Susan Wik
Week 1 at Webster

Welcome to Webster! We rolled into town on Monday morning, May 18th, as snow came down. I raced to haul all my clothes in without getting too cold! We had a tour of the hospital and clinic, met some of the staff, and had a bit of time to settle into our rooms. For lunch, Evelyn (program coordinator) and Kim (health coach) took us out to Pereboom’s, the local café. After lunch, we had a driving tour of Webster where we saw the small-town shops, restaurants, and attractions. The city built a new swimming pool two years ago and is working on a new football field and track. We then went back to the hospital where we shadowed Cheryl Hairgrove, one of the PA’s at the clinic. She did two well-baby exams. I had never worked with children in the clinic, and it was great to see how patient she was with these babies.

The second day we found ourselves in outreach shadowing Kerry Jerke, a certified nurse practitioner who specializes in nephrology. This was also a new experience for me, so I was very excited to shadow her. Nephrology saw a similar patient pool as the Internal Medicine physician I previously shadowed. It was easy to see how much Kerry cared about her patients. She asked questions about their personal lives as well as their health. The best part about shadowing multiple providers is learning about the kind of provider I want to be someday. In the afternoon, we shadowed the physical therapy department. Kyle and Dave said they have not been very busy in the last few weeks, but we did see them work with one patient both using the bike and the steps. Cheri, the REHPS director, came to town to take us out to supper and talk about any questions we might have that night.

Wednesday we started in cardiac rehab with Lana. All heart patients spend some time in cardiac rehab after their procedures; this is where their stamina and progress is measured based on different exercises. Dr. Sharma, an interventional cardiologist, was in outreach in the morning over telemedicine. I had never seen telemedicine before; the stethoscope has a cord that hooks into a laptop, and Dr. Sharma can put on headphones and hear heart and lung sounds. He has said that using the headphones on telemedicine sounds just as good as being there in person with his own stethoscope. The technology was amazing. The local newspaper interviewed us on Wednesday afternoon where they asked about our background, the program, and what got us interested in healthcare. We then shadowed Lola, the other PA in the clinic. She removed a lesion, which was very interesting to watch. Lola invited us to attend her Key Club meeting; she is the advisor for the high school club. We had supper with the club and listened to their meeting as they planned the year’s events.

Thursday we followed the orthopedic outreach physician, Dr. Fites. He saw eight patients with different ailments. We saw several x-rays, thumb injections, and a torn rotator cuff. Orthopedics is another field I have never shadowed. It was very intense. For the afternoon, we shadowed Josh in radiology. He showed some of his most interesting x-rays to us and then took us golfing. It was a great afternoon to experience the Webster community; we didn’t golf too bad either! After golfing, Angie, the hospital pharmacist, took us to her kids’ soccer game because she is the coach. We had a blast cheering on the “Sparrows”! After the game we went to dinner at Pizza Hut with Angie, her husband Tom, and their four kids. Tom and Angie seem like great advocates for the community and growth of Webster; it was fun to hear their ideas and talk about our experiences in Webster so far!

Friday we started downtown at Cornwell’s in the pharmacy. I have never shadowed the pharmacy, nor do I know much about medications or how a pharmacy is run. It was very interesting to see how busy the pharmacy was in such a small community as well as watch how the pharmacist and the tech worked to fill prescriptions. We were invited to a luncheon with the new doctor the clinic is interviewing to hire. He is originally from Syria, but has been practicing in New York for the past twenty years. He is looking to move his family to a small town background. We followed Dr. Gravley in the afternoon; she was on call, and we ended up with a crazy afternoon in the clinic. We saw a fishhook removal, several rashes, a torn Achilles tendon, and three ER visits. I was exhausted by the end of the week, but I ended the day smiling. We have been so welcomed by the staff and community in Webster, and I am so appreciative of the time each preceptor has taken to explain everything to the interns. I am looking forward to next week!

Week 2
The clinic was closed for Memorial Day, so we were sent home for the long weekend. Tuesday we came back to a full day with the surgeon, Dr. Christensen. We saw several colonoscopies and EGD’s, which is a scope of the upper gastrointestinal tract. We also saw several patients of his that day for follow-ups, consults, and scheduling of surgeries. There was a particular patient who came in for a check-up and was suffering from dementia; Dr. Christensen showed such kindness and patience in his examination amidst the patient’s confusion. One of the best parts of this experience is observing everyone’s manner in the exam room. I learned a lot from Dr. Christensen about how I want my own manner to be in the exam room someday.

