Alaskan Clinical experience
My catch of the day in Alaska
Day one (March 18, 2013)
By Kevin Toboleski
Today was the first day of our clinical
experience. First we went to
Department of Health, where we will be spending the morning learning about the
RN’s role in Alaskan Health care. After being introduced to the staff we were
giving a short tour of their building. It consisted of a small main waiting area
with reception desk. Also there were four offices, two exam room and one
meeting/ lounge area. Currently they have four Health care nurses on staff with
one receptionist/office worker. The public health nurse then introduced us to
the rest of her staff. After having a short discussion on why we were here
(exposer to rural health care), she gave us a brief description what her job
duties were. From there we watched a video on the old believers. This is an old
order Russia Orthodox community that has several settlements in the area. Next
Sharon brought us over to the WIC office to meet the staff there and for them to
explain their program to us. One of the unique aspects of their office, since
being so small, is that they have a nice open lounge area with comfortable
furnishing in it. They use this area to conduct most of their interview. The
staff said that this promote a much more relaxed atmosphere; thus the client is
more relax and more willing to open up to them. From there we went on a tour of
the town of Homer AK. The public health nurse drove us past the hospital and all
the clinics in Homer. They also have a Planned Parenthood office, women and
children shelter, assisted living, long term care and several low income housing
areas. Once back at her office she went over their MAPP (Mobilizing for Action
through Planning& Partnerships) program. This program is used to assess
community needs and collaborate with the community to find ways to address these
needs. This assessment is updated every three years and they are currently in
the middle of this update. For the most part the community needs are not all
that different from other areas of the country. One area that they are higher in
is the amount of TB in Alaska. Currently the three highest areas for TB in U.S.
are Alaska, Hawaii and Washington DC. The public health nurse felt that due to
all the small tight knit communities, there remote location and the mobility of
family and friends moving in and out of these communities accounts for some of
the increase in TB.
After lunch we then went over to the SVT Health and Wellness
clinic for a tour. This clinic is operated by one of the tribes of Alaskan
Natives for Alaskan Native health care. One of the different aspect of this
clinic is that they have received a grant to provide all the low income care
for the community. By receiving this grant the clinic has to be open to all
people. Another area that also made this clinic unique is the wellness center
that’s part of their clinic. This center offers acupuncture and several other
naturopathic medicine choices. One of the staff stated “this service has been
well received by the community”. The nice part about this is all the different
services are together in one building. Many other communities offer
Naturopathic medicine but, generally you have to go from one location to
another to receive these service. Here it is all in one building. After
thanking the staff for taking time out of their busy schedule to see us we
left.
By Kevin Toboleski
Today was the first day of our clinical
experience. First we went to
Department of Health, where we will be spending the morning learning about the
RN’s role in Alaskan Health care. After being introduced to the staff we were
giving a short tour of their building. It consisted of a small main waiting area
with reception desk. Also there were four offices, two exam room and one
meeting/ lounge area. Currently they have four Health care nurses on staff with
one receptionist/office worker. The public health nurse then introduced us to
the rest of her staff. After having a short discussion on why we were here
(exposer to rural health care), she gave us a brief description what her job
duties were. From there we watched a video on the old believers. This is an old
order Russia Orthodox community that has several settlements in the area. Next
Sharon brought us over to the WIC office to meet the staff there and for them to
explain their program to us. One of the unique aspects of their office, since
being so small, is that they have a nice open lounge area with comfortable
furnishing in it. They use this area to conduct most of their interview. The
staff said that this promote a much more relaxed atmosphere; thus the client is
more relax and more willing to open up to them. From there we went on a tour of
the town of Homer AK. The public health nurse drove us past the hospital and all
the clinics in Homer. They also have a Planned Parenthood office, women and
children shelter, assisted living, long term care and several low income housing
areas. Once back at her office she went over their MAPP (Mobilizing for Action
through Planning& Partnerships) program. This program is used to assess
community needs and collaborate with the community to find ways to address these
needs. This assessment is updated every three years and they are currently in
the middle of this update. For the most part the community needs are not all
that different from other areas of the country. One area that they are higher in
is the amount of TB in Alaska. Currently the three highest areas for TB in U.S.
are Alaska, Hawaii and Washington DC. The public health nurse felt that due to
all the small tight knit communities, there remote location and the mobility of
family and friends moving in and out of these communities accounts for some of
the increase in TB.
