Week 1 at Chamberlain

This week was a very busy, yet rewarding week. While Monday was mostly laid back, by Tuesday I was bouncing around all over the hospital and beyond. Thus far, I have gotten to work with nurses in the hospital and care center; spoke Spanish with a patient who knew no English; worked with a vascular physician; observed a surgery; worked and traveled with social workers to manage cases; observed administration and logistics within the hospital; and visited with pharmacy workers, in which I studied drugs related to mental health. I think the most notable realization of my experience thus far is how incredibly flexible health care systems have to be in a rural setting. Sure, there are limitations to the amount of technology or the amount of surgeons available, but it is just astounding to learn about how adaptable each employee has to be, filling more roles than when placed at a large hospital, and attending more training sessions to understand how to fill those roles. The people here are brave, genuine, and have such hard work ethics, which makes me have so much respect for life in rural SD. I look forward to the next three weeks because I know I have so much more to learn and experience!

Week 2

Monday
Monday was an eventful day. There were so many patients in the hospital, ranging from birth to very old age.  Over the weekend, there were two births, meaning that there were four extra patients that came in unexpectedly over the weekend. That is a lot added to the plate for a rural hospital. Additionally, there was another mom in labor throughout the entire day today. I spent most of my time learning about the process of labor, but wasn’t able to get in on the birth. I found myself wondering what kind of mental health care new moms get, and especially for those who have a history of mental disorders. That is something I will look into throughout my time here. Instead of witnessing the birth, I was working out with a junior high/high school athletic training program called Power. That was quite the workout considering it was nearly 90 degrees Fahrenheit and lots of humidity! It was also rewarding, because I am always interested in physical training. It was a long day, but very cool to see how much this Chamberlain health care setting has to offer its area.

Tuesday
Tuesday, I spent a lot of time with the nurses and social workers that dealt with case management. I have learned how much these social workers and nurses have to think ahead for their patients. There are many geriatric patients in the hospital, and with the Care Center (nursing home) on site, the social workers are consistently looking to see whether or not patients of the hospital are a fit for the Care Center, or if they would be better off at a different nursing home.  A lot goes into this planning, and I respect them very much for taking most, if not all, of the responsibility for fitting their patients into the right spot with all the right accommodations made for them.  It is impressive, and my hat’s off to them.

We also went to the hospital’s board meeting. That was interesting.  There is this statewide phenomena occurring in which unemployment is low, while the demand for skilled jobs is increasing. By skilled jobs, I mean the type of jobs in which a couple years of post-high school education at most is needed. There is a rise in jobs that do not require as much education as what is sought after in today’s society such as Certified Nursing Assistants and jobs that are skills based rather than bachelor’s or beyond that.

Wednesday
Wednesday started off in the Coumadin Clinic, and then to St. Joe’s Counseling Services with the social worker. To me, the highlight of this day was at St. Joe’s. I really enjoyed understanding how it all worked out. I went to a Catholic school growing up, and so I really appreciate settings that get to sort of lay their own rules and practice their own faith. It was awesome to learn that the Native American religion and culture was accounted for in the Catholic belief system there on campus. It was also great to learn about the widespread use of mental health professionals there on campus.

Thursday
Thursday was a busy day. First, I observed a colonoscopy, which was very interesting to learn about because I know someday I will have to experience all of that! Then, Tami and I interviewed the superintendent of the Chamberlain school district for the SD Good and Healthy project. From there, we visited the clinical psychologist in town, who actually went through the same graduate program at USD as I am! That was definitely the highlight of my day. I was able to understand how the exact degree I am obtaining earns the ability to work and thrive in a rural setting. I loved hearing that she does a little bit of everything that applies to mental health, which keeps life interesting. After visiting with her and having lunch, Tami and I went to physical therapy and spent some time understanding their role at Sanford. To finish off the night, we helped set up for the Relay for Life event that was to take place on Friday. It was good to meet new people there, and I was happy to help such a good cause!

Friday
Today, Tami and I followed the health coach in the morning. The health coach is a title given to Sanford nurses who undergo training to help individuals reach their attainable health goals. It’s a free program for anyone to use, and consists of basic guidance for individuals who might want to lose weight, manage their diet, learn about nutrition, manage their diabetes, and much more. Doing all of these things help prevent problems relating to diabetes, congestive heart failure, heart disease, etc. I love that there is prevention going on in health systems today! There even was a mental health questionnaire to ensure individuals are doing well in that respect, with follow-ups if there were any risks. What a great day!

 Week 3
July 27- August 2
Monday
Today, Tami and I spent the morning covering some HIPPA requirements for our afternoon visit to the Indian Health Service (IHS) in Fort Thompson, SD. After the HIPPA video, we helped Jessica Neilan work with Sanford’s photographer for a program they are starting this fall. The goal of this new program is to prevent emergency visits that are less than emergencies. About 90% of emergency visits to Sanford Chamberlain are not actually considered emergencies, which end up costing the hospital and patients a lot more money than necessary. This program is an educational one, promoted through brochures, health fairs, physician and nurse education during clinic visits, and much more. I think it is a great idea, and hopefully it will lessen emergency visits. At the Ft. Thompson IHS, we visited with the pharmacists there, and learned a lot about how it is a good mixture of retail and hospital pharmacy work. We also learned about public health service work, which an awesome program to get into if you can work it perfectly to fit your life, and is much easier to do in an IHS setting.