This week also found us seeing patients in the clinic as well as experiencing nursing home rounds. This was the first time I had been to the Bethesda Nursing Home, and I enjoyed meeting many different residents. All of them seemed excited to see students working in the clinic and truly appreciated Dr. Gravely’s attentiveness. Dr. Amin was also here, an oncologist from Watertown. He was one of the most intense doctors we have met, and he quizzed us in the exam rooms with the patients. This made me nervous but also seems to be one of the best ways to learn. The patients loved him, and I could tell he spent a lot of time getting to know them. Wednesday evening, Dave, the CEO of the hospital, and his wife Heather took us out to eat in Eden, SD. This is the home of the famous wing night where they serve anywhere between 4,000 and 6,000 wings on Wednesday nights. We waited awhile (even though they said it wasn’t a busy night due to the couple of empty tables), but the wings were awesome and the conversation even better. Dave and Heather are so welcoming, and their positive energy is infectious. We laughed so much!

As part of the REHPS program, we are required to collect data about the community in which we are living. There was a training this week, so we travelled to Aberdeen with a few of the other REPHS students. The project is all about wellness coalitions and developing ways to create a safe and healthy environment for the community. We will be interviewing different members of the community to collect this data. More to come on that later. While we were in Aberdeen, we stopped by the State Street Pharmacy to check out what a compounding pharmacy is like and how it works. I had never learned about this at all, so I found it super interesting. Dani (my partner) explained more to me later about the differences between compounding and non-compounding pharmacies.

We closed out the week with one of our best days yet. Melissa, the occupational therapist, took us on a house call with one of her birth-to-three patients. This particular child suffers from a rare syndrome. The symptoms include developmental delay, lack of speech, seizures, and issues with walking and balance. Despite all this, patients with this syndrome are usually very happy and laughing a lot. We saw evidence of all of these things in the little patient we saw. It was such a joy to be around, and Melissa talked a lot about the progress the patient has made. We also experience occupational therapy in the nursing home. The “regulars” were in the exercise room and feeling feisty this morning! It is so fun to meet all the residents and hear about their stories. We then went back down to the clinic to shadow Cheryl. She taught us how to suture using a curved needle attached to thread and an orange! I was so excited, and we took pictures to show our parents as well as carried around our oranges to show everyone in the building! Later we also learned that Evelyn had gotten us in to shadow the OB/GYN in Aberdeen. I am very interested in this field and am really looking forward to this experience!

We are on call this weekend, so hopefully we learn some interesting things about emergency medicine!

Week 3
Our weekend spent on call was relatively quiet with very few ER visits coming in. We were hoping for a bit more excitement, but it is always good to have a quiet ER! This week is full of a few different things, especially getting our interviews for our project done! We spent time with Angie in the hospital pharmacy as well as lots of time in the nursing home, which is conveniently attached to the hospital/clinic. We were able to follow the nurses, the director of nursing, and the nursing home pharmacist as well as shadow a “mock” survey in which Sanford brings specialists into the facility to ensure that everything is up to code. This was a new side of healthcare that I had never seen and gave me an interesting perspective into the safety of residents and patients. 

We were also able to spend an entire day with a podiatrist based in Watertown, Dr. Torness. I can’t say I was the most excited about this outreach experience at the beginning, but by the end of the day I had come to the conclusion that I really liked it! Dr. Torness was fun to work with and treated his patients with the utmost respect. He was also very good about explaining what he was doing. It’s so hard to believe our third week has already come to a close!

Week 4

This week I was able to switch things up a bit and spend two days in Aberdeen with the OB/GYN. Dr. Mueller does outreach in Webster, but our schedules never lined up so I traveled west to check out this specialty! The first day was spent entirely in the office. The number one aspect I enjoyed was that in general, all the patients were happy. It made for a very up-beat office atmosphere. Dr. Mueller invited me back for a second day to see a few surgeries, so I arrived at the hospital early, got outfitted in some scrubs, and went into the OR. The first patient was a c-section; I had never seen a baby born before and it was incredibly special. The technology amazes me; that a mother can be awake and be operated on is really something to witness. There were two hysterectomies scheduled, but one ended up being cancelled. I actually was able to “scrub in” on the second hysterectomy where I was able to hold tools and suction as needed. I worked with Dr. Mueller as well as her father Dr. Anderson from Mitchell; I was thankful to have been able to shadow both of them as it was truly a wonderful learning experience!

After that I headed back to Webster and caught the tail end of shadowing the optometrist. The eyes have always fascinated me, and this experience was super fun because we actually got to look into a few of the instruments ourselves! Wednesday found us shadowing Dr. Sharma, cardiology, once again, but this time he was in Webster not just over telemedicine. I really enjoyed his sense of humor and demeanor when talking with his patients. I think cardiology is very interesting primarily because it is so versatile! That night Ashley, CNO, and her husband Cory took us to dinner at the Bitter Lake Lodge, and we did a bit of fishing after supper. We ended up getting rained out, but several fish were caught (none big enough to keep though)! We still had a lot of fun despite the weather!

That brings us to the close of our time in Webster. It went by incredibly fast, and I learned so much. For me, it was so beneficial to be able to see so many different physicians and the way they approach patient care. I was also thankful to have developed a relationship with many of the staff members as well as Dani!