After lunch we then went over to the SVT Health and Wellness
clinic for a tour. This clinic is operated by one of the tribes of Alaskan
Natives for Alaskan Native health care. One of the different aspect of this
clinic is that they have received a grant to provide all the low income care
for the community. By receiving this grant the clinic has to be open to all
people. Another area that also made this clinic unique is the wellness center
that’s part of their clinic. This center offers acupuncture and several other
naturopathic medicine choices. One of the staff stated “this service has been
well received by the community”. The nice part about this is all the different
services are together in one building. Many other communities offer
Naturopathic medicine but, generally you have to go from one location to
another to receive these service. Here it is all in one building. After
thanking the staff for taking time out of their busy schedule to see us we
left.
Old Believer Russian Orthordox church south of Homer AK.
Day two (March 19, 2013)
Were off to see three different old
order Russia Orthodox schools. The first school would be the most conservative
of the three. They have 77 students housed in two house’s converted to schools.
All the students here wore the old style traditional clothes of their culture(no
pictures allowed). Are school nurse explained that there are many different
cultural needs she has to aware of to be able to successfully work with the
children and their parents. Just knowing if you can use any type of medication
can be challenge. We were there about one hour and then we moved on to the next
community. Even though the next community can be seen from the last one there is
very little interaction between the two communities. This is due to the
different in there priest and how strict they follow their belief. The next
community was about the same size as the last with about 70 students. Their
community is more liberal then the last. Big different I seen were the homes
were more spread out and the dress code was more relaxed. We did not get into
the classrooms in this school because the nurse’s office was in a separate
building from them. After spending about hour at this school we moved on to the
last school for this day. This school was bigger with 145 students of which 30%
are Russian orthodox even thought the school is in the middle of a Russian orthodox
community. This school was by far the most liberal of the three. You could see a
further change in dress style and a change in what is being taught. Our nurse
even said the parents are much more involved in school activities then they are
in the other two. It was very interesting seeing the cultural changes from one
area to another. Today was an unusually day for our nurse. Normally she spends a
full day at each school once a week. But today she had to go to all three
schools to make sure her paper work was all in order for the upcoming audit.
Were off to see three different old
order Russia Orthodox schools. The first school would be the most conservative
of the three. They have 77 students housed in two house’s converted to schools.
All the students here wore the old style traditional clothes of their culture(no
pictures allowed). Are school nurse explained that there are many different
cultural needs she has to aware of to be able to successfully work with the
children and their parents. Just knowing if you can use any type of medication
can be challenge. We were there about one hour and then we moved on to the next
community. Even though the next community can be seen from the last one there is
very little interaction between the two communities. This is due to the
different in there priest and how strict they follow their belief. The next
community was about the same size as the last with about 70 students. Their
community is more liberal then the last. Big different I seen were the homes
were more spread out and the dress code was more relaxed. We did not get into
the classrooms in this school because the nurse’s office was in a separate
building from them. After spending about hour at this school we moved on to the
last school for this day. This school was bigger with 145 students of which 30%
are Russian orthodox even thought the school is in the middle of a Russian orthodox
community. This school was by far the most liberal of the three. You could see a
further change in dress style and a change in what is being taught. Our nurse
even said the parents are much more involved in school activities then they are
in the other two. It was very interesting seeing the cultural changes from one
area to another. Today was an unusually day for our nurse. Normally she spends a
full day at each school once a week. But today she had to go to all three
schools to make sure her paper work was all in order for the upcoming audit.
Nurse's office Kenai AK.
Day three(March 20, 2013)
After leaving Homer last night we
drove to Soldotna AK where we will be staying for the next three days. Today we
will travel to Kenai AK to one of the elementary school. We would spend the day
with the school nurse. Unlike the smaller school we been to this would be a
full size elementary school with 370 students. Our nurse said she stays pretty
busy. She usually sees about 70 students a day. Today was a little slower than
normal which was good for us. This allowed her time to explain what her job
duties are. She also went on to explain what type of things she sees in a
typical day. They are bumps and bruises, bloody noses, upset stomach,
headaches, sore throats, and ear aches. She also showed us her red and yellow
list which is a list of students with existing medical problems. With red list
being the most sever and yellow less sever medical condition. One of the other
functions of the school nurse is keeping a supply of clean cloths, hats,
gloves, snow pants, snow boots and jackets. I was surprised by how many
students either lost one of these items or didn’t have them. She went on to say
that there is a high rate of poverty in this area; in fact many students don’t
even have running water. It was a fun day. Children are so cute at this age and
so good at making up stories. Our nurse was very good at picking up on this.
The interact with the children and nurse made for a great day.
