Good Friday - Final Day
Friday morning several of us drove to Soldotna for our second day of school nursing. At the elementary school I shadowed the nurse, Tammy, and visited a few other programs at the school. The first program was for autistic and developmentally delayed children in early elementary. I absolutely loved this program! The teachers here were so flexible and actively seeking new research on how to improve curriculum and activities to maximize these kids' ability to reach full potential. One of the teachers flew to the University of North Carolina for their teacch autism program. She has implemented the activities from this program into her classroom. She said one big thing they focus on is sensory training. Doing activity with extra weight is helpful to engage the body and calm the child. Kids are instructed to take numbered jugs that are weighted and place them along the hallway according to the number. Another sensory intervention is a weighted vest. Children may wear this during work time while they write letters or numbers. The innovation used in this program is phenomenal; they really adjust to the kids' needs.
The second program was the same type, but for older elementary kids. One of the kids in this class was completely non-verbal and used a device like an iPad for all communication. At this age students had grown to different levels of development. It was cool to see that they each had their own types of assignments that had been adjusted to fit their individual needs. It is encouraging to see a school system with programs like this.
The third program I visited was the preschool. It was Good Friday and the kids were making snakes out of plastic easter eggs. I sat and talked with a few kids and helped them with their snakes. Earlier they had made bunnies with their picture on the face and their footprints in paint for the feet; they were so excited to show me!
The nurse's office was also an active place! One student comes in to self straight cath with the help of the nurse. This was cool to see a child be so proactive in adjusting to needed self cares. Three other students come in for carb counting and insulin. A few students also come in for daily medications around lunch time. One student came in with a headache and nurse Tammy asked a few questions and found that the cause of this headache was worrying. This taught me how to not jump to conclusions when treating a patient. She could have easily just medicated the symptom and moved on, but instead she got down to the root cause of the problem.
The last visit of the day, a girl came in from the playground holding her arm and crying. Tammy raised the sleeve of the girl's shirt, saw a U-shape of a bone in her forearm, and knew the girl's arm was broken. She got the child ice and called her mother to have her brought into the emergency room. While Tammy was charting and the girl was waiting for her mom, I sat and talked to her. I was amazed to see how my distraction had an effect on her pain level. While we were talking she stopped crying, and she even told me a story and laughed! From this I learned that once you ask all the necessary questions for diagnosis and documentation, change to subject of conversation with the child. This is a really good trick to have up your sleeve! Also, the nurses office is open simply for use of the bathroom. When the bathroom in the hallway is occupied, then kids go to the nurses office to use that bathroom. Nurse Tammy's reasoning for this is to eliminate bullying in the bathrooms. I thought this was such a great idea! The heart this woman has for her students is amazing!!!
After school we traveled back to Anchorage and stopped at Moose Tooth for pizza. After dinner we sang happy birthday to Sue and had cupcakes! :)
When we got home for the night we all packed and hung out for our last night together in Alaska :(
The week flew by and I'm not quite ready to leave, but I am happy to be home with family for Easter. I will be applying to jobs in Alaska, and I hope it's not too long before I return.
Adios, Alaska.
The second program was the same type, but for older elementary kids. One of the kids in this class was completely non-verbal and used a device like an iPad for all communication. At this age students had grown to different levels of development. It was cool to see that they each had their own types of assignments that had been adjusted to fit their individual needs. It is encouraging to see a school system with programs like this.
The third program I visited was the preschool. It was Good Friday and the kids were making snakes out of plastic easter eggs. I sat and talked with a few kids and helped them with their snakes. Earlier they had made bunnies with their picture on the face and their footprints in paint for the feet; they were so excited to show me!
The nurse's office was also an active place! One student comes in to self straight cath with the help of the nurse. This was cool to see a child be so proactive in adjusting to needed self cares. Three other students come in for carb counting and insulin. A few students also come in for daily medications around lunch time. One student came in with a headache and nurse Tammy asked a few questions and found that the cause of this headache was worrying. This taught me how to not jump to conclusions when treating a patient. She could have easily just medicated the symptom and moved on, but instead she got down to the root cause of the problem.
The last visit of the day, a girl came in from the playground holding her arm and crying. Tammy raised the sleeve of the girl's shirt, saw a U-shape of a bone in her forearm, and knew the girl's arm was broken. She got the child ice and called her mother to have her brought into the emergency room. While Tammy was charting and the girl was waiting for her mom, I sat and talked to her. I was amazed to see how my distraction had an effect on her pain level. While we were talking she stopped crying, and she even told me a story and laughed! From this I learned that once you ask all the necessary questions for diagnosis and documentation, change to subject of conversation with the child. This is a really good trick to have up your sleeve! Also, the nurses office is open simply for use of the bathroom. When the bathroom in the hallway is occupied, then kids go to the nurses office to use that bathroom. Nurse Tammy's reasoning for this is to eliminate bullying in the bathrooms. I thought this was such a great idea! The heart this woman has for her students is amazing!!!
