Minot Daily News SATURDAY, APRIL 22, 2017 MinotDailyNews.com • Facebook • Twitter
Healthcare & Education Cutting-edge techniques revolutionize heart surgery By JILL SCHRAMM • Senior Staff Writer • jschramm@minotdailynews.com
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Dr. C. Etta Tabe uses a heart model to illustrate the purpose of a bypass. Jill Schramm/MDN
Tremendous strides are being made in the field of cardiothoracic surgery, and Trinity Health is beginning to bring those advancements to Minot. Dr. C. Etta Tabe, a cardiothoracic surgeon at Trinity, said new minimally invasive techniques are having a noticeable, positive impact on patient care when compared with traditional open heart surgery.
“It’s dramatic, and you are really impressed when you see it,” he said. Although open-heart surgery, requiring a long chest incision and division of the sternum, still is commonly used in medicine, Tabe adopted a different approach to coronary artery bypass operations involving more than one blood vessel. Making a much smaller incision on the left side of the chest, a healthy vessel can be grafted to bypass a blocked coronary artery. It does not require dividing the sternum or use of a heart-lung machine. “You have to feel comfortable doing
beating heart surgery because you are not stopping the heart,” Tabe said. Two surgeons, working with the medical company Medtronic, developed instruments and procedures to be able to perform minimally invasive bypass surgeries involving multiple blocked vessels. Practicing in New Mexico before coming to Minot, Tabe gained experience in this type of surgery. Because of the equipment and staff training See HEART — Page 4
ee it.” s u o y n e h w pressed cic surgeon at Trinity Health im y ll a e r e r a rdiothora and you , ic t a Etta Tabe, ca . C m a r. r D d — ’s “It
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SCHOOL MERGERS By ANDREA JOHNSON • Staff Writer • ajohnson@minotdailynews.com
Sawyer most recent school district to consider a merger
The history of North Dakota schools is also the history of school districts closing or consolidating with other nearby districts or forming cooperative partnerships. The most recent area school district to ponder a cooperative agreement with another district is Sawyer, which will send its high school students to Max High School this coming fall. Principal Tom Warman said the district will retain its elementary school and possibly a preschool in the coming school year. “(Loss of) enrollment is huge,” said Warman. “Kids have been flocking (from the district) left and right.” In a letter to patrons this spring, Sawyer superintendent Wayne Trottier said enrollment in the district started to decline about six to eight years ago. The financial state of the district had become serious enough that it became necessary to form the cooperative agreement with Max. Two years ago there were enough students attending the high school for the district to keep it open, said Warman. Unfortunately, the district also has lost a number of students in the past two years. Warman took over as school principal during the 20162017 school year. He had previously been a teacher at Sawyer between 2008 and 2012 and then worked in the oil business for awhile before returning to education. He will remain as school principal next year. Warman said the district held community meetings during planning for the coming consolidation and also met with area school boards. They had first approached Velva about the See MERGER — Page 8
Submitted Photo
Fifth- and sixth-graders at Sawyer Elementary work on a Picasso art project on April 11. Sawyer will close its high school in the fall and many of its students will attend Max High School under a cooperative arrangement.
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Minot Public Schools students are
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TECH SAVVY By ANDREA JOHNSON • Staff Writer • ajohnson@minotdailynews.com
Tech director Alicia Eslinger said tech is a useful tool in Minot Public Schools classrooms ABOVE and BELOW: Students at Minot High School-Central Campus use technology to complete school assignments. Submitted Photos
Minot Public Schools students are preparing for a world where they use technology as tools to help them learn and create. Technology director Alicia Eslinger said the school district employs six technology coaches to assist teachers in making use of technology in the classroom, three at the elementary level and three at the high school level. The tech coaches do such things as introduce tools such as Google Apps, which teachers and students use to create video newsletters or video announcements. Students at the elementary will likely also find themselves using other programs like iMovie, a movie-making app, and Do Ink, a way to create green screen images and videos on an iPad or iPhone. The videos are broadcast to the school using a teacher’s Google account. Eslinger said the videos are not made public. “They’re learning all sorts of tools, neat tricks to do with iPads,” said Eslinger. Kids are also likely to use the new tools to deliver a report on a book.
