UNE Students Share Experiences on their Second Day of the Fall Long Weekend Western Maine Rural Health Immersion

October 11th, 2017 by healthinnovation
Minh Tam Hua, second year pharmacy student, and Rodger Carter, first year osteopathic medicine student provide a blood pressure screening to a volunteer at the Fryeburg Fair on Saturday, October 7th.

Minh Tam Hua, second year pharmacy student, and Rodger Carter, first year osteopathic medicine student provide a blood pressure screening to a volunteer at the Fryeburg Fair on Saturday, October 7th.

Ten UNE health professions students recently participated in a long weekend rural health immersion to Oxford County in western Maine and to Carroll County in northern New Hampshire.  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 fourth immersion experience that the Maine AHEC and CEHI have provided for UNE students but the first time that a group has traveled to Oxford County.  Last May 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; last March 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.  Of the four immersions that have been held so far, this was the most diverse group of students, five different health professions were represented from UNE from the College of Osteopathic Medicine, College of Pharmacy, College of Dental Medicine, and Westbrook College of Health Professions Physician Assistant and Bachelor of Science in Nursing (BSN) programs.  Throughout the trip the students were split into interprofessional teams so that they could learn about the roles of the other professions and how to communicate effectively across disciplines in order to provide team-based care and improve patient outcomes, a primary learning outcome of the four year Josiah Macy Jr. Foundation grant that helps fund the immersion experiences.   The students experienced a variety of clinical, community, and population health activities in underserved areas in western Maine and northern New Hampshire.  Below are reflections from one team after the second day on Saturday, October 7th, 2017.

Brittany Malia, second year dental medicine student

The rural health immersion trip has been an amazing experience! Today was our second day and in the morning we volunteered at the Fryeburg Fair to help staff the First Aid centers. At the fair, we handed out care kits and provided blood pressure screenings. I enjoyed interacting with members of the community at the fair and talking to them about the communities that they live in.

After the fair, we toured a local community Pharmacy at a Hannafords supermarket. The pharmacist showed the entire group how a prescription is filled from start to finish, which I thought was enlightening since I will be prescribing once I become a dentist. This was just one of the many places that we have been able to see throughout the weekend; yesterday we also toured two critical access hospitals, two community health centers, and an oral health clinic. The rural health immersion trip has been a wonderful opportunity to learn about the roles of other health professions, and how we can successfully work together as a team in order to provide the highest quality care to our patients.

Later in the evening we returned back to our house on the water to play board games and have s’mores in front of an open fire. During this trip, I have met many wonderful students from other health professions that I otherwise wouldn’t have had the opportunity to meet. I highly recommend this trip to anyone considering attending!

 

 

UNE students pose for a photo in front of one of the first aid stations at the Fryeburg Fair, where the students helped hand out free Care Kits and provided health screenings to anyone interested.

UNE students pose for a photo in front of one of the first aid stations at the Fryeburg Fair, where the students helped hand out free Care Kits and provided health screenings to anyone interested.

Minh Tam Hua, second year pharmacy student

Today during the Fall Long Weekend Rural Health Immersion, I got the opportunity to volunteer taking blood pressure and passing out Care Kits to the people at the Fryeburg Fair, which is known to be the largest agricultural fair in Maine. We were divided into groups, where each groups consisted of a medical student, a nursing student, a dental student, and a pharmacy student. This was my first time working with other students from other health professionals so I got the chance to learn more about their profession and what their roles were.

This event gave me the opportunity to meet and talk with people from the rural communities in Maine. My group and I took blood pressure of total 12 people and only one person turned out to have a “normal” blood pressure reading. The other 11 people’s blood pressures ranked in the hypertensive range. From class I know that the normal blood pressure reading in a healthy individual is around 120/80 and anything higher than that will be a risk factor for developing certain diseases. I was shocked that it was that many people who were at risk of getting Hypertension. As future health care providers, my group and I would recommend that the people whose blood pressures were in the hypertensive range be referred to the paramedics on staff. To our surprise, most of them weren’t concerned that their blood pressures were high. I feel that most of the people that we met during this fair didn’t want to hear about many of the health risk factors, such as unhealthy diet, lack of exercise, smoking and high blood pressure readings and how they can all lead to serious health issues in the future.

