2019 REHPS Robert Kranz
The hospital Fall River Health Services is integral to the health and welfare of the Hot Springs community. The people of the town are very invested in the hospital. The hospital runs as a 25 bed critical access hospital, 24/7 emergency room, “7 Sisters” which is a 48 bed nursing home and a walk-in clinic offering a menagerie of health services.
The first week had a variety of healthcare related and community based experiences. I met my rural experience partner Luke who was based in clinical psychology the Sunday before our first week. We partnered in attending quality assessment meetings, nursing home meetings, manager meetings, infectious disease control meetings, and engaged with psychologists, doctors, and pharmacists in their work. We also shadowed ultrasound, CT, nurses, HR, special services, and just about every other operation of the hospital. Every employee had their own stories about Hot Springs and the community they were eager to share. To give one example, Brian, who handled Medicare cases, lent us a book of trails and hikes in the surrounding area. Luke and I were able to use the book to hike black elk peak, cathedral spires, and to see many more scenic locations around Hot Springs and Custer. In addition, I assisted pharmacy technicians with filling bubble packs, Omnicell machines, and delivering medications to the Pine Hills assisted living center, VA veteran’s center, and patient rooms. We also worked to ensure medication carts and Omnicell machines were well stocked and ready for nurse use.
The second week I spent time shadowing Doctor Lias, Doctor Robbins, Doctor Score, and the Psychiatric Nurse Practitioner, Tracy Romey, as well as Dr. Wilson. I was grateful for the long list of clinical experiences, surgeries, and procedures that I was able to experience. I worked under Dr. Robbins for the administration of a Kenalog and Lidocaine knee injection and observed Dr. Lias complete a hernia surgery. At the conclusion of my second week, I worked with my preceptors, Shelly and Sue to work with NIOSH drugs at the veteran’s home.
My last two weeks at the Fall Rivers Health Systems was again, a whirlwind of unique experiences and opportunities to learn. During this time at FRHS, my partner Luke and I received the chance to shadow a rural veterinarian named Kayla Brown. We experienced the necessity of Kayla’s work in the rural setting. In the morning we helped her perform autopsies on calves of some local ranchers. Kayla cut samples from the calves themselves and we packaged them for the university to determine what type of disease was killing the calves. Kayla allowed me to administer injections and vaccines to animals under her close supervision. We joined her on her trip to Custer, where we worked with alpaca, donkey, horses, pigs, and house pets. One of the ranchers allowed us to ride horses around his ranch after we worked with his animals. Kayla was kind to animal owners as well as professional, and very capable. It was astounding to see her work as she administered dental care, chiropractic care, wound care, and surgeries to the animals she worked with. Her scope and ability to practice was amazing.
I had the opportunity to shadow Mr. Greg Zike, a physician’s assistant at Fall River. He taught me a great deal about the medical system and how to live the good Christian life. He was willing to take a personal interest in me, more than just my education. He had one of the best bedside manners I had ever seen. He caused nervous pediatric patients to laugh and smile, while simultaneously speaking professionally to their parents, or working carefully with adult patients to help them understand their particular disease state. It was a pleasure and a privilege to shadow him.
One of my pharmacy preceptors Sue Kopp and I worked together to create new Diabetic type II handouts that would be given to newly diagnosed type II patients. These handouts were more precisely geared toward those patients who might not be willing to read a great deal of information. It was very condensed so as to give patients a good idea of how to treat their disease state. Sue further had the idea to make auxiliary handouts that patients could be given which provided more and more detail on particular sections like diet, exercising, foot care, dental and eye care, and other topics.
Natalie, a pharmacy student on rotation, and I got the chance to scrub in for 7 surgeries under Dr. Lias. It was incredible to see the different procedures from a pharmacy standpoint. We also worked to compound tetracycline eye drops using sterile technique and a filter system. The compounding was difficult but also a very valuable and challenging experience.
In short, my time at Fall River Health Services has taught me so much about rural health care, and the health system in general. I have received so much perspective into many different aspects of healthcare. The time I spent with REHPS I will never forget, and I will carry the knowledge and lessons I learned here far into my career.