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Students answer the call

Effort to combat COVID-19 draws assistance from each program

Cassie Renfold, SDSU student at Avera COVID-19 testing station
Cassie Renfeld, a second-year student in the medical laboratory sciences program, logs testing data at the Avera COVID-19 testing site on Minnesota Avenue in Sioux Falls March 19. Her own COVID-19 experience came in October 2020, before she started her Avera job.

The year-plus fight against the COVID-19 pandemic has presented plenty of service opportunities in the College of Pharmacy and Allied Health Professions.

  • • Pharmacy students have been delivering vaccinations.
  • • Master of Public Health students have worked in contact tracing.
  • • Medical laboratory science student Cassie Renfeld has worked in testing.
  • • Several respiratory care students took hospital intern positions in their field.

Interim Dean Dan Hansen said, “All these examples of student outreach and service shine a light on the unique nature of this college. We have students from a variety of academic programs who are able to go out and affect the lives of patients across the state in a positive way. It is our way of helping the university fulfill its land-grant mission.”

 

Student pharmacists deliver injections

Madalyne Schuldt
Madalyne Schuldt

Madalyne Schuldt, a P3 student from Jefferson, has been among the more active pharmacy students on the vaccination front.

Already an intern with Avera McKennan Hospital in Sioux Falls, she heard about a co-worker and classmate who were joining the vaccination effort during Christmas break and Schuldt decided to join them. After completing online training from the Centers for Disease Control and Prevention and the Department of Health, she started working full days during break.

Schuldt received training on giving vaccinations during her P2 year. Now that happens in the second semester of the students’ P1 year.

Some days Schuldt would board a van at 6 a.m. and head up to 170 miles away to nursing homes in Winner, Lake Andes, Mitchell, Dakota Dunes or Watertown. Depending on the size of group being vaccinated, she would be paired with one or two licensed pharmacists. The team would go from room to room with a vaccination cart.

She also participated in large-scale immunization clinics in Sioux Falls. In one case, health care workers were being vaccinated at a nursing home. At a huge clinic for health care workers at Avera, her only responsibility was to draw up vaccine doses into syringes.

Schuldt said her work in the vaccination effort has “helped me with my communication skills with patients. It felt good to calm people’s fears with the vaccination, explaining the data we have and what they can expect based on data I learned from the CDC training.”

Most of her counseling was with nursing home residents, but she also recalls relieving the fears of a custodial care worker who was terrified of needles, “talking her through it, holding her hand, stressing the importance of the second shot,” Schuldt said.

“There are a lot of people doing this. Even the delivery drivers taking vaccines from one site to another, they’re unsung heroes,” she said.

 

Significance of vaccine comes clear

Brittney Meyer
Brittney Meyer

All told, more than 50 pharmacy students have gotten involved, whether through their roles as a pharmacy intern, volunteering at point of dispensing (POD) clinics in Brookings or working with Avera long-term care to deliver shots to nearby nursing homes.

“It’s a testament to the things were teaching them that what they learn can be implemented right away, whether it’s vaccinating, monitoring or counseling patients or helping organize a community health event. Having the opportunity to practice newly learned skills has been a silver lining in this crisis,” Brittney Meyer, an associate professor in pharmacy practice, said.

The significance of their work was brought home when Meyer and a student were working at a Brookings mass immunization clinic.

After receiving a shot, an elderly woman became emotional. “I asked her if she was OK. She said, ‘Yes, I just wish the vaccine had come sooner. I lost my husband to COVID in November.  I’m so happy to get it now.’”

 

MLS student joins COVID testing crew

Renfeld, a second-year medical laboratory science student from Hancock, Iowa, heard of a job opportunity doing testing with Avera through an email from Stacie Lansink, director of the MLS program. “I thought, ‘I already had a job and I need to focus on studies.’ But I had heard another student said state that she liked how Avera worked with your schedule. I also thought this was a great opportunity as I start my laboratory career.  My job interview was over Zoom,” Renfeld said.

Initially, she worked as an intake screener at medical clinics on Marion Road in Sioux Falls, giving temperature checks and asking COVID-19 questions.

When classes resumed in January, Renfeld got shifts at a drive-up testing site run by Avera. The former Vern Eide car dealership was utilized for this testing site. There were six spots on the lot where people would drive up after being referred by a physician. Depending on the individual’s situation, they would either be given a rapid test, in which results were available in one to two hours, or a PCR test, in which results were available in 24 to 48 hours.

In most cases, Renfeld gathered a sample by getting a nasal swab using an elongated Q-tip and swirling it around five seconds per nostril.

The rapid, or antigen, test was given to people who had been experiencing COVID-19 symptoms for three to five days. The polymerise chain reaction (PCR) test, considered the “gold standard” in SARS-CoV-2 detection, detects RNA that is specific to the virus and can detect the virus within days of infection, even those who have no symptoms.

 

Schooling proves useful in patient contact

“If we didn’t feel 100 percent comfortable offering the rapid test based on their signs and symptoms, we would offer PCR,” said Renfeld, whose job included explaining the tests.

“It has been great to take what I have learned in my MLS courses and see first-hand how everything connects. For example, the rapid antigen test, it was cool to see how learning about it in immunology and then actually applying what I learned by performing the actual test. It was a full circle moment. All that hard work (academically) does make sense now. That was useful in explaining the tests to patients.