Eslinger said the days of the old book reports are gone; these days kids are apt to make a video acting out the plot of a book or promoting the author. The district has Chromebooks dispersed in classrooms across the district and teachers have been trained in ways to use technology to enhance their teaching. At the high school level, kids can take classes in the science, technology, engineering and mathematics areas that require them to use a 3D printer or software that lets them practice flying a plane. Two additional classes will be offered next year at Minot High SchoolCentral Campus. Sports and activities multi media will cover topics including the use of digital images, videos, creating meaningful documentation, writing for the web and the way people interact with online resources. Current technologies will teach students how to make the best use of different types of social media. Eslinger said teachers at the high school level have also been encouraged to permit students to use their own devices for class lessons. She said students are hopefully using their smartphones in class to do math or science problems like measuring distances or determining how long it will take to reach a destination from a particular point. Since technology changes quickly, there will always be something new for the district to do with it.
“They’re learning all sorts of tools, neat tricks to do with iPads.” —Alicia Eslinger Technology director at Minot Public Schools
Submitted Photo
Jim Hill Middle School students showcased Virtual Reality (VR) Field Trips during the 65th North Dakota Legislative Assembly. Students took a trip to the Legislative session in Bismarck at the State Capital and demonstrated how they use Google Cardboard in the classroom.
surgical care for women
Robotics improve
Saturday, April 22, 2017
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Submitted Photo
By JILL SCHRAMM • Senior Staff Writer • jschramm@minotdailynews.com
There was a time when women undergoing hysterectomies could expect to spend three days in the hospital and be laid up at home for three weeks while healing from a sizable incision. Today’s laproscopic surgery, using the robotic da Vinci system, has reduced the procedure to same-day surgery with only a week or two of down time. “A lot of women just suffered from painful, cramping periods because a hysterectomy was a daunting thing,” said Dr. David Amsbury, obstetriciangynecologist with Trinity Health,
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Minot. The da Vinci procedure changed all that. “It really doesn’t disrupt your life very much. It empowers a lot more women,” Amsbury said. “They didn’t feel like they had really good options before.” Da Vinci is a laproscopic, robotic surgery that offers more dexterity to the surgeon. Unlike a traditional laproscopic device, the da Vinci allows a surgeon to turn tools 360 degrees and move in areas that weren’t accessible in the past. The robot is attached to ports See DA VINCI — Page 8
Dr. David Amsbury stands next to the da Vinci robot surgical machine.
Trinity’s da Vinci provides safer, less invasive option
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Saturday, April 22, 2017
Pediatrician Koyejo Oyerinde and physical therapist Reed Argent pause in an exam room at the CHS St. Alexius Health medical plaza March 29. Jill Schramm/MDN
oncussion Head injuries get ulture needed attention
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C “There’s a lot we still don’t know about concussions. We are better informed than in the past, but we still don’t know a lot about it.”
By JILL SCHRAMM • Senior Staff Writer • jschramm@minotdailynews.com
Physical therapist Reed Argent recalls his high school football team keeping smelling salts on the sidelines just in case a player was hit hard. “They certainly don’t carry these in any sports medicine bag now,” Argent said of the heightened attention to the dangers of concussion in recent years. “Now we are maybe overly safe, but that’s better.” It’s not just youth sports where concussions are being taken seriously. Head injuries and their repercussions have the attention of sports organizations at all levels as well as medical professionals who deal with people who have suffered accidental injuries. Wahpeton native and former North Dakota State University stand-out Ryan Smith recently announced his retirement after three years in the Canadian Football League, citing concerns about hits that add up and the dangers of accumulated head injury. Former Minnesota Twins player Justin Morneau suffered a concussion during a collision at second base in July 2010. The injury was one of a series of head injuries, and while he eventually got back into the game, he’s stated the effects will always be with him. The American academies of medicine, family medicine and sports medicine all have supported new care guidelines for concussions, said Dr. Koyejo Oyerinde,
—Dr. Koyejo Oyerinde, CHI St. Alexius Health
Heart Continued from Page 1
involved, Trinity has not yet implemented this approach to multi-vessel bypass surgery, but Tabe said the goal is to do so within the next two years. Another procedure, called transcatheter aortic valve replacement or TAVR, is predicted to change the
way surgeons operate on aortic valves, which control blood flow from the heart. With TAVR, surgeons run a catheter through the femoral artery from the thigh area. Instead of removing the existing aortic valve, the surgeon threads a crimped valve through the catheter, wedging it into the old valve’s place. Once the crimped valve then expands, it pushes the old valve out of
