UNE students share reflections on day three of their week-long rural health immersion in western Maine

Fifteen UNE health professions students participated in a rural health immersion over their spring break in Franklin County, Maine.  The immersion experience is a part of a pipeline program with Maine’s Area Health Education Center (AHEC) program and UNE’s Center for Excellence in Health Innovation (CEHI) to address healthcare provider shortages in rural Maine.  This is the second immersion experience that the Maine AHEC and CEHI have provided for UNE students, last May a similar number of different students participated in a weeklong immersion in Aroostook County. The students have been split into five interprofessional teams consisting of medical and nursing students.   The students are experiencing a variety of clinical and community activities in underserved areas in Franklin County.  Below are reflections from one team after the third day in Franklin County on March 13th, 2017.

Students wake up early to meet for breakfast and talk health policy with Maine state senator Tom Saviello

Students wake up early to meet for breakfast and talk healthcare policy with Maine state senator Tom Saviello

Kane Kunst (first year nursing student)

Today started earlier than most with an 7 AM meeting with legislator Tom Saviello. A thirty-year native to Franklin County, Mr. Saviello informed the students about many of the complications surrounding a rural community. The dynamics of the Maine rural communities are changing with the closing of the mills. The lack of jobs and shrinking forest industry has worried the community as the unemployment rate climbs.

A common theme surrounding the trip is the close-knit-community. Most of us do not come from a small town, let alone from a major industry promoting an individual as a focal point.  In Franklin County, the three main employers are the hospital, school, and ever shrinking mill.  If you work in the health care field it is not uncommon to spend additional time grocery shopping, or at the bank or shopping in general.  As a provider, you service the community and that community sees you as always on duty.  The staff speaks to the work life balance and the overall feeling of community, both in the hospital and out.

As we moved through the day, we were granted a guided tour of the hospital. The aesthetics resemble that of a rural cabin.  This hospital is an all-inclusive approach to patient care.  Considering the rural community, the goal is for people to visit once and receive all the treatments and screening to prevent a return trip just a few days later for more tests. The emergency department, hospital, patient service, general practitioners, behavioral health, MRI, and other screenings are all in connected buildings.  Patients can make an appointment with one facility and additional services can be scheduled/coordinated.

Students get a tour of Franklin Memorial Hospital from nursing staff at the hospital

Students get a tour of Franklin Memorial Hospital from hospital nursing staff

Kristin Frisby (first year medical student)

Today began at our new favorite restaurant, Calzaolaio’s Pasta Co., having breakfast with legislator Tom Saviello. Tom spoke at length about his desire to do right for his community and give back to them the same way they had so generously given to him in his time of need. We learned even more about the unique problems the area has faced with unemployment and some of the possible solutions.

Our final event of the day before the impending snow storm was a tour of Franklin Memorial Hospital followed by a discussion of the preventative health efforts put forth in the community. The stand out message of the tour was the amazing capacity for flexibility and teamwork that everyone displays in order to provide the best possible care for the community. At the end of our discussion, it felt as though we too were being invited into that team as our ideas and suggestions were openly embraced, which served to solidify a goal of this trip, interprofessional collaboration.

It is becoming increasingly more evident that there are overlying themes of communication and teamwork that are interwoven into every aspect of the immersion. We are learning that, even though the problems are monumental and overwhelming, this doesn’t stop people from all different professions from coming together and trying to solve them. This is a true testament to the spirit of the people in rural Maine.

Brad Gilbert, RN, talks to the students about his career path as a nurse and how he ended up in rural medicine

Brad Gilbert, RN, talks to the students about his career path as a nurse and how he ended up in rural medicine

Valerie Bedard (first year nursing student)

Today we had the opportunity to take a tour of the Franklin Memorial Hospital in Farmington. Walking around the hospital with Brad and Tina gave us a firsthand view of what it is like to work in a rural hospital. The sense of community that is instilled into their facility is clear and insightful of the qualities of life people that chose to work here deem important. Hospital faculty are able to snowmobile and cross-country ski to work demonstrating their passion for the environment as well as their personal health. When the children of hospital faculty are sick they are encouraged to bring them to work where they would be cared for on the pediatrics unit while they work.  It is evident that health care providers that chose to work in this area thrive in a setting that is dedicated to the care of its residents.

Whereas for a large portion of the events and collaborations we have attended thus far have been conducted by managerial staff, the tour of the hospital was conducted by working nurses. They held different perspectives on the pros and cons of working in a rural health care system, as well as the nature of the position. Providers in this particular location are held to high standards in that they are often called upon to be knowledgeable in several different fields.  The amount of staff working at one time is smaller then would be found in an urban hospital and so it is imperative for staff to have leadership experience, as well as the necessary medical skill set.  Staff collaboration is not only encouraged but also necessary to facilitate successful patient care in rural healthcare.

Although our day was cut short midday due to the impending blizzard it was an efficacious morning. As a collective group we reiterated all the information we have absorbed over the last few days, building on what we have learned and considering all of the competences of rural healthcare that we have not yet begun to understand. The night was spent in deep conversation with other students about our ability as educated professionals to empower change in communities, which begins to expand in potential when we open our minds to the opinions and viewpoints of other professions. Even though the storm limited the events that were attended that day the extensive conversation that ensued throughout the night ensured that the time was not wasted.

Students hunker down for dinner during a Nor'easter that brought more than 16" of snow overnight

Students hunker down for dinner during a Nor’easter that brought more than 16″ of snow overnight

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