• How did it go? What have you learned? What can you improve? How do you plan to improve these new skills?

Urgent care ended up being one of my favorite rotations. I was afraid that the repetitive viral URI cases coming in during this winter season would inhibit me from enjoying this rotation; however, I liked the autonomy that the PAs had while also being able to lean on their PA colleagues working with them or the doctor who was only a phone call away. With that said, I was also trusted to perform a great portion of the patient encounter, which I greatly appreciated. Something I learned about myself during this 5-week rotation was that I would love to would in urgent care after graduation. Regarding areas of improvement, I know that I should improve my knowledge on some of the more common urgent care things. For example, I should improve my knowledge with suturing; I know how to suture but I need to study when to remove them, which suture material/size to use, and how to care for the wounds after repair. I also need to read more about common viruses, their incubation periods, and how long someone is contagious for. I would also like to know more on vaccine schedules – such as COVID vaccines and boosters. I plan to improve by studying and incorporating these topics into my studying for the PANCE. I will also check the CDC website for updates on vaccine recommendations for COVID, and USPSTF for other vaccines.

 

• Exposure to new techniques or treatment strategies – how did that go?

This rotation really reinforced the concept that each provider has their own way of performing certain tasks. I learned new techniques for many procedures such as digital block, I&D for paronychia, and splinting. I had the pleasure of performing incision and drainage procedures for several paronychia cases in urgent care, and each time I was instructed to do it a different way because I was with a different provider. Now, I have learned which technique I prefer.

 

• What one thing would you want the preceptor or other colleagues to notice about your work in this rotation?

I am a team player. On busy days when the medical assistants were backed up, I would triage patients by taking their vitals, performing routine COVID/flu tests, and documenting everything. I did lots of charting, and I did not mind doing so because it was good practice for me, and I knew it would help the providers later on while closing charts. I really made efforts to contribute as much as I could to help move things along and take the workload off others.

 

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

The patients that I found slightly challenging were the ones that would completely refuse the providers’ recommendations. For example, if the PA and I believed that the patient should go to the emergency department for further evaluation and treatment, sometimes patients would not adhere to this despite lengthy discussion and education. They would then sign out AMA. Of course, I understand that patients have the right in these situations to do as they please. Obviously, they cannot be forced to go to the ED. Another similar group of patients that would not consider the providers’ recommendations were those who would demand antibiotics when deemed unnecessary. Overall, I only found these patients “challenging” because I was concerned for their wellbeing and wanted them to have the best outcome. However, what I learned about these interactions is that all you can do as the provider is try your best. You should try your best to educate the patient about why you are giving your recommendations, explain everything, and give your suggestions based on your medical knowledge. As providers, that is simply what our job is.