June 8, 2019 (Saturday- due by Monday, June 10th at 0800)

June 8, 2019 (Saturday- due by Monday, June 10th at 0800)

What did you do while you were here to improve the health of others?  How do you feel this population is able to get healthier now and for future generations?  How have you been changed or impacted by this experience?

I was able to assist in the soup kitchen by feeding the poorer community. I was able to educate patients to teach them how to live a healthier lifestyle. This was hard as I did not find too many people willing to learn due to their lack of trust of healthcare providers. 

I feel as if what basic information we provided them they can pass it down from generation to generation. Some basic education they received was on managing high blood pressure and what it can cause when not controlled. Another is what long term drug and alcohol use can do to your body. Another why seeking help for mental health problems is so important. I feel as if I have been highly impacted I have learned so much. 

I learned what I feel the true value of life is and that is surrounding yourself with happiness. People that I ran into no matter their situation were happy because of the place they lived, the people they knew, and their religion. It makes me have an appreciation for other cultures and opened my eyes up to another part of the world that was completely different than the one I live in.  

June 7, 2019 (Friday)

June 7, 2019 (Friday)

What are the challenges that individuals you met today face?  How does The Open Door help with some of the needs of the community?  Are there other connections in the community to help improve health for those facing health disparities?

One challenge that is faced by some of the individuals I met today are finding a job. Most of the individuals I talked to said that there aren't very many opportunities or they have a hard time getting someone to give them a change. Individuals also are uneducated with healthcare and don't trust doctors. Another challenge that the individuals face is drug addiction. Many of the individuals are addicted to drugs. Something I found truly interesting was that these individuals were happy with their life. They loved where they lived, they never want to move. A lot of them have left and came back. They are comfortable and happy. The open door helps with so many different things. Monday-Friday they serve breakfast and lunch. Saturday-Sunday they serve breakfast, lunch, and dinner. They also give food out to people to take home with them like frozen meat and mac and cheese. The open door allows individuals to do laundry and bathe themselves. There is a second-hand store that has low priced items for them to buy. They have 30 churches that volunteer every month to cook food for everyone. Every church is assigned the same day each month.  They also pay to fill prescriptions for people. Some connection in the community is Meridian which helps with drug and alcohol abuse. Meridian also helps with behavioral health issues which are their main focus. Also, there is a shelter about 3 miles away to try and get people off the streets. Learning from these individuals today was an experience that I will never forget. They are such interesting individuals and so smart. They took a wrong path and are more than willing to admit it. They believe what they believe and that makes them happy. I found out from the individuals I personally talked to that health wasn't really that important to them because they were happy. I found one individual that one of the staff continued to ask him to talk to the nurses and he refused. He said he was "fine." He wasn't "sick." I attempted to talk to him and he wanted no education and left shortly after. This opportunity really opened my eyes to what means the most to people and having nothing means a lot more than having everything in a way. They considered each other as family and everyone new everyone. 

June 6, 2019 (Thursday)

June 6, 2019 (Thursday)

How did Mission Hospital compare to the Swain County Hospital?  What is the distance that people come to receive care here?  What stood out to you the most today?

The Mission Hospital did not compare to Swain County Hospital. The hospital had 750 plus beds. The swain hospital treated more like rehab patients rather than the sick and ill. Mission Hospital is advanced with their medicine and nurses in the emergency department. The nurses can do IO's which is not something nurses typically do. When asked what the nurses did in Swain Community hospital a typical response we received was "send them out." I was truly pleased with Mission Hospital, with the staff, their smart rooms, and overall the flow of the hospital. The distance varies on how far they travel to receive care at Mission Hospital due to them serving over 25 counties. Swain County Hospital is over an hour away from Mission Hospital and that is just one of the counties. So typically they travel a pretty decent distance to obtain care. What stood out to me most was their emergency department. They have two trauma rooms that are very warm for patients. These trauma rooms also include a chart on the wall that explains each personals position within in the room and where to stand. That amazes me. It takes the pressure off on not knowing where to stand or how to access the patient for what you need. They also wear name tags that identify who they are so you can't forget what position each person is, whether its the head nurse or who the recorder. Another thing that stood out to me was that the psych rooms had cameras in them and a CNA would sit in a room and watch all of the psych patients and that would count as a "sitter." I thought that was an amazing idea because of the personnel it saved. Today was a great experience and it really opened my eyes up to possibly working in a hospital.

  

June 5, 2019 (Wednesday)

June 5, 2019 (Wednesday)

How does the lack of health care access affect population health and patient wellbeing in a community?  What is the biggest take away from today’s Wilderness First Aid course?  How can you incorporate some of the lessons you learned today into your care of patients back home?

The lack of healthcare can affect a community's quality of life. It affects the community physically and mentally because the community cannot properly get the care they need. Due to the lack of access patients are unable to effectively prevent diseases and acquire the medications they need to control their diseases.

The biggest take away was triaging and taking care of the most critical patients first because you never know how long you will be with that patient. Also, your patient is your priority so you should continue to care and reassess your patient for trends to make sure your patient is not declining. I really enjoyed learning from this course as it is very similar to EMS back home and that is something that I love. I enjoyed using critical thinking skills and stabilizing limbs.