After school we traveled back to Anchorage and stopped at Moose Tooth for pizza. After dinner we sang happy birthday to Sue and had cupcakes! :)
When we got home for the night we all packed and hung out for our last night together in Alaska :(
The week flew by and I'm not quite ready to leave, but I am happy to be home with family for Easter. I will be applying to jobs in Alaska, and I hope it's not too long before I return.
Adios, Alaska.
Thursday
Thursday was our first day of school!!! I went to the Homer High School. I shadowed the school nurse Ella May. I was able to do a vision and hearing screening for the first time. We saw a couple kids with headaches. There has been a bad virus going around that starts as a headache. Also there has been a pertussis outbreak, so we are also checking for signs of this as kids come in.
After school, we went to the Smokey Air base and picked up Anna and Sue who flew in from Syldovia where they went for the day to shadow the school nurse. Then we all went down to the spit. A "spit" is a piece of land is a narrow coastal land formation. Most of the shops on the spit were closed and boarded up. Andrea said they are open in the summer and it is super busy. We went to the Salty Dawg Saloon. It was an interesting place; it kind of reminds me of The Anchor in Superior, WI. Andrea and I walked down the pier and saw The Bandit ship from The Deadliest Catch. I've never seen the show, but it was still pretty neat.
After school, we went to the Smokey Air base and picked up Anna and Sue who flew in from Syldovia where they went for the day to shadow the school nurse. Then we all went down to the spit. A "spit" is a piece of land is a narrow coastal land formation. Most of the shops on the spit were closed and boarded up. Andrea said they are open in the summer and it is super busy. We went to the Salty Dawg Saloon. It was an interesting place; it kind of reminds me of The Anchor in Superior, WI. Andrea and I walked down the pier and saw The Bandit ship from The Deadliest Catch. I've never seen the show, but it was still pretty neat.
Andrea and I took the scenic route back to the cabin. We took a detour and did some beautiful site seeing. On the way back to the cabin we spotted a moose on the shoulder of the road. The moose began trotting down the road as we drove toward it. We followed it for about 100 yards until it crossed the road and ran down the hill.
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Wednesday
On Wednesday we toured the ANMC clinical and traditional healer. These two practices are combined in one building. I found this extremely interesting because typically I see people who agree with either medicine or traditional healing. Never before have I seen a mix of these two practices. Providers will actually refer someone to the traditional healer and vice versa. Actually after our presentation with the traditional healers was finished one of the women there mentioned she was headed to a doctor appointment, so we know that the combination of these two practices is really true to them. I thought this was so cool to see!
The clinic here was amazing! It is so different from what we are used to seeing because it is truly patient centered. Even the designs and layouts of every wing and every room are catered to what best suites the patient. Also, ANMC doesn’t call them patients; they are customer owners. They say that the hospital is owned by each of the customers there. Another cool thing is that the doctors try to do as much during one visit as possible to prevent customer owners from having to make a second trip into the clinic. I think this is opposite of the mindset of the providers in Minnesota where the clinic wants the patients to come back many times because they get money each time a person is seen. Some clinics in Minnesota even refer to patients as RVUs (revenue units).
After leaving ANMC we went to University of Alaska Anchorage to tour around the nursing classrooms. A faculty member lead us around and told us about the curriculum of their program, which was actually very similar to ours. They have trimesters rather than semesters, and they also have a two-year RN program. They accept 40 students to the program at a time so they end up accepting 120 students a year just like we do at CSS.
The clinic here was amazing! It is so different from what we are used to seeing because it is truly patient centered. Even the designs and layouts of every wing and every room are catered to what best suites the patient. Also, ANMC doesn’t call them patients; they are customer owners. They say that the hospital is owned by each of the customers there. Another cool thing is that the doctors try to do as much during one visit as possible to prevent customer owners from having to make a second trip into the clinic. I think this is opposite of the mindset of the providers in Minnesota where the clinic wants the patients to come back many times because they get money each time a person is seen. Some clinics in Minnesota even refer to patients as RVUs (revenue units).
After leaving ANMC we went to University of Alaska Anchorage to tour around the nursing classrooms. A faculty member lead us around and told us about the curriculum of their program, which was actually very similar to ours. They have trimesters rather than semesters, and they also have a two-year RN program. They accept 40 students to the program at a time so they end up accepting 120 students a year just like we do at CSS.
