This week was nice and (relatively) laid back. There were some interesting cases, too! Granted, there were a lot of appointments for checkups/medication refills and upper respiratory infections, but we also saw a couple cases of mono and some other things. One patient was particularly interesting...her appointment slot just said she was there for medication refills, but once we were in there talking to her she started talking about how she'd been losing her balance over the past few months. Later, she mentioned that she'd been having some trouble holding lightweight objects (like a piece of paper) in her hands, because her grip "wasn't strong enough." On exam, she had a positive Romberg (balance test), ataxic gait, slightly weakened grip strength, and couldn't perform some of the cerebellar function tests. Needless to say, she got a referral to a neurologist. My preceptor and I both couldn't come up with a good idea behind why she was having these symptoms...we have a few ideas, but nothing seems to fit perfectly. I'm glad I'm here for another 8 weeks still so I'll be able to find out what happens!
And on Thursday, I got to hang out with a radiologist all day. I realize that most normal, non-medical people wouldn't think that's very exciting, but it was! Thursdays are my preceptor's days off, so he sent me out to this other town (90 miles away, or a "hop, skip, and a jump" to Montanans) to learn some