pediatrician with CHI St. Alexius Health in Minot. “There’s a lot we still don’t know about concussions,” Oyerinde said. “We are better informed than in the past, but we still don’t know a lot about it. That’s why, I think, we play it safe.” Symptoms of concussion can include unconsciousness, dizziness, confusion, blurry vision or headache. The key to recovery is rest to allow the brain to heal, Oyerinde said. Continuing activity can aggravate the injury and extend the recovery time, potentially leading to long-term problems, he said. Every injury that isn’t allowed to completely heal creates damage that accumulates. It’s not just the traumatic head injuries that create risk. Now the medical community knows that even simple, less dramatic encounters create risk, Oyerinde said. Unlike most physical injuries, brain injuries don’t show up on diagnostic screenings. Diagnosis is based on symptoms that may be subjective. Argent, with First Choice Physical Therapy in Minot, said at the professional sports level, testing sometimes is done to determine an athlete’s baseline brain response, which can be matched against responses following a suspected concussion. Typically, though, doctors have to de-
the way and takes over its job. The surgical technique was developed for patients who were high risk and not good surgical candidates, Tabe said. Trials showed TAVR mortality was low and patients did well, he said. A study with patients of intermediate risk had the same good results. Trials now are being conducted on patients of low risk, which
pend on the cooperation of the patient and the patient’s willingness to accept an injury and the requirement to rest, Oyerinde said. Rest is not just about remaining off the court or field but also avoiding intense brain activity, as might occur with video games or other highly stimulating events. How long the recovery lasts is dependent upon the injury. Argent noted the North Dakota High School Activities Association requires coaches to have concussion training every year. Many teams also have trainers who decide whether an injured player is fit to play, avoiding the need for a coach, a parent or the player to make that decision. Memory loss is the most common longterm complication, and it can show up years after accumulated damage, Oyerinde said. Sometimes the challenges of living with the damage can lead to psychological issues, such as depression. “Parents also need to pay attention to the risk of concussion in children. We shouldn’t stop them from playing but we should be alert to when they are showing signs of a concussion,” Oyerinde said. The attitude of winning at any cost, including keeping an injured child in the game, needs to change, he added. “It’s OK to lose this match for the sake of the health of the kids,” he said.
could lead to the surgery becoming generally available to all patients in the United States, as it already is in Europe, he said. “All these things that are on the horizon, that’s the one being looked at the most because that’s going to change again the landscape for surgery. Just as coronary stents changed it for CABG (coronary artery bypass graft), this surgery is chang-
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ing it for aortic valve replacement,” Tabe said. “That’s going to be the big game changer in terms of patient care.” Because of the extensive criteria required to offer TAVR, it may be three to five years before Trinity will be able to implement the changes needed to offer the program, he said. Another innovation is thoracic endovascular aortic/aneurysm repair or TEVAR. The operation also uses a thigh or pelvic catheter. The surgeon delivers an expandable stent graft through the catheter to an area of aneurysm within the artery. An aneurysm is an abnormal ballooning of an artery caused by weakening of the artery wall. The stent graft provides a substitute avenue for blood flow through the artery, protecting the aneurysm from pressure that can lead to damage. Trinity is using TEVAR to treat certain types of aneurysms. Tabe said researchers also are looking into minimally invasive methods for offering mitral valve replacement, making additional advances in surgical procedures likely in the not so distant future. In addition, small improvements,
such as a new device that ties and secure sutures, hold potential to simplify surgical tasks and shorten operation times. The end result is patients who bounce back from surgeries more quickly. Traditional surgery that opens the chest commits a patient to six to eight weeks of reduced activity with no heavy lifting. Minimally invasive surgeries get them back on their feet faster. “Looking at patients afterwards, it’s night and day. They are sitting up, drinking two hours after the operation,” Tabe said. He compared that recovery with traditional surgical patients who may still be on ventilators two hours after surgery and not eating until the next day. “Patients can go back to work sooner. They can go back to their normal lifestyles,” he said. The advances occurring in cardiothoracic surgery show that minimally invasive operations aren’t limited to general surgery, where those new procedures have seen rapid adoption, but can apply to all areas of medicine, Tabe said. “We are realizing we can do it. You just have to have the training,” he said.
