Brant Haase, Doctor of Pharmacy Student, on his time in Britton, SD
Week One:
Jake and I just finished our busy, first week in Britton! We arrived at the Marshall County Healthcare Center on Monday and were introduced to the various staff of the hospital. The rest of the day was spent getting moved into our house that is designed after an old-time saloon. Our schedules on Tuesday through Friday were packed with experiences involving various healthcare professionals. Just this week, we have been with nursing, a speech therapist, radiology, an occupational therapist, pharmacy, and doctors. These experiences have already educated me on the daily responsibilities of the different professions I was not completely familiar with and how a small town adapts to be able to provide a wide spectrum of services to its patients. A few of the highlights from this week were getting to see our first diabetic foot, shadowing Jill, the nurse practitioner, when she met with patients in the clinic, and having home cooked meals every day at the hospital. They told us the hospital food was the best in town and they were definitely right! We finished the week by preparing for our community project on the shingles, pneumonia, and flu vaccines that we’ll present next week to elderly members of the community.
Week Two:
The second week in Britton once again brought a variety of rural experiences. We have now grown a lot more familiar with the hospital and the town, which has made for an even more positive experience. We had the opportunity to shadow physical therapists, doctors, radiology, medical lab, pharmacy, and optometry this week. As a pharmacy student, I enjoyed meeting with the hospital pharmacist on her day in Britton. It was interesting to see how a rural facility can contract out a part-time pharmacist while still making sure to provide enough services for the patients and staff. This seems to be a common trend for rural hospitals that cannot necessarily afford to have a full-time position for every healthcare service. I also learned a lot more on the growing trend of antimicrobial stewardship through a conference call with doctors and pharmacists in Sioux Falls. These conference calls are also common in many areas of the hospital and provide rural hospitals with access to advice from professionals who are experts in their area. Another experience I enjoyed was shadowing the physician when he made his weekly rounds to the nursing home. It was interesting to see the varying comfort and treatment plans for patients in different stages of their stay there.
This week also gave us the opportunity to become more acquainted with Britton. One afternoon, we got to tour most off the industries here, and, to my surprise, there are quite a few! One, in particular, sells over $10 million dollars in machinery parts each month and employs over a 100 people. It was fascinating to see how important these industries are to the community through jobs, donations, and other aspects. Nick, the CEO of the hospital, also introduced us to the lakes in the area which is the major source of recreation and entertainment for people here. We have even had a few opportunities to try our luck at fishing on the lakes and hope to do so a few more times in the next couple weeks!
Week Three:
My third week here in Britton was highlighted by home health visits, assisted living activities and presentation, a visit to the Hutterite colony, and a walleye fishing trip with the hospital administrator. Like previous weeks, we also got to further shadow doctors, nurses, pharmacists, and physical therapists. However, this week we also got to go into the community with the home health nurse and provide services at patient’s homes. This was a very interesting experience because it took us out of the controlled environment of the hospital and put us into the life of the patients. These patients were usually somewhat physically and mentally disabled and relied upon these services to get adequate care.
Another healthcare related activity we performed was helping the assisted living residents with their activity time. The assisted living in Britton is attached to the hospital and so after lunch we walked down and helped the residents play bean bag toss. They really enjoyed us being there and after the activity we gave our presentation on the shingles, pneumonia, and flu vaccines to them. We will hopefully make it down there again next week for some activities!
The fun parts of the week were definitely the visit to the Hutterite colony and the fishing trip. Located all around the area are Hutterite colonies and last week happened to be one of colonies graduation ceremony. Since the administrator of the hospital is the School Board President, we got the opportunity to attend the graduation. This was a very valuable experience to see a way of life very different from my own. Also, the residents of the colony utilize the healthcare services in Britton frequently so it was important to become familiar with their culture. We’ve quickly learned that they are the best patients because they are always very loyal to their treatments. Finally, we went with Nick, the CEO of the hospital, on a fishing trip. We ended up catching our limit on walleyes and one was eight pounds! I can’t mention the lake because we were sworn to secrecy but let’s just say the fishing around here is very good!
Week Four:
We just finished up our last week in Britton and, needless to say, it has been a very valuable experience. This week we got to go on a couple more home health visits that were eye opening. One patient had colorectal cancer that was treated with radiation which caused perforations in his bowel. This has led him to have both a colostomy and urostomy which needs to be changed a couple times per week. Despite having a family member that is a nurse, the care is just too overwhelming so he has a home health nurse come in and take care of him. Seeing these conditions and hearing about the complications he has experienced was very eye opening.
Another good experience was shadowing the hospital pharmacist, Aly, when she was doing her Coumadin clinic. With the roles of pharmacists expanding, it was important for me to see some of the different responsibilities pharmacists are picking up in order to benefit patients. While I was with her, I also got to see a patient utilizing telemedicine to have an appointment with an infectious disease doctor in Sioux Falls. This was just another important service rural hospitals use to provide specialized care for their patients.
The last weekend in Britton also gave us the opportunity to attend a fish fry at Nick’s, the hospital administrator, house and get a steak at Todd’s Tavern in Amherst, South Dakota. It was fun to meet some more members of the community and talk to them. Also, the steak at Todd’s Tavern was one of the best I have ever had and we got to play a couple card games afterwards. Overall, I had a very good REHPS experience in Britton and learned a lot about healthcare in rural communities!