“The tests can be confusing but working in a lab provides us the knowledge to know how the test works and to properly report results.  The antibody (PCR) test is a blood test to see if someone has had it recently. The patient has to be actively showing symptoms for the rapid antigen test to be effective.

“After seeing so many people, you start to see similarities in those that are sick. If someone looks ill and has been showing symptoms for three to five days, we recommended the rapid antigen test,” Renfeld said.

At the peak, she was working 15 hours per week with Avera, 28 to 40 hours per week as a pharmacy tech at Walmart and going to school full time. Fortunately, for the first 12 weeks of the spring semester, that has been online learning. For the final 12 weeks, she will be working 40 hours a week in a hospital lab, so outside employment opportunities will be off of the table.

But she has been thankful for the opportunity to aid in the fight against the pandemic as well as broaden her health care experience.

Renfeld had her own health care experience with COVID-19 in October 2020, before she started with Avera. She was ill for a week with low oxygen levels, nausea and vomiting. Renfeld drove herself to the emergency for an inhaler and medication. When she was vaccinated, she had headaches and body aches after each of her shots.

Protected by full personal protective equipment during testing, she stayed healthy then, “but there definitely were days that were harder than others.”

 

Public health students work contact tracing

Brent Calkins
Brent Calkin

Brent Calkin, a December 2020 Master of Public Health graduate, is among the students in that program that took part in case investigation and contract tracing.

The online program is a joint effort between SDSU and the University of South Dakota. In August, the Community Action Response Epidemiology team was created in collaboration with the state health department and the Great Plains Tribal Leader’s Health Board to help with the COVID-19 response within South Dakota. The team started with a focus on tribal communities and the USD community.

Calkin started in August with several others from the program as well as a handful of undergraduates.

At its peak, there were 20 people working 15 to 20 hours per week from home calling people to report that the individual’s COVID-19 test was positive, sharing disease information and best practices for the patient as well as getting a list of people with whom they had been in close contact, then calling those contacts.

After the test result was reported to the S.D. Department of Health or the tribal health authority, the goal was to contact the individual within 48 hours and connect with that person’s close contacts in the next 24 hours.

 

Finds mixed public reaction

The public’s reaction was mixed, he said. “The more mild the case, the more they blew it off. The more severe illness, the more serious it was taken, or someone who was close to them had a severe case, they took it serious. It was definitely a polarizing issue.”

On the other hand, “What a time to be in public health. It couldn’t have come at a more interesting time for my schooling,” said Calkin, who earned a bachelor’s in health care administration from the University of Minnesota in 2014 and now is looking for a position in health promotion and disease prevention.

He said the work will prove valuable for him because “it helped us work as a team with project deadlines.” Team meetings were held by Zoom or Microsoft Teams. Gaining collaboration between two unrelated government agencies and working with an underserved population, the Sisseton-Wahpeton Oyate, also proved interesting, he said. 

By mid-March, the team was down to eight and Calkin’s workload was only 10 hours per week.

Part of the focus also has changed. Time also is spent calling people age 65 and older to see if they have received their vaccination, encouraging them to do so if not and letting them know where vaccinations are being offered, Calkin said.

As one of the leaders, he also has been responsible for training new members. “The team was ever-evolving. We were always bringing on more people to meet the need,” Calkin said.

 

Respiratory students take intern roles

Carolina Diaz
Carolina Diaz with respirator at Sanford Health, Sioux Falls.

Twelve of the 16 students in the respiratory care program gained temporary respiratory care therapist licenses so they could work at hospitals in Sioux Falls and Rapid City.

Students in the two-year associate program take classes and clinicals at the hospitals and were encouraged to apply for student intern status to gain valuable experience before entering the workforce and relieve overburdened registered respiratory therapists. The request came not long before fall semester break, so they were able to work full time until classes resumed Jan. 11.

“While sometimes it was hard to work with COVID patients, other times it was rewarding because the patient improved and was moved to another floor; they had a lower oxygenation need and could be transferred to another floor. I felt good that I did something and the patient got better,” said Carolina Diaz, a student in the Sioux Falls program.

Brent Aukerman, who is in the Rapid City program and will graduate in May, said he and his classmates were told shortly before Thanksgiving they could apply to work as interns while finishing their degree and help address the severe workforce shortage facing the 386-bed Monument Health hospital.

Four of the seven students at the Rapid City site accepted the offer.

 

An ‘incredible’ learning experience

Brent Aukerman
Brent Aukerman at Monument Health, Rapid City

Aukerman applied to Monument, was interviewed and obtained a temporary respiratory therapist license from the state. By December, he was working full time—three 12-hour shifts a week. Because students train on equipment in the hospital’s lab and are mentored by the hospital’s registered respiratory therapists, hospital directors have a lot of confidence in the program’s second-year students, according to program director Lacy Patnoe, of Rapid City.

The scenario is in the same in Sioux Falls, where eight of the nine students opted to work as a temporary respiratory therapist.

“It’s been, from a learning experience, incredible. You can see how differently COVID patients can respond to different treatments and contrast the oxygen demands for one person versus a similar patient. You’re trying to do the things you usually do, but the patient doesn’t always respond as expected,” Aukerman said.