Saturday, April 22, 2017
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MSU NURSING PROGRAM continues tradition of skilled care One of the big things we teach and want soon-to-be nurses to know is we are the advocates for that patient. We are the ones who are going to watch out for them. – Mary Smith assistant professor of nursing at Minot State University
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A group of nursing students at Minot State University gather in a classroom to review course material between classes April 10. Jill Schramm/MDN
By JILL SCHRAMM • Senior Staff Writer • jschramm@minotdailynews.com
Simulation labs and phone apps give nursing students new ways to acquire knowledge, but decades of technological advances haven’t changed the core values that motivate students to pursue nursing careers. Linda Pettersen calls it the passion and compassion element, and she has continually seen it in students during her 40 years as an instructor at Minot State University. “The reason they want to go into nursing is they want to help and be able to do good for others. I feel good about that – that they are coming in with some of those values,” said Pettersen, an assistant professor. “One of the big things we teach and want soon-to-be nurses to know is we are the advocates for that patient. We are the ones who are going to watch out for them,” said Mary Smith, also a long-time assistant professor of nursing at MSU. “We look out for that whole person, that whole community. That’s a pretty awesome job when you think about that.” MSU is preparing to graduate another 19 students through its pre-licensing program in May and has a number of associate-degreed registered nurses completing bachelor’s degrees through campus or online courses. Last May, MSU graduated about 45 nursing students in total.
Other community programs exist that educate certified nursing assistants, licensed practical nurses and associate-degreed registered nurses. MSU provides the four-year option for registered nurses with two-year degrees who wish to advance their careers. Linda Schaefer, an assistant professor and long-time educator at MSU, said the transition process toward a bachelor’s degree is smoother than it once was. Students also used to have to travel to Minot or staff traveled to Williston and Rugby to offer classes to registered nurses looking to get their bachelor’s degrees. Education later was offered over an interactive video network before going online in more recent years. “So they can live and work and stay where they are. Some never see Minot,” Schaefer said. MSU’s nursing program was developed through the collaborative efforts of the North Dakota Joint Committee on Nursing Needs, the sisters of St. Francis School of Nursing, area state legislators and university administrators. The 1969 Legislature approved a resolution supporting the establishment of a bachelor’s degree program. Sister Mabel Meng, the first director,
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da Vinci Continued from Page 3
inserted through small abdominal incisions, and the surgeon sits in a separate area, operating the da Vinci with two joysticks and a console. “I don’t even have to be scrubbed in any more,” Amsbury said. “It’s kind of like playing a video game. It’s a lot of eye-hand coordination.” It’s the improved outcomes for patients that impress him, though. Da Vinci dramatically reduces blood loss during surgery. Post-surgical pain is greatly reduced, with some women needing nothing more than extrastrength ibuprofen, Amsbury said. “I see women back to taking care of their kids, running their homes, back to their jobs in a week or two with very little disruption, very little pain. It makes me a better surgeon. It gives the patient a better outcome. The da Vinci is not going anywhere. The proof is in what we see
Merger Continued from Page 1
possibility of a district consolidation, but weren’t able to reach an agreement. Max, some 30 miles away, has been very welcoming, said Warman. About nine current Sawyer students plan to attend high school next year in Max. In return, Max will receive foundation aid payments for those students and a $40,000 lump sum payment from the Sawyer district that will cover incidental expenses. Max will also pay for transportation for its students who will be attending classes in Max. Some other current Max students also intend to enroll in Velva, South Prairie or Minot Public Schools, said Warman. There are currently
ell. Live w t a E
The proof is in what we see with patients. It’s safe, and it’s effective and it makes difficult surgery easier. It has been a game changer. – Dr. David Amsbury Trinity Health with patients. It’s safe, and it’s effective and it makes difficult surgery easier. It has been a game changer,” he said. Da Vinci offers a surgical option that didn’t exist previously for severe scar tissue and large fibroids. Da Vinci also is used in a few
other types of surgeries, particularly in urology in prostate or kidney procedures. Hysterectomies aren’t the only options for women with uterine problems, however. Improvements in medical procedures have made
about 16 sixth through 11th graders who will be affected by the closure of the high school. Sawyer is graduating five high school seniors this spring. There are currently 28 children in grades kindergarten through sixth grade at Sawyer. Warman said the district will hold an open house at Max High School sometime this spring to help introduce current Sawyer students to their new school and teachers. One of the hardest things Warman has had to do is to non-renew the contracts of five high school teachers at Max, all of whom will lose their jobs because of the merger. Other details are also being worked out, such as special education services. Fortunately, both Max and Sawyer school districts are
under the umbrella of Souris Valley Special Services. Pat Windish, the superintendent at Max, emphasized that the arrangement between Max and Sawyer will be a cooperative agreement rather than a consolidation. Sawyer will still maintain its district boundaries and ownership of all its land. In order to make a cooperative agreement work between school districts, one district has to be attached to a district with a high school. That is what Sawyer is contemplating. Windish said he won’t know exactly how many students from Sawyer will be attending Max until the first day of school, since parents still have the option of open enrolling students in other area schools. Windish said he sees the
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endometrial ablation, or burning of the inner lining of the uterus, a viable option for women suffering from heavy or irregular bleeding. It involves no incision, and provides an effective, temporary fix. Amsbury said use of the procedure has significantly
increased in the past 10 years. Another more commonly used option is uterine artery embolization, in which blood supply is cut off to fibroids so they shrink. Educating the patient about options is an impor-
tant part of finding an individualized solution, Amsbury said. Sometimes women postpone seeking help because they aren’t aware of the options or have misinformation about them, he said. For instance, a woman can be assured her hormonal balance won’t be affected by a hysterectomy, in which only the uterus is removed. Hormones are affected only if ovaries are also removed. While technology is changing women’s surgical healthcare, increased knowledge about cancer has led to updated screening recommendations for women. One of the biggest changes in the past five years has been the revision in the Pap smear recommendation from every year to every three to five years for low risk women, Amsbury said. Even with the change, the number of abnormalities diagnosed has remained constant, indicating the less frequent Pap smears are effective in identifying women who need more monitoring, he said.