Tuesday
Today, Tami and I helped with Camp Fuel. This is a health and wellness camp for grade school kids in Chamberlain. The dietician hosted the camp, and she had a lot of planned activities for the kids. During this day of camp, we visited Kimball, SD to understand how the popcorn ball factory works. It was awesome to learn that they have a honey-flavored popcorn, which is healthier than other sugar flavorings. I think in another life, I probably would have been a dietician. I love everything that revolves around healthy living, which is probably why I enjoy preventative psychological work, also! It was a rewarding day.

Wednesday
Wednesday was a busy day. We spent time in the Coumadin clinic, observed some radiology readings, worked with a social worker, and finished out the night by helping out at the Care Center (nursing home) family meeting. We also went to coed softball, and played in two games. It was a busy, but fun day. A lot was learned, and I met many new people.

Thursday
Today, I followed the Cardiologist who travels to Chamberlain every couple weeks for appointments. This process was so interesting to observe. There is such advancement in technology for understanding the function of the heart. Some patients underwent a test in which the function of the heart was measured, and other patients were having checkups with Dr. Stys, the cardiologist. He was a brilliant man, and it was awesome to hear a practicing cardiologist does research, also. I hope I will be able to keep up with the world of research while being a psychologist.

Friday
Today, the morning was spent observing a C-section, which was an educational experience. It was just amazing to see a living being enter the world, with the help of the scientifically tested medical advances. The afternoon was then spent with the social worker, helping to admit a new individual into the Care Center. It is quite a lengthy process. One thing I definitely learned about this process is how easily connected these rural health systems are, which can make the job of transferring, admitting, and releasing patients a lot easier. We finished out today by going to Kimball, where we watched some bull riding. It was a fun night!

Week 4

Aug 3-9
Monday
Today, we spent the majority of the day with the physicians and nurses in the clinic who performed sports physicals for the upcoming school year. Doing so took me back to my younger years. It is different, however, in that the kids who go to Chamberlain school actually have to do these physicals yearly, while I remember them being biyearly when I was in school. I can see why they are conducted yearly, because a lot can change during those years of such growth and activity. It was great to visit with the physicians and nurses and understand their perspective in the whole process. It was a great Monday!

 

Tuesday
Today, Tami and I started off at nursing huddles, which is always interesting because then we get to know the latest on the hospital patients. Then, we visited with a  blood pathologist, who basically regulates and manages the blood transfusions within Sanford Chamberlain. From there, we had lunch with Paul (operations manager) and the St. Francis board he is on, which promotes economic development within the area’s communities. It was awesome to get in on all the upcoming attractions they are planning for the area, and to learn of the work they do promoting new community professionals in order to keep them here. From there, I worked a bit with a social worker. Lastly, I had an ultrasound done because the radiology unit is training new employees. I had never had an ultrasound, so this was a rewarding experience. All my organs were in the right place. That was reassuring.

 

Wednesday
Today we first met Greg, from the city management crew, for the SD Good and Healthy Project. He was a great person to meet with because he was talkative and thoroughly explained how a river and tourist community strives to support its residents’ health. From there, I went to the Coumadin clinic, which was not a lot new information, but still a good to experience. From there, Tami and I headed to a Care Center resident meeting, where the residents discussed new and old business and concerns regarding their experiences. They also voted for going out to eat one night for supper, which I could tell meant a lot to a few of the residents. From there, we had lunch. After lunch, we went to a managers gathering, where all the managers discussed what’s been going on lately both professionally and personally. That is something I think is good for communication throughout the hospital, but is also good self-care because support is available. From there, we worked on our presentation for Friday, and then headed to the laboratory to learn about the capabilities and limitations of the Chamberlain lab. They can do a lot more tests than I anticipated, so that was good. Tonight, we are headed to play softball in a coed softball tournament.

 

Thursday
Today, it was easy to gather that our time here in Chamberlain is coming to an end. The morning was busy, but the late afternoon was given for packing time. In the morning, I went to nursing huddles. From there, I was in on a care conference for five residents living in the Care Center. Care conferences are basically checkups on the care given to the residents, including information from nurses on medications and mood, dietary updates, case management updates, and activities updates. I really enjoyed this time because I like this holistic approach in the Care Center, and they cover mental health, which is even more interesting to me. After this, I went down to the Chamberlain community center and listened to Mindy, the dietician, give a presentation on nutrition to some women in a group called Ollie. Food is another topic I am interested in a lot, so this was a great day for me. Tami and I also went to Sanford Home Health and learned about the services they offer to the area. We ended the day with dinner in Kimball with a couple physicians and Mindy, the dietician.

 

Friday
Today, we gave our presentation about our experiences while in Chamberlain. It was informal, but that was what Tami and I thought was best for the audience, the timing, and us. I really enjoyed my time here in Chamberlain, SD. I know I will always remember this time. I was so fortunate to live for four weeks riverside, with a great family, and a great deal of time committed to learning how rural healthcare works. I will always be a resident of South Dakota, and if the opportunity is just right, I might even return to Chamberlain someday for my career as a Clinical Psychologist.