June 8th

While on this trip, I was able to help educate clients while visiting the Open Door.  For instance, one of the people I had the pleasure to sit down and chat with expressed that he has hypertension.  He stated that his blood pressure usually runs around 180/120 mmHg.  This was concerning to me because having persistently high blood pressure can cause damage to several different body systems.  I was able to explain to him that vessel damage, kidney damage, heart disease, and  a stroke can all result from untreated hypertension.  After speaking to him, I was able to help find resources that he may be able to use.  A local organization called Meridian offers wellness checks and the Open Door offers help with filling prescriptions.  This is just one of the ways I was able to hopefully help improve the health of others.  I feel that future generations and even current generations ca get healthier by using the preventative care that is available to them.  It is important to prevent illnesses before it turns into managing illnesses.  Understanding the importance of using healthcare systems that are available and understanding what prevention and being healthy is, will hopefully make the community healthier.  It was so impacting getting to educate the clients that I met within the community because being healthy really starts with providing good education.  I will forever use knowledge gained throughout this course in my nursing career.  I am used to having accessible healthcare, and seeing things from the other point of view was eye-opening.  Understanding health disparities around you, as they are everywhere, can help ensure that each patient is getting the care they need.

June 7th

Today we were able to work with the people that live within Waynesville and Haywood as we volunteered at the local soup kitchen, The Open Door.  This organization is ran mainly by churches within the local and surrounding communities and ensures that those living in poverty still get the essentials needed for survival.  The soup kitchen offers 2 meals a day throughout the week and one meal on the weekends.  It was amazing how many people work together to make sure that the community is taken care of.  We helped with several different tasks such as serving meals, restocking the shelves, helping with maintenance around the building and providing education to the community.  The individuals I was able to meet today faced several challenges within their day-to-day life including the lack of healthcare resources,  lack of support, substance abuse, and lack of shelter.  The open door provides food, gas cards, access to a thrift store, boxes of food, prescription assistance, and also provide game/craft days that allow them to occupy their time.  Other resources within the area include shelters and a place called Meridian that holds group sessions for those dealing with substance abuse, mental health illnesses, and preventative screenings for those within the community.  All of these places work together to help give to those that are in need.  Overall, I was able to learn a lot from the community and I enjoyed how willing the people were when I asked to talk to them.

June 6th

As I walked around Mission Hospital today, I realized how vastly different it was from Swain Hospital.  Mission Hospital is very similar to our urban hospitals within Peoria, IL.  The hospital in Asheville is a level 2 trauma center and takes specialty patients from 24 different counties.  This is the main hospital and some communities have to drive an hour or more to reach it.  Swain Hospital is only able to take patients that are stable but need more assistance.  The level of acuity is very different between how sick the patients can be at each hospital.  The thing that stood out to me the most is the sense of community within the hospital.  Although they could hold 750 patients within the hospital, most of the staff and management staff especially knew the employees of each floor.  This hospital uses teamwork and makes sure that patients are taken care of as best and quickly as possible.  After visiting this hospital, I was very intrigued with employment here as it seems to have some of the best resources and gets to care for several different communities.

June 5th

When there is a lack of access to healthcare, the community as a whole can become very unhealthy.  When people aren't able to reach proper healthcare, their health can decline quickly.  In a rural area, there is a huge lack of access to healthcare which we were able to see see first hand over the last several days.  When accidents happen or healthcare is needed quickly, there is almost always a delay.  Nursing staff and other healthcare professionals have to be well trained in how to stabilize patients because their care and skills can make or break a situation while waiting or traveling long distances.  I was able to take away how important it is to think critically and do what you think is best in the situation.  It's so important to make sure your decision is safe for both you and the victim.  Back home I can use all of my skills learned in several different ways.  If I am ever in a situation where I need to stabilize someone and have minimal resources, I will be able to use what is available as I have been trained to make do with what you have.  I will also be able to use it when taking care of a patient in the hospital because sometimes you don't have access to exactly what you need when a crisis is happening and being able to critically think and find fast but safe solutions is important.  I enjoyed learning about medicine within a rural area and especially within the wilderness.  I think these skills could come in handy in all circumstances.  I'm grateful for the knowledge I have gained within the last two days!