There are currently about 16 sixth through 11th graders who will be affected by the closure of the high school. Sawyer is graduating five high school seniors this spring. There are currently 28 children in grades kindergarten through sixth grade new g e n e r a t ion at Sawyer. growing up being the arrangement as “small rural school districts working together.” He understands Sawyer residents’ desire to maintain their school and their identity. “A school is a focal point of your small town,” said Windish. This arrangement will also mean that elementary students in Sawyer won’t have to be bused 25 or 30 miles away to a neighboring town to attend school. While elementary schools sometimes close after a high school closes, that isn’t always the case. Windish said his own hometown school district of Tower City in the eastern part of the state kept an elementary open for about 20 years after its high school closed. Consolidation was a positive event for another school district that merged some 16 years ago, said TGU-Granville principal Tonya Hunskor. Hunskor said the combined school system has been able to offer more educational opportunities to
its students and more efficiently share staff and resources. When the districts first chose to consolidate, Towner and Granville each maintained their own K-12 schools. Upham initially had a K-6 elementary, then reduced that to a K-3 elementary, and finally chose to close altogether about three years ago. But Upham’s past is still maintained in the name of the district, even though students attend either Towner or Granville schools. The district shares one sports team. The district buses kids to sports practices and other school district activities. Towner and Granville are 22 miles apart. During the consolidation process, the schools chose a new school mascot and new school colors as well as adopted a new school handbook. A successful merger requires involvement from the surrounding community, the parents and students, said Hunskor. “Now we have a whole
TGU Titans, not being the Eagles or Orioles or Cardinals,” said Hunskor. Other districts in the reading area have also merged over the past decades. Among them are Lewis and Clark, which merged North Shore and Berthold school districts, and the Mohall-LansfordSherwood school district, which merged in 2005. South Prairie and Nedrose, both rural Minot school districts that built their own high schools in the past two years, are an exception to the trend. Both schools had previously paid tuition to send their high school students to schools in surrounding towns such as Minot or Sawyer. Two other rural Minot school districts – Eureka and Bell School – changed in different ways. Eureka School District was dissolved and its students are now attending mainly Minot schools. Bell School remains open but is now one of Minot’s several elementary schools. Middle school and high school students from the former Bell District now attend classes in Minot.
Saturday, April 22, 2017
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Healthcare & Education
New Town moving forward Schools in New Town are moving forward By ANDREA JOHNSON • Staff Writer • ajohnson@minotdailynews.com NEW TOWN – New Town Public Schools are also a major landlord in the city, out of necessity, said Superintendent Marc Bluestone. “We didn’t have any housing in our community,” said Bluestone. The district now owns 48 rental units between apartments and houses. Forty-seven out of the 48 rentals are occupied by school district employees. The 48th resident is a long-term tenant who has always been a good renter. Bluestone said the district made it clear that their housing would go to school employees, but also said they would not force anyone to leave who had been living in the rentals before the school district bought them up. Another company that did force longterm tenants to leave housing in New Town caused a lot of hard feelings in the community, said Bluestone. Without the subsidized housing, it would have been difficult or impossible to attract teachers to the community, since most would not have been able to afford to live there at rents that could go as high or higher than $1,000 per month. “That has helped us immensely in getting teachers to stay and attracting other teachers to the district,” said Bluestone. Housing shortages have probably curbed some of the growth in New Town over the past few years. Families coming to the area with the oil boom might have been more likely to relocate to other communities like Stanley that had housing available. “We’re kind of landlocked in some respects about getting housing built,” said Bluestone. Housing for sale might include older houses, but younger buyers aren’t necessarily interested in purchasing older homes. Bluestone said when other housing is eventually built, he anticipates that New Town could see an additional 35 to 40 students added to the district. The oil boom already stopped what had been a slow decline in numbers. Business manager Dan Uran, who is also the mayor of New Town, said a couple of decades ago the enrollment had dropped to about 625 students Now it is up to 925 students. The district has added on to the school in recent years too. In 1997, the district added the first part of its middle school. In the past five years, the district has also built a new high school, a new gymnasium, a new career and technical education center and have added on to the elementary school. Some of
the funding for the projects came from roySubmitted Photos alty money, said Bluestone. ABOVE LEFT and ABOVE RIGHT:The New Town School District has An addition to the new gym is being planned and Bluestone said another addition added a new high school and a new career and technical center in recent at the elementary might become necessary, years. though the district will have to build carefully due to lack of available land.
