Brandon Reiff on his time in Miller
I arrived in Miller on Monday night after the long Memorial Day weekend. I was extremely excited to get started with all of the amazing experiences and opportunities that I knew were ahead of me. My first day started with a short meet and greet breakfast with some of the staff of the hospital. Right away I could tell that they were going to be very welcoming. After breakfast, Marissa gave Victor and I a tour of the town. I must say that I was surprised with all that Miller has to offer for a town of around 1500 people. There is a movie drive in, a race track, a golf course, Dairy Queen, and many other stores and restaurants that I was not expecting. For the remainder of the day I was at the local community pharmacy, Rexall Drug. The first thing that stuck out to me was how kind Travis and his technicians were and how much the community trusted them. Travis showed me around the pharmacy and even allowed me to fill some prescriptions on the first day. Rexall Drug is much different than the retail pharmacies that I am used to that are located in grocery stores in Sioux Falls. His pharmacy had an ice cream bar where many of the locals would come at lunchtime to visit with one another and it was also like a gift store where you could find pretty much anything you need. At the end of the night Cheri came to town and took Victor and myself out to dinner at Willies Bar and Grill which was really good. To finish the night off Victor and I went to the local grocery store to grab a few things and then we hit the hay in our cozy sleep study rooms.
On the second day, I was able to follow Dr. Hopkins in the hospital clinic. This was my first time ever following a doctor so I was very excited. Throughout the day, Dr. Hopkins and I met with patients of all backgrounds and disease states. The majority of the patients were getting check ups for their diabetes, high blood pressure, or high cholesterol. Dr. Hopkins and his patients had a very close relationship and I could tell that he truly did care for his patients. I was able to watch a prostate exam and multiple annual physicals.
I spent the remaining two days of the week at Rexall Drug. I was able to help fill prescriptions and counsel some patients with Travis’s guidance. Whenever a patient came into the pharmacy Travis knew them by name and would always start up a conversation with them. Travis was also very helpful with any questions or concerns that anyone had. On the final day of the week Travis and I made a home visit to counsel a patient with a disability that made it hard to travel to the pharmacy. In any bigger city, I do not believe that a pharmacist would take the initiative that Travis did to make sure that this person was taking their medications as they were directed. This is one example of how close the relationships people have with one another in Miller. For the weekend I traveled about an hour southwest to Chamberlain to go fishing. Overall, my first week here in Miller has been fun and rewarding and I am excited for the next three weeks!
On Monday morning, I had the opportunity to follow Kim, a respiratory therapist. Kim was very knowledgeable about her field and was also a great teacher. Throughout the morning she explained to me what CPAP machines are used for, the goal of sleep studies, and how they help treat sleep apnea. I was able to look at the results from one of the sleep studies and it was very interesting to see how people’s oxygen levels can get dangerously low during the night. When this happens, a CPAP machine is used to help them breath during the night. Kim also showed me a device called the LUCAS. This is a device that can do chest compressions on patients who are in cardiac arrest. During the afternoon, I visited Rexall Drug again and continued to work on my craft as a future pharmacist. That evening Victor and I did a little shopping at the local Dollar General and also went to Dairy Queen.
On Tuesday, I was able to spend the entire day at Rexall Drug where I spent some time making blood pressure and blood glucose handouts for our community project in the upcoming week.
On Wednesday, I followed Alica in the laboratory. The lab was full of all kinds of different machines that are used everyday to check CBCs, electrolytes, cholesterol, INRs, and many others. While in the lab, a patient came into the ER for heat exhaustion. The doctor called the lab and we rushed down there to draw blood and start performing the tests that were ordered. Alica was very quick and efficient and I was able to see how crucial the lab is for diagnosis.
Thursday, Victor and I had the privilege of watching Dr. Bormes perform cataract surgeries. Dr. Bormes travels from Aberdeen once a month to Miller to do cataract surgeries. We were able to look through an additional microscope that allowed us to observe every incision and move that Dr. Bormes made. I could tell that he has been doing these types of surgeries for many years as he made it look so easy and each eye only took about 8-10 minutes. I was also able to visit with the anesthesiologist about what type of medications that the patients were being given to help them relax. For the remainder of the day I was able to follow a physical therapist. During my time with her we saw 3 different patients and helped them do their exercises. That night Victor and I went to Turtle Creek Saloon, a local bar that we were told had excellent steaks and we were not disappointed.
On Friday, I was able to follow two radiology technicians. I was able to see the process that goes into doing both CT scans and x-Rays. They also had a stack of about 100 old x-rays that I was able to go through and try to figure out what I was looking at. Friday afternoon was spent at Rexall Drug.
