As a part of this unique clinical immersion in West Virginia, I had the opportunity to shadow in the Pulmonary Rehab clinic. The Pulmonary Rehab center operates as part of the Cabin Creek Health System clinic at Dawes. In this setting, patients with chronic lung issues, such as COPD, sarcoidosis, and Coal worker’s pneumoconiosis, attend biweekly group sessions under the supervision of registered nurses and a physician. In these sessions, patients perform strengthening exercises and various aerobic activities. Additionally, the nurses incorporate an element of patient education care. For example, the nurses educated on the importance of adequate nutrition with chronic lung disease. During my time between both the primary care clinic and the pulmonary clinic, I’ve been exposed to the ways in which the populations in this region deal with lung issues which stem from culture and tradition.
Coal worker’s pneumoconiosis, otherwise known as Black Lung, is all too common in this region. Coal has indeed been an integral part of this state’s history and encompasses a sense of pride and hard work among many generations. The coal industry has employed a significant number of West Virginia’s population for some time, dating back to 1742 when coal was first discovered here. Though the coal industry has indubitably experienced a decline as West Virginia looks to other economical outlets such as alternative energy, the health of individuals has been uniquely and negatively impacted.
Coal worker’s pneumoconiosis is attributed to chronic inhalation of dust from high-carbon coal over decades. The coal dust accumulates around the bronchioles and alveoli, leading to coal nodules as the collagen accumulates. Ultimately fibrosis and functional impairment occur which obstructs airflow. The treatment of Coal worker’s pneumoconiosis entails pulmonary rehab, use of inhalers, and potentially supplemental oxygen. I had a chance to chat with a very nice gentleman who was participating in his session of pulmonary rehab this particular morning. He had worked in mine’s for nearly 30 years, and describes that he and his fellow employees in the mines just didn’t know the negative implications of not wearing proper protective respiratory gear. He was on his 21st of 24 sessions of pulmonary rehab, and describes how it helps him maintain and sustain other activities in his day-to-day life despite his chronic illness.
Overall, this immersion trip has been an incredible learning experience. Cabin Creek Health System and New River Health Systems function as FQHC (Federally Qualified Heath Center) in underserved areas of West Virginia which are directly impacted by various health, economic, and educational disparities. I resonate with the mission of providing holistic care to patients in primary care settings who face financial barriers and have limited access to specialty care, and this experience has further inspired me to work in an FQHC myself as an FNP.
Megan Kaylor, BSN, RN