Rotation 4- LTC Reflection
How could the knowledge I’ve gained here be applicable in other rotations/disciplines?
The knowledge that I’ve gained here will be applicable in other rotations because the geriatric population continues to grow. Not only that I will see geriatric patients in long term care, but also in my future rotations such as emergency medicine, internal medicine, or even psychiatry. Dealing with geriatric population and interviewing them can be very different. They will have a long list of past medical/surgical history and medication. I learn how to be more cautious about polypharmacy, drug interaction and drug contraindication. For example, many elderly with end stage renal disease requires dialysis, and we have to be careful about prescribing drugs that are nephrotoxic or adjusting the dosage for them. In addition, elderly are more prone to falls with weakness and difficulty seeing when they age. Therefore, it is important to assess fall in elderly because they may lead to fracture and brain bleed. These types of patients can be seen in all my other rotations as well as my future career as a PA.
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 continue to work on my procedure log book. There are still a lot of other clinical skills that I would like to practice. I want to have the opportunity to practice and learn as many clinical skills as possible. My action plan to accomplish that is letting my preceptors know that I am really interested in practicing my clinical skills and ask if they are willing to teach me when there is a chance.
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 as a result of this rotation for elderly patients. I have learned that communicating with elderly patients may be different and requires more time compared to the younger population. To communicated effective with elderly, I will have to plan more time instead of appearing rushed or uninterested. Because they will sense it and shut down. It is also important to sit face to face because some older patient may have vision and hearing loss. Sitting in front of them and maintaining eye contacts will allow them to read your lips and also providing them with undivided attention. Another thing about interviewing elderly patients is that I will speak slowly, clearly, and loudly. This will help them to take in the information slowly.
Types of patients you found challenging in this rotation and what you learned about dealing with them
Geriatric patients are overall challenging in this rotation. I have learned how to communicate with them more effectively, especially those that are not as educated. They will require more time for explaining the information. In order to communicate with them effectively, I will try to stick to one topic at a time because overload of information can confuse patients. I will also simplify instructions and write the instructions in a list on a paper. Patients can easily check off each item with such a list. Charts and pictures are also great visual aid that will help patients better understand their condition and treatment.
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