That [subsidized housing] has helped us immensely in getting teachers to stay and attracting other teachers to the district.
– Marc Bluestone
New Town Public Schools Superintendent “We’re one or two classrooms away from having no room down at the elementary school,” said Bluestone. Students at the district also have a number of educational opportunities, including dual credit classes that enable them to earn college credit, and classes in the Hidatsa language that are offered. Kids can also take classes in tribal culture and tribal government. While some of the students in the district deal with problems caused by generational poverty, Bluestone said the district also has a number of services available to help students graduate on time. There is an onsite daycare center where students who are parents can leave their babies during the school day. There is no cost for the daycare for students who are parents. Teachers and staff members can also leave their kids at the daycare at a subsidized rate. There is an alternative school program and regular tutoring or classes offered on Saturday to help students make up missing work. Parents are texted or emailed if their children have missed an assignment. A social worker is available at each building and there is also a graduation coach at the high school level. Bluestone said the board has been generous in supporting programs and there are more teachers employed by the district than one might expect for a town the size of New Town. The average starting salary for a beginning teacher has increased to $42,500, going from 49th in the state to eighth in the last several years. Bluestone said teachers have also benefited from the success of the school district financially. Bluestone said the goal of the district is to help students to become successful and to graduate from high school.
New Town students at work in a class in April.
Cro by
Submitted Photo
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Healthcare & Education
Nursing Continued from Page 8
shared an office in the Science Building (Cyril Moore Hall) with refrigerators, tables, another faculty member and a secretary, according to a departmental history. She told stories about an escaped snake from a science laboratory located under her desk and about an office move to a “broom closet” that was the passage way to the photo lab. Contrast that with today’s modern nursing department, located in Memorial Hall in 1996 after construction of the new building brought human service departments under one roof. A second clinical nursing lab opened in 2011, allowing for expansion of the nursing program. For the past several years, MSU has offered a laboratory with simulated “patients” capable of presenting with a variety of conditions. The lab provides a realistic, safe learning environment where students can test their critical thinking skills and faculty can measure student knowledge to better determine where to focus further teaching efforts. Students need to know about electronic health records, intravenous pumps and all sorts of technological advances in medicine. MSU depends on its clinical partners to assist in educating students on new technologies. Technology changes are so extensive and rapid that MSU can’t keep up with everything, making the opportunities
that exist with the clinical sites that much more valuable, Schaefer said. Still, technology has changed drastically on campus, too. Pettersen, who graduated with MSU’s first graduating class in 1973, recalled her class donated a tape recorder to the department because the students felt technology was important. In those early years, an overhead projector was a luxury. The first computers didn’t show up until the mid-1990s. Now students carry around more data on their smartphones than students used to find in a backpack of textbooks. “Overall, they are very, very techsavvy and they are very open to and expect to see all those kinds of things within the program as well, because they see it out in the work world. So we have to be in tune,” Smith said. Due to the explosion of information, faculty members have taken on larger roles as facilitators rather than presenters of information. Courses are more interactive and participatory, Smith said. Much of the content remains the same, even though some of the tools have changed and the white dresses and hose are gone. Black pants and tops are the new look for students, who are faced with a curriculum that’s increased in its rigor. Pettersen credits visionary staff in the department’s early years for establishing a lasting program that creates student connections on community, national and international levels. Over the years, students gained clinical experience at the John Moses Air Force Hospital,
Minot Air Force Base hospital, St. Joseph’s Hospital and Trinity Hospital. Of those, only Trinity remains, and the MSU nursing college continues to work closely with Trinity and the area’s rural hospitals. Connections made through a nursing student from Peru led to a nursing exchange program in that country. Later exchanges occurred with Tanzania and Mexico. Three faculty more recently visited Haiti and are planning another trip with students. “We need to learn about all of our different cultures and how to be sensitive to cultural needs and also look into those kinds of opportunities to go other places for those types of experiences,” Smith said. In the past, those opportunities have been as close as American Indian reservations and an immigrants’ clinic in Fargo. Smith said the nursing program has received strong community support in Minot, and in return, students give back through service projects conducted by their student nursing organization. Going forward, Smith said, the goal is to enhance and strengthen the program as it works in tandem with a national goal to have 80 percent of registered nurses with bachelor’s degrees by 2020. “I know we want to be able to continue to not just maintain but grow and stay ahead of the curve with technology,” Smith said. “We always want to continue to work on how we can grow our numbers as best we can and still produce that best quality nurse.”
