of my own, and work with Dr. Gallagher to reach a diagnosis and plan of treatment. On Sunday night, I performed my first set of sutures! I am looking forward to more experiences in the emergency department!

Week Two
During my second week in Sisseton, I got to experience many different aspects of health care. On Monday, I visited the Browns Valley clinic, where I worked with Dr. Gallagher. Browns Valley is about 20 minutes east of Sisseton, and is one of the satellite clinic’s Dr. Gallagher sees. Together, we saw about 15 patients, which kept us busy all morning. On Tuesday, I again shadowed Dr. Gallagher in the CDP clinic in Sisseton. Later that night, I attended a prenatal class hosted by one of the nurses, Nicole. We spent the evening talking about the benefits of skin-to-skin contact after delivery, the advantages of breastfeeding for mom and baby, and reviewing a balanced diet for a pregnant mom before and after delivery.

Wednesday was an exciting day, as I was able to manage camera for a laparoscopic cholecystectomy (gall bladder removal). This was the first laparoscopic surgery I had seen, and Dr. Kamlitz was very knowledgeable as she walked me through each step. She taught me a new type of suture, and allowed me to close two of the incisions. Thursday afternoon, I spent a few hours on the simulation truck. Here, nurses, physicians, nurse practitioners and pharmacists worked together to treat a simulation patient. The scenarios were very realistic, as the simulation dummy had pulses, could bleed and sweat, had breath and heart sounds, and the pupils could react to light. The situations were interesting, and it was a great way to practice our skills while working alongside other disciplines.

On Friday, Ashley and I were able to get involved in a community event! For a local babysitting clinic, we taught first aid and choking procedures for infants. Fourteen girls, aged 10-14, attended the clinic, and their day was packed with learning first aid, preparation of healthy snacks, games to play with children, and safety when babysitting. They also had a chance to tour an ambulance, which they loved! It was a great event for younger individuals to attend, and help them feel more comfortable and safe while babysitting siblings or other children.

Overall, it was another great and busy week for me! I am looking forward to attending Relay for Life next Friday, and for more hours in the clinic throughout the week!

Week Three
I started off week three with a fun Monday in the pharmacy! I have not spent much time in the pharmacy to this point, so it was a new experience. Over the course of the day, Ashley showed me how to fill the Pyxis machines in the hospital and emergency departments. We also unit dosed many medications, and conducted medical reconciliations for patients. It was enjoyable to meet with the patients in the hospital and go over their medication lists with them.

On Tuesday, I spent the day with Jackie Bartlett, a PA, at the Rosholt clinic. She allowed me to meet with the patients first, to gather information. I also was able to conduct a short physical exam including examination of the ears, throat, heart and lung sounds, as well as a verbal review of systems. We saw mainly acute injuries or issues, and renewed prescriptions. Wednesday, I again shadowed Dr. Gallagher in the clinic and emergency department.

On Thursday, Ashley and I made our way over to IHS with a CDP social worker, Melissa. There, we met for the “First 1,000 Days” meeting, where they discussed the issue of pregnant mothers that are addicted to drugs, and adverse childhood experiences. It was a very eye-opening meeting, as we heard about a conference they had put on. The conference seemed to influence many of the attendees, and they will continue to hold them in the future. During the afternoon, I shadowed a physical therapist and a speech language pathologist. With the speech language pathologist, I was able to sit in on a patient session as they worked on improving cognitive function and memory recall.

Friday was another busy day as we spent most of our time in the emergency department. There, I was able to start my first IV on an elderly patient. The IV went well, and I was able to administer his injectable medications. Later that day, we helped set up for the local Relay for Life event, and stayed to help sell tickets at the prize giveaway.

Week Four
I can’t believe it is already my last week! Time has flown by. On Monday, I was able to shadow Dr. Peterson, and Tuesday, I spent with Dr. Gallagher. I was thrilled to get more clinic time in! On Wednesday, I started the day with a mole removal alongside Dr. Gallagher. After removing the skin, Dr. Gallagher allowed me to suture the patient. I can already see that my sutures have greatly improved throughout my four week experience. After this, I also got to manage camera for another laproscopic cholecystectomy. Afterward, I was able to suture two incision sites.

Later on Wednesday, I spent a few hours in the lab, and learned how to do a urine analysis. I was also introduced to the blood testing that is done in Sisseton, and was able to see how cultures are grown. During lunch, I was paged over the intercom to scrub in for an emergency laproscopic appendectomy. The surgery was surprisingly quick, and I was again allowed to manage camera. As usual, I got to suture a few of the incision sites.

During the rest of the week, I spent more time with Dr. Peterson. On Thursday afternoon, Ashley and I were able to witness a vaginal delivery. The experience was wonderful, and it solidified my desire to become an OB/GYN. Dr. Peterson was a joy to work with, and I appreciate her knowledge and eagerness to get students involved as much as possible.

Friday, Ashley and I shared our presentation with a group of staff from CDP. We are both so glad we were able to be a part of the REHPS program, and feel that we were exposed to many different areas of health care. Thank you to all of the CDP staff and to Cheri for organizing this experience and for welcoming us into the community of CDP/Sisseton!