#rural placement

[beingdreeyore]

On my walk. I’ve got questions.

[confused-scientist]

So my new consultant is a little on the older side... and as they’ve been working in this area for a long time lots of the patients know them or have been treated by them in the past.

We went to see a patient yesterday and as they introduced themselves another patient ‘ Oh Dr [X], you are my favourite doctor in the world!’; after which another patient exclaimed ‘Dr [X]?! I thought they had died!’ lolzzzz

^^ Me, my consultant, and my reg ^^

[beingdreeyore]

Allowed to leave to go to work and allowed to grab food (on the way to and from work). Otherwise, this is my world for the two weeks that I’m in “quarantine.”

Five Covid swabs down. Five to go.

Note the second suitcase (what an ordeal that was) and also the weighted blanket that was acquired on the first approved trip out of the room.

It’s Friday night and I’m not allowed leave this space again until Monday morning. Big sigh. Deep breath.

So many tears this week. So far from home. So overwhelmed. So confused. So broken-hearted. Feeling so lost and worthless. But alive. Breathing. Taking things one hour at a time.

7.5 days left in this room. 25 weeks until I can go home.

[confused-scientist]

I just had to kill multiple (MULTIPLE) spiders in my room.

They were just Daddy-long-legs but still... living rural is tough.

[confused-scientist]

Things I Learned in Med School - Week 93

Greetings from Bourke - aka gateway to the outback - aka middle of effing nowhere.

Here are some bonus facts (about Bourke):

1. Its a town of ~approx 2,500 people of which about 1/3 are indigenous Australians

2. Its on the banks of the Darling River - the river and its use for farming, agriculture and cotton are hot tops in the area.

3. It was once the largest inland port in the world - mainly exporting wool down the Darling River.

It was a pretty nice drive up as I split it over two days.

On Tuesday we had a half day clinic orientation at the Sexual health clinic which was fine, and then after lunch (and ice-cream) I drove from Sydney to Mudgee and spent the night there. And then drove the rest of the way to Bourke the day after.

I’m staying in student accommodation which has a couple of other students in it who are super nice, although one left on Friday and the other one doesn’t actually spent that much time at the house... so it’s a little like living in my own place.

Spent Thurs/Fri at the medical center. On Thursday (and apparently for pretty much the whole week) they only had 1 doctor to cover both the GP practice AND the local hospital - which is just CRAZY! We ended up getting called into the hospital in the afternoon for an emergency - and the Dr had to call the larger base hospital (Dubbo) for advice and to eventually fly them out.

Overall though, my small exp in the practice has been relatively similar - scripts, referrals, work cover etc but then you’ll get something a little bit different... like a gnarly diabetic foot ulcer that ended up being osteomyelitis... and their BSL at the time was >20!

I’ve got another 2 full weeks here - so looking forward to it! Hopefully I’ll get to see some interesting stuff!

Anyway, here are some things I learned in med school this week:

1. Almost 1/3 of all people who commence tobacco use become addicted smokers

2. ~50% of newly acquired nasopharyngeal (aka nose/throat) cancers are related to HPV infection... most likely gotten through oral sex

3. 80% of people with peripheral vascular disease affecting their lower limbs are smokers or ex-smokers

4. 15% of deaths are reported to the coroner

‘til next week

[beingdreeyore]

On social media all my friends are celebrating the end of lockdown and publicly making plans to see each other.

And I am still stuck here with no one to talk to and nowhere to go, all while our numbers just exploded and we are understaffed. Our vaccination rate is less than 50%.

Do not tell me to reframe this positively.

[humansofjcuhealth]

Pharmacy Students on Rotation: a Real Rural Experience

Every year in January there is an opportunity for JCU Pharmacy students in year four to undertake a rural rotation together with an American PharmD student also in their final year of study from D’Youville College in Buffalo, New York, with whom we have a memorandum of understanding. This initiative is a joint undertaking between JCU Pharmacy and the Centre for Rural and Remote Health and is led by Ms Selina Taylor as the preceptor from the Centre together with Professor Beveley Glass from Pharmacy in the College. This year Kiralee Gross (JCU Pharmacy student) and Nathaniel Damon from D’Youville participated in the many activities of the rotation which are designed to be beyond the scope of a typical placement.

Nate and Kiralee undertook Medication Reviews in Aged Care and also after researching a particular topic of interest presented their findings as part of Continuing Professional Development for staff at the aged care facility. Amongst many other activities, they participated in community pharmacy, an Aboriginal Medical Service, cultural awareness, interdisciplinary learning sessions and were involved in health promotion at a local school where they shared with the children on food groups and healthy eating. 

