Archive for August 9, 2021

Moultrie Summer Immersion Trip Week 2: Morning grind and starry night

Let me paint the picture of where I called home for a week. In the heart of south Georgia is Moultrie, population size around 15,000 people. For a birds eye view comparison, Atlanta has about 33 times that population. The paved roads are lightly sprinkled with dust and the buildings are slightly rundown. However, the energy and spirit of the children and farmworkers starkly contrast their surroundings. This experience provides a unique opportunity to work alongside interdisciplinary practices such as pharmacy, dental, physical therapy, and mental health students from schools across Georgia. Morning camp involved performing routine screenings on school children, and night camp involved screenings for farmworkers in a field or nearby local break station. We served as an extension with the local clinic to provide healthcare services.

At 8:30 AM, we drove less than 10 minutes away from our hotel to the local elementary school where as a collective unit, we provided child approved physical therapy exercises/activities, blood pressure and hemoglobin screenings, hearing and vision testing, dental care, and a final visit with a NP-S. As kids started lining up to be partnered with a NP student, we were making final adjustments to our booths to make them kid friendly. We practiced a handful of rarely used skills such as a fundoscopic exam that is usually deferred in my previous clinics to ophthalmology/optometry. My most memorable kid was a 4th grader who was held back a few grades. After completing my exam, I stood up to walk her back to the front when I looked down and saw her frustration as she was sounding out words in her coloring book. I could tell she was upset and looked up at me. Two thoughts came to mind, I could either walk her back up front and grab another kid, or I could sit back down and help her sound out the words. I sat back down and we practiced her reading skills. I didn’t know how many hours she had at home with her family to improve her reading, but I knew I could give her an additional 5 minutes of my time to get through that 5 sentence paragraph. My pediatric professor gave us advice when we encounter kids for screenings. More often than most, kids don’t come to the doctor’s office unless they are sick. She noted that when you do see them, use your time with them and be that point person to lead discussions and start education early. I wanted to ensure that the time that I shared with them was spent treating that experience as an opportunity for steps towards success.

As a NP student, consulting pharmacy and PT has been a saving grace. Instead of placing a referral into the system and questioning if the patient will even go or be contacted, I can walk 40 feet away from my station to access their expertise within the same field, pun intended. The opportunity to work with interdisciplinary specialties strengthened my critical thinking skills and sharpened my plan of care. For example, I diagnosed a patient with tinea cruris and unfortunately, we did not have ivermectin on hand. I consulted pharmacy and came up with a game plan of starting them on clotrimazole cream and gold bond with emphasis on counseling them on educational points for prevention. At the end of the day, would this treatment plan mirror what I would do in a private primary care setting? Probably not. I would have access to a chain pharmacy that supplied the oral medication and I would have the patient send me a telephone encounter letting me know if the treatment worked or failed as part of continuity of care. Working in this environment of this magnitude allows me to be more thoughtful about the present and knowing that whatever I tell this patient in the here and now, will be my first and last contact of care. Knowing the weight that this carries and understanding that we may be the only healthcare opportunity for some of these farmworkers in the US, buys into the vision that our team makes a difference.

Photos of the Trip with captions

Watermelon Sugar high before starting night camp featuring the generosity of the farm workers and our Pediatric Nurse Practitioner Students at night camp
Late night podiatry practice and hygiene counseling with the farm workers
No filter needed
NP students pregaming before night camp
Night camp tent set up; the preview before the big storm

UGA Pharmacy prepping for the night ahead
Emory MN students manning the triaging stations
Group photo taken at the end of week 2 featuring all students, faculty, and translators