Based on this personal experience, I feel that we as health professionals should create more events in Rural communities where we provide free screenings and educate the community about the danger of the chronic diseases, such as Hypertension, Diabetes, Hyperlipidemia, Stroke, and Heart diseases. I think that, as students, we can make an impact on the health of these people. From a health professional point of view, and from what we’ve learned during this immersion so far, I believe that it’s important and better to prevent a disease early on than treating it later on. I feel that if we all stand together and contribute our part, we will be able to help reduce the number of chronic diseases that are taking place not only in these rural areas but also throughout the US.

Students conducted a Worksite Health ScoreCard at the fair to assess it's performance in several categories like Animal areas, Nutrition, Tobacco, and more.

Students conducted a Worksite Health ScoreCard assessment at the fair to assess it’s performance in several categories like Animal areas, Nutrition, Tobacco, and more.

 

Kimberlee Sell, second year pharmacy student

On the second day of the immersion we attended the Fryeburg Fair which can attract between 30,000-40,000 people in a single day. We split into three teams, two teams worked at the first aid stations and one team would check the “Health Score” of the fair using an altered health assessment tool created by the CDC. While at the first aid stations we offered free blood pressure screenings and we gave out Care Kits consisting of things like toothpaste, soap, and band-aids. While the care kits seemed insignificant to me, it felt good to see how excited people were to get some basic health supplies for free, especially the toothpaste.

My first two shifts at the fair were spent giving blood pressure screenings. There was a good number of people who were very excited to see what their blood pressure was. I did notice a lot of people had a blood pressure that read into the hypertensive range. We would talk to them about visiting their primary care provider and hand them off to the NP or paramedic on staff with us. The people I talked to didn’t seem eager to visit their provider when we talked with them about it, perhaps because they had to travel long distances or couldn’t afford the co-pays at their doctors office.

The third station was checking the health of the Fair regarding Tobacco and Nutrition policies. The only ‘no smoking’ signs were located by the first aid stations. We noticed many people smoking in the middle of crowds of people. We thought the fair could improve it’s tobacco policy in order to make it a more healthy environment for guests; one recommendation would be to have designated smoking areas away from crowds of people. We also noticed that the healthy food choices were few and far between. We did see a steak salad and a smoothie bar. Overall, it was a fried paradise- anything you could think of was fried, oreos, ice-cream, dough, and more. Because of this we also thought the fair could improve its nutrition score by providing more healthy food options.

 

DSC_1071 smaller photo fire

Later in the evening the students returned to the house to enjoy s’mores over an open fire and reflect on the days activities.

UNE’s Fall Long Weekend Rural Health Immersion Kicks off

October 10th, 2017 by healthinnovation
DSC_1077 smaller file group pic

Ten UNE healthcare students recently participated in a long weekend rural health immersion to western Maine and northern New Hampshire. (From L – R Row 1 Taylor Ouellette OMS I, Brittany Malia CDM II, Kimberlee Sell CDM II, Minh Tam Hua CoP II, Kelly Banks CoP II, Katie Clark BSN IV, Nicole Caron CDM II; Row 2 Ian Imbert MPH, Rodger Carter OMS I, Lesley Lafland BSN IV, Rachel Moore PA I)

Ten UNE health professions students recently participated in a long weekend rural health immersion to Oxford County in western Maine and to Carroll County in northern New Hampshire.  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 fourth immersion experience that the Maine AHEC and CEHI have provided for UNE students but the first time that a group has traveled to Oxford County.  Last May 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; last March 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.  Of the four immersions that have been held so far, this was the most diverse group of students, five different health professions were represented from UNE from the College of Osteopathic Medicine, College of Pharmacy, College of Dental Medicine, and Westbrook College of Health Professions Physician Assistant and Bachelor of Science in Nursing (BSN) programs.  Throughout the trip the students were split into interprofessional teams so that they could learn about the roles of the other professions and how to communicate effectively across disciplines in order to provide team-based care and improve patient outcomes, a primary learning outcome of the four year Josiah Macy Jr. Foundation grant that helps fund the immersion experiences.   The students experienced a variety of clinical, community, and population health activities in underserved areas in western Maine and northern New Hampshire.  Below are reflections from one team after the first day on Friday, October 6th, 2017.

