Gracias a Dios
Gracias a Dios, “Thank God,”- uttered in gratitude and uttered in desperation.
Gracias a Dios - quietly shared among the patients waiting for an appointment regarding an infection, a medication refill and an aching shoulder at the Union Gospel Mission (UGM) medical clinic. Gracias a Dios - muttered under our breath as we log on to the electronic medical records, find a glucometer for a patient with uncontrolled diabetes, and students show up to open a clinic that would have otherwise been closed for these patients.
Last week, our PNWU D.O. students partnered with the Yakima Valley Inter-professional Education Coalition (YVIPEC), Washington State University (WSU) pharmacy, Heritage nursing, and the UGM medical clinic to open a student-led clinic while the mission clinicians and staff attended a conference.
About 80% of the patients are monolingual Spanish-speaking and we were lucky to have D.O. and B.S.N. students who could fill the role of medical interpreter while simultaneously filling their student role. Students worked in inter-professional groups to provide team-based care. They tackled specific course objectives (i.e. clinical reasoning or family assessment) and then put their heads and their skills together to meet the needs of the patient. The symptoms of inflammation that concerned the D.O. student inspired impromptu lessons on vasoactive pharmacology with the pharmacy student and preceptor. The nursing student’s presentation of the patient’s sexual history led to a quick review of possible physical exam findings of genitourinary infections in males and females.
Our students were out of the classroom and engaged in on-site, on-skin learning. They were wrestling with history taking skills, diseases, medications, and physical exam findings. They were learning with, from, and about each other and were learning quickly because they needed to help a patient that was sitting right in front of them. The light bulbs of discovery could have lit up Yakima.
Gracias a Dios.
On the schedule was a patient who had run out of medications for her heart. She was weeping in the waiting room and other patients offered their comfort. The nursing team inquired about the family and discovered financial and relationship crisis complicating her medical needs and pointed her to community resources. The clinic formulary did not contain her exact medication, so the pharmacy team worked to find equivalents that were given to her that day.
Gracias a Dios. We say, “We treat the whole person,” and were able to model and practice this “whole” care by working as a whole team - a compassionate waiting room of patients, a comprehensive assessment by a nurse, a pharmacist who educates and interprets dosage equivalents, and a doctor of osteopathy who provides comprehensive care.
Assistant Professor Family Medicine
College of Osteopathic Medicine
Pacific Northwest University of Health Sciences