Linh Tu, class of 2017

Linh Tu (left) and Lauren Hall

Linh Tu (left) and Lauren Hall

This was my first Remote Area Medical trip; I’ve always had a passion for helping the underserved populations.  During the few days at RAM, I felt like I learned not only to be grateful for everything I have but also to be more open-minded as a future health care professional.

It is an experience that is not only life-changing but is priceless.  The patients were all so grateful for us being there, it brought some of them to tears.  We take for granted the easy access to health care we have here, but these patients have never even seen Washington, D.C., their entire life, and it is only a few hours away from them.

I have patients who came up to me to thank us for all the help we were giving them even if they couldn’t even be seen that day.  Our presence was enough for them.  The part I love most was during the medication reconciliation when I took down patients’ current medication histories. I felt like I was given an opportunity to really connect with these patients on a personal level.  They told me stories of their journey getting to Wise, Va., and how long they waited to just get access to health care.  They also told me about their family, their concerns and their dreams.

I felt more connected to them in our five-minute conversation than I would with someone who talked for hours.  It was then that I realized this trip was beyond just helping patients and giving medical treatments, it was about building a connection with people. Sometimes the most therapeutic thing a person can do to help is to just listen.

Linh Tu (second from left) with Erin Hickey (left), Irene Lee and Khang Le

Linh Tu (second from left) with Erin Hickey (left), Irene Lee and Khang Le

Khang Le, class of 2017

Khang Le in the pharmacy

Khang Le in the pharmacy

The atmosphere was unbearable inside the makeshift barn. Even with constant whirl of multiple fans, the heat was still stifling. I was sitting in line with the other patients to meet with an optometrist. We have been waiting close to three hours already in the poorly ventilated barn. The situation would have been intolerable if it wasn’t for the patient I was sitting next to.

The patient was there to get new glasses and also check on her glaucoma stemming from diabetes. She was an interesting character, to say the least. Throughout the insufferable wait, she remain lively and optimistic. Through my interaction with her, I found out she was a very literate person. She explained to me how she got her accounting degree at a local college. She told me how she was laid off and the tragic story of her boyfriend’s passing from leukemia.

I counseled her on taking care of her diabetes, but she surprisingly was very health-literate. However, for the past year, she had no access to medical services. She noticed her vision was deteriorating along with her health and was very glad that RAM came that year.

This touched me and supported my decision to go to RAM. As I sat in line with the other patients, I experienced firsthand the stress of waiting to be seen by a provider. However, people like the patient I sat down with have no one else to help them, and they still remain optimistic and cheerful. RAM truly is an important service to this population; sometimes, we are all they have.

Triage area, awaiting patients

Triage area, awaiting patients

Lauren Hall, class of 2018

Lauren Hall (right) with Erin Hickey (left) and Meredith Weakley Crumb

Lauren Hall (right) with Erin Hickey (left) and Meredith Weakley Crumb

“We’re so excited to be back this year,” said a middle-aged lady assisting her older, non-English speaking father at the Remote Area Medical clinic in Wise, Va.  I was helping determine what medications were appropriate for the older gentleman to take before going to have some teeth extracted.  “Oh, so you’ve been to RAM before?” I asked.

While I was getting a blood glucose reading for her father, she proceeded to tell me that last year at the RAM clinic her father had gone to visit the medical tent.  There, the doctors noticed something out of the ordinary and eventually discovered that her father had a tumor on his lung.

Because of the treatment her father received at RAM, he was able to then seek out care for what ended up being a stage 3 lung cancer that he had been completely unaware of.  His daughter told me as of last month, 11 months after his diagnosis, her father is now cancer-free!  Her father was very excited to be alive and healthy enough to come back this year to take advantage of the dental services RAM offers.  His story has stuck with me — RAM really does save peoples’ lives.

While this is the most poignant example, I had many very similar conversations with patients who were all so lastingly grateful for the positive impact RAM had had on their health and lives.  As a health care professional in training, hearing stories and being able to actively participating in the care of these patients inspired me.   I left RAM with a charged sense of purpose and gratitude.

A mission that really saves lives

A mission that really saves lives

Anesa Hughes, class of 2018

Although this was my first year as a volunteer at RAM, it wasn’t my first time participating. In years past, I was a patient at the event along with some of my family and friends. Just like most families in rural Appalachia, my family was no stranger to the hard times that seemed to be targeting the area. Health services and resources were, and still are, scarce. And with the coal industries dying out, so was the money.

Anesa Hughes (left) and Chelsey Llayton working in pharmacy

Anesa Hughes (left) and Chelsey Llayton working in pharmacy

If I were being honest, when I was younger I did not want to go to RAM. I didn’t realize what a great opportunity it was nor did I appreciate it. I was sort of embarrassed and didn’t want to be judged. However, I quickly learned that asking for help was nothing to be ashamed of, and RAM was there to benefit me.

