{"id":8898,"date":"2016-06-28T11:17:09","date_gmt":"2016-06-28T18:17:09","guid":{"rendered":"http:\/\/depts.washington.edu\/medex\/?p=8898"},"modified":"2016-06-28T11:17:09","modified_gmt":"2016-06-28T18:17:09","slug":"healthcare-from-the-heart","status":"publish","type":"post","link":"https:\/\/familymedicine.uw.edu\/test\/healthcare-from-the-heart\/","title":{"rendered":"Healthcare From The Heart"},"content":{"rendered":"

K<\/span>ira Sandon of MEDEX Spokane Class 18<\/span><\/strong> is standing outside the Heritage Health mobile unit in Coeur D\u2019Alene, Idaho. This specially fitted RV is part of the clinic\u2019s Homeless Outreach Program that meets the needs of underserved patients in several local neighborhoods. Kira is working in these tight quarters until August under the guidance of her family practice preceptor, TJ Byrne, PA-C. Together they follow a published schedule of stops in Coeur d\u2019Alene and neighboring Post Falls.<\/p>\n

\u201cA lot of what we provide involves some social work, or some psych care,\u201d she says. \u201cSome of them just want somebody to listen to them, without judgement.\u201d Patients may also find some food, water or basic supplies on the mobile unit. \u201cWe carry a lot of over-the-counter medications, and this time of year a box of cetirizine or bottle of sunscreen can have a dramatic effect on quality of life.\u201d<\/p>\n

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TJ and Kira do what is necessary to break down the barriers between themselves and their patients. For instance, their dress code is jeans or shorts. \u201cWe\u2019re not looking to appear to be at a different level from them, which I think helps them open up more, give full disclosure,\u201d she says.<\/p>\n

This is a long way from Kira\u2019s background in medicine as a surgical tech. \u201cMy background is primarily in the operating room,\u201d she says. For 13 years she worked at a Coeur d\u2019Alene hospital, the last 7 as a surgical first assist. Consequently, she\u2019s accustomed to moving about in her job.<\/p>\n

This presented a challenge in her didactic year at MEDEX where students are corralled in a classroom. \u201cIn surgery we stand for 12 hours a day, so it was hard to do all of that sitting,\u201d she says. \u201cIt was a lot of constant studying or reading or writing papers\u2026 and sitting.\u201d<\/p>\n

F<\/span>ortunately, Kira enjoys learning.<\/span><\/strong> \u201cI used to take college courses just for the heck of it,\u201d she says. Still, she calls the MEDEX didactic year \u201cintense.\u201d Looking back she declares there was a lot to learn. \u201cNow I feel like I’ve forgotten most of it. But being out in the field doing it is great. You learn way more than just sitting in a classroom, for sure.\u201d<\/p>\n

As part of the requirements for her clinical year at MEDEX, Kira has fulfilled six 1-month clinical rotations meant to expose students to a broad range of medicine, including behavioral, emergency, inpatient and surgery. With each rotation, she considered a potential career choice. \u201cI thought, \u2018Well I can do this for a career, it’s not bad and I like what I’m doing\u2019,\u201d she says. \u201cThere wasn’t anything where I thought, \u2018No way.\u2019 But this has definitely been the most rewarding rotation.\u201d<\/p>\n

The gig with the Heritage Health mobile unit came up as part of Care Week during Kira\u2019s didactic year. Falling at the end of the second academic quarter, Care Week assigns the MEDEX first year students to a practicing clinician for one week. It\u2019s the one break from classroom studies that allows students to shadow a clinician and get a practical taste of what their future career might be like.<\/p>\n

Kira was assigned to TJ Byrne for her Care Week. \u201cI think that was set up mostly because it’s in Coeur d’Alene and that’s where I live,\u201d she says. She learned that TJ took students for the 4-month family practice preceptorship. \u201cI asked specifically if I could go with him.\u201d<\/p>\n

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Working outside the four walls of a clinic setting appeals to Kira. \u201cWe take the mobile unit to them. We go where they are, where they gather, such as the shelters, soup kitchens, and food banks, and they come on for all of their medical needs, essentially. It’s just a different environment than in the clinic.\u201d<\/p>\n