 

The first stop of the day was at Saccopee Valley Health Center in Porter, ME, where the students met with Dr. Jeff Ray, DO, Medical Director, and Dr. Israel Adeloye, DMD.

The first stop of the day was at Saccopee Valley Health Center in Porter, ME, where the students met with Dr. Jeff Ray, DO, Medical Director, and Dr. Israel Adeloye, DMD, to discuss providing care to underserved populations.

Rachel Moore, first year physician assistant student

Reflecting on the first day of the Rural Health immersion, it is hard to fully sum up everything I experienced and learned. From the very first stop at Saccopee Valley Health Center (SVHC), I was in awe of all the things I took for granted as a practitioner. We quickly learned that many patients in this community are severely limited by transportation, which limits their ability to go to Portland for referrals or any further care that SVHC was not able to offer. Not only that, but even basic oral hygiene did not really exist; and their dentist discussed how for a while 75% of his appointments were full mouth extractions because his patients teeth were beyond the point of repair. From one clinic to the next we witnessed the struggles everyone faced with opioid addictions and patients who are at or below the poverty line and unable to pay for their care. At Bridgton Hospital, we were informed that nearly half of the babies are born addicted to tobacco, alcohol, or other drugs. It would be understandable if someone were to look at the challenges their health practitioners are facing and feel they are insurmountable.

And yet, despite the seemingly insurmountable challenges, at each clinic we saw health care practitioners full of passion, creativity, and love for their community. Each of the people we met with were full of excitement to serve the rural populations and were willing to do whatever it took to do right by them. Throughout the day we say endless examples of this, including a dentist fresh out of school who built the entire dental program at SVHC from scratch and started outreach to the community to teach proper teeth dentition to children in schools; an NP who had achieved countless additional certifications, including one in Psych to help serve the specific needs of her community; the Bridgeton Hospital’s free shuttle for their patients so they can get the care they need; the cross competency trainings of nurses in all the departments so that they can change departments at a moment’s notice to serve where they are most needed.

There is a vast network of community in these health systems and everyone seems to know everyone and offer their support to help serve their patients. It’s true that the rural communities that we’ve visited so far have been underserved but nevertheless it is so clear that the providers that we’ve met give every ounce of their energy to improving the health of their communities.

 

 

The students discuss population health initiatives with Sue Ruka, RN, PhD, at Memorial Hopsital, a Critical Access Hospital in Conway, NH.

The students discuss population health initiatives with Sue Ruka, RN, PhD, at Memorial Hopsital, a Critical Access Hospital in Conway, NH.

 

Taylor Ouellette, first year osteopathic medicine student

What resonated with me most about today’s site visits was the passion of the providers that spoke to us about their practices. Providers of various backgrounds showed us around each site, and the different backgrounds of these providers added to our visits and served to show us the unique personality of each place. When these individuals showed us around the facility and interacted with other providers and staff at the site, we could tell by looking at their facial expression and listening to their presentation how excited and proud of their office, hospital or clinic they were even though these sites are not the may not have the most state of the art equipment to practice medicine and see patients. In fact, one provider at a small community health center communicated to us that although the practice was lacking in funding and resources, there was another similar sized health center in the state that was worse off than the site she worked at, as if to say “it could be worse”.

Hearing this providers optimism about her practice showed the positive and steadfast attitude these rural healthcare providers have about the work that they do every day. These providers that we are meeting with know how significant of an impact they are making on the local community and how vital they are to the wellbeing of the community as a whole. Yet, they were humble about this fact as they were talking to us. Listening to the providers tell stories about patients in the community they care for was very inspirational and uplifting despite the challenging circumstances of many of the people these providers treat. Their passion was contagious.