After leaving Homer last night we
drove to Soldotna AK where we will be staying for the next three days. Today we
will travel to Kenai AK to one of the elementary school. We would spend the day
with the school nurse. Unlike the smaller school we been to this would be a
full size elementary school with 370 students. Our nurse said she stays pretty
busy. She usually sees about 70 students a day. Today was a little slower than
normal which was good for us. This allowed her time to explain what her job
duties are. She also went on to explain what type of things she sees in a
typical day. They are bumps and bruises, bloody noses, upset stomach,
headaches, sore throats, and ear aches. She also showed us her red and yellow
list which is a list of students with existing medical problems. With red list
being the most sever and yellow less sever medical condition. One of the other
functions of the school nurse is keeping a supply of clean cloths, hats,
gloves, snow pants, snow boots and jackets. I was surprised by how many
students either lost one of these items or didn’t have them. She went on to say
that there is a high rate of poverty in this area; in fact many students don’t
even have running water. It was a fun day. Children are so cute at this age and
so good at making up stories. Our nurse was very good at picking up on this.
The interact with the children and nurse made for a great day.
Milk bottles made into a igloo by students
Day four (March 21,
2013)
Today I will be spending my day
with a school nurse in Soldotna AK. The Soldotna elementary school is actually
two schools in one. It has a pre-K thru 6 grade public school and a pre-K thru 6
grade charter school. In Alaska attendance at a charter school is highly sot
after. In fact the only way you can attend a charter school is by being picked
in a lottery. Nurse Tammy told us that once a student gets into a charter school
they tend to still there till they graduate; whereas in the public schools they
tend to be much more fluid moving from area to area. We arrived a few minutes
early and Nurse Tammy was not in yet, so the office staff let us into her
office. The door was hardly open and we had two students come in. Both had a
traumatic event which we helped with till Nurse Tammy came in. So
the day started out fast paced, but it soon slowed down. This school had 475
students and the nurse sees about 30 to 40 students a day. A much slower pace
than the last school we were at (70 students a day). It was interesting seeing
the different styles between the two school nurses. This is common due to how
far apart the school can be. You are on your own and need to set up your office
how it works best for you. If they need help they have to call someone else.
Many times the person they are calling is busy so it can cause a delay in care.
Thus you learn to be very independent in quick hurry. With nurse Tammy’s slower
pace we were able to take a tour of both schools, which we did not have time to
do at the last school. It was interesting see some of the differences between
the two schools in this one building. Even the design of the class rooms was
different. The charter school encourages much more independent thinking and uses
technology much heavier than the public school does.
As the day went on we transition
from being observers to taking total care of the students. By the end of the day
we were assessing each student when they came in, providing the care they needed
and documenting our care in the computer. Of course Nurse Tammy was observing
the whole time and stepped in when we needed her. This made for a great
experience. All the time we were there nurse Tammy explain what her job duties
are and she would give us valuable tips on how to do the job well. Thanks nurse
Tammy for a great day. I know my time with you was well spent and I will use
this experience help me during my nursing career.
2013)
Today I will be spending my day
with a school nurse in Soldotna AK. The Soldotna elementary school is actually
two schools in one. It has a pre-K thru 6 grade public school and a pre-K thru 6
grade charter school. In Alaska attendance at a charter school is highly sot
after. In fact the only way you can attend a charter school is by being picked
in a lottery. Nurse Tammy told us that once a student gets into a charter school
they tend to still there till they graduate; whereas in the public schools they
tend to be much more fluid moving from area to area. We arrived a few minutes
early and Nurse Tammy was not in yet, so the office staff let us into her
office. The door was hardly open and we had two students come in. Both had a
traumatic event which we helped with till Nurse Tammy came in. So
the day started out fast paced, but it soon slowed down. This school had 475
students and the nurse sees about 30 to 40 students a day. A much slower pace
than the last school we were at (70 students a day). It was interesting seeing
the different styles between the two school nurses. This is common due to how
far apart the school can be. You are on your own and need to set up your office
how it works best for you. If they need help they have to call someone else.
Many times the person they are calling is busy so it can cause a delay in care.
Thus you learn to be very independent in quick hurry. With nurse Tammy’s slower
pace we were able to take a tour of both schools, which we did not have time to
do at the last school. It was interesting see some of the differences between
the two schools in this one building. Even the design of the class rooms was
different. The charter school encourages much more independent thinking and uses
technology much heavier than the public school does.
As the day went on we transition
from being observers to taking total care of the students. By the end of the day
we were assessing each student when they came in, providing the care they needed
and documenting our care in the computer. Of course Nurse Tammy was observing
the whole time and stepped in when we needed her. This made for a great
experience. All the time we were there nurse Tammy explain what her job duties
are and she would give us valuable tips on how to do the job well. Thanks nurse
Tammy for a great day. I know my time with you was well spent and I will use
this experience help me during my nursing career.
One room school house
Day five (March 22,
2013)
Day five we find ourselves packing
up to leave Soldotna AK to return to Anchorage and then back home. It is about a
145 mile drive back to Anchorage. During this time we would travel from west
side of the peninsula to the east going over a mountain range to get there.
