Elizabeth Scholl, Medical Lab Science Student, on her time in Winner
I arrived in Winner on Sunday the 7th of May, before my partner, and I got all settled into the loft that we will be living in for the rest of the internship. After getting settled in, I took a walk and ended up at the hospital and scoped it out so I knew where to go the next morning.
On Monday, I met up with my partner, Jodi, a nurse practitioner student, before entering the hospital and meeting our preceptor, Krystal, an RN. We were originally going to tour the town and the hospital/long term care/clinic in the morning but an outreach physician, Dr. McNamara, was at the hospital for high risk pregnancy visits so we shadowed him all morning. I got to see multiple ultrasounds for my first time ever and learned more about what is important to look at in a developing fetus to assess its health. After lunch, Krystal took us on a tour of Winner and the hospital facilities. We helped Jodi get settled into the loft and I made tacos for us and of course had to give myself an oil burn.
I spent Tuesday with Dr. Taylor, DO, in the clinic. We saw multiple patients with various conditions and he introduced me to an interesting book on laboratory diagnostics. We ended the day by discharging a patient from the hospital. Cheri came at lunch and took us out to eat at Sargent’s.
On Wednesday, I spent a lot of the time in the lab and in radiology. I got to see two CT scans and do some micro work in the lab.
On Thursday, an outreach ophthalmologist was here to perform cataract surgeries. I had the opportunity to see two of the surgeries and saw the entire process of a patient being checked in to them being checked out. The surgery process is interesting especially when the broken-up lens is sucked out of the patient’s eye before they receive a new lens.
I was scheduled to go to Burke with Dr. Clark on Friday but she had no patients to see so I ended up staying in Winner and spent most of the day hanging out in the lab. They even let me draw blood on two patients! I also spent some time in the ER and got to follow a boy who had broken his arm. I was able to easily identify the fracture on the X-ray without any help!
The coolest thing I got to see this week was two deliveries!! One was around 10 pm and I did not mind losing sleep over it because watching life enter this world is the most amazing thing ever.
On Saturday, I drove up to Pukwana to visit my friend and his 200 baby pheasants.
On Sunday, I went to First Baptist Church in Winner with a friend from college, Trevor. Later that day, I drove out to his ranch and met up with some more college friends and shot a few guns which I’m not used to. I somehow wasn’t a terrible shot!
After a fun weekend with some college friends, it was back to the hospital on Monday.
I was scheduled to be in surgery in the morning. A patient was getting a colonoscopy and hemorrhoidectomy. This was my first time seeing a colonoscopy and I thought it was very interesting and I can say that I am not excited to get them when I’m older! I also didn’t realize that hemorrhoids could be so big!
Next, I had the opportunity to see a port flush. Ports for chemotherapy need to be flushed once in a while when they aren’t being used for chemo for a certain time.
In the afternoon, I was scheduled to be in the clinic with a CNP but she was actually the hospital based provider for that afternoon. Because there were no ED patients, she had no patients to see at all so I learned about charting.
On Tuesday, Jodi and I did our community outreach program with 2nd graders that were getting a tour of the hospital. We taught them about sun safety and gave them goodie bags with sunscreen and sunglasses. In the afternoon, I spent time in the long term care facility (nursing home) with the head nurse and then with Dr. Henderson on her rounds.
On Wednesday, an orthopedic surgeon was at the hospital doing outpatient check ups and surgery consults so I followed him and the physical therapists all morning. There was one very interesting case of a knee that moved all sorts of directions due to the lack of the ACL. In the afternoon, I spent time in the clinic with Dr. Taylor. We saw some interesting cases and I learned about BP reference ranges being different for every patient based on their age and medical conditions.
On Thursday, I spent the morning with Jodi in the pharmacy. We pulled drugs off the shelves for patients and I realized that some patients require only a few and others require more pills than I would care to swallow. We also restocked the Pyxis out on the floor. This was my first time dealing with a Pyxis and I think it is a very interesting system that is great for drug control. In the afternoon, I spent some time in the lab.
On Friday, I was scheduled to be in the lab all day and came in at 0600 instead of 0800 to draw blood on some inpatients and clinic patients. The lab techs let me draw blood on 5 patients and I didn’t miss a single one! I also spent some time in the ED when there were patients there. It was one of the more exciting days in the ED for Winner so I’m happy I got to be in the ED a little but that day. The rest of the time that I had in the lab was spent running samples and learning a bit about IHS from the lab techs.
This week was a very full week of exciting and unique experiences for a Medical Laboratory Science student.To start the week off, I followed Dr. Mahrous, a cardiologist that comes down to Winner from the Avera Heart Hospital. I learned about and saw nuclear stress tests, an echocardiogram, and vasovagal syncopy. I also learned a little about TAVR (transcatheter aortic valve replacement) which can be used as an alternative to open heart surgery in order to replace a valve. A third-year Med student was also following the cardiologist with me and he was able to answer some of my questions. Finally, Dr. Mahrous taught us about the Goldman (or Revised Cardiac Risk Index) which is a set of five conditions that help to assess risk in a noncardiac surgery.
On Tuesday, I spent the first hour in the lab. I got to draw a surgery patient and set up a few samples. I also had the opportunity to help switch out old units of blood with new units (the older units get sent back to Rapid City where they can actually get used before they expire). After that, I followed the audiologist, Al, who comes down from Pierre to check on patients’ hearing and get them fitted for hearing aids. To be honest, I did not think I would enjoy this, but I learned a lot and actually had fun! He even tested my hearing in between his patients; contrary to what I thought, my hearing is pretty darn good.
On Wednesday, I went to the Jail with one of the PA’s and we saw four patients there. I also followed a nurse with a cardiac rehab patient; the patient was monitored while walking on a treadmill for 30 minutes. I spent some time with the lab manager in her office looking at QC material and doing some of my own calculations which I really enjoyed (I hope to be a lab manager someday). There was also an ER patient so I followed the PA through the process of figuring out a diagnosis and then deciding what to do next and where to send the patient. It was a very interesting case that I am glad I got to be a part of.
Thursday was an exciting day because I got to go to the clinics in White River and Mission, on Rosebud Reservation. Usually, Dr. Marts and the other MD’s that go out to those clinics have mostly OB patients that will then come deliver in Winner. However, there were not many OB patients to see. There were some patients with colds and a patient that needed a Pap smear. Needless to say, it was a fun and interesting day.
Dr. Lashley, a dental surgeon was here on Friday to perform cleanings and fill cavities on patients that needed to be under general anesthesia. This was very interesting experience and it wasn’t the easiest to see because of all the tools being in the mouth. But, I learned about ways to fill cavities and what to fill different ones with; for example, cavities that go all the way to the pulp need to be treated differently than how a cavity that doesn’t reach the pulp would be treated.
During the weekend, I spent some time with Jodi and her aunt and cousins. On Saturday, I met up with a few friends from college to go to a country dance in Norden, Nebraska. On Memorial Day, I went down to a friends’ farm and got the full farm experience including feeding a bottle calf!
This week was a pretty short one due to Memorial Day and being done at 1pm on Wednesday.
On Tuesday, I was in the lab all day. I drew patient’s blood at the clinic and outpatients at the hospital. The rest of the time was spent in the lab running samples. For fun, I had my blood drawn and ran a CBC and made a slide.
On Wednesday, Jodi and I were both in surgery with Dr. Scheer the orthopedic surgeon. I had the opportunity to see a knee scope and it gave me a new appreciation of orthopedics! Unfortunately, due to the timing of our presentation on our experience I was not able to get in on a total knee replacement. After the knee scope, Jodi and I presented to hospital employees and Cheri.