Journal #8 for the Community Clinic

Sara Johnston
6 April 2007
MIDS 201

Journal Entry #8

At first, I did not think my volunteerism at the Clinic would benefit me or others very much. I spent a lot of time standing around waiting for someone to give me something to do. But the more time I spent there, the more I learned what things needed to be done. Anytime there was a lull in rooming or triaging patients, there were always charts that needed to be re-filed. I also did not realize the value of being able to talk to the other volunteers. There is one man in particular. His nametag says James, but everyone calls him Butch. He at first seems a little strange, with some missing teeth, a ponytail, and a gravelly voice. He’s very personable though, and loves all of “his girls” who help him. Everyone teases him about all the girls that help him with the triaging on clinic days. He likes to tell us all stories from his life, ranging from his military service in Vietnam to the “real” carne asada burritos that he can only get in southern California. It’s also great to be able to talk to some of the doctors about their experiences in medical school, and what fields they think we pre-meds should or should not enter.


I also did not think I was providing any kind of great service to the patients. What I was doing, almost anyone could easily do, I thought. I now realize that it doesn’t matter that anyone can do it- they’re not doing it; I am. I was with Dr. A yesterday with a patient. When Dr. A was finished, the patient thanked him for just talking to them. I knew that I had helped put the patient in the room and get them ready for a doctor. At one point, I was standing waiting for more patients to room or triage. A doctor came out of a room and said he needed a female nurse. He had a female patient with a boil on her rear-end and needed a nurse to help drain it, and he needed a female in there with him because he was working in a delicate area on a woman. Anytime his nurse had to leave to go get something, she would pull me in the room so there would be a female in there at all times. I talked to the patient, and we even joked. She was not upset, and it felt so good to help her relax during an obviously painful and embarrassing time. I knew that this was not something everyone could do- some people might be grossed out or embarrassed by the situation. I was not, and realized how much I had served that patient. She also served me, by letting me know that I could handle that kind of situation and be able to comfort someone, which is what the medical profession is all about.


Some might also think that office work is menial and unimportant. I beg to differ. Addressing, stuffing, and licking envelopes for the Clinic newsletter is not unimportant- it lets all of the volunteers and others who come across it know what happens at the Clinic and how they can help. Stamping hundreds of appointment cards is not unimportant- that is how the patients stay in contact with the Clinic and know when to come back. When I stamped the cards, I had a few old ones to look at- I couldn’t believe how crooked and off-center some of the stamps were. It made me mad that whoever had done those hadn’t taken the extra half-second to try and make the cards look nice. Those cards reflect the Clinic and the people who work and volunteer there. I think I now understand why there was all of the red tape in the beginning to start my volunteerism. The Clinic only wants hard-working, dedicated individuals who will take what they are doing seriously. It doesn’t really matter what your letters of recommendation say- all of them are basically the same, promoting the individual. What matters is the fact that you took the time to fill out the application and to seek professionals to provide the letters. This is the essence of anything: as long as you put forth the effort, good things will come of it.

Week #7

Sara Johnston
29 March 2007
MIDS 201

Journal Entry #7

Today was a busy Clinic day. It was also the longest I’ve ever stayed at the Clinic at one time- over 3 hours. The reason it ran so late was not that there were a lot more patients than normal, but that none of the doctors showed up on time. One doctor was supposed to be there at 3:30 and another at 4:00, but both did not show up until close to 5:00. Appointments started at 3:00. I know that these doctors work all day long, and then come and volunteer their time at the Clinic, but if they are going to be late, would a phone call hurt? One patient, the first one in line, was supposed to be at work at 5:00. That was the time she finally got to see a doctor, after waiting for 2 hours. This got me to thinking about a large political issue- nationalized healthcare. The benefits of free or very cheap healthcare are obvious- everyone will have access to the medical attention that they need. The drawbacks are not so obvious- if many more people are now needing those same, limited amount of services, there will be a lot of waiting around for them. People in Canada come to the U.S. and pay for medical services so they can get them in a timely fashion. Should these people at the Community Clinic have to wait extra-long to see a doctor just because they have lower incomes than the rest of us and can’t afford insurance?


I also got to go around with Dr. A today. We only saw a few patients, and I didn’t do much but observe, which is still a very valuable learning experience- just listening to patient-doctor interactions.


There was also something I noticed today: when we, the few Honors students, started volunteering at the Clinic, there was a high school girl there. After our being there a couple of Thursdays, she has not been there since. I wonder if we scared her off, or if she felt like she wasn’t needed anymore. I would hope that volunteers wouldn’t offend other volunteers. You would think that an excess of volunteers would be better than a shortage, but perhaps not if older volunteers feel threatened by newer ones.

