My emergency department rotation was at QHC, which was very convenient, since it was located only minutes form my house. The clearance process went very smoothly nd I was cleared within an hour the week before my rotation started. We met with Julia on the first day to have a preceptor assigned to us, get out IDs, and be provided with a procedure/ patient log book. The log book was to be collected at the end and would be used to determine our grade at the end of the rotation. After we got our IDs we ( Loretta and I) went to our assigned preceptors and immediately started seeing patients.
The first day was great my preceptor assigned me a patient and asked me to present after I developed my plan for them. After presenting the patient she gave me some feedback on what I needed to change or add for that patient. Then I went on to see some more patients and she kept on helping me direct my plan for each patient. She gave me a lunch break and when I came back I realized there about 20 more patient there now. It was surprising how it went from a quite ED to a chaotic setting in less than 45 mins. I helped her see patient and started to understand the process was so different from my other rotations. The reason I say that it the exams were much more focused, and decision were made so quickly. Also notes were written quicker with shorter HPIs, and focused physical exams. Before I knew it, it was time go home and I was surprised at how fast the day had gone. It was such an exciting day and I was looking forward to my next shift already.
The next day was even better, I had three laceration repairs back to back. For the first one my preceptor asked me to set up, she showed me how to administer lidocaine and watched me for the first few mins then left to see other patients while I finished. The next two laceration she just assigned the patient to me and just stayed while I numbed the area to be repaired and then left me alone with the patient. That day I saw 25 patients at the end of the day she explained how much she appreciated my help and that made me feel so accomplished.
The following days were all equally rewarding as I was able to do many other procedures such as draining abscess ( finger, pilonidal cyst, armpit, toenail removal, splinting, venipuncture/ IV placement, bladder scans, pelvic exams, foreign body removals (finger and ear), NG tubes, urinary catherization, slit lamp exam, and some others. I also started to write the notes for my patients and observed what the preceptor would change when they reviewed it. I would then apply what I learned from their correction to my next note which helped me include important information in my notes.
At times I would forget to ask the patient an important question or do a part of an exam, so I would return to the patient to obtain the missing information or part of the exam. While doing this I realized I was getting better at doing complete exams and became more competent in asking the correct questions. I encountered many patients that had a similar compliant, allowing for repetition, which in turn helped me become more proficient in managing patients. Also the fact that things had to be done quickly pushed me to develop a routine way of examining patients. This allowed me to do a complete exam on every patient but in at a faster pace.
During this rotation I was able to see many different cases, which taught me a lot about how to approach such patients in terms of assessment/management. I will definitely be using all of the knowledge and the skills I obtained from this rotation in the care I provide to my patients in the future. Most of the PAs at QHC really put an effort into teaching students and I was glad to have had my rotation there.
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