Monday March 12, 2018
After a fun weekend, today was the day to start my nursing clinical here in Anchorage Alaska. My nursing clinical was at the Municipality of Anchorage which is the Department of Health and Human Services in Anchorage. The floor I was on had a few different departments such as the immunization clinic, disease management and prevention, and the reproductive health clinic. The Municipality also provides services such as a WIC clinic and an environmental health floor. My day started off by meeting my nursing preceptor Robert, who is a public health nurse. He has been there for about 2 years and he has been in a few of the different departments. I got to tour the building and meet many of the employees. Everyone was very friendly and excited for me to be here in Alaska. My role throughout the week was going to be mostly in the immunization clinic. So today I was in the vaccination room with nurse Cortney. I was able to get a lot of information from Cortney about how they provide services to patients and learn about all of the immunizations they provide. The patients that are coming in for immunizations are mostly walk-in patients, but some will have an appointment. Since this is a public health clinic, the electronic health record is different than anything I had seen before. They use a electronic health record called "insight." They also have a Alaskan database they can use to look up information about patients immunizations if they aren't sure they have had a certain vaccination or have no record of their immunizations. It is called "VacTrak." All of the vaccines are provided by the state of Alaska who anyone under the age of 18 years old or if they are still in high school up to the age of 23. If people do not have insurance and it is not covered, the Muni will send patients to the Anchorage Neighborhood Health Center where they can see a provider and get services for free. It was spring break in Anchorage, so we got a lot of youth patients who were coming in to get their immunizations updated. We also provided education about the Mumps outbreak that is going around Anchorage. There are about 300 cases of mumps within the area so the state of Alaska is providing people a free booster shot if they had not gotten one within the last 5 years. I found that we gave a lot of the booster shots due to the increasing rate of mumps. The needles that are used in the vaccination room are vanish point needles. These needles are awesome because they have a retractable needle. The needle will retract once all the solution is gone. I thought this was awesome and will prevent many needle stick injuries. I had never seen that before and it is something that I hope will be available to everyone. In the vaccination room, they also provide TB testing and screening. One of the things they do that I found was great was that they have a IGRA blood test for TB. This test is a lot more accurate compared to the PPD skin test. They will do the IGRA blood test to people who have previously had TB, think they have been around others who have TB, or people who are from out of the United States. This test is not as fast as the PPD test, but is more accurate so that is the nice part. The results will come back within a week. Overall the first day was great and I learned a lot of information about vaccinations.
After a day at the Muni, Sarah and I came home to Cindy making us fish dinner. It was great!
Tuesday March 13, 2018
The second day at the Muni, I was in the vaccination room again with Nurse Robert. Robert was great at teaching me about certain vaccinations. He was great at showing me the recommendations provided by the CDC and would show me his process when getting a patient. I thought Robert was great at educating patients about immunizations that are not required, but are recommended to patients such as the HPV vaccination. It was great to be able draw up many vaccinations throughout the day as I had not done a lot of drawing up medications in my previous clinicals. Throughout the day we had time to talk about other communicable diseases that are common within Alaska. Robert taught me about some of the common ones such as giardiasis, salmonellosis, shellfish poisoning, and campylobacter enteritis.
After another good day in the public health setting, Sarah and I wanted to explore a little of Anchorage. So we drove up a mountain. We were able to get up the mountain with the van, but it was a struggle. At the top of the mountain we were able to see all of Anchorage. The views were amazing!!
Wednesday March 14, 2018
Today at the Municipality of Anchorage I worked with Cortney and Robert again in the immunization room. I was able to watch them perform a few IGRA blood tests and see the way they perform it. The 3 tubes of blood will be picked up at the end of the day by someone from Providence Hospital where they will then provide the results to the Muni within a week. Today Robert taught me about another service they provide at the Muni, which was the I-693. This is a service to refugees who want to get their green card. The refugees who want to get their green card have to have lived in the United States for a year and once they have they can schedule an appointment where the public health nurse, such as Robert will help them. The Muni will usually get a couple refugees a month. The refugees usually will have had a physical and then they come to the Muni to make sure they have all their immunizations done and get help finishing the application for the green card. If they do not, the Muni will provide them with information about the vaccine and then give them the vaccination. A barrier for the public health nurses is that the refugees do not speak English well, so they have to get an interpreter. They use LanguageLink, which is a link you call and get an interpreter for the specific language needed. It was interesting to learn about another service they provide within the immunization clinic.
After clinical today, Sarah and I decided it was a day to relax so we stayed at home tonight to catch up on things we needed to do.