Today would be the first day that was not clear skies and sunshine. It would
start out cloudy and turn to snow shortly after we left. Along the way back to
Anchorage we will be stopping at a one room school house in Cooper’s Landing AK.
On arrival we were met by Tom the only teacher. This school teaches pre- K thru 12
grade. There is one main class room when you come in the front door with a
smaller study area /library behind it. Behind that was three small offices. Down
a short hall you get to the gym, kitchen and boys and girls locker room/
bathroom. There are 17 students
at this school. Five are pre-K and one is a junior, the rest of the 11 student
fall in-between these two groups.
We met up with school nurse and she gave us a tour of the school. She
also went on to say that this is one of five schools she is responsible for.
She lives in Seward AK and drives
each day to a different school. Cooper’s Landing is 90 miles from Seward and is
her longest drive. All the
students have desk in one room and work on assignment together in that room.
They rely on technology for much of their instruction. This allows the teacher
to teach more than one group at a time. The teacher does have three other staff
members that helps him along with specialty staff that travels to the school as
needed ( ie Speech, OT, PT, etc). After a short visit to this school we
were on the road again. My group would be heading to Alyeska ski resort to go
skiing while the other two groups will travel back to Anchorage to spend the
rest of the day shopping. It will
be a short night for us all since we will have to be up at 2:30 AM to pack and
head out to the airport to catch our flight back to Minnesota at 5:45
AM.
2013)
Day five we find ourselves packing
up to leave Soldotna AK to return to Anchorage and then back home. It is about a
145 mile drive back to Anchorage. During this time we would travel from west
side of the peninsula to the east going over a mountain range to get there.
Today would be the first day that was not clear skies and sunshine. It would
start out cloudy and turn to snow shortly after we left. Along the way back to
Anchorage we will be stopping at a one room school house in Cooper’s Landing AK.
On arrival we were met by Tom the only teacher. This school teaches pre- K thru 12
grade. There is one main class room when you come in the front door with a
smaller study area /library behind it. Behind that was three small offices. Down
a short hall you get to the gym, kitchen and boys and girls locker room/
bathroom. There are 17 students
at this school. Five are pre-K and one is a junior, the rest of the 11 student
fall in-between these two groups.
We met up with school nurse and she gave us a tour of the school. She
also went on to say that this is one of five schools she is responsible for.
She lives in Seward AK and drives
each day to a different school. Cooper’s Landing is 90 miles from Seward and is
her longest drive. All the
students have desk in one room and work on assignment together in that room.
They rely on technology for much of their instruction. This allows the teacher
to teach more than one group at a time. The teacher does have three other staff
members that helps him along with specialty staff that travels to the school as
needed ( ie Speech, OT, PT, etc). After a short visit to this school we
were on the road again. My group would be heading to Alyeska ski resort to go
skiing while the other two groups will travel back to Anchorage to spend the
rest of the day shopping. It will
be a short night for us all since we will have to be up at 2:30 AM to pack and
head out to the airport to catch our flight back to Minnesota at 5:45
AM.
Relaxing together after a long day
Conclusion
This was a fantastic trip and a
once in a life time opportunity for me. I like to thank the Fond du Lac Tribal
& Community College for allowing us to go on this trip. Without your support
this trip would not have been possible. I would also like to thank our
instructors who accompanied us on this trip. Your hard work made this trip a
success. I want to say thanks to my fellow classmates that went on this trip ( 7
women, 1 man). We all worked well together for such a large diverse group. Though we spent the bulk of time in school, we did have a
couple of days to ourselves to experience Alaska’s beauty and nature. As you
can see from the various pictures across the web site we did get to go ocean
fishing, we did get to snowshoe and climb a glacier, to go skiing on a mountain
and to travel the entire Kenai Peninsula with all its spectacular beauty and
ever changing scenery. I seen a
lot learned even more and left Alaska a better person for it.
This was a fantastic trip and a
once in a life time opportunity for me. I like to thank the Fond du Lac Tribal
& Community College for allowing us to go on this trip. Without your support
this trip would not have been possible. I would also like to thank our
instructors who accompanied us on this trip. Your hard work made this trip a
success. I want to say thanks to my fellow classmates that went on this trip ( 7
women, 1 man). We all worked well together for such a large diverse group. Though we spent the bulk of time in school, we did have a
couple of days to ourselves to experience Alaska’s beauty and nature. As you
can see from the various pictures across the web site we did get to go ocean
fishing, we did get to snowshoe and climb a glacier, to go skiing on a mountain
and to travel the entire Kenai Peninsula with all its spectacular beauty and
ever changing scenery. I seen a
lot learned even more and left Alaska a better person for it.