First Week at the Clinic

Well I survived my first week at the clinic!

A hard thing to get used in the clinic is all the lingo/cultural stuff.  There’s a lot you need to think about when it comes to your patients that you don’t think about every day in practice in Iowa, or somewhere less remote.  Like, is this a patient that’s just stopping through, are they going to have enough medicine to last through their next boat trip, how much longer is the season of why they’re here and when will they be going back home, where IS home for them, what’s their native language, is there anyone in the clinic that can translate for us, are they safe to go back out on a ship where they might not be able to come back in for a while, etc, etc.  It’s very interesting and challenging at the same time.  I didn’t realize how diverse of a population it was going to be here.  There’s a lot of Philippinos, Vietnamese, Hispanics, Samoans, and many others.  Working through translators is always a challenge because a lot of time it feels like you aren’t getting everything across.

Although this is a family practice rotation, it’s pretty different than family practice I’ve done in the past.  It’s much closer to working in an Urgent care clinic than anything (which I really like).  We have more patients come in with acute problems than the chronic problems like hypertension and diabetes.  We have that as well, but a lot of times it’s just refilling their medications till they are able to see their doctors back home.  We also see a lot of injuries: lacerations, smashed fingers (a LOT of people drop boxes of frozen fish on their fingers), sprained ankles.  A lot of it is kind of like working in an ortho clinic (which I also really like).   We also have an emergency room.  There have been a couple emergencies while I’ve been here, but for the most part our job is to stabilize the patient and get them life-lighted to Anchorage.  If they are stable enough to fly commercially but still need to go to Anchorage to see a specialist or get further imaging (the most we have is an x-ray), they’ll get “bumped” on to the day’s flight off the island.

One of the biggest things that is crazy to me is that there are no doctor’s here.  The clinic staff consists of 3 PAs, Josh, Lisa and Kim, and 2 nurse practitioners, Laura and Clare.  It seems crazy to me that they don’t have a doctor here!  While I think they all do a really good job, I don’t think I would feel comfortable working in the same situation.  At least not until I had waaaaay more practice somewhere else!

Overall, it’s a really great experience.  Everyone is fun to work with and the nursing staff is awesome.  There’s a lot to learn, but it keeps things interesting!