UNE Students share their Experiences on the second day of the 2018 DownEast Rural Health Immersion

Ten UNE health professions students recently participated in a weeklong rural health immersion to Washington County in 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 sixth immersion experience that the Maine AHEC and CEHI have provided for UNE students but the first time that a group has traveled to the DownEast area.  In March a group of 10 students traveled to Piscataquis County; last Fall a group of 10 students traveled to Oxford County and Carroll County in New Hampshire for a long weekend immersion; in May of 2017 a group of 13 medical, pharmacy, dental, and nursing students traveled to Maine’s midcoast region of Knox and Waldo Counties for a weeklong immersion; in March of 2017 medical and nursing students participated in a weeklong immersion in Franklin County; and in May of 2016 a group of 15 medical, pharmacy, and dental students participated in a weeklong immersion in Aroostook County.  Throughout the immersion the students are purposefully split into interprofessional teams so that they can learn the roles and how to communicate effectively with other disciplines in order to learn the skills necessary to provide high quality team-based care and improve patient outcomes.  The students experienced a variety of clinical, community, and population health activities in rural and underserved communities in Washington County, including Calais, Eastport, Lubec, Campobello, and Machias.   Below are reflections from one team after the second day of the trip on Thursday, May 24, 2018.

 

Amanda Follensbee, first year social work student

Spending the morning at the Calais High School and visiting the onsite health center and school nurse I instantly felt the sense of hardship and adversities that the community faces with the minimal organizations that they have. Yet, this did not seem to stop the small-town community from persevering and strengthening the resources they have by “double dipping”. Utilizing the school nurse as also a place for the health center it became evident how resourceful and strategic the people of Calais were.

Similarly, speaking with the students about higher education at the high school I felt the same sense of hardship coming from them in the sense that a few of them felt stuck in the small town they grew up in. These students expressed a responsibility to the community to stay where they are and help where help is needed. I related to this feeling of responsibility for the community when I was in high school; nearly every teacher told me to “Come back to Vermont and work”. I didn’t venture far for my undergraduate education and I did feel the need of the community in Vermont for social workers. But when I returned to school to pursue my Masters of Social Work, I wanted to broaden my horizons and therefore attended school at UNE in Maine. Through that, as well as through the DownEast rural health immersion, I learned that the need for social workers and health professions as a whole are needed in almost every community.

During our time at the Lubec Regional Medical Center I felt a strong message of support and community; the term “People place” came up often during our discussion with the staff and faculty at the facility. The rural health immersion taught me the importance of a strong community and pulling resources together in order to provide for the need of the community. Our visit to Lubec and Campobello strengthened the idea that we’re all in this together.  I learned that it’s much better to utilize what the community already has and strengthen those resources, rather than wishing for more or better, or for things that are unattainable.

 

Joelene Nguyen, third year pharmacy student

The third day of our Maine Adventure continued to surprise me with more motivational and inspiring works from the healthcare providers in Washington County.

We visited Calais Highschool and actually had a chance to tell our story and inspire other students. Talking to the current high school students really allowed me to reflect on my experience and journey as a future healthcare provider. The students were shy and appeared unresponsive in the beginning; however, some of the head nodding at the end showed that they were listening. After the presentation, I thought about how I acted when I was in their seats back then as a high school student.  I could see myself being shy about asking questions, and sometimes distracted whenever there was an opportunity to listen to any speaker. However, I think as I continue my education, I have become more focused and listened to everything being presented to me, which is one thing I tried to emphasize to the high school students. I think it is important to not shut down any idea the first moment that I am being presented to. I’ve used this thinking during the DownEast rural health immersion, where I have tried to take all the information in and slowly process it, especially as I ponder the decision to practice pharmacy in a rural area.

The visit to the health center in Campobello was a very interesting experience. Seeing the advantages of having universal healthcare in Canada, I did question if the healthcare system in the U.S. is the cause of much of the poor health outcomes that we learn about in class.  These poor health outcomes aren’t limited to rural areas but as a nation as a whole. A common theme that might explain these poor health outcomes in the U.S. that we’ve seen so far in the DownEast rural health immersion is that there is not enough healthcare providers in the communities that we’ve visited (Calais and Lubec so far).  Due to the healthcare professional shortages, we saw certain health professionals wearing many hats and juggling between different responsibilities to deliver the best patient care possible. Another theme that we talked about at length in Campobello, was that a large portion of patients in the rural US are uninsured and that can have an effect on payment to for services and the day to day operations of healthcare systems in rural communities. Thus, I think this issue in particular plays a major role in de-motivating health professional students from practicing medicine rurally because they might struggle financially due to their student loan burden. So, I reflect now and question what if we had universal healthcare in the U.S.? I definitely believe that it would increase accessibility and also allow an easier path for students to fully immerse in practicing their career wherever they want.

This trip has given me a chance to be exposed to rural medicine. So far, I have heard from so many inspirational community members, and their stories about what brought them to rural Maine. The conversations that we’ve had so far and the places that we’ve visisted have made me realize that there is such a need for healthcare services in the rural areas in the state of Maine and I may be able to make a difference as a future provider.

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