Author Archives: Joshua Lager

When the Coronavirus hit North Dakota, schools closed, and businesses closed or altered their business model. Daycares were impacted and many in Stanley chose to close. This created a challenge for staff at Mountrail County Medical Center. A cooperative effort between Ragamuffins Ranch Daycare and the Mountrail County Health Foundation worked to fill that need over the last two months.

MCMC Administrator Steph Everett says that the process started on March 23. She began receiving texts from staff expressing their concerns about what they would do as they faced closing schools and daycares. She said that she reached out to Carol Maurer at Ragamuffins Ranch who opened their arms to the staff’s children.

Everett says that each request was met with a “we’ll figure it out” response that was amazing. As they began the conversations, Everett says they had no idea how many staff members would need daycare. Based on the texts from staff, she knew it would be more than just a few.

As they received the guidelines from the state regarding daycares, working together the daycare was ready to start taking students by the weekend of March 27. Working hand in hand, they were ready for the first children on March 30.

Ragamuffins Ranch Daycare owner Carol Maurer says that working on the Bright and Early curriculum and achieving the Step 3 designation made the process easy. The assessments and training she says that by the blessing of God helped them be prepared to take on the challenges.

She says they were already set up to the new standards and guidelines set up by the state for childcare facilities in response to the Coronavirus. That includes the way they use spaces in the daycare, their sanitizing processes and the separations for age groups they already had in place.

They already were separated to eat in smaller groups and play in smaller groups and different areas. The babies, toddlers and older children already interact in their own groups on a regular basis.

Maurer says that the biggest challenge was to bring in children that didn’t know them or their environment. She says they wanted to make sure that each child felt safe and comfortable during this stressful situation. They wanted them to feel at home and happy, knowing this was a safe place to be.

The children coming into the daycare have moms and dads that work on the frontline during this virus fight. Life can be stressful, and children often pick up on that stress.

The staff put their heads together, even knowing it might not be easy, but knew they could do it and come out for the better. Maurer says they really stepped up to the plate and did a great job.

As they got ready to add new children to their groups, Ragamuffins reached out to their parents. For some, they were already planning on keeping their children home with schools and businesses closing or reducing staff. Others offered to keep theirs home to make room, saying that it was important to take care of first responders’ families. She says she gives credit to those families for giving the okay to use their spots.

With some of their kids not coming because of the virus, Maurer said they missed their kids. It was hard emotionally on everyone, but at the end of the day they came back and grew a whole new family with these new children.

As for helping out staff at the medical center, Maurer says that they knew the needed the help and they were ready to do it. It was amazing to watch, she says, and now as the two months come to a close, they will be missing these children that will be going back to their former providers.

Looking back now, Maurer says that everything was a learning curve with stepping stones at the right time with the right help to set up this difference to succeed. She said, “I do it this way and it works. Sometimes you pray and ask God to show you the way. My heart is put into this and we have invested so much of ourselves.”

Everett says that for the two months Ragamuffin met their needs, they were a lifesaver. Eight families with eleven children were helped during this time. Mountrail County Health Foundation, along with grant funds from the NWND Community Foundation helped cover some of the costs.

While many families will be returning to their previous providers this week as daycares resume operations, a few will be staying at Ragamuffins Ranch enjoying the new relationships they have formed.

Steph Everett says that they just knew at the beginning they had to do something to help their staff. All of this was so new to medical facilities. They had heard about the first stories with coronavirus coming from a nursing home in Washington. The focus became on what if it happened here.

“For medical staff, there is no choice but to be at work. The last thing we wanted was for staff to have to make a hard choice. We needed them here, for Health Centers never shut down. Some of our Staff made shifts from their clinic positions to helping at the nursing home, for they were needed there to ensure our nursing home residents were cared for,” said Everett.  “The partnership with Raggamuffin Ranch allowed us to take one huge stressor off our staff. Especially through this, maneuvering through unchartered territories over the last few month,” Everett said.

The two month partnership between the medical center and Ragamuffin Ranch is just another example of small towns pulling together to help each other through these challenging times. It is also an example of meeting critical needs through collaborative effort.

This article is republished by the gracious consent of the Mountrail County Promoter.

May 4th, 2020

As we all work together to reopen “North Dakota Smart”, we here at the Mountrail County Medical Center want to let the public know how we will be reintroducing our services starting the week of May 4th. Due to the encouragement of Governor Burgum, we as a facility did mass testing of our county, our employees and our residents the week of April 20th. Over 450 tests were completed in 48 hours, with only one new positive emerging from this testing. With these results, we feel confident to slowly reopen our clinic, our outpatient services and bringing our specialists back to Stanley.

Details

Inpatient Services: The providers in the clinic will slowly start working at seeing their normal patient load the week of May 4th. Telemedicine will still be utilized, when seen fit. Respiratory issues and COVID-19 symptoms will still be seen through the ER, along with traditional ER patients. We are doing all COVID testing through the ER also.

Outpatient Services: We will start providing mammograms the week of May 4th. Christine and Nile will be rejoining the physical therapy team, with Heidi. MRI’s will begin to be scheduled again starting May 11th.

Specialists: Dr. Joshi and Dr. Amsbury will start seeing patients again on May 14th. Dr. Williams will start again the following Wednesday, May 20th.

Checking in Process: This will look a bit different for everyone. All patients will still be screened per the CDC COVID-19 guidelines. All clinic patients, outpatients and specialists’ patients will check in through the clinic. When you arrive please call 701-628-2505 and you will be given instructions on how to get registered. Please sit in your vehicle until your appointment time, so we can maintain social distancing. Special arrangements will be made if this is not possible for the patient. We also will require each patient to wear a mask, so please bring one to your appointment.

COVID—19 Screening and Cleaning Process: All technicians, specialists and their staff will follow the same screening protocol the rest of the Mountrail County Health Center staff follow. They will come in door 11 and get their temperature, change into MCHC scrubs and go through the basement to get to the clinic, avoiding the Mountrail Bethel Home. Our cleaning process in the clinic will be expanded and door knobs, desk areas, seating areas and clinic rooms will be sanitized between patients. For any questions, please call the Rural Health Clinic at 701-628-2505

Mountrail County Medical Center is now offering virtual visits through telemedicine. 

For non-urgent visits such as medication refills, routine follow-up appointments, etc., they are encouraging all patients to consider the telemedicine visits.

Tammie Braaflat, FNP says that from a Primary Care Provider perspective they are able to still offer the same level of care, without requiring unnecessary travel during the pandemic. Patient’s routine healthcare needs have not stopped due to COVID-19 and medical conditions like diabetes, high blood pressure, asthma and depression can all be managed through telemedicine. Feedback from the patient perspective has been overwhelmingly positive as most patients needing routine care are also being very cautious with leaving their homes during the COVID-19 pandemic.

Telemedicine is not new, especially in rural areas. Mental health, psychologists and counseling professionals have used this method for quite some time, and most specialty visits through the VA Health System are done by Telehealth.

Braaflat says it is easy for a patient to switch their currently scheduled appointment to telemedicine. They would just need to call the receptionist at the Clinic at the Mountrail County Medical Center and ask them to make the switch.

Patients can also schedule new appointments the same way. Patients that are unsure if they need an appointment can call the clinic. If the receptionist is unsure, they will transfer you to a nurse for more information.

There are many ways to use the technology at the clinic beyond the telemedicine. Patients can email their provider through the patient portal. That allows them to directly message their provider with simple questions like whether they need an appointment. The receptionist should be able to help you set up the patient portal if you have not already done so.

Telemedicine appointments are very easy to navigate with a computer, tablet or smartphone. It uses video and audio allowing patients and their provider can to see each other. Patients without access to a smartphone, computer, tablet etc. can visit with their provider over the phone.

The clinic has been working to set up schedules for all providers as they face the potential challenges with COVID-19. There is a designated provider on-call 24/7 to manage acute emergent and non-emergent patient concerns.  Patients with acute healthcare concerns are urged to contact the clinic directly during normal business hours to speak with a nurse to arrange for the most appropriate visit.

Currently most of our acute visits are being managed through the Emergency Department by the Emergency Provider on-call. Any patient with fever, cough, or any other respiratory symptoms are being treated and screened separately in specially designated area of the hospital. 

A different provider is on staff in the clinic for non-acute/non-urgent clinic services and taking care of the residents in the Bethel Home. Braaflat said she had been working in the clinic for the past two weeks, which has also lowered her exposure risk to potential COVID-19 patients.

This helps to ensure they are taking the best care possible for all patients, and especially those in the nursing home. Braaflat says that a lot of planning has been going on to ensure the care provided within the hospital, clinic, and Bethel Home is done in the safest manner taking into consideration the fragile nature of the nursing home population.

Braaflat says that for the last two weeks most of her clinic visits have been telehealth visits. Anyone that has called has been encouraged to schedule their visits through telehealth if possible. She says that they

have been handling a wide range of visits this way, including those health conditions like diabetes, etc., as well as rashes, prescription refills and more. If during the visit they determine a patient needs to have lab work, or radiology they are ordering the appropriate tests at which time the patient would have to come to the hospital.

With the MCHC campus doors locked, Braaflat says patients might drive by and see an empty parking lot. This is because of the telehealth. A lot of time and energy has gone into planning how to best take care of the community, patients and residents. They are still there wanting to provide the services patients need, especially during this stressful time when more people are facing uncertainty with employment, anxiety and depression. She says it is important that patients can still access their primary care.

Braaflat also says that Medicare and many insurance companies have removed many of the restrictions on telehealth visits, meaning they can bill insurance just like a regular clinic visit.

Connecting to your provider for a telemedicine appointment is very easy. You go to the Mountrail County Health Center webpage at stanleyhealth.org. On the home page there are links to connect to each of the providers. You check in within a few minutes of your appointment time and are connected.

Virtual physical therapy visits are also possible for patients for follow up appointments. The initial appointment would be conducted face-to-face, but follow up appointments may be done virtually.

This article has been republished with the gracious consent of the Mountrail County Promoter.