Thursday March 15, 2018
Today was a fun day at the Muni. I was able to experience a few different areas. I started out in the vaccination room where we gave immunizations to children and adults as well as reading TB tests. After being in the vaccination room for a couple hours, I was able to go outside of the building. I went with Numia to deliver TB medications. It was very interesting to experience delivering TB medications to all different aspects of people. Numia had to call a few people to let them know that we were at their place so they could come out to take their medications or unlock their door. Numia has to witness them taking the medications before he can leave them. Numia does this every day so he is very use to the behaviors and where he is delivering each medication. I realized that his job takes a lot of patience and you have to develop a trusting relationship with these people. I asked Numia a lot of questions regarding his job and he said it can be really hard sometimes. He said that sometimes people do not want to take their medications or they are asking why they need to take these medications all the time. It was a great experience to be able to see how he interacts with the patients and how he does his job. After being with Numia for about 5 or 6 deliveries, I was brought back to the Muni for lunch. After lunch I got to be in another part of the clinic. I was able to shadow Sally in the Reproductive Health Clinic/STI testing. I got to learn about how the reproductive health clinic works and what they provide to patients. The patient that I got to observe was having symptoms of a yeast infection. Sally was able to do an exam and look under the microscope to see weather the patient had an infection. It was interesting to learn that as a public health nurse, you are able to do exams and pretty much diagnosis a patient. It was another great observation of what it is like to be a public health nurse in the reproductive health clinic.
This was my last day at the Muni and it was such a wonderful experience. I was able to experience many different areas of a public health nurse and learn so much! I couldn't thank all the nurses enough for the amount of education they did with me. It was awesome!
Today was a special day for Sarah and I as well. One of the nurses that worked with Sarah was able to get us a plane ride with her boyfriend. I was very nervous as I didn't know this person at all and I hadn't been in such a small bush plane for a long time. I just wasn't sure what to expect. Leigh, the nurse, brought us out to the airport to meet Monty. It was interesting to learn about this airport as it is a hub for about 2,000 bush planes. Monty showed us that he he can add either skis or pontoons to the wheels, which allows him to use his plane all year round. I thought that was so cool! We used the wheels to taxi over to the lake and then we used the skis for takeoff on the lake. I don't think I will ever experience that again so it was incredible to do something so different than a huge commercial plane taking off on a runway. Once we were in the air, the views were beautiful! I was so happy to be able to experience this and had gotten the opportunity to do something that was not planned on this trip. Thanks Monty!
After a fun weekend, today was the day to start my nursing clinical here in Anchorage Alaska. My nursing clinical was at the Municipality of Anchorage which is the Department of Health and Human Services in Anchorage. The floor I was on had a few different departments such as the immunization clinic, disease management and prevention, and the reproductive health clinic. The Municipality also provides services such as a WIC clinic and an environmental health floor. My day started off by meeting my nursing preceptor Robert, who is a public health nurse. He has been there for about 2 years and he has been in a few of the different departments. I got to tour the building and meet many of the employees. Everyone was very friendly and excited for me to be here in Alaska. My role throughout the week was going to be mostly in the immunization clinic. So today I was in the vaccination room with nurse Cortney. I was able to get a lot of information from Cortney about how they provide services to patients and learn about all of the immunizations they provide. The patients that are coming in for immunizations are mostly walk-in patients, but some will have an appointment. Since this is a public health clinic, the electronic health record is different than anything I had seen before. They use a electronic health record called "insight." They also have a Alaskan database they can use to look up information about patients immunizations if they aren't sure they have had a certain vaccination or have no record of their immunizations. It is called "VacTrak." All of the vaccines are provided by the state of Alaska who anyone under the age of 18 years old or if they are still in high school up to the age of 23. If people do not have insurance and it is not covered, the Muni will send patients to the Anchorage Neighborhood Health Center where they can see a provider and get services for free. It was spring break in Anchorage, so we got a lot of youth patients who were coming in to get their immunizations updated. We also provided education about the Mumps outbreak that is going around Anchorage. There are about 300 cases of mumps within the area so the state of Alaska is providing people a free booster shot if they had not gotten one within the last 5 years. I found that we gave a lot of the booster shots due to the increasing rate of mumps. The needles that are used in the vaccination room are vanish point needles. These needles are awesome because they have a retractable needle. The needle will retract once all the solution is gone. I thought this was awesome and will prevent many needle stick injuries. I had never seen that before and it is something that I hope will be available to everyone. In the vaccination room, they also provide TB testing and screening. One of the things they do that I found was great was that they have a IGRA blood test for TB. This test is a lot more accurate compared to the PPD skin test. They will do the IGRA blood test to people who have previously had TB, think they have been around others who have TB, or people who are from out of the United States. This test is not as fast as the PPD test, but is more accurate so that is the nice part. The results will come back within a week. Overall the first day was great and I learned a lot of information about vaccinations.