The rotation also took them on road trip to Kurumba luckily during a dry spell in the wet season where they experienced rural community pharmacy practice in Karumba.  What an experience for Nate, from -20C in Buffalo to 40C but he took it in his stride and with good humour which might have been somewhat diminished  when he came back to Townsville to encounter the floods, a 100-year event. But he was able to join Kiralee to help out at her usual workplace (a community pharmacy in the Willows Shopping Centre) in Townsville, during the floods and also visit the Townsville hospital to experience Australian Pharmacy Practice firsthand.

"I am incredibly grateful for the opportunity that I was given to experience living and working in rural Australia, which allowed me to continue my professional development in a unique way”. -  Nathaniel Damon PharmD student from D’Youville College in Buffalo 

“Undertaking the rural rotation has been a very rewarding experience. My highlight was undertaking health education at Dajarra State School, which as pharmacists presents us with both challenges and opportunities”. -  Kiralee Gross, JCU Pharmacy student

These experiences are made all the more eventful, by mostly what is unplanned – a visit to the School of the Air in Mount Isa due to a chance visit with a staff member at the Granites having a barbeque  a really special experience of the underground hospital in Mount Isa and fishing in Kurumba where Nate managed to catch not one two catfish at once.

[humansofjcuhealth]

A Saskatchewan Adventure

Our third year Medicine student Madeleine Brown shares her adventure in Saskatchewan, Canada where she travelled to for placement as part of the Lynn Kratcha Bursary. 

“Unlike my travelling companion Mac, my knowledge of English literature is fairly limited and moulded by the great philosophers and authors studied in my Year 12 English class. However, when reflecting on my month-long rural medical placement throughout Saskatchewan, my favourite Year 12 philosopher, Alain de Botton, once again, pulled through with the goods. In his text Art of Travel, de Botton suggested that “journeys are the midwives of thought…” Indeed, my experiences in Saskatchewan gave birth to new insights into the multitude of factors that contribute to the health status of Canada’s Indigenous people, whilst challenging my understanding of healthcare in my own country.

Throughout our two weeks in Saskatoon, Mac and I were warmly welcomed by the University of Saskatchewan community. Under the guidance of Carlyn, Val and Cal, we were offered insights into the cultural and spiritual beliefs of Canada’s First Nations and Metis People, as well as the emotional, physical, mental and spiritual trauma that continues to influence the inequalities experienced by these people, even to this day. Whilst it is hard to pinpoint a single highlight of our time in Saskatoon, my thanks go out to Bob Badger and his family at the Kawacatoose Reserve. The Badger family humbly welcomed Mac and I into their home to participate in a traditional Sweatlodge Ceremony and feast - an experience I will never forget. Bob’s willingness to share his knowledge and wisdom is a testament to the resilience of his people, and the strength of culture in overcoming enormous adversity.

Our opportunities to learn were countless in Saskatoon. Some of the most valuable experiences included those at the SWITCH Clinic and Station 20 West, both of which humanised the social determinants of health. I was humbled by the generosity of all of those who welcomed Mac and I into their workplaces. For me, their attitudes towards their work, and those they are working with was just as inspiring as the actual work itself, and one of the greatest lessons I took from my Saskatchewan experience was the power of their empathy and humility.

On our great journey through Saskatchewan, Mac and I were privileged to experience the diversity of rural medicine in a number of settings, many of which I had never previously experienced. In Fort Qu’apelle, the All Nations’ Healing Hospital provided an exempla model of the fusion of western and traditional medicine in the management of renal dialysis - a major health issue amongst Indigenous communities of both Canada and Australia. The Needle Exchange program delivered out of Access Place in Prince Albert modelled the role of harm reduction strategies in community health and infectious disease control, whilst the centre itself emphasised the importance of opportunistic care in helping society’s most vulnerable members.

One of the highlights of my Saskatchewan adventure was the ten days spent in the northern village of Ile-A-La-Crosse. Amongst ice fishing, cross country skiing, sledding, ice hockey and northern light chasing, we were privy to some inspirational rural medicine, driven by the team of doctors at Ile-A-La-Crosse hospital. Here, we saw the medical staff live and breathe their community; a huge investment that bred a deep respect and rapport amongst those they were serving. Their dedication to ensure the best outcomes for their patients, despite enormous geographical isolation and support, was inspiring.

My journey through Saskatchewan was life changing in the way in which in re-birthed my perspective of rural medicine. However, the lessons I learnt and the connections I made are an attribution to those who so humbly shared their knowledge, expertise, experiences and homes with both Mac and myself. My thanks goes to Carlyn, Val and Cal at the University of Saskatchewan for the time and generosity they invested in organising this wonderful experience. Thank you also to the much respected Dr Tom Smith-Windsor for his generosity in hosting Mac and I, and sharing his passion for rural medicine. Thank you also to Sharon Favel and the entire Ile-A-La-Crosse community, including Darcey and Reid McGonigle for making the very cold Ile-A-La-Crosse such a warm and welcoming place.”

- Madeleine Brown, Third Year JCU Medicine student