2019 REHPS Melanie Heeren

From the moment I arrived in Redfield, everyone was extremely welcoming and excited to meet us. All of my past pharmacy experience has been in the community setting at an independent pharmacy. I was eager to experience a new environment. One of the first things I noticed was how close all of the health care buildings were located. The city of Redfield has one building that contains the Community Memorial Hospital, Community Memorial Clinic, Physical Therapy, and independent Randall Pharmacy all within one building. This greatly increases the convenience for providers who are seeing patients in the clinic and hospital as well as patients who need to pick up a prescription after a clinic visit.

During the first two weeks, I had the opportunity to work with a variety of health care professionals including physician assistants, nurse practitioners, nurses, and many more. One unique case in the ER involved a patient with a brain bleed. It was extremely interesting to watch as multiple health care providers worked together to make immediate plans to fly the patient to Sioux Falls. Additionally, Abby and I were able to tour the South Dakota Developmental Center (SDDC). SDDC is state facility for patients with cognitive disabilities and a psychiatric diagnosis. The entire campus is a community of its own. There’s a dentist, PA, PT, and pharmacy on site. The dentist on staff is great with patients and lets patients who are nervous get comfortable with the space prior to starting any dental treatment even if it takes multiple visits for the patient to climb in the chair. Some of the patients are able to be placed back in the Redfield community and live independently.

I have learned so much regarding the diagnosis process from Abby and the providers at the hospital and clinic. I’ve been able to witness and learn the signs to make a diagnosis such as appendicitis, how to adjust anticoagulation therapy to obtain a goal INR, and so much more. I have immensely enjoyed observing the entire process of when a patient comes into the hospital from taking a history of the chief complaint, to ordering and reviewing labs, and lastly, deciding on the best course of treatment. I’m looking forward to learning more during my last two weeks in Redfield.

The last two weeks in Redfield flew by! Abby and I had the opportunity to participate in dry-needle therapy with a physical therapist. It was a very interesting procedure where needles were placed into a muscle group and then stimulated via vibration. Dry-needle therapy is used to help relieve muscle tightness and pain. This type of therapy was recently approved in South Dakota for physical therapists. The PT department has seen significant improvement in patients undergoing this treatment.

Additionally, I had the opportunity to make a recommendation for bridging warfarin and enoxaparin therapy for a cholecystectomy surgery. The patient had Factor V Leiden with a history of two pulmonary embolisms from five years ago. It was a great experience to apply my pharmacology and therapeutics skills in a clinical setting. Researching the guidelines improved the counseling session by allowing me to explain why this therapy was needed and why the timing of the doses was crucial to optimize the treatment.

Abby and I were able to update one of the bulletin boards in the CMH hospital to provide educational material on sunscreen and firework safety. Also, we had the opportunity to write an article for the Redfield Press to bring awareness regarding safe storage and disposal of opioids. Another great experience was observing the psychiatry day at SDDC. Every couple of weeks a psychiatrist and two residents come to Redfield to monitor the patients at SDDC. It was a unique experience to watch as these professionals interviewed the patient, behavioral therapists, and case managers to make adjustments in the treatments with the goal of having the patients be placed back in the community.

All in all, my experience in Redfield has enhanced my interest in rural health care. I had the opportunity to work with a variety of health care professionals and departments such as home health, wound clinics, endoscopy, an anticoagulation clinic, physical therapy, emergency care, and nursing homes. I greatly enjoyed observing the personal and professional relationships providers have with their patients. Thank you to everyone in Redfield who helped welcome me and made my time here memorable!