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2018 REHPS Gabbie Price

 

Week 1:

As the first week comes to an end, there are many exciting experiences to reflect upon. I didn’t quite know what to expect at first as this was my first time completing clinicals in a rural setting. I was quick to realize how welcoming and friendly the staff was and the eagerness they had to educate me on the rural healthcare experience throughout this upcoming month. Due to a lower patient census than a larger city, I appreciated that the providers were able to take time to explain certain procedures and talk more in depth with me about complex patients. It was also evident how the providers utilize an interdisciplinary approach to their practice, often calling radiology or pharmacy for recommendations.  It was helpful to spend time with a variety of departments and see firsthand how they operate, as it helps prepare me to work with those departments in the future as a nurse practitioner.

Week 2:

                This week I really saw the connection between the variety of departments. Patients I had seen on home health visits last week, I saw in the clinic and ER this week. Clinic patients I had seen previously, I saw again with respiratory therapy follow ups and in radiology to get outpatient imagining completed. I really felt welcomed into the community and both patients and employees would say hi to me in local stores. It was also beneficial to follow patients through their entire healthcare process, as I would see them in the ER, help admit them to the hospital, complete hospital rounds on them and then work on their discharge planning. It really enhanced my education to see each step of the process and to help enter the orders for each of these steps.

Week 3:                                   

                This week I had the opportunity to see an outreach physician’s impact on the community. Patients who would normally not be able to travel long distances were able to receive specialized care their own community, which enhances healthcare in this rural town. It was beneficial to learn how the tests I would be ordering in my future practice are completed and how the results are interpreted. Additionally, this week I was able to go with multiple nurse practitioners in the clinic. Each were incredibly knowledgeable and open to sharing their experiences and advice with me. It is evident how every provider in this community has a connection and compassion for not only their patients, but the patients’ family members as well.

Week 4:

                This was the last week in Miller and it’s unbelievable how fast the month here has gone. This week I spent most of the time in the clinic, again being able to go with multiple providers. This allowed me to round out my clinical experience and gain insight on how different providers manage their practice. I completed the week spending time with the pharmacist. Spending time at the pharmacy has been incredibly beneficial as the pharmacist was able to discuss important aspects of medications and his viewpoints on prescribing, which I will be able to consider when prescribing medications to my own patients in the future.

Final Reflection:

There is much to reflect upon over the last four weeks. When I first arrived in Miller, I wasn’t quite sure what to expect, but what I found was an experience that was both insightful and educational. Miller is an incredibly welcome community that was open to accepting me as one of their own for four weeks. On arrival to Miller it was evident that individuals in this town are invested in their community were eager to share the rural living experience.

In review of my clinical experiences here, some of my favorite opportunities revolved around the emergency department. Although some tragic patient situations came through during the month here, it was interesting to see the collaboration that took place between the provider in Miller and the emergency physician over telemedicine. Additionally, I was given the opportunity to help with clinical skills such as suturing, casting, and charting. Having worked in a large emergency department, it was beneficial to experience a different perceptive of treating critically ill patients.

I found it surprising that staff knew not only their patients, but each of their patient’s family members as well. It was also wonderful to observe that providers were aware of patients who were going through difficult times, from word of mouth in the community, and therefore were able to be sensitive of certain topics during their appointments.  Additionally, providers spent much more time with their patients than I had seen in previous clinical experiences. I was also shocked at how many outreach providers come to Miller to provide specialty care to their patients. This demonstrates how dedicated this hospital/clinic is to providing the best care possible for their patients who may not be able to travel to larger towns.

I am incredibly thankful for being able to participate in such an enlightening experience that exposed me to rural healthcare. Being immersed in the community provides a firsthand opportunity to experience not only learning what it would be like to work in a rural community, but live in one as well.  It was an eye-opening experience that has made me more open minded and willing to work in a rural community.

About SD AHEC

The South Dakota Area Health Education Center (SD AHEC) has a mission to “connect students to careers, professionals to communities, and communities to better health.” Established in 2009 through a HRSA grant awarded to the Sanford School of Medicine, the statewide program currently has three centers,  Southeast SD AHEC, Northeast SD AHEC and West River AHEC.

SD AHEC
https://www.usd.edu/medicine/south-dakota-area-health-education-center/
https://www.nesdahec.org/
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