Monday morning I had the opportunity to follow Vance, a registered nurse. That morning Vance was responsible for taking care of two patients who were going through alcohol and narcotic withdrawals. Both patients had classic symptoms of withdrawal including sweating, tremors, and anxiety. Vance was very good at communicating with the patients even though they were in an agitated state and also kept an open line of communication with the provider about what he was seeing. Later in the morning a patient came into the ER complaining of chest pain. Right away people from all areas of the hospital came to work the patient up including radiology, lab, respiratory therapy, and the physician on call. It was really exciting to see how fast they respond to ER visits and the teamwork that is utilized to optimize patient care. If anyone ever has to come to the Miller emergency department, you can rest assured that you are in the best of hands. That afternoon I started the hospital pharmacy project. This project consisted of me doing inventory of all the oral and IV products that the hospital had in stock. That evening, Victor and I went to Guardians of the Galaxy II at the drive-in theatre.
On Tuesday I traveled to the nursing home in Highmore, about 20 miles west of Miller, with Dr. Hopkins to do rounds. We saw 5 residents there for routine checkups where he talked with the residents about how they were doing and if they had any concerns. After that we traveled back to Miller and went to the nursing home located in Miller to do rounds. There we saw about 15 patients, mostly for routine checkups as well. That evening Victor and I went and played some pool at the Turtle Creek Saloon.
I spent Wednesday morning at Rexall drug with Travis and his staff. Travis put me to work doing prescription transfers, some dispensing, and also counseling. That afternoon I went back to the hospital to work on the pharmacy inventory. This was a tedious project but was very important, as the hospital needs to know which medications they are running low on.
On Thursday I spent the morning with radiology. A special truck came from Aberdeen that was capable of doing mammograms. I was able to go through the process with the technicians of how mammograms are performed and what they are looking for. The remaining of the day I spent finishing up the hospital inventory. Overall, the project took me about 10 hours to complete.
To finish out the week Victor and I held our community project at Rexall Drug. Travis allowed us to use his pharmacy to conduct free blood pressure and blood glucose screenings for the public. It was a very successful event as we were able to check 40 blood pressures and 30 blood sugars. Throughout the day we did see some patients who had very high blood pressures and glucose. We were able to refer these people to the clinic to get further evaluation. Later we learned that these people had no idea that they had high levels and were even diagnosed and started on medication after their clinic evaluation. Overall it was another great week in Miller and I am looking forward to one last week!
On Monday I spent the entire day over at Rexall Drug. I was able to experience just how busy it is at Rexall Drug on a Monday and I think that this shows how important the drug store is to the community of Miller. There I was able to continue learning from Travis as he always had something new to teach each day.
On Tuesday I spent the day following Dr. Hopkins in the clinic. Throughout the day we saw many different patients some who came in for routine physicals and others for more serious issues. One patient came in complaining of chest pain, shortness of breath, and fatigue, which were all unusual symptoms for this patient as he/she was usually very active. Dr. Hopkins ordered some lab tests that came back showing that the patient had possibly experienced a heart attack just days prior. Right away Dr. Hopkins decided that we needed to fly this patient to Sioux Falls as soon as possible. We took the patient over to the ER where we began the necessary prep for the 45-minute helicopter ride to Sioux Falls. We later saw another patient who came in with neck stiffness, body aches, a headache, chills, and a fever. Dr. Hopkins believed that this patient may have contracted the West Nile virus and sent the patient to the lab. The lab test that is used to detect West Nile takes multiple days to be completed so I was not able to see what the cause of this patient’s symptoms were. Overall, it was a busy but exciting day in the clinic.
On Wednesday Victor and I had the opportunity to watch Dr. Werth perform colonoscopy surgery on multiple patients. It was very interesting to see how the scope and different tools are utilized to examine the colon. Dr. Werth explained to us that 90% of colon cancers are preventable by getting colonoscopies because during a colonoscopy the surgeon is able to remove pre-cancerous polyps. Later that day Cheri came to town and took Victor, Marissa, and myself out to eat at the Hi-Lite grill, which is a local favorite. The remainder of the day was spent working on our presentation for our final day in Miller!
I spent my last morning here in Miller over at Rexall Drug. I can’t thank Travis and the rest of his staff enough for letting me spend so much time in their pharmacy and teaching me so many different things. One day I hope to have such a great relationship with my patients and community as Travis does. Our last hour in Miller was spent eating lunch with the staff members of the hospital. We had a taco bar and Victor and I gave our presentation explaining what we did throughout the four weeks and how much we enjoyed our time here. Overall, REHPS is an awesome program that allowed me to meet so many different people and learn so much about multiple different fields of health care. I just want to say thank you to all that allowed me to follow them and for being so genuinely kind to me during my stay!