Running head: PRE-REFLECTION PRACTICUM PAPER: REMOTE AREA MEDICA 1

Pre-Reflection Practicum Paper: Remote Area Medical Mission Trip

Kelley Schlosshan

Bon Secours Memorial College of Nursing

Vulnerable Populations and Global Health Practicum

4215P

Rani Sangha, MSN,MBA, BHSM, RN

January 13, 2018

Honor Code: I Pledge…

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In November 2017, I applied to be part of the Memorial Regional Medical Center

team on its first annual Remote Area Medical Mission (RAM) trip to Buena Vista, VA. I was

one of the twenty people selected to participate. The RAM trip takes place Friday, March 9th

through Sunday, March 11th, 2018. Remote Area Medical provides free medical, dental and

vision care to families who do not have access or cannot afford to visit a doctor. Buena Vista,

Virginia is located in the Blue Ridge Mountain region in Southwestern Virginia. According to

2016 data from the United States Census Bureau the population is estimated to be 6,452 people;

18.8 percent of the population over the age of 65, females compose 53.4 percent and the area is

predominantly Caucasian at 90.6% (United States Census Bureau, n.d.). Between 2012 and 2016

the median household income of the area is $29,109, which is significantly below the median

income of Virginia of $66,262. Access to health care in rural areas has significantly changed

within the past decade. In rural areas, hospital closures and changes within health care delivery is

adversely affecting rural areas. The number of primary care physicians in rural areas is steadily

decreasing (AHRQ, n.d.).

During my nursing career, I have practiced within an assisted living facility and in a

hospital in central Virginia. Most of the patients I have helped care for have had access at least at

some level with primary care physicians and information and education on preventing diseases

such as high blood pressure, heart disease and type II diabetes. Through this experience, I think I

will learn far more from those I come in contact with then they may learn from me caring for

them. During my career as a nurse, I have not worked in rural health care and I hope from this

practicum experience to learn more about promoting health care in a rural area through treating

members of the community who do not have easy access to nurses, physicians, dentists or other

health care providers.

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As you can see from the statistics above, Buena Vista, Virginia, is one of the poorest

communities in Virginia. In general, my bias towards poor people are they are uneducated,

unhealthy, obese and lazy and they do not wish to pull themselves or their family out of poverty.

My strengths include a positive attitude and using my faith to guide me in the right direction to

provide good help to those in need. I want to be a part of Bon Secours missions and values by

bring compassionate care to those in need, treating all people with dignity, justice, integrity,

being a good steward, providing quality care, and promoting growth and development.

With much lower population density in rural areas it makes it difficult to deliver services

which would target those in the area with special health needs (AHRQ, n.d.). In caring for health

needs in a rural community I am hopeful I can use skills I use every day within the pre-admission

testing department at MRMC. As a nurse I learn a great deal about the patients I care for by

listening and empathizing with each patient. It allows me to help prioritize their needs both

immediate and future. I am hopeful that I can use the same skills in the Buena Vista community

and help provide them with practical knowledge they can use in the future.

A rural community without easy access to health care or health care providers, a few of

the barriers I can foresee includes; difficulty for them to receive ongoing care due to a lack of

primary care physicians and hospitals. Our clinic is a three day clinic in the area and we will not

be able to deliver follow-up care to those who may need it. Through participating in the RAM

trip to Buena Vista, I anticipate I will gain a better understanding of patient needs within a

community without easy access to health care providers and this will make me a better nurse in

caring for all my patients. I am also hopeful I can learn how to educate those in a rural area on

how to care for themselves so that basic illnesses do not become more acute.
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References

AHRQ. (n.d.). https://archive.ahrq.gov/research/rural.htm

United States Census Bureau. (n.d.).

https://www.census.gov/quickfacts/fact/table/buenavistacityvirginiacounty/PST045216