APPEs at Wind River Wyoming

Yellowstone National Park is one of those places that has to be seen to be believed, and believed to be seen. Yellowstone was discovered by the famous mountain man,  John  Colter, in the winter of 1808. The stories he told of the beautiful hot springs and geysers that were active in the dead of winter seemed too unbelievable to his colleagues, causing them to name, what is now Yellowstone, as Colter’s Hell. There aren’t as many picturesque mountain vistas to look at from Yellowstone NP as there are from Grand Teton or Glacier NP. But don’t let that discourage you as Yellowstone has its own unique beauty.  John  and I enjoyed Yellowstone so much we took two trips to see it.  The Grand Prismatic spring and the other beautiful hot springs, colored so uniquely by thermophilic bacteria, are some of the most incredible sights that one can imagine. You may hear some say that once you’ve seen one geyser, you’ve seen them all. Which may be true for some but for me each g...

     Clinic weeks 4-5 gave us valuable interprofessional experience.    Ben and I were tasked with preparing a short presentation about changes to the CDC STI treatment guidelines to deliver to the medical staff at the Arapahoe Clinic.    We presented these updates to the medical staff on Thursday morning of our penultimate week in Wyoming, which was followed by a lively discussion between the medical providers about their opinion on the new treatments.    The modifications to the guidelines included a regimen for chlamydial infection that required more adherence from the patient and counseling from the pharmacist, but they did not seem concerned about switching a one dose regimen to a weeklong regimen to eradicate infection.    We later ran into a doctor at the Riverton clinic and got to pick his brain about his opinion on the guidelines, his comfort with staking patients to more complex antibiotic regimens, testing for bacterial e...

Weeks two and three taught us valuable hands-on public health lessons about access to care, barriers, and patient motivation. Our week 2 started off with and would be defined by COVID-19 vaccine clinics. The tribe council the week of our arrival approved giving tribe members $50 reimbursement per shot for receiving their COVID-19 vaccine. Fully vaccinated individuals could receive a compensation of up to $100. Additionally, if the tribe achieved 70% vaccination status, each member would receive $500. Given the financial incentive, the reservation was suddenly met with a huge burden from unvaccinated individuals requesting to be immunized. As pharmacy students we were able to play a crucial role in not only working the vaccine clinics, but running many aspects of the vaccine clinics.    The mantle of management and orchestrating interprofessional communication to ensure every aspect of proper immunization delivery (storage, documentation, intake, patient counseling, readiness a...

- Getting In and Week One Ben and I had the fortune of drawing the Wind River rotation a week after a schoolwide off week in APPEs at the end of July, so we could make use of all of Friday, Saturday, and Sunday to drive about 8 hours a day for the ~24 hour drive from Birmingham. If you get this rotation without an off week in between your last rotation and this one, it’s a good idea to ask your preceptor if you can take off the last day of rotations to follow suit if you’re not comfortable with driving about 12 hours each day. Ben and I will attempt this on the way back, fingers crossed! We chose to stay at Hilton hotels for our two nights on the road, one in St. Charles (30 mins west of St. Louis) and one in Sidney, Nebreska (home to Cabela’s world headquarters). In my opinion, if you cross into Wyoming, you may as well try to make it all the way home to Fort Washakie since the hotel prices are much steeper in WY. What else is steeper in Wyoming are the gas prices, so it’s wise to fil...

Living in Wyoming- Info and Tips for Future Students Student housing is provided by the IHS clinic and located in Ft. Washakie (pronounced WAH-sha-key) The house contains three rooms with two twin beds each, one full bath, and a shared kitchen and common space. When Lauren, Autumn, and I were there, our roommates included two students from the University of Tennessee pharmacy school and one optometry student. They graciously gave us the larger room so we could move and fit a third bed to stay together.                                                  *Note: There is no dishwasher- be a good roommate and wash your dishes in a timely manner! The house is about a 30 minute drive from the Arapahoe Clinic (main clinic), 45 minutes from the Riverton Clinic, and 10 minutes from the Ethete (E-tha-te) Clinic (which we never went to). In Lander (abo...

Starting week 3 of our rotation, we got some new pharmacy students at the clinic on rotation! We spent the first few days helping orient them to the clinic, our typical daily tasks, and the clinic's technology. We also showed them where the candy drawer is!   We continued working on our medication reconciliation project that focuses on consolidating patient profiles and making sure the providers in the clinic have the patient's current medications accurately listed in the EHR.  We had lots of opportunity to counsel patients on their prescriptions- we particularly counseled patients with diabetes about their insulin and blood sugar monitoring!  During week three I had the opportunity to present a formal drug information question response to the Pediatric Committee consisting of doctors, nurse practitioners, and nurses. My response was to a question about the evidence for alternating ibuprofen and acetaminophen in the pediatric population.  We also traveled to the Rive...

We took Friday off this week and went to Yellowstone. We left after rotation on Thursday at 4 o'clock and made it to our hotel in Cody, Wyoming around 7 o'clock. Cody is about an hour from the east entrance to Yellowstone. We had dinner at Trailhead Bar that night and then went to bed early to prepare for a full day at Yellowstone.  We left the hotel on Friday around 10 o'clock. Our plan for the day was to see the Grand Canyon of the Yellowstone and then drive the scenic highway called Beartooth Pass, but one of the roads was closed and the new route would have added 4 hours to the drive. After seeing the Grand Canyon of the Yellowstone, we headed towards Old Faithful. We stopped at Mud Volcano Thermal Area on the way there. This area has a ton of muddy hot springs and smells like sulphur, so we didn't hang around for long. We then drove about an hour to Grand Prismatic Spring and walked on the boardwalks built around the spring. Then we drove to a trailhead right down ...