Journal #6

Sara Johnston
21 March 2007
MIDS 201

Journal Entry #6

I went to the Clinic on Thursday over Spring Break during the adult clinic, and today, Wednesday. I’ll talk about today first because it’s short and not that exciting. Last week, Doris, one of the nurses, asked me if I would be in this week. When I told her yes, she was glad and gave me a task to do: stamp the Clinic’s name, address, and phone number on appointment cards. I’m sure this is much, much cheaper than having business cards made. So, I spent two and a half hours stamping cards. I did not mind this at all. It was quiet, because when I arrived there was a staff meeting going on. It had started before I got there, and let out just as I was leaving. I think they have those meeting every other week, and its nice to know that they keep themselves constantly updated on everything concerning Clinic operation. Also, when I got there the front doors were locked, so someone had to come open them for me from the inside. I wonder if they keep the doors locked on days they don’t have patient clinics. But it still really doesn’t make much sense- it makes them seem not very accessible and open to the public and new clients.

Last Thursday I got to see more patients with Dr. Arvelos. I also did some rooming of patients and filing of charts. I got some hands on experience this time. One patient, a larger person, was complaining of swelling in their legs and feet, and thought it was from bad circulation. (I know “they” is grammatically incorrect, but I’m using it to protect patient confidentiality) Dr. A said it wasn’t bad circulation, just loss of valves in the veins that help pump blood back up to the heart, caused from standing at work all day. He said if his assistant, me, could feel a pulse in their feet, they didn’t have bad circulation. He showed me where to find the pulse, and I felt it. Another patient needed refills on breathing medication. They told Dr. A that they were going to have to quit sheet rocking, because it was worse for their lungs than smoking. Dr. A said that wasn’t true, but the patient refused to listen. Dr. A listened to their lungs, and then gave me the stethoscope and told me to listen. I don’t have much experience with one, and thought I just wasn’t listening in the right place. I told Dr. A I didn’t hear anything, and he said that was correct, that the patient didn’t hardly have any lungs left. One patient complained of severe headaches, and a bad knee. When the doctor flexed and rotated their knee, I helped hold them because it hurt.

It felt really good to do some work these past two times, instead of just mostly standing around. I also got some more experience in my (hopefully) future career. After the first couple of times I volunteered, I did not think that I would get much medical exposure and experience, just office work. But now I’ve gained more than I thought, learning how difficult patients can be, and how defensive people can be towards their doctor.

Week 5

Sara Johnston
8 March 2007
MIDS 201

Journal Entry #5

I went to the Clinic on Wednesday. I hoped that when I showed up they would have enough things to do to keep me busy for a couple of hours. The Volunteer Coordinator had returned from her vacation, so that gave me some hope. Upon my arrival at 1 PM, everyone was eating Charlie’s Chicken. The first thing they did when they saw me was instruct me to eat. After that, I looked around for something to do. Because it was not an adult medical clinic day, I figured there would just be a bunch of paperwork and things to file. I was correct. Each month, volunteers start a new sign-in sheet. I was assigned to put the sheets from February into the volunteer folders. I punched holes in them so they would fit in the brackets in the folders. Once I started opening the folders, I saw that the majority of the old records sheets were not in order and were not held in place by the brackets. The folders were grouped by last name, but not alphabetically in order in each group. So, being the super-organized Honors student that I am, I put all the folders in alphabetical order, and punched holes in all of the time sheets and put those in order in the folders. That pretty much occupied my two hours.

One older volunteer, probably in her 60s, was pulling charts for the next day. I asked her if she wanted any help, and she rudely told me that we would probably just end up tripping over each other. As I was filing the sign-in sheets, she was putting the charts in stacks for the times of their appointments: 3, 3:30, 4 and so on. Instead of just stacking them with stickie notes on each of them with the time of their appointments, she was putting on the clips with the order of the patients, which is not supposed to be done until the patients are there and triaged. When she was told that she needed to take all the clips off, she complained that someone had told her earlier to not put stickie notes on the charts. I had the smug satisfaction in knowing that if I had pulled the charts, I would have done it correctly. That’s what that old lady gets for thinking that a younger person would not be of any use.

Wednesdays are dental clinic days. As I was walking down the hall looking for Kathy, the volunteer coordinator, I heard a familiar voice: Steve Menke, the dentist that day. I know him because my brother and his sons played sports together, and I have been skiing with him through a mutual family. I stuck my head in and said hi. He and his assistant were putting stitches in a girl’s mouth. There was a girl in the other chair, waiting her turn. She looked terrified as she watched them stitch up the girl’s mouth and wipe blood off of their tools on her protective paper bib. I think she should have been kept in the waiting room, not watching what was about to be done to her. I had my wisdom teeth removed last year. If I had had to watch it done to someone before the procedure was performed on me, I would have run from the room screaming.