HISTORY OF THE DEPARTMENT OF NURSING
1969 – North Dakota Legislature authorizes the establishment of a bachelor of science degree in nursing program at Minot State College. Private dollars funded the first 18 months for the director, and applicants to the Sisters of St. Francis School of Nursing program were referred to MS. 1972 – ND State Board of Nursing approval received. 1973 – First class graduates 17 students. 1976 – Nursing program moved to west wing of Hartnett Hall. 1979 – Three-year grant received that provided funding for curriculum changes needed for accreditation. 1981 – Title changed to Division of Nursing and Health Management Science; accredited by National League for Nursing. 1984 – Designated as School of Nursing and Health Management Sciences. 1987 – Designated as College of Nursing. 1994 – Research and Professional Activity Forum held, which was impetus leading to the development of the Mabel Meng Honor Society in Nursing. 1996 – College moved to Memorial Hall as part of the Institute for Rural Human Services. 1998 – Omicron Tau chapter, Sigma Theta Tau, International, chartering ceremony at Minot State University. 2007 – Bachelor of Science in Nursing completion online program started. 2008 – Implementation of Adult Health maintenance Clinic at Henry Towers. 2009 – Incorporation of High Fidelity Simulation into Learning Resource Center. 2011 – Clinic Nursing Lab II opens. 2012 – EMS Arcadia system for Simulation installed; electronic health records incorporated into curriculum. 2014 – Accreditation Commission for Education in Nursing, formerly National League for Nursing Accrediting Commission, grants continuing accreditation. 2016 – North Dakota Board of Nursing grants full approval of the MSU baccalaureate degree nursing education program until March 2021.
Saturday, April 22, 2017
Parshall students benefit from out-of-state teachers
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By ANDREA JOHNSON
Staff Writer • ajohnson@minotdailynews.com
PARSHALL – Parshall High School principal Mark Grueneich said the faces in his school building have changed quite a bit since he first came there some 28 years ago. “When I first came here, almost the entire staff was from North Dakota,” said “Everybody Grueneich. lived in town or not far out of town. Very rarely, we had people who drove here to work.” In the past few years, it has been harder for the district to attract locals to teach in Parshall. “We have more out-ofstate people than we do instate,” said Grueneich. “We’ve had to go national to attract (people.)” Teachers in the district come from states as far away as Georgia, New York, Florida and Alabama. “They make up the bulk of our staff,” said Grueneich. “It makes for an interesting dynamic in school.” The increase in teachers from other states has not carried over to the student population, said Grueneich. Most kids in Parshall have grown up in North Dakota. But the students have benefited from the diversity of experiences their teachers have had. Kids are able to ask their teachers, “How do they do things where you used to live?” and find out about differences in cultures in other states. “It makes it interesting for the staff to mingle with each other,” said Grueneich. He said many of the new transplants are also quite young. “Eighty percent of our out-of-state applicants are younger teachers,” said Grueneich. Most who apply have told him they had difficulty finding jobs in their home states. The younger teachers are the ones who
are more comfortable with moving across the country to take a job in a small town like Parshall. The oil boom did affect Parshall, but not in terms of the student numbers. Grueneich said there has been a lot of construction in the Parshall area, but most of the men who came to North Dakota to work in the oil business either did not have families or left them behind in other states. The school district had to purchase housing for its faculty and staff to live in because of the high cost of rent in the area during those years. Grueneich said some of their staff also commute longer distances to get to work in Parshall. One drives from Stanley, one drives from Max and one drives from Minot. An hourlong drive in the morning and an hour at night is grueling and it can be difficult to hang on to staff who are in those circumstances. Grueneich said it is particularly challenging if the roads are bad due to a winter storm. Parshall has also changed in other ways since Grueneich came to the district. Students have more opportunities than they once did when it comes to class offerings, said Grueneich. Kids in small towns can take classes over interactive television or earn college credits through Williston State College. Students at the school can also take Hidatsa language classes. The student population has also gone from about 30 percent Native American decades ago to 75 to 80 percent Native American. Grueneich, who is also the biology teacher at the high school, said educators have an opportunity to affect the lives of the students they teach.
