Getting to Bennett County Hospital & Nursing Home, Martin, SD for clinical, inter-professional experience, and having the opportunity to work with one of the finest providers I have ever met has been an amazing clinical exposure for me. Not knowing what to expect in underserved community in rural South Dakota, my first 2 –weeks at the hospital has been eye opening and rewarding.

I have had multiple opportunities to demonstrate care and compassion in the clinical setting to the local community with a large proportion being Native Americans. I have learned a lot about their culture and healthcare needs. The first day at Bennett County Hospital & Nursing Home started with orientation to staff (Nursing, Practitioners, Non- medical staff), online training on HIPPA, Basic hospital safety rules, patient care, Hazard awareness, and a tour of the facility.

During the first week, I had the opportunity to see the Nursing Home (NH) with Jason Bustin, PA-C and Hannah Brown, PAC. At the nursing home, we saw 3 patients with ulcers on heels, wounds on amputation and buttocks. There was a staff meeting with PT, OT, Nurses, RT, where we discussed patients in the NH and how they are doing and better ways to improve treatment and manage their health. We spent most morning and afternoons with PA Jason and Hannah seeing patients with skin tags, pre-op physicals for hernia repair, falls injury. From clinic closure until mid night, we spent most of the time at the ER seeing patient with head injuries, leg lacerations, dental pain, foot evulsions. I was able to put in sutures on the foot injuries, stapled head injury, gave injections on trigger points, placed cast on foot, and do lip sutures as well as dental block for dental ache. I feel I have grown in my ability to communicate effectively with my patients and address their concerns. I felt both an increase in my confidence and knowledge in treating and managing patient conditions.

I was able to practice learned skills and also attempt new ones in the first two weeks of my inter-professional experience understanding my own competence and scope of practice as it guides me to good clinical practice and the delivery of my care to my patients. Most of the mornings and afternoons were spent in the clinic and the evenings and nights were spent at the ER. We spent an average of 12hrs/day at the hospital and nursing homes except for weekends where we spent the whole day at the ER. We were always on ER call in times where we were outside the hospital site.

Early part of most days were spent at the nursing home where we (my REHPS colleague, the nurses, health providers) did wound care on several patients (average of 5). Common wounds addressed were abdominal, hip, trochanteric, elbow, coccyx, and foot wounds. I was able to place Foley catheter in patients with urinary retention and dribbling that were admitted. I was able to visit the labs where I understood how various samples are processed to get better results that directs patient care. I also appreciated the time it took for samples to get ready.

At the clinic, I was able to see patients with insomnia, irritable bowel disease, lower back pain, cough, sinusitis, upper respiratory infections, pneumonia, migraine headache, sore throat, ADHD, and back pain. I was able to perform multiple injections which included antibiotic, steroid shots, and pain medications.

The evenings were spent at the ER where we saw patients with chest pain, shortness of breath, ST elevation myocardial infarction, injuries, gunshot wounds, rib pain, assault injuries, suicidal/homicidal ideation, and COPD exacerbation. I was also able to dress wounds and review chest x-rays, fractures, and injuries with my preceptor as well as do sutures on hand and face/lip lacerations on my own.

Interaction with other health professionals was one of the things I really enjoyed during this experience since they all offered unique expertise. The nurses have been helpful to me a lot too. I have understood that poor communication between members of inter-professional teams affects the quality of care patients receive and can result in any number of bad experiences for the patients therefore it is very important to involve patient and family in their care. I really like the idea of meeting in-patients at the bed side with the whole care team and updating the patients and family about their health status and plan of care as well as progress. This was the first unique experience I had when I consider all my other clinical experiences.