Week 4 at Community Clinic

Sara Johnston

3 March 2007

MIDS 201

Journal Entry #4

I went to the Clinic on Thursday, which is when the Adult Clinic is held. It is supposedly the busiest day of the week, but I have yet to see that. This is the second Adult Clinic I have been to, and the second time I have been told that it was unusually slow. The Volunteer Coordinator was gone this week on vacation, so there was no one designated to find something for me to do. When I arrived at 3, Austin Ahles was already there helping triage patients- weighing them and taking them to nurses to take blood pressure and vitals. When a doctor arrived, I helped call patients back and put them in exam rooms. Other than that, I mostly just stood around for three hours. I did not get to go around with Dr. A to see any patients: there were so few patients left by the time he arrived, that he only saw one or two and was gone before I even knew he was there. I did put a new garbage bag in a trash can that was full; I cleaned off the counter after a glass of tea was spilled; and I showed Sara Burton how the filing system works, because it was her first time coming to volunteer.

Any time anyone at the clinic asks me why I am there, I tell them I am with the MSSU Honors Program and that I am fulfilling my service-learning requirements. The next question is then always “Are you a nursing student?” When I reply no and tell them that I am pre-med, they always seem disappointed. I wonder if this is because nursing students have already had hands-on clinical training and know more about procedures, such as taking vitals. That is not my fault- that is what I’m at the Clinic for: to get my feet wet in the medical community and learn about what goes on there. There are also students there from the Franklin Tech medical office programs doing internships. One student in particular is always there when I am, and she stands around just about as much as I do.

I also met a celebrity on Thursday. I had seen him at the Clinic before and thought he looked familiar, but it was not until he introduced himself that I knew who he was. He told me his name was Howie, and I immediately knew he was Howie Baby from the local radio stations. He left radio a few years ago, and is now a full-time preacher. He is the chaplain for the Community Clinic. I asked him if he missed being on the radio, and he told me no, that he had a greater calling now. At 3:30, Howie made an announcement that prayer would start in one minute. He then said a prayer over the intercom system. This was the first display of religion I had seen at the Clinic. I had seen a few signs mentioning that the Clinic incorporated faith-based values and a couple of angel statues on top of the dusty shelves that contained the patient charts, but the clinic-wide prayer was the first active demonstration of religiosity. Because I am not a religious person, I felt slightly uncomfortable when the whole clinic paused to hold hands and pray. It made me wonder if any of the patients felt uncomfortable, and if any did, if they were kept away by the Christian values that the Clinic holds. I would hope not, but it definitely gave me something to think about.

Week 3 at Community Clinic

Sara Johnston
23 February 2007
MIDS 201

Journal Entry #3

I was only able to go the Clinic one day this week, Wednesday, because volunteers from College Heights Church were there every other day this week.

Something I forgot to mention that happened last week: seeing prisoners brought in to receive healthcare. It was strange and unsettling to see people brought in wearing orange jumpsuits and shackles. Before they arrived, one of the office assistants told Austin Ahles and me that prisoners were going to be brought in. They would come in through the back door, with an armed guard accompanying them at all times. Austin needed to leave to go to work, but her purse was back in a room that was past the prisoners. Luckily, someone showed us how to get back to that room by going down a different hall. It surprised me that the prisoners were not put in a room by themselves, they were just sitting in the hallway. Any patients taken back to exam rooms would see them. I think if patients saw the prisoners, it would them feel worse about their situation: They are already uninsured and at their last resort for healthcare, and now they receive the same kind of care as a prisoner, who most people, I think, view as sub-standard humans. It could also make them feel unsafe, which is something I’m sure many of them already feel in their lives. I know that not all of the people who use the clinic are very economically disadvantaged; they are just without health insurance at this point in their lives. Most of the patients that I have viewed, though, fit in the former category.

This week, when I was pulling charts for the patients that would be coming in on Thursday, I was told to not bother looking for the last two on the list: they were the prisoners, and had no charts, or at least theirs were not with all of the others. I didn’t know if this was a clinic policy, or something court-mandated, that the medical records of prisoners be kept separate.

Pulling charts was the only thing I did on Wednesday. And it didn’t even take that long. The only thing I dislike about my volunteerism at the Clinic is how much time I spend standing around, waiting for someone to give me something to do. On Thursdays it’s much better when I have a doctor to observe during the very busy adult clinic day. My dad called me while I was there to talk to me about registering for the MCAT. At first I felt bad about spending 15 minutes of my volunteer time talking on the phone (even though it was about something very important and time-sensitive), but later I was thankful for it because it made 15 minutes less that I just stood there. Even the paid workers at the clinic get bored and just stand around and talk with us, eating whatever food someone has brought in. When you hear that the Clinic is in desperate need of volunteers, I think it is referring to medical professionals, not college kids who need some volunteer hours. Obviously, we are trying to accomplish more than just accumulating hours, but it does not seem that way when I am just standing there feeling useless.

