Types of patients you found challenging in this rotation and what you learned about dealing with them

I found the most challenging in this rotation is that hard to have productive encounters when patients exhibit the angry, defensive, frightened or resistant patients. When I see these signs, try to uncover the source of difficulty for the patient and pay attention to the way his or her emotions relate to the medical issues at hand. For example, a patient who is in pain and has been waiting for an hour might be quite angry when I finally get to the room. So simply taking a deep breath and offering a sincere apology would be a more constructive response. A statement such as, “I can understand why you are upset, and I appreciate your waiting for me,” would go a long way toward easing the patient’s frustration. In addition, if I sense that a patient is fearful about a diagnosis or treatment, encourage the patient to talk about it, and assess whether the fear is appropriate in proportion to the situation. This may help to establish a context for the fear, allowing the patient to deal with it more constructively.

How could the knowledge I’ve gained here be applicable in other rotations/disciplines?

During 4 weeks rotation of urgent care, the most important thing I learned is to identify how serious the patient’s presentation is and how soon to get medical care. For example, patients need to go to emergency room right away, or patients need to follow up with their primary care doctors, or patients’ problems can be solved over urgent care. It is important to think about the right place to go, not only for patient’s presentations, also for the work up which the ER can provide. We usually screen the patient first and then decide what to do next. For example, a 68 years old patient presents with chest pain and SOB, after we did EKG, even the result showing regular rate and rhythm, we still suggested patient go to ER for the further work up.

How your perspective may have changed as a result of this rotation (e.g. elderly patients, kids, IV drug users, etc).

My perspective has changed for open wound patients as a result of this rotation. Since I did not have my surgery or emergency medicine rotations yet, prior to this rotation, I did not have much experience with giving injections, suturing, or with wound care. Suturing and wound care in particular was more challenging at first because patients sustain wounds differently and based on the presentation, we would have to consider gluing versus stitches, where to put the stitches so that the wound heals and looks the best, and what type of splint to give for the patient. I also enjoyed the high volume of patients per shift. My experience in this rotation only solidified my preference of working in fast paced environments with little to no downtime.

What do you want to improve on for the following rotations? What is your action plan to accomplish that?

For the following rotations, I would like to complete more procedures listed in the procedure log. In urgent care, I do not have a chance to complete procedures such as dressing changes, stable removers, and I&D. For my next rotation in surgery, I will be proactive in learning and observing these procedures. I will be asking for the opportunity to learn and perform these procedures. I would also like to practice doing more pelvic exams in the future rotations.