Remote Area Medical became a sort of saving grace for us. It truly was a blessing for my mom to get the glasses she needed without having to worry about how she was going to pay for them. For me, a dentist appointment meant I didn’t have to worry about the fact that I didn’t have dental insurance for a little while longer. Along with the services provided by RAM, there was peace of mind.

This summer I was granted the opportunity to be on the other side of the fence. I was a volunteer, along with my fellow pharmacy classmates and VCU nursing students, at the Wise County Fairgrounds. I was thrilled to be presented with this opportunity, but of course I was very nervous.

As I had just completed my first year of pharmacy school, I didn’t feel like I had enough knowledge or experience under my belt to be of any help and felt an immense amount of pressure to do everything correctly. I didn’t want to let my team down, but I also didn’t want to let my neighbors down. However, when RAM started, all of my insecurities seemed to be inconsequential.

I fell into the work flow smoothly, and there was always something I could do to help. One of my favorite things was premedication at the dental tents. I actually felt like I was using some of the skills I had learned in my first year of pharmacy school, and even I knew more than I thought!

While premedicating, I tried to get to know the people I was talking to. I know my people and I know they are talkers, so in making conversation with them I knew it would help them feel more comfortable. I also remembered the shame I once felt when I first was a patient, so I really wanted them to feel welcomed.

Most of my patients really liked the fact that I was a “local girl” who had been in their shoes more than once. One woman expressed her gratitude and how she was thankful for every one of us. She let me know that no matter how small or big our efforts seemed, they meant the world to her. She also told me how proud she was of me for helping out my community.

I also enjoyed working at our makeshift pharmacy. I mostly worked at prescription drop-off and pick-up. I had face-to-face interaction with the patients. I was not only able to tell the patients about their medications, but I was able to tell them about other medical and dental services that are provided throughout the year for their assistance.

It really made me proud to volunteer for RAM. I felt that I was able to connect to the patients and make a difference in their lives. I have always wanted to give back to my deserving community and never dreamed of being able to do so through RAM. It was a great learning experience for me to be able to practice my clinical skills.

Not only was I able to educate my patients, they taught me multiple valuable lessons. My community stays strong and seeks to help one another in hard times, and it was rewarding to see them come together like this. I hope I am able to work the RAM event again in the future. 

A professional and personal mission for Anesa Hughes of Appalachia

A professional and personal mission for someone who grew up in the area

Chelsey Llayton, class of 2018

Chelsey Llayton (right) with Anesa Hughes working in pharmacy

Chelsey Llayton (right) with Anesa Hughes working in pharmacy

I was nervous during orientation and the first morning of RAM, but my fears were quickly calmed when I started interacting with patients. My first shift was spent talking with patients and writing a medication list for those waiting in line. I figured this task would be tedious, but I loved talking with the patients and discussing their medications with them.

Right away it was obvious how grateful they were to receive the care they needed, and they showed great patience as they waited in line. This helped me get over my fears, and I was able to just focus on helping these patients as much as I could.

An experience I didn’t expect to enjoy as much as I did was observing a tooth extraction. As soon as I walked up to the patient, she grabbed my hand and would not let go. It was obvious she was scared, and the dentists were having trouble removing all of the roots, so I held her hand and tried to comfort her the best I could. With my other hand, I helped hold back her cheek and tongue with an instrument the dentists gave me.

Any time I tried to move, the patient would squeeze my hand tighter, so I stayed with her for over an hour. It was a great reminder that a simple act of kindness can go a long way, and I’m just happy I was there. This feeling stayed with me throughout the experience; I found it truly rewarding, and I’m so grateful for the opportunity.

The dental tent

The dental tent

 

Welcome, Pharm.D. class of 2018 and new graduate students!

We are happy to have you! Here are a few links you might find of interest as you get to know the school. Many student organizations and fraternities have their own websites and Facebook pages, as well.

* VCU School of Pharmacy website

* VCU School of Pharmacy Facebook page 

* Class of 2018 Facebook page 

* The Capsule student newsletter Facebook page

*  VCU School of Pharmacy LinkedIn page

* VCU School of Pharmacy YouTube channel

Of course, if you’re reading this, then you have already discovered our VCU School of Pharmacy blog!

VCU School of Pharmacy’s eighth RAM event: mission trip accomplished!

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School of Pharmacy associate professor Evan Sisson (first row, left) initiated and has helmed the school’s participation in Remote Area Medical for eight years. Sisson is also an alumnus of the school.

About two dozen VCU School of Pharmacy students, faculty and residents made the journey to Wise County, Va., in July 2014 for the eighth year running. Why? To participate in RAM — Remote Area Medical — and to be among more than a thousand volunteer health-care professionals and students helping thousands of unserved and underserved patients in two and a half days. Here are the students’ stories.