She\u2019s impressed by the character and gratitude of those served. \u201cThese people are so appreciative and polite and thankful,\u201d she says. \u201cYou know, they don’t really have anything, and what little we could give them makes their day.\u201d She contrasts this with time spent in the clinic setting where some patients act entitled. \u201cIt\u2019s just a whole different feeling, and I really like what Heritage does for the homeless. We treat everybody with respect and they give that back to us.\u201d<\/p>\n

TJ Byrne, PA-C, was formerly on the teaching faculty of the MEDEX Spokane site. Now he is in charge of Homeless Outreach for Heritage Health in Coeur d\u2019Alene, and also serves as Kira\u2019s preceptor for the four months of her family practice preceptorship.<\/p>\n

“TJ is just an amazing man,\u201d Kira tells us.\u00a0\u201cHalf the time he\u2019s a social worker as much a medical provider.”<\/p><\/blockquote>\n

“TJ is just an amazing man,\u201d Kira tells us.\u00a0\u201cHalf the time he\u2019s a social worker as much a medical provider. He shows a lot of compassion for our patients, yet he isn’t a pushover either. I’ve seen him literally give someone the socks off of his feet because they had none when we finished caring for their blisters. They know that being seen on the mobile unit is a safe place and he makes it clear that we aren’t there to judge them.\u00a0\u00a0Most of our patients have problems with addictions, in various stages.\u00a0\u00a0We see a lot of folks that have just been released from prison as well.\u00a0\u00a0We try to connect them to local resources for housing, jobs, etc. TJ is the epitome of Healthcare from the Heart.\u201d<\/p>\n

A<\/span>board the mobile unit<\/span><\/strong> they can handle all types of minor procedures, including casting, splinting and excision of lesions. Because they park in regular locations on a scheduled basis, they see a lot of patient follow-up. \u201cSometimes we\u2019ll see them two or three times a week,\u201d Kira explains. \u201cSo we can rebandage their wounds or ask them if they picked up their prescription. Sometimes they’ll come by just to say, \u2018Hey, I’m feeling better, thanks.\u2019 I don’t think you get that much follow-up, or feedback, in a clinic setting.\u201d<\/p>\n

Referrals become necessary for more complex conditions. \u201cWe can do referrals from the unit such as an x-ray, labs, or an ultrasound,\u201d says Kira. \u201cWe had someone come in the other day with abdominal issues and a hernia and we referred him to general surgery. We are connected to WiFi so we use the same EMR system and can send prescriptions and access reports the same as if we were in the clinic.\u201d<\/p>\n

On some scheduled afternoons, TJ and Kira practice street medicine. They leave the RV behind, load medical supplies into a backpack, and walk to where the homeless or nearly homeless are camped out. \u201cTJ knows where they\u2019re staying, or if they can’t get out to us,\u201d she says. \u201cA lot of them are living in a motel room or RV, and we go to them and take care of their needs. They are really a community and a lot of them give us tips about someone they know that isn\u2019t doing well and we will seek them out and find out if they will accept our help.\u201d<\/p>\n

For Kira, graduation is a mere two months away. As she looks ahead to her future as a physician assistant she considers all her of deep connections in the Coeur d\u2019Alene area after 13 years as a surgical tech\/surgical first assist. \u201cMy heart is really in surgery, so right now I\u2019m primarily looking into those specialties.\u201d<\/p>\n

She hesitates then speaks forthright. \u201cThat being said, if I could have the opportunity to work alongside TJ every day, I would do it in a heartbeat.”<\/p>\n

\"C-Kira<\/a>
Kira Sandon of Spokane Class 18 with her family practice preceptor, TJ Byrne, PA-C, outside the Heritage Health Mobile Clinic in Coeur D\u2019Alene, ID.<\/figcaption><\/figure>\n","protected":false},"excerpt":{"rendered":"

Kira Sandon is spending her MEDEX family practice preceptorship tending to the homeless of Coeur d\u2019Alene, ID. Alongside her preceptor, TJ Byrne, PA-C, she\u2019s working out of a mobile unit, taking care of the basic needs of this often-marginalized population. She\u2019s learning medicine, of course, along with patience and empathy. <\/p>\n","protected":false},"author":1,"featured_media":8901,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8],"tags":[],"class_list":["post-8898","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-clinical-experience"],"_links":{"self":[{"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/posts\/8898","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/comments?post=8898"}],"version-history":[{"count":0,"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/posts\/8898\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/"}],"wp:attachment":[{"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/media?parent=8898"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/categories?post=8898"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/tags?post=8898"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}