You can incorporate care you learned from this training for your patients back home by using the triangle. Your safety always comes first. That doesn't change from wilderness to hospital settings. Then treating life threats comes next. You can essentially use the whole triangle in your patient care at home beside the evacuation part due to the patient being where they are unless they need to transport to a higher level or burn center.

This class was interesting and I could not be happier that I was able to be a part of it and advance my skills in a different way.

Blog 3

June 3, 2019 (Monday)

Now that you are here, what is your first impression of the environment in Cherokee? What did you find most interesting about this culture’s history? What are the services that the Swain County Hospital is able to offer the community?  Are there workforce shortages in this community?  What types of healthcare services are frequently difficult to access in rural areas?

I really like the Cherokee environment. I love how they live in the mountains and it's their land not owned by the government. I like that everyone knows everyone. I like how they have a "pow wow" every year. I really enjoyed the traditional dances they do. I felt it was very interesting how they hold the women on such a high pedal stool. I feel like being in that culture and being on that pedal stool would be hard because I personally see relationships as an equal. We take the males last names but they take their wives tribe. I enjoyed how they used what was in their environment to make everything they have. They are truly creative humans. I have really enjoyed learning about the history of their culture but what I thought was most interesting was how at the wedding ceremony the groom presented the bride with meat to show his manhood. The bride would present her groom with an ear of corn to show her women-hood and that she can care for her groom. It amazes me how symbolic they are. The services that are typically offered at Swain County Hospital are slim, they are similar to prompt care. The services include acute care, pneumonia, COPD exacerbation, wound care, and physical therapy. What I thought was truly interesting was that the hospital had a "swing" are which is where they are ready to be discharged but are not ready to go home so they stay and get the care they need until they are ready to go home. They are able to do imaging and stabilizing of a patient until they are ready to be transferred to a facility better equipt to take care of the patient. They do offer pain control area of the hospital. There are many workforce shortages in the area. This includes all of the positions from CNA's, nurses, doctors, and specialist. The hospital pays tuition for two students every year in exchange for them to work for the hospital. They have one doctor mainly for the hospital that covers the emergency room and the admitting floor. What is unique about this hospital is that they don't have a high turnover rate with employees. Healthcare services that are frequently difficult to access are pretty much all your main specialties like surgery, OB, pediatric specialist, hospice, mental health, substance abuse, and these are just a few of those that are difficult to access. One of the main points everyone we talked to at the hospital made was they have a shortage of resources. The Swain County hospital only admits 2-3 percent that comes in and has to send the rest out. Rural area healthcare services are very interesting because they depend on each other to know their skills and they need to be proficient for things to work smoothly. There isn't a specific thing they study.   

Sunday Post!

June 2, 2019 (Sunday)

Considering the visit to the Appalachia Museum, what did you find most interesting?  Compare and contrast health disparities between Appalachian and the non-Appalachian communities.  What are some strong core values commonly found among the Appalachian culture?  How does the Appalachian life compare to your own way of living?

I found a lot of things interesting at the museum. I enjoyed reading all of the signs about how much the loved their culture and "what we had is what we made ourselves." I really enjoyed that what we use as a bedpan today they used as a "Ukuweewee Banjo." What I thought was most interesting was learning about Dr. Odie Miller, he was the blind doctor of Big Valley. He became blinded by drinking poisoned moonshine. However, he continued to practice medicine by hiring a driver to take him around. 

"Appalachian North Carolina’s stroke mortality rate is 13 percent higher than the national rate and 3 percent lower than the rate in non-Appalachian North Carolina." This is due to the lack of medical facilities being close enough to be able to handle this medical emergency. In Appalachian diabetes, COPD, mental health, obesity, and cancer have a significantly higher mortality rate than non-Appalachia communities due to not being able to adequately care for yourself due to the distance to the facility, not having enough money, no way of transportation, and a lack of education are just a few reasons for this. 

Strong core values that are found among Appalachian culture is they love their land, mountains, family, and culture. They are very prideful in what they have and what they make. The Appalachia life compares to my way of living is I am proud of what I have. I work very hard every day to have what I have. I love my home. Most of all my life compares because I love my family and culture. My culture is symbolic of me and represents what I believe and who I am. 

Fact Sheets and Infographics. (2017). Retrieved from https://www.arc.gov/appalachian_region/FactSheets.asp#Disparities

First Blog!

June 1, 2019 (Saturday)

What are you most excited about in the days to come? What are your apprehensions? Do you think you may have any cultural biases/ prejudices/ pride/stereotyping that you may need to set aside to have better understanding about this culture? Why or why not?

I am most excited to learn about a different culture and their beliefs on healthcare. I am also interested to learn about how they utilize what little they have. A fear that I have would be not being able to help them more. I fear for their residences that suffer because of the lack of access to healthcare. I personally don't believe I will have any cultural biases/ prejudices/ pride/ stereotyping because I have been in healthcare for 6 years and I truly believe people do what they think is best for them and who am I to tell them any different, all I can do is express education to them. In the end, they will still choose to do what they wish and I believe that is their right to do so.