As an aside — but important to know in recognizing the program’s ongoing success — the School of Pharmacy’s ongoing participation in RAM earned it an American Association of Colleges of Pharmacy 2013-14 Student Community Engaged Service Award. Read more about it!

“Although this was my third year attending RAM …,” ERIKA LAMBERT, class of 2015

Erika Lambert, with SOP associate professor and alumnus Evan Sisson, plans to return to RAM once she's a practicing pharmacist. She was student leader for the school's participation in RAM 2014.

Erika Lambert, with SOP associate professor and alumnus Evan Sisson, plans to return to RAM once she’s a practicing pharmacist. She was student leader for the school’s participation in RAM 2014.

Although this was my third year attending RAM, it was a very different experience RAM from the perspective of the student leader compared to a student participant.  This year, my focus was to ensure that students and preceptors had the tools and support to provide quality care for the thousands of patients we saw over the three-day clinic.

While the uncharacteristic cold and rain added some unique obstacles, it was a pleasure to lead such a dedicated and compassionate team.

This year, we provided an additional service of measuring cholesterol levels with CardioCheks to patients with diabetes or identified as pre-diabetes.  This service was possible through the award money received from the AACP Student Community Engaged Service Award, which recognized the commitment that VCU School of Pharmacy has made to Wise, Va., over the past seven years.  The cholesterol levels, in addition to the A1C values, provided patients with greater insight into their diabetes management and cardiovascular health.

Utilizing these values and pertinent medical and social history, students calculated and educated patients on their individual 10-year and lifetime risks of atherosclerotic cardiovascular disease (stroke, heart attack, etc.). Through these calculations, we were able to show patients how their modifiable risk factors (blood pressure, total cholesterol/HDL, smoking status, etc.) impacted their risk of having an ASCVD event.  These calculations were an incredible teaching tool as it was evident how much patients were impacted by seeing their risk scores and how their risk can decrease with lifestyle and medication management .

A duty of the student leader is to teach smoking cessation classes with members of Becky’s Place, an outreach organization with the Virginia Breast Cancer Foundation.  In collaboration with nurses and other health care professionals, we taught four smoking cessation classes with a focus on nicotine replacement therapy options.  The interactive classes allowed us to understand just how important is to educate patients on the proper use of the products, especially the nicotine gum.

The smoking cessation tent

The smoking cessation tent

Many people expressed that they had tried and failed using nicotine gum, but we came to find that they had been using it inappropriately, which greatly hindered the affect and made the therapy very expensive.  We also had great group discussions about e-cigarettes and provided the most recent safety information to help patients make the decision whether or not to use this option.  Several patients came back for multiple classes and were excited at the prospect of quitting smoking.

It was an honor to serve as the student leader as my last trip to RAM before graduating.  Without a doubt, I will return to RAM.  It may not be next year or the year after, but I will one day return as a practicing pharmacist to serve not only the patients, but students as well.

My experiences at RAM over the last three years have been invaluable to my education and have made a large impact on where I see myself as a professional.  Because of RAM, I want to continue to work with underserved patients and apply my years of schooling and practical experience to providing them with the highest quality care possible.

“After three years of volunteering …,” LAUREN GRECHECK, class of 2015

Lauren Grecheck (right), with nursing student Anna Young, feels medical outreach trips are critical to the student experience.

Lauren Grecheck (right), with nursing student Anna Young, feels medical outreach trips are critical to the student experience.

After three years of volunteering at medical outreach events, I have witnessed my role at these events change. During my first year, I was soaking in all the knowledge that upperclassmen, practicing pharmacists  and patients were able to share with me. I was utilizing the practical skills from lab by taking blood pressures, checking point-of-care blood glucose  and counseling patients on their medications and smoking cessation.

Now, in my last year of pharmacy school, I still found myself using these skills, but my role as a volunteer changed to include teaching as well. With the roles reversed from my first year, I was now the one able to teach younger students, patients and even practicing pharmacists.

Many underserved populations have undiagnosed or uncontrolled disease states, such as diabetes. As part of this year’s Remote Area Medical (RAM) trip in Southwest Virginia, VCU School of Pharmacy was able to perform A1C tests and cholesterol checks on patients who had a history of diabetes or had a high point-of-care blood glucose result during triage.

At this station, students were charged with checking these values and then counseling the patients on what their numbers mean and ways of improving these numbers to decrease risks and complications. Because the pharmacy volunteers are from across the four years of pharmacy school, this was a perfect place for students to learn. I was teaching pharmacy and nursing students how to use the devices for testing and proper counseling points based on the results. I was also able to counsel the patients on their values, explaining to them what their goal values mean, why we aim for these numbers and lifestyle changes that can be adopted to improve their values.

