Thursday, September 15, 2011

PRIMARY CARE

Well, I can hardly believe it, but I've finished my Primary Care rotations! Wow! One block of rotations down, three left. I enjoyed primary care because of the variety of cases, the (sometimes varying...) continuity of care, and because you can really get to be a part of some of the families. I appreciated being the provider that helped people be proactive in their own care, the provider that helped patients cope with what will be life-long illnesses, the provider that patients could confide and trust in. Primary care really re-instated that "patient-driven" kind of practice in me and I learned very quickly that relating to and communicating with the patients is where good care starts. My last rotation wrapped up really well! It was another great rotation where I learned more and more each day, got new opportunities, and enjoyed the preceptor and office staff. I'd have to say, I had some really great rotations for primary care! The final exam was...umm...challenging. Not challenging in the sense that it was biased or unfair, but it was extraordinarily comprehensive, which I didn't quite expect. And sometimes I'd have an internal conflict of what the textbook says to do and what experience/actual situations would guide me more towards. It was also challenging because I haven't taken an exam in about 3+ months! I think my brain almost forgot how to take these PA-school exams! I did just fine on the exam, but it helped point out some weaknesses I may have developed while away on clinicals instead of in a classroom. C'est la vie...live and learn! So here are some highlights of what I learned in Primary Care:
1. For my first job, I want to work for someone who wants to teach and encourage me to grow.
2. My idea of an "emergency" and someone else's can be quite different. I learned how to gently, but effectively, express this and how to tell someone that (only in an appropriate situation...) their complaint would probably be better managed in an office rather than my ER.
3. Pain is entirely subjective. Relief of pain is also subjective :) This can be influenced. Some people think they will experience an entire lifetime without ever having pain-I think this is naive and dangerous.
4. Learn to communicate with your patients. They have to TRUST you to take your advice; they can't trust you if there is a communication deficit. This will involve actively listening to the patient.
5. It's all about confidence. Not being arrogant or cocky, but confident. A smile doesn't hurt, either.
6. The nurse or MA in the office is my best friend. Special thanks to the nurses and MAs on my rotations who helped show me the ropes, saved me when I needed help, and taught me so much!
7. I can do a whole lot more than I ever gave myself credit for.

I'm not sure if Primary Care is my calling in healthcare, but it's definitely still in the running. So what now? Four weeks of general surgery, four weeks in an ER, and four weeks in surgical oncology. We are about to find out if I have a future in surgery or not. While, from the little experience I have, I've enjoyed surgery, I'm a little worried about my pesky "passing out" issue. I haven't had a big episode in a little over a year, so I'm afraid I'm about due and the OR just might be the trigger that's been missing. I had an "almost" episode a few weeks ago while in surgery...I guess we'll find out soon enough! Regardless, I'm looking forward to new adventures and new experiences. And when this block is finished, it will be Christmas-time! YAY!