For my eighth rotation, I was at Gouverneur Skilled Nursing Facility for Long Term Care. I wasn’t necessarily sure what to expect going into this rotation and was pleasantly surprised at the outcome. I was fortunate enough to work with Dr. Kolessa, who shared his wisdom with me while giving me the opportunity to meet a completely different patient than I’d experienced thus far in my rotations.
I interviewed a patient and his family during my first week and was able to build a close bond with them. Every day when I arrived I saw the patient’s son who asked me to come in and say hi to his dad because my conversation meant so much to them. That, to me, is why I want to be a PA, because of the difference I can make in a patient’s life. This situation also changed my perspective in caring for the elderly population. I was always a little hesitant to insert my self where I may not be welcome, but this situation proved that I should try and add value where I can.
As a student, I was very involved in the day-to-day care of Dr. Kolessa’s patients. I took it upon myself to befriend and build relationships with the staff to allow for a better flow of information and ultimately better patient care. Dr. Kolessa regularly questioned me (and the other students) on pharmacology and highlighted the importance of polypharmacy in the elderly population. One day, he specifically asked us about every antidote he could think of, which thankfully I was well versed on from our pharmacology classes!
I worked with Dr. Kolessa daily on the new admissions and was fortunate enough to have the opportunity to work within their EMR and learn another system. I wrote HPIs and full H&Ps based on these admissions but also met with patients and updated charts where appropriate. I definitely honed my physical exam during this rotation, as a full exam was required with each admission. Additionally, it is important to note that many of these patients had multiple co-morbidities, wounds or were in SAR following a hip fracture and required their care to be tailored appropriately.
Gouverneur is unique (to me) in that it represents both Subacute Rehab as well as Long Term Care facilities and the patients that go along with those acuities. There were two patients that I’d gotten to know on the SAR floor, who were eventually transferred to the LTC floor during my five weeks at Gouverneur. This was particularly interesting to me because there were several reasons for which these transfers were made and it was very important to understand the social aspect that went along with the decisions.
On the other hand, there were patients that I’d met on the LTC floor that had been there years and had relationships with the nurses, PCAs and doctors. With those patients, it was important for me to enhance their stay and remember that this was their ‘home’ and I was a guest. In some instances, the LTC floor was challenging for me because many of these patients didn’t have regular visitors and existed without any familial interaction. That was really hard for me to witness, especially when the patient realized it, which is why I tried to make my time with these patients as memorable as possible. Ultimately, it was a lesson for me that I can do the best I can but it was definitely something I was cognizant of throughout my rotation.
As I move on to my next rotation, it is important for me to carry the skills I learned during my LTC rotation and apply this compassion in the same way at my Psychology rotation. I did a few procedures during this rotation but I want to continue to build and hone my clinical skills in my next rotation. Ultimately, this rotation was very positive and I was fortunate to have the opportunity to work with a provider that empowered me as a student. I will continue to utilize the skills I worked on at Gouverneur as I finish my clinical year and as I embark on a career.
This entry is licensed under a Creative Commons CC0 1.0 Universal Public Domain Dedication license.