What I loved the most about these interactions was how, as the teacher, I was also a learner. Younger students who had volunteered at events such as these were able to provide pointers on how to obtain a better sample of blood with the pipettes for the cholesterol machine. Additionally, working closely with other students in this environment allows one to observe others’ counseling techniques, which enables students to refine their own counseling skills.

However, it is not just the students and preceptors teaching each other at these events; the patients teach all of us. The patients we help at these events are living with these diseases every day. They teach us the reality of how hard it is to pay for medications, such as insulin, and the experiences they have had with certain medications. Hearing about these experiences firsthand allows me and other students to better care for future patients because we will have a greater understanding of what living with these conditions entails.

Lauren Grecheck (right) and Erika Lambert

Lauren Grecheck (right) and Erika Lambert

While my role and experiences at these outreach trips has evolved from mostly learner to more informed teacher over the last three years, the thing that remains the same is the appreciation for these patients for allowing us into their homes to provide care for them. Without these experiences, students would be unable to apply what they learn in school to real-life scenarios.

I am so touched when I see patients receiving the care they deserve, but I feel empowered in my profession when I see younger students expanding their confidence in taking blood pressures or counseling on discharge medications at these events. Medical outreach trips are critical experiences for students, an experience that I wish more students were able to have.

Many people think of these events as medical professionals serving patients, but the reality is that we are all serving each other. Patients invest their time and trust in us, and in return we are able to learn and grow so we can provide optimal health care to more patients in the future, as well as teach future students to provide this level of care.

“When I look back on my time at RAM …,” SERENA BARDEN, class of 2016

Serena Barden found RAM to be a good reminder of why she chose pharmacy as a career.

Serena Barden found RAM to be a good reminder of why she chose pharmacy as a career. She was the school’s 2014 RAM student co-leader.

When I look back on my time at RAM this year, I remember the encounters I had with the people of Wise, Va., I think about the many patients I was able to talk with and hear their stories of why they were at this event.

Many patients had spouses who lost their jobs, some had recently been laid off from the local coal-mine and others had never been able to afford adequate health care. The majority of patients that were seen received dental care such as extractions, fillings and cleanings. Other patients were able to see an optometrist and receive new glasses.  Some patients were seen by medical doctors and were assessed for certain disease states.

I remember one patient specifically because of the impact he had on me while I was at RAM this year. It was 5 a.m. on Friday morning, and I was helping with triage. The nurse that I was working with was someone I had just met 15 minutes prior to starting to triage patients. He explained to me that he worked as an RN at a free clinic in the town where he lived.

I was excited to work with a health care professional that I hadn’t known prior to this event and, with my cup of coffee, was ready to see patients. One of the first patients of the morning was a man who explained to me that he was here strictly to see a dentist and get a few of his teeth pulled. After taking the patient’s vital signs and discussing the patient’s medical history, I asked him if his blood pressure normally ran high. He explained that yes, it did, but when he measured his blood pressure and the reading was high, he would just take one of his mom’s blood pressure pills.

I quickly explained to him that it was not beneficial to sporadically take blood pressure medication, that it was a maintenance medication intended to be taken every day. The nurse and I then counseled the patient on the importance of lowering his blood pressure and the implications down the road if he chose to continue not to do anything about it. I then asked him if I could get him a medical sheet that I would fill out for him, and he responded that he would, yes, like to see a doctor about his blood pressure.

Serena Barden (right), with Erika Lambert, discussing risks for cancer.

Serena Barden (right), with Erika Lambert, discussing risks for cancer.

I made sure he had two people with him when he left triage; one to hold his place in the line for extractions and one to walk him to the medical tent. I then returned to my station at triage and continued to work throughout the day at various places on the fairground. Around 4 p.m., I was walking to the A1C station where VCU pharmacy students were conducting A1C and cholesterol screenings. I turned around when I heard someone yelling “Miss, miss.”

To my surprise, it was the same patient I saw earlier that morning. He told me that he wanted to find me and thank me personally for what I had done for him that morning. He said he was able to see the doctor and was prescribed blood pressure medication, which I jokingly reminded him to take every day. He gave me a hug and said that my presence at RAM was a true blessing and thanked me again for helping him.

In my opinion, it is often hard as a pharmacy student to fully grasp the importance of why we are doing what we have chosen to do as a career. It is easy to get caught up in making good grades, impressing future employers and getting involved in organizations as we complete our four years of doctoral work. I came to pharmacy school in hopes that I would be able to give back to my community and help people who needed our services.

RAM has allowed me to see that what truly matters after my four years in pharmacy school is the positive impact we make on the world through our profession and the people we help along the way.