After a day at the Muni, Sarah and I came home to Cindy making us fish dinner. It was great!
Tuesday March 13, 2018
The second day at the Muni, I was in the vaccination room again with Nurse Robert. Robert was great at teaching me about certain vaccinations. He was great at showing me the recommendations provided by the CDC and would show me his process when getting a patient. I thought Robert was great at educating patients about immunizations that are not required, but are recommended to patients such as the HPV vaccination. It was great to be able draw up many vaccinations throughout the day as I had not done a lot of drawing up medications in my previous clinicals. Throughout the day we had time to talk about other communicable diseases that are common within Alaska. Robert taught me about some of the common ones such as giardiasis, salmonellosis, shellfish poisoning, and campylobacter enteritis.
After another good day in the public health setting, Sarah and I wanted to explore a little of Anchorage. So we drove up a mountain. We were able to get up the mountain with the van, but it was a struggle. At the top of the mountain we were able to see all of Anchorage. The views were amazing!!
Wednesday March 14, 2018
Today at the Municipality of Anchorage I worked with Cortney and Robert again in the immunization room. I was able to watch them perform a few IGRA blood tests and see the way they perform it. The 3 tubes of blood will be picked up at the end of the day by someone from Providence Hospital where they will then provide the results to the Muni within a week. Today Robert taught me about another service they provide at the Muni, which was the I-693. This is a service to refugees who want to get their green card. The refugees who want to get their green card have to have lived in the United States for a year and once they have they can schedule an appointment where the public health nurse, such as Robert will help them. The Muni will usually get a couple refugees a month. The refugees usually will have had a physical and then they come to the Muni to make sure they have all their immunizations done and get help finishing the application for the green card. If they do not, the Muni will provide them with information about the vaccine and then give them the vaccination. A barrier for the public health nurses is that the refugees do not speak English well, so they have to get an interpreter. They use LanguageLink, which is a link you call and get an interpreter for the specific language needed. It was interesting to learn about another service they provide within the immunization clinic.
After clinical today, Sarah and I decided it was a day to relax so we stayed at home tonight to catch up on things we needed to do.
Thursday March 15, 2018
Today was a fun day at the Muni. I was able to experience a few different areas. I started out in the vaccination room where we gave immunizations to children and adults as well as reading TB tests. After being in the vaccination room for a couple hours, I was able to go outside of the building. I went with Numia to deliver TB medications. It was very interesting to experience delivering TB medications to all different aspects of people. Numia had to call a few people to let them know that we were at their place so they could come out to take their medications or unlock their door. Numia has to witness them taking the medications before he can leave them. Numia does this every day so he is very use to the behaviors and where he is delivering each medication. I realized that his job takes a lot of patience and you have to develop a trusting relationship with these people. I asked Numia a lot of questions regarding his job and he said it can be really hard sometimes. He said that sometimes people do not want to take their medications or they are asking why they need to take these medications all the time. It was a great experience to be able to see how he interacts with the patients and how he does his job. After being with Numia for about 5 or 6 deliveries, I was brought back to the Muni for lunch. After lunch I got to be in another part of the clinic. I was able to shadow Sally in the Reproductive Health Clinic/STI testing. I got to learn about how the reproductive health clinic works and what they provide to patients. The patient that I got to observe was having symptoms of a yeast infection. Sally was able to do an exam and look under the microscope to see weather the patient had an infection. It was interesting to learn that as a public health nurse, you are able to do exams and pretty much diagnosis a patient. It was another great observation of what it is like to be a public health nurse in the reproductive health clinic.
This was my last day at the Muni and it was such a wonderful experience. I was able to experience many different areas of a public health nurse and learn so much! I couldn't thank all the nurses enough for the amount of education they did with me. It was awesome!
Today was a special day for Sarah and I as well. One of the nurses that worked with Sarah was able to get us a plane ride with her boyfriend. I was very nervous as I didn't know this person at all and I hadn't been in such a small bush plane for a long time. I just wasn't sure what to expect. Leigh, the nurse, brought us out to the airport to meet Monty. It was interesting to learn about this airport as it is a hub for about 2,000 bush planes. Monty showed us that he he can add either skis or pontoons to the wheels, which allows him to use his plane all year round. I thought that was so cool! We used the wheels to taxi over to the lake and then we used the skis for takeoff on the lake. I don't think I will ever experience that again so it was incredible to do something so different than a huge commercial plane taking off on a runway. Once we were in the air, the views were beautiful! I was so happy to be able to experience this and had gotten the opportunity to do something that was not planned on this trip. Thanks Monty!