Week 2

Sara Johnston

17 February 2007

MIDS 201

Journal Entry #2

I did finally get to start my service-learning this week at the Joplin Community Clinic. On Tuesday I arrived at 1. The first thing that surprised me when I walked in was that there was no one in the waiting room. Because all I ever hear about the Community Clinic is their desperate need for volunteers and supplies, I figured it would be packed all of the time. I learned that this was due to the fact that they do not have doctors in every day at all hours- they have different clinics on different days.

I did not even get a tour of the facility like I expected- the volunteer coordinator showed me where to hang my coat and where to sign in and out. She then gave me the task of stuffing envelopes with the Clinic newsletter. I did not mind this at all, even when I then had to address a few dozen and then lick them all. I was then shown the filing system. I pulled a few charts from a list of people I was given. I wrote down the patient’s name, city and county, and whether or not they had Medicaid.

When I left at 4, the waiting room was full of people there for their medicine refills, which is also something that is only done at a certain time a certain number of times a month. This tight scheduling of services indicates to me that if someone is serious about receiving care from the Community Clinic, he/she must be careful to know when the clinic offers the services he/she needs, and that the Clinic will be offering prescription refills before he/she runs out.

On Thursday I arrived at the Clinic at 4. Thursdays are the adult clinic days, so they are the busiest days of the week, when there is the most to do and the clinic is open the latest. One of the doctors that my mom works for, Dr. Anthony Arvelos, volunteers on those days, and I had already arranged with him that I could be his shadow on those days. When I first got to the Clinic, I did not see him because he was already with a patient, so I pulled all the charts of the people who were coming in the next day for the dental clinic. I then was able to see a few patients with Dr. A. Two out of the three patients had borderline diabetes. The third one was a man who Dr. A was not seeing officially; when Dr. A walked past the room he was in and saw him, he stopped to talk to him. The patient was an example of what people often think of as the stereotypical person who would need to use the Clinic’s free services: he was a ragged man, with missing front teeth, no car, and more things wrong with him than can be counted. He was there to see the dermatologist about a skin rash; an R.N. about his high cholesterol, blood pressure, and a giant lump on his elbow from where his arm had already been broken and then was fallen on. It was pretty amazing that Dr. A remembered everything about this patient’s history and was willing to help him.

When Dr. A was done with his patients, he talked to me a little. He told me that most of the people there were good people who knew that the Clinic was their last place to receive healthcare, and that they would do whatever they were supposed to to keep those very needed services.

Week 1- Trying to volunteer at the Community Clinic

Sara Johnston

10 February 2007

MIDS 201

Journal Entry #1

This week I did not get to volunteer. It was not that I waited to the last minute to contact the Joplin Community Clinic to set up the volunteerism, it was that when I did try to call them, I could not get a hold of the person I needed to- the volunteer coordinator. When you call the Clinic, you get a ridiculously long recording that is almost impossible to listen to. It made me wonder how many people that need to use the clinic do not because it was difficult to understand all of the details- what proof you did and did not need of things, what days you could or could not make appointments for this or that, what things you did need appointments for and what things you did not, what days and times certain special clinics were open, and even what days the clinic was open and its hours on those days.

I finally got the extension of the volunteer coordinator and left her a message on Tuesday, January 30th, telling her that who I was, that I was from the Honors Program at MSSU wanting to volunteer for my service learning class, and that I was a Pre-Med major. Two days later, I got a message at home telling me to call her and leave my address on her voicemail so she could mail me the application. Application? I knew I would have to sign some things or fill out a questionnaire and do an interview, but a full-blown application? I know that the Clinic is an important place where people’s lives and security are of the utmost importance, but I did not realize I would have to go through a screening process. Isn’t it just enough that someone wants to volunteer? Is it a bad assumption to make that someone who volunteers is doing it for a good reason, is credible, and is a “good person?” It is understandable that someone, once they find out all what is entailed in what they would like to volunteer for, might back out; they might also learn they do not have the experience necessary; but that could all be easily figured out in an interview.

I decided it was ridiculous to wait for a mailed application- I live in Joplin, and it would take me ten minutes to go pick one up. So on Wednesday the 7th I did. The volunteer coordinator was not in, so someone else had to go find me an application. When the lady brought it to me, she showed me what pages to fill out, then the two reference sheets I needed to have filled out by two people, which had to then go in sealed envelops with their signatures across the seal. Even more hoops to jump through, and more people to involve! There is even an orientation before one begins to volunteer. Of course, when I got home, there was the application in the mail. I figured now if I made a mistake on one, I had a backup. All of this red tape makes me wonder how many potential volunteers are scared away by it. I may not have got to start getting my volunteer hours this week, but I have already learned a lot about the Joplin Community Clinic.