June 3rd

Where do I start?! Lets start with expressing how much I genuinely enjoyed learning about the community I will be spending the next week in.  Learning about the Cherokee community has allowed me to gain so much knowledge and also get rid of some stereotypical thoughts about this area.  Cherokee is nothing like I imagined it would be.  I had an image in my head that the community would be as it is depicted in an Indian film.  The community is very modernized compared to my original thoughts and I knew that there was going to be a lot of room for growing my knowledge base this week.  It was very interesting to learn about the seven different clans within the Cherokee community.  I was also under the impression that the clans respected each other but didn't intermix.  Learning about how they marry between clans was really interesting to me.  I also believed that the men were respected in the culture and made most of the decisions, but I was wrong.  I found it so interesting that men join their wives clan and that the children are considered to be her children and are now within that clan.  In our culture, I feel as if men are looked at above women and I just assumed it was like that within theirs as well.  Learning how highly women were seen within their culture was actually such a neat thing to learn about.

When visiting the Swain Community Hospital, I was honestly shocked at how little their hospital was and how many resources they lacked.  The hospital right now has 48 and only 25 are currently being used.  It was shocking when they stated that only 2-4% of the patients seen in the ED get admitted to their hospital (diverting the rest to Harris, their sister hospital, and to Ashville, if necessary.)  The hospital currently holds mostly swing bed patients (sort of like a transitional care floor) and some med-surg patients.  Currently, they have 4 rooms in their ED and usually those hold psych patients until they can find placement.  It was really interesting to learn about the major health disparities within North Carolina as a whole state regarding the lack of mental health facilities (as there are only 3 in the state.)  They are working on a plan for a Mental Health unit, which I feel will be very beneficial to the community they are serving.  They do not currently have any sub-specialties so anything that fits under a specific type of care unfortunately has to be diverted to bigger facilities that are better equip to provide that type of care.  The hospital is staffed with 5 nurses, 1-2 CNAs, and 1 physician for all of the impatient patients.  Although they do not have a shortage of employees, if one were to call in, it would cause a whole shift in the patient care teams. 

June 2nd

The Museum of Appalachia was such an interesting and knowledge filled museum!  I think the thing that caught my attention the most was all of the medical equipment and how much it has progressed over the years.  It was so neat to see wheelchairs and other assistive devices and where they first started.  In my head, I honestly didn't really give them enough credit for all of the different things they used in that time period.  I think when I imagine medicine in history, I don't see it as anything like what we use today.  However, a lot of the different supplies are very similar to the stuff you would see within healthcare today.  It was mind-blowing that they had assistive devices for people with amputations and how much easier these devices probably made things in that time period.  I believe that I didn't give them enough credit for just how far along the community was.  I enjoyed learning more about the culture and medicine in that time period!  The community in the Appalachian mountains only had the resources available to them that were within a short distance, unless they had the means to travel.  Their Doctor's office was also very small and had limited resources.  The people of Appalachia also believed in herbal treatments and there was a plant for almost every illness.  People that live in a Non-Appalachian community may have health disparities similar to being unable to get the resources needed, but are far more likely to have access because of the area they live in.  If compared to our area, we are able to go to health departments and free clinics to get the preventative screenings and medicine needed.  The Appalachian lifestyle is very different than the lifestyle I live.  I am able to seek healthcare easily, drive to get resources needed, and do not have to work a labor job for minimum outcome.  I think that Appalachians have to work harder for their food and shelter, have limited access to healthcare, and do much more physical labor as far as their jobs as most of them make a living with their hands.  I enjoyed learning about the community and history of the Appalachian Mountains!

June 1st

Throughout this course I hope to gain knowledge about rural areas and the way of life in these areas.  In our area, we are so used to being close to everything we need.  It will be interesting to learn about the different types of lifestyles within the communities we visit.  I am also very excited to learn more about the people I will be spending a week with!  One of the biggest apprehensions I have going into this week is how to speak to the elders within the community.  I of course always try to be respectful, but certain things that are acceptable in our day-to-day life may seen as disrespectful to them.  However, I am very excited to see how their family systems work, as many of them seem to be close knit.  I feel pretty open about the people within the Native American community and overall I am just so ready to learn from them!  I think that everyone has an idea of what a Native American "looks like," and I am eager to see how different the community is as opposed to what everyone thinks it is.  I cannot wait for all of the learning moments to come!