I was also very impressed by the fact that these providers develop the skills to think on their feet and get creative with the limited resources they have to treat patients who face many barriers to accessing quality healthcare. Furthermore, these providers are remarkable in the sense that their scope of practice is forced to become so broad as they have to become competent in a variety of topics due to the range of issues they deal with on a daily basis in a rural setting. I’m looking forward to what tomorrow has in store for us!

 

Sue leads the students through one of the Gemba boards at Memorial Hospital.

Sue leads the students through one of the Gemba boards at Memorial Hospital.

 

Kelly Banks, second year pharmacy student

The first stop of the day was at Sacopee Valley Health Center with Dr. Jeff Ray. Before arriving the perception of a rural area was the potential for lack of resources. What was fascinating about Dr. Ray and his facility was how much more ahead of the medical game than most facilities are in a non-rural area. When asked about E-prescribing and electronic records he indicated his facility has been working with that type of system long before it was mandatory. When asked about the opioid crisis he indicated they offer plenty of access for patients to speak with someone at the facility, hold meetings, and try their best to regulate the date at which the prescriptions can be filled. An issue he did bring up with the opioid crisis is that the pharmacy will sometimes fill prescriptions earlier than indicated which he was hopeful will eventually change.

The second stop was at Memorial Hospital in which the pharmacy students got the option to speak with the pharmacist. He had worked in community pharmacy for a number of years before working in the hospital setting. What I took away from the visit with him was the sense of community he has by working in a smaller hospital pharmacy. Two pharmacists will run the whole hospital while a larger hospital has one pharmacist per level. He explained that everyone seems like family, all of their families grow up together, and it gave him a better “quality of life”.

The third stop was White Mountain Community Center. What seemed to amaze everyone about this facility was that there was a food pantry in the middle of the practice that was run by volunteers in the community. They have a physician on site only a couple times a week so the NPs on staff run the show. Another important point to this stop was that the NPs would get extra certifications in order to serve the community needs better. This facility also had a teen clinic run by volunteers in the area where kids could get birth control, condoms, and someone to talk to if needed. There are not many teen clinics around so they are crucial to helping the area.

The last stop was Bridgton Hospital which was the most enthusiastic work setting of all. The atmosphere in the hospital was that the patient comes first while making use of their small facility. It was interesting how, in the case of a sudden patient surge, the different departments of the hospital can expand to become a part of other departments by just opening up a few doors. This helps with work flow depending on staffing and time of day.

The Rural Health Immersion allowed for us to get an idea of what health professionals deal with on a daily basis. Whether the facilities were teaching how to brush teeth through community outreach at the schools or helping the nearly 50% of babies born on drug dependence, the facilities adapt to serving their community as it needs it most. The first day showed me how much of a difference each health care professional can make on the rural community one day and one patient at a time, especially when they work well together as a team. This Rural Health Immersion has really opened my eyes to how difficult but rewarding working in a rural health community can be with the right attitude.

The students pose for a photo outside of Conway Oral Health with Dr. Eric Heirschfield, DMD.

Later in the day the students pose for a photo outside of Conway Oral Health with Dr. Eric Heirschfield, DDS.

Lesley Lafland, fourth year nursing student

I enjoyed the Rural Health Immersion to Oxford County, it was truly an eye opener as it provide a glimpse into rural health. My two favorite stops today were Saccopee Valley Health Center and Bridgton Hospital. I grew up in what I thought was a rural setting in Aroostook County but, looking back, I always had readily accessible health care.   After todays experiences, I realized that I actually had it a lot better than most people in rural settings. I had a hospital in my hometown and transportation to get to my appointments whereas the patients in the greater Porter community have to travel over an hour to get to the hospital or to specialists. I’m considering becoming an infusion nurse and noticed that they don’t have anyone doing infusions there, largely due to the fact that there is no way to monitor the patients and make sure they are communicating with their oncologist and following their treatment plan.

Bridgton Hospital was great to visit and learn that even though it’s in a rural area and is a critical access hospital they have an infusion room so that cancer patients don’t have to travel over an hour to Central Maine Medical Center to receive their treatments. Despite being a small hospital it’s great to see that that patients can get the care they need without having to travel a long distance, which is sometimes the difference between whether a patient completes their treatment plan or not.