After these tours we began our 5-hour drive to Homer. It was gorgeous! We took a pit stop in Cooper Landing, got ice cream and took pictures down by the river. Not too far from Cooper Landing we spotted our first moose of the trip! The placement was like something out of a movie. The moose was drinking out of the river that weaved through the pine trees beneath the mountains – picturesque!
We also stopped at Solid Rock Bible Camp, which was a cool place to see. I would love to take a few weeks out of summer to volunteer at the camp.
We also stopped at Solid Rock Bible Camp, which was a cool place to see. I would love to take a few weeks out of summer to volunteer at the camp.
We finally arrived in Homer and continued about seven miles out of town down an old dirt road to find one of the two cabins we had rented. We unloaded all of our stuff at the first cabin. I joined Andrea and Sue at the other cabin and we had to take four wheelers there because the road was not strong enough car the vehicles this time of year. I taught Sue how to drive a manual four wheeler!
Tuesday
These are picture of the Alaska Native Medical Center. Tuesday we toured the hospital and had several meetings to learn about the facility and the technology they use. The hospital uses a system called Telehealth, which uses video calling to interact with other hospitals. This is an awesome means of collaborative care!
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The ANMC facilities are filled with handmade things created by natives across Alaska. The objects in this picture are walrus ivory and baleen. These baskets are weaved so tightly that they will hold water.
One thing I learned about leadership in this hospital that I think is so amazing is that each hospital unit has a unit council. Members of the council meet together once a month to discuss what is working well on the floor and what isn’t working well. They also come up with new ideas to engage positive behavior on the floor and encourage staff. An interesting fact I learned today is that once a child has had two surgeries in the operating room his or her IQ has a great chance of drastically decreasing. |
Monday
For our first clinical day, we had our cultural awareness workshop at the Alaskan Native Heritage Center. I'll be honest, I wasn't exactly looking forward to a full day workshop, but I really enjoyed it! We were given an overview of AK native cultures. There are over 200 languages in AK! We continued by discussing what culture means, and the different aspects of culture. We also spent time talking about interethnic communications. This was super interesting to learn about the differences within communication including the tempo, pitch, and volume we use, as well as the distance we leave between ourself and the person we are speaking to.
We also toured the Heritage Center and saw the things different tribes make by hand. We also learned the specifics behind why certain things are made in a specific manner in order to fit the needs of the tribe. The picture to left is a two headed eagle illustration on a large kayak. The reason this kayak is so large is because they must be able to haul a lot of material in one trip. In warmer parts of Alaska people are able to launch kayaks into the ocean year round. Tribes in this area use smaller kayaks.
The illustration of the two headed eagle is a sign of peace to the Russians. The Russian flag has a two headed eagle, so this tribe puts this image on their kayaks to show the Russians that they are not present as a threat. For the last part of the day, a native Yupik, Yaari Walker, spoke to us about her life story. She stressed to us the importance of understanding a patient's culture while treating them, as well as how to approach them to ask about their culture so that we do not make assumptions based upon looks. I really enjoyed learning about the cultural differences today, and how to be more therapeutic in my approach towards my patients. One specific I learn is to ask my patients, "How are you feeling physically? Mentally? Spiritually?" All of these are separate questions and equally important. My goal is to heal my patients' mind, body, and soul. |
Thursday - Saturday |
It's official - Alaska is the most beautiful of all 50 states!
It was dark when we arrived Thursday night, but Friday morning we woke up to snow covered mountains outside our bedroom windows! Our first day we hit up a local coffee shop located inside a food market (waaay better than Starbucks). The majority of the day we spent traveling along Turnagain arm on the Seward Highway taking in the nature surrounding us. . . and stopping for photo shoots of course! During our journey, we stopped at the wildlife conservation center and looked at many of the different animals that live in AK. After a wonderful home cooked salmon dinner, we went to the high school state basketball tournament at the University of AK Anchorage just down the road from our house. It was so cool to hear the stories about entire villages spending a ton of money flying several different small planes just to make it to UAA to support their team! |
Alaskan Wildlife ConservationHere they have a rescued Bald Eagle living in captivity. This eagle was shot and required amputation of his entire left wing.
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State Basketball Tourney |
Alyeska Ski ResortFriday night we got a good layer of ice covering the ground followed by a few inches of snow. Weather conditions were not the greatest, but that didn't stop us from shredding the best mountain in Alaska! We made it through the treacherous Turnagain pass and into Girdwood. It continued to snow all day giving us a little more powder to cover the ice. The lift to the highest part of the mountain was closed to to a recent fire, but people opted to hike the ridge to the north face. I planned to do this until I took my first run down a single black diamond and slid on the ice halfway down. At that point I realized a double black diamond probably wouldn't be a good idea that day. I'd love to come back next winter!
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