Miriam Stricklan (l) Barbie Fulton (r)

PCRMC Dent Medical Clinic Offers Patient-Centered Care

Family Nurse Practitioners Barbie Fulton and Miriam Stricklan both grew up in south-central Missouri, so the chance to help care for the communities where they were raised really appealed to them when choosing to work for Phelps County Regional Medical Center (PCRMC).

Fulton and Stricklan, along with their collaborator, family medicine physician Kimberly Bohlmann, MD, currently see patients at the PCRMC Dent Medical Clinic in Salem. They specialize in family practice.

Fulton, who was born and raised in Salem, has been a nurse since 1994. In 2005, she earned her Master of Science in Nursing (MSN) from the University of Missouri-Columbia to become a nurse practitioner. Fulton initially worked in the PCRMC Pain Clinic but has been helping patients in Salem and surrounding communities at the PCRMC Dent Medical Clinic for the last three years.

Stricklan, who grew up in Rolla and now lives in Salem, has been employed as a nurse since 2004. She worked in the Intensive Care Unit (ICU) and has been a shift manager at PCRMC. She earned her nurse practitioner degree by completing the MSN program in 2017 at Frontier Nursing University in Kentucky.

Stricklan started out seeing patients in PCRMC’s Rural Health Clinic before moving to Salem and joining the PCRMC Dent Medical Clinic. “I’ve worked for PCRMC for most of my career, so choosing to practice here was a no-brainer. I didn’t want to go anywhere else,” Stricklan says.

For Fulton, the transition from nurse to family nurse practitioner allows her to provide a full spectrum of care to the community. “I can treat patients more completely,” Fulton says.

When Stricklan came to Salem, she said one of her goals was to help patients establish care with a primary care provider.

“In the ICU, I saw people who were very sick, and I wanted to keep people from getting to that stage. I want to keep people healthy, so our primary focus is preventive care,” Stricklan says.

Both Fulton and Stricklan say what they enjoy most about their jobs is serving their community.

“It’s kind of like caring for your close friends and family,” Fulton says.

“It’s very rewarding to see how even the smallest of changes can make a big difference in our patients’ lives,” Stricklan says.

Fulton says she tries to get to know her patients, beyond just their medical issues. “I want to help them improve their quality of life,” she says.

Stricklan and Fulton take the time to listen to their patients and pay attention to their concerns. Both take a holistic approach to patients’ health issues.

Because the Dent Medical Clinic is part of the PCRMC network, patients have access to a variety of primary and specialty care services, including cancer care as well as care for the digestive, respiratory and nervous systems. PCRMC serves a six-county area, including Phelps, Dent, Texas, Pulaski, Maries and Crawford counties, so patients can receive care close to home.

Walk-in and same-day appointments are available at the PCRMC Dent Medical Clinic. In addition to family medicine, the clinic offers well-women exams, well-child exams, general wellness physicals, sports physicals and annual exams.

The PCRMC Dent Medical Clinic, located at 1010 Scenic Rivers Blvd., is open Monday through Friday from 8 a.m. to 5 p.m. For more information, call 573-729-5533 or visit pcrmc.com.

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4th Annual Hospice Butterfly Release Celebration Planned for May 19

Phelps Regional Homecare, a division of Phelps County Regional Medical Center (PCRMC), will host its 4th Annual Hospice Butterfly Release Celebration on Saturday, May 19, 2018, from 2:00-4:00 PM at Huffman’s Flowers of the Field, located at 18148 County Road 1000 in St. James, MO.

“This event offers the chance to remember our cherished family and friends,” says Tara Peters, marketing coordinator for Phelps Regional Homecare. Releasing butterflies is a unique way to pay tribute to loved ones because butterflies symbolize hope, new life and transformation.

“The Hospice Butterfly Release Celebration honors the memory of those we love and serves as a celebration of life,” Peters says.

For $30, participants can release a live butterfly and receive a T-shirt. The deadline to reserve a butterfly is Friday, May 4, 2018. Businesses and organizations also can sponsor the event.

In addition to releasing live butterflies, the afternoon will include beverages and light snacks for attendees.

Proceeds from the butterfly release help relieve the financial burden for those in need when facing end-of-life decisions. This event benefits the Phelps Regional Health Care Foundation’s Hospice Fund, which assists hospice patients and their families with prescription medications, personal bills, food supplements and other needs.

An extensive team of professionals and volunteers with Phelps Regional Homecare deliver hospice care to patients in this region. Hospice care staff responds to people’s needs for comfort, empowerment and self-directed care while supporting the patients’ families both during patients’ illnesses and after death. The goal of hospice care is to maintain the highest quality of life and dignity to the greatest extent possible for patients.

In addition to hospice, Phelps Regional Homecare offers home health and in-home services. Phelps Regional Homecare serves all of Phelps, Crawford, Maries and Pulaski counties and portions of Dent, Gasconade and Texas counties.

For more information about the butterfly release, to reserve a butterfly or sponsor the event, call 573-458-3802 or email tpeters@pcrmc.com. To donate to the Hospice Fund, visit giving.pcrmc.com.

Jessica Fisher

PCRMC Diabetes Outpatient Clinic Helps Individuals Manage Their Diabetes

People who have been diagnosed with diabetes often feel overwhelmed or powerless at times. They do not know where to get the knowledge and skills needed to help manage their chronic illness.

Diabetes Self-Management Education and Support (DSMES) services offered at Phelps County Regional Medical Center (PCRMC) help ease learning and empower individuals who have been diagnosed with diabetes.

“We teach participants how to manage their diabetes and not let diabetes overwhelm or control them,” says Jessica Fisher, RN, diabetic nurse educator at PCRMC.

Unlike some other diseases, medicine alone cannot be used to treat diabetes. Nutrition, exercise, monitoring blood sugar levels and support are ways that DSMES help participants better manage their diabetes and develop healthy lifestyle changes. “Our service complements treatments by providing resources to aid in successful management of diabetes,” Fisher says.

Understanding the causes and symptoms of diabetes increases people’s awareness of the disease. The information and support provided by PCRMC’s diabetes nurse educators encourages participants to determine what lifestyle changes they need to make in order to improve their health and well-being.

PCRMC’s Diabetes Outpatient Clinic provides both group and individual sessions and is designed to meet the participants’ needs. This service is not about doing everything for the participants but rather providing the tools necessary to actively engage and motivate healthy behavioral changes.

Once a primary care provider referral is received, an appointment is made and participants meet with diabetes nurse educators to learn about the services provided by DSMES, identify barriers impacting their disease and identify the goals for diabetes education they want to accomplish.

One option available is a 10-hour diabetes education curriculum divided into four classes, each focusing on a different aspect of diabetes self-management such as basic diabetes information, nutrition and meal planning, monitoring blood sugar and recognizing patterns, sick-day management, short- and long-term complications, screenings and current medications involved in the treatment of diabetes.

Establishing realistic goals while participating in DSMES is key to the successful management of diabetes. Diabetes nurse educators help participants create achievable goals and then evaluate the impact their goals have on their life with diabetes.

Additional services available for DSMES are meter teaching, insulin administration and management, survival skills to manage low blood sugar, glucagon administration and management, and medical nutritional therapy. PCRMC diabetes nurse educators can help with whatever individuals need to meet their challenges.

While participants may have met their goals, care does not stop there. PCRMC diabetes nurse educators continue to follow up with patients at three months, six months and annually. “We care for these individuals just as they were our own family members,” Fisher says.

PCRMC offers a free diabetes support group for diabetes patients, their family members, caregivers and anyone interested in finding out more about diabetes. The support group meets the first Saturday of the month, except for January, July and September, from 10 a.m. to noon in PCRMC Private Dining Room 2.

The PCRMC Diabetes Outpatient Clinic offers services in Rolla and Waynesville. For more information, call 573-458-7314. Services provided at the PCRMC Diabetes Outpatient Clinic require a referral from a primary care provider, internal or family care provider. 

CNMs

PCRMC Certified Nurse Midwives Celebrate Accomplishments

Phelps County Regional Medical Center’s (PCRMC) midwifery program offers care for women throughout every stage of life. PCRMC Certified Nurse Midwives (CNM) Heather Wildebrandt and Karen Ulrich are proud to celebrate their two-year anniversary. One of the most notable accomplishments Wildebrandt and Ulrich would like to recognize is expanding birthing options within the community.

PCRMC’s midwifery program officially launched in February 2016 and has helped families welcome more than 200 babies. Some families have even welcomed or will soon welcome a second child through the program.

Midwifery-led care throughout pregnancy and birth differs slightly from traditional, physician-led care. Certified nurse midwives are educators who join with patients and their families to work toward mutually identified goals. Midwifery care involves high touch, low intervention, continual education and constant support.

Wildebrandt and Ulrich feel that they have been well accepted into the local birthing community and feel supported by their OB/GYN physician colleagues. “We have an excellent collegial relationship,” Wildebrandt says. “As the program continues to mature, we hope to further develop those relationships and bridge the gap between physician-led and midwifery-led prenatal care to provide a seamless patient experience.”

Both Wildebrandt and Ulrich are proud of the impact their services have had; some of the added services include provider bedside support, massage and aromatherapy during labor.

Wildebrandt and Ulrich are eagerly anticipating additional changes in the near future that will continue to support uninterrupted birth, such as the addition of prenatal exercise classes and the ability to listen for intermittent fetal heart rate during labor. By continuing to support uninterrupted birth, Wildebrandt and Ulrich expect to continue positively influencing the local birth outcomes.

“We enjoy working with families to achieve the birth experience they hope for,” Ulrich says.

“When patients are proud of themselves and their birth experience, I know I’ve had a part in that and that’s when I am the proudest,” Wildebrandt says.

For more information about midwifery or the PCRMC Women’s Health Center and Maternity Services, please call (573) 426-2229 (BABY) or visit www.pcrmc.com

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PCRMC’s Cardiopulmonary Rehabilitation Program Benefits Patients in Many Ways

Jodie Donati, a lifelong resident of the St. James/Rosati area, has lived the vast majority of her life without any heart or lung problems. With the exception of an incident when she experienced shortness of breath early last year, Donati, now 88 years old, has led a healthy life.

However, that changed in June of 2017, when she started having symptoms of what she thought was simply indigestion. When her left arm began hurting, Donati’s daughter rushed her to the Phelps County Regional Medical Center (PCRMC) Emergency Department.

It turns out Donati was diagnosed with coronary artery disease (CAD), which occurs when plaque builds up in the heart’s arteries. When this happens, the plaque narrows the arteries and reduces blood flow to the heart muscle.

“I had three arteries that were blocked, but I didn’t feel anything until the fourth was blocked,” Donati recalled.

PCRMC Cardiologist Timothy Martin, MD, FACC, CCDS, cared for Donati during her hospital stay. She received her preliminary care at PCRMC, but surgery to remove the plaque in her arteries took place in Springfield. To help clear the blockage, Donati had a small expandable tube known as a stent placed into the blocked arteries.

After her surgery, in the fall of 2017, Donati began rehabilitation with PCRMC’s Cardiac and Pulmonary (Cardiopulmonary) Rehabilitation program. Through this service, patients who have had heart or lung problems receive a combination of supervised exercise and education.

An individualized plan is created for each patient to help recondition his or her heart and lungs, regain strength, prevent the condition from worsening, reduce the risk of future heart or lung issues and improve the patient’s quality of life.

Located on the first floor of the PCRMC Medical Office Building, the PCRMC Cardiac and Pulmonary Rehabilitation gymnasium offers exercise equipment for patients to improve their heart and lung capacity.

Donati tries to exercise at PCRMC about twice a week, usually about 15 minutes on one of the gym’s treadmills. She also performs arm exercises and sometimes uses the stationary bicycle to help build up her strength.

“This is exercise I wouldn’t do at home,” Donati said. “This is the best thing I’ve done for myself.”

After her surgery, there was a time when Donati was walking with a cane, but she no longer has to use one.

PCRMC’s Cardiac and Pulmonary Rehabilitation care team consists of highly trained and skilled professionals who work with patients to monitor their exercise. “They caution you not to do too much for too long and watch to make sure you don’t overdo it,” Donati said.

Donati said she enjoys working with PCRMC respiratory therapist Helen Thomure as well as Becky White and Melanie Stulce, both RNs with the PCRMC Cardiac Rehabilitation unit.

Another aspect that Donati enjoys is the social atmosphere of the gym. “You get to meet people and talk to them while you’re exercising,” she said.

In addition to exercise, Donati has learned how to keep her heart and lungs healthy. “We had a dietitian come in and we got to ask questions, which was nice,” she said.

In addition to nutritional counseling, PCRMC’s Cardiac and Pulmonary Rehabilitation program also offers tips for stress management, smoking cessation and other lifestyle changes designed to prevent or reverse the development of cardiac and pulmonary diseases.

“I would definitely recommend this to other people who have had heart or lung problems,” Donati said.

Patients with certain heart and lung issues, such as those who have suffered heart attacks or have congestive heart failure, persistent asthma or Chronic obstructive pulmonary disease (COPD), can qualify for the services provided by PCRMC’s Cardiac and Pulmonary Rehabilitation program. Most private insurance companies provide coverage for these rehabilitation services, too.

For more information about PCRMC’s Cardiac and Pulmonary Rehabilitation services, please call 573-458-3110.