My name is Laura Wittmann. I am a board-certified Family Nurse Practitioner and Emergency Nurse Practitioner with 30+ years as an ICU/ER/OR nurse as well as managerial and educator experience. I am currently working in a community health/ER clinic on a remote island in Alaska.
The health clinic I work in is on an island in the Tongass National Forest, approximately 30 miles west of Juneau, Alaska. As one of three providers, we primarily service the different native tribes of Alaska. This island is home to the largest Tlingit population in the world. These people, having been displaced by advancing glaciers 400 years ago, made their way to this area resulting in 900 Alaskan natives living here today. In the health clinic we perform primary and walk-in care Monday through Friday from 8am-5pm and after hours/weekend urgent and emergency care.
While rewarding, practicing remote or frontier medicine has its own unique challenges. One of these challenges being the logistics of administering care. The only way on or off the island is by seaplane, 6-seat Cessna, or ferry. We have minimal medication, x-ray, and lab availability at the clinic. If a patient needs a CT, they must fly or ferry to a facility approximately 75 miles away in Sitka. In an emergency, the patient will either fly to Sitka, Anchorage or sometimes even Seattle. However, our airfield is a daylight only landing field. Any transport at night or in inclement weather requires Coast Guard assistance.
Practitioners working in remote medicine must rely on an accurate history of present illness and physical examination skills because there is no immediate access to diagnostics. We have a few point-of-care labs available to us, such as urinalysis, pregnancy, blood sugar, flu, strep, Covid-19, etc. And while we do have x-ray capability, x-rays are only done by scheduled appointment. The skills learned through EKU’s Rural FNP program have given me a solid foundation to accurately diagnose and treat patients, order appropriate referrals, and perform follow-up all without the benefit of advanced diagnostics.
The focus of EKU’s program on the healthcare accessibility challenges faced by residents in rural/remote areas prepared me to provide the type of care not usually done in urban or suburban clinics where ancillary services are readily available. We consult with specialists via telehealth or consulting services to ensure best practice. The rural focus also helped prepare me for the cultural attitudes towards healthcare. Many of the Alaskan natives still rely on traditional medicine such as salves and often come to the clinic only when the condition has worsened significantly.
WHY EKU? Eastern Kentucky University and the online Rural FNP program was a perfect fit for me as a travel nurse. I really wanted an online program that was cost-effective, would allow me to perform clinicals where I worked and didn’t require campus visits. After researching various programs, I came across Eastern Kentucky University and the online Rural FNP program. From start to finish there was readily accessible support. From registration through to graduation I always had guidance and felt part of the program.
The rewards of working frontier/remote medicine are priceless. I am so glad to have gotten my Rural FNP at EKU!
By: Laura Wittmann, Family Nurse Practitioner Graduate
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