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Saturday, April 22, 2017
Minot Daily News PROGRESS
Healthcare & Education
Page 11
Jill Schramm/MDN
Electronic medical records improve patient care in Minot
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By JILL SCHRAMM • Senior Staff Writer • jschramm@minotdailynews.com
One of the biggest innovations in medicine isn’t a new drug or even an advanced medical procedure. Dr. Vishal Chhibber, a family medicine physician with Sanford Health’s Northwest Clinic in Minot, said electronic medical records are making a positive change in the health-care delivery system. EMRs allow primary-care physicians like himself to track a patient’s medical history over time and get an overview of care provided by specialists, Chhibber said. “It’s just easier for physicians to treat patients. I see a lot of pretty chronically ill patients so it’s nice to be able to pull up their cardiology notes, their pulmonary notes,” he said. “You are able to follow the patient a lot better.” Heather Carlson, clinical operations director at Sanford’s Northwest Clinic in Minot, said electronic medical records benefit patients as well. EMRs allow patients to access their records or test results and communicate with the nursing staff if they have questions about their care or about symptoms they are having. A patient who communicates through the records system can get a response as quickly as with a phone call, and for some patients, it is a more convenient way of exchanging information, she said.
sionals associated with a patient’s care, there is an expectation that information will be promptly updated with every patient visit. Sanford’s system makes it easy to add information through typing or dictation – whether using a transcriptionist or electronic software that converts voice to text. Privacy issues, which might have created some hesitation when electronic medical records were introduced, haven’t risen to any level of concern. Carlson said the systems contain various safeguards to ensure legitimate access and all mouse clicks and keystrokes are tracked. Communication of records from one hospital system to another also can be seamless, and records from pharmacies or immunizations can be connected. “It’s almost like 360 degrees in terms of health care,” Chhibber said of the connectivity. “Not only is it connecting one hospital system, but it’s connecting different big hospital systems and different EMRs together.” Sanford uses a major software system called Epic, which is used by many other medical providers. Chhibber foresees improvements occurring that allow
tty lot of pre a e e s I eir ients. treat paatble to pull up th o t s n ia hysic ’s nice to be alth sier for p a e t s ts so it onary notes.” n fo r d H e ju n a S ie t t a a “It’s p n l lly il pulm sicia chronicagy notes, their icine phy d e m y il lo m cardio b e r , fa hal Chhib is V . r D — better communication be-
Chhibber added it gives patients more autonomy in their health care. “It’s amazing. I wouldn’t want to go any other way. You can really learn a lot about a patient just going through their EMR rather than having all these charts,” he said. He added it reduces potential problems because the medical information is so available. Things don’t get overlooked as they might in depending on patients to recall details of their medical history. EMRs offer ease of use through an interface that lets physicians find and access information quickly. Again, it avoids the need to page through a collection of paper records. “EMRs hold physicians to a little higher standard,” Chhibber said. Because the records are accessible to all medical profes-
Staff are on duty at Sanford’s Northwest Clinic in Minot March 15. Jill Schramm/MDN
tween medical systems, even across different software platforms, because of the importance of EMRs in health care. EMRs are just one way technology is improving health care. Another is the use of telemedicine. Sanford brings a number of its Bismarck specialists to Minot on a regular basis, but telemedicine has proved to be an efficient and effective way to augment those visits. Genetic counseling and psychiatry have been major users of telemedicine. Patients seeking follow-up care after surgery or procedures in Bismarck also can take advantage of telemedicine. Sanford is working to increase medical access so people can receive care in their community, Carlson said. Whether through visiting specialists or telemedicine, Sanford’s goal is to provide care locally, she said.
Dr. Vishal Chhibber of Sanford Health logs in March 15 to the Epic software system that serves as Sanford’s electronic medical records system.
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Minot Daily News PROGRESS
Healthcare & Education
Saturday, April 22, 2017