Amanda Wilde (Host): Welcome to Neighbors Helping Neighbors, the official podcast of Ward Memorial Hospital. Thanks so much for joining us. We're talking about checkups, shots, and small town care for kids with Family Nurse Practitioner, Krista Powell. I'm your host, Amanda Wilde. And Krista, so glad to be having this conversation with you today. Thank you so much for being here.

Krista Powell, APRN: Well, thank you for inviting me. I'm honored to be on your podcast today.

Host: You spent some of your childhood here in Monahans, so you know what it's like to grow up in a rural community. Why is it so valuable for kids to have access to care right here in a rural community like Monahans?

Krista Powell, APRN: You know, a lot of it is exactly that-- access. That accessibility to the bigger cities is limited. And travel can take 30 minutes to an hour, depending on the closest town you're trying to get to. We are very much out here on our own. And it's important that children have a place that their parents feel comfortable to take them for the care they need and the quality of care that they need.

Host: And when you say access, do you find that having a hospital there in the community means people will come more often for more of the kind of care that you do need to turn to hospital care for?

Krista Powell, APRN: For sure. You know, out here, we're also in the oil field. Having that emergency room is desperately needed and having that hospital that has the rooms that we can put patients in when needed is important for that continuation of care.

Host: Rural hospitals are constantly being challenged. I'm curious what inspired you to work in family medicine and then to gravitate to rural hospitals?

Krista Powell, APRN: Well, family medicine is just that-- the whole family. I see everything from my obstetrics, my OB patients, all the way until death. And so, it's an amazing, rewarding practice to be in because I walk in one room and I have my 93-year-old patient walk into the next room and have a two-week-old baby. It's very rewarding. It never gets boring. But I get to take care of the whole family

Host: As a mom yourself, does your personal experience help shape how you care for families in your practice?

Krista Powell, APRN: For sure. I try to remember being in the place of the mothers when they had little ones and thinking to myself, "How can I help them? How can I educate them for the times that maybe I didn't have that? What was important to me? What was it I needed in guidance with my kids?" And so, I try to put that into practice and I try to treat my patients like they're my loved ones from the parents that are with the children to the children. How would I want somebody to treat my child? Are they listening to me as a parent? All of that is so important and I tried to put myself in the place of the patient.

Host: So, you've sort of just touched on this, is there anything you can add to how you make doctor visits easier for nervous kids or for anxious parents?

Krista Powell, APRN: So, I try to meet the child where they're at. We walk into the exam room, you have the table. And most of the time, we're all trained in this culture; you sit on the table, you sit there and let the provider listen and do their exam. But I try to meet the patient where they're at. And by that, I mean if the child doesn't want to sit on the table and the parent needs to hold the child, I'm okay with that. If we can't go head to toe and we have to start with just a heart, that's okay. Because I want them to be comfortable. Because if a child starts crying, you are not going to get a good exam and they're not going to have a good experience. So, I try, again, starting with, "Hey, let's just look at the otoscope and play with the otoscope," or "Look at the stethoscope and let's touch it and see what it does." To me, that works better than just going at them with a stethoscope or sticking something in their ears.

Host: Right. You don't force the issue. But like you said, meet them where they're at, meaning you adjust what you do.

Krista Powell, APRN: Yes, and that helps the parents be more comfortable as well.

Host: Now, when it comes to vaccines, it's become a hot topic, I think more so in more recent years. What are some of the most common questions or concerns you hear from parents when it comes to vaccines? We know kids don't like shots, but we'll talk about that in a minute.

Krista Powell, APRN: I try to meet the parents where they're at, what are their concerns? A lot of times is, "Will this hurt my baby? Will they have side effects? " And then, of course, there's what they hear on the news, "Is this going to cause autism?" Try to educate. Education is so important to help with their fears and their concerns. I try to empower the patients. And so, if the parents have those concerns and we can discuss them, that builds trust. And when the parents are trusting, the child trusts, and that goes hand in hand with the care of our little ones-- or a guardian.

Host: What advice would you give parents who have a child that's nervous about shots or doctor visits?

Krista Powell, APRN: Talk to your little one. Children need to be prepared. They don't know what to expect. I love the parents that utilize like Doc McStuffins or these cartoons that have the cartoon figure pretending they're a doctor. I love when the parents buy the little play stethoscope and a doll and pretend that they're taking care of them, bring that with you. Bring those special toys or bring whatever comforts that child, but be real and talk to them. "We're going to go see the doctor and this is what they're going to do. They're going to listen to your heart," and prepare them for it. I think that just eases a lot of anxiety in children. And then, just being upfront and personal with them and letting them know that it's all okay. "This may not be a fun visit if we have to give shots, but this is to help you be healthy. This is to help you protect yourself from diseases and things that make you very sick."

Host: Well, that sort of leads to the idea of immunizations being so important. What should parents know about the importance of childhood immunizations and about staying on schedule?

Krista Powell, APRN: I also try to affirm parents that if they're not exactly on the date of getting those shots, we can still work with it. We're not going to talk down to you, we're not going to make you feel bad about that, because life is crazy. But we try to keep you on track with your child's immunizations. But we sure can catch up if we need to.

Amanda, I know you were aware with the news recently about the outbreak of measles in this area. It's very real to our population in this area and the impact it had on these small communities. When we're limited to healthcare, when there's an outbreak like that, it sure catches your attention. So, there was a lot of buzz around Monahans, and fear that we had to walk through with parents of little children. But that should be enough also to empower them to realize, "Hey, this is important that we keep this bubble of immunizations around our children so we don't see these illnesses come back into our population and, unfortunately, lose people that we love."

Host: That is another reason it's so valuable to have access to consistent pediatric care right here in a rural community like Monahans. Lastly, what do you like most about working with kids and families?

Krista Powell, APRN: Kids never fail to make me laugh and smile. It takes me back to, "Hey, enjoy your life." Children are innocent. They love life, they have imagination, and they love when you pay attention to them. It's a good reminder for me to stop in the busyness of life and spend time in the simple things like our children do. Enjoy the butterflies going by or the bubbles that you're blowing. Just enjoy them, the children, where they're at. It can make my day to walk into a room and see a child smiling. It just keeps me going.

Host: Well, Krista, thanks for that, your insights and your practical tips as well.

Krista Powell, APRN: Well, thank you.

Host: That was Family Nurse Practitioner, Krista Powell, at Ward Memorial Hospital. For more information, call 432-943-2057. Stay connected and learn more about upcoming episodes at wardmemorial.com/podcast. We appreciate your support and look forward to bringing you more candid conversations with our local medical experts and leaders. Thanks for being part of Neighbors Helping Neighbors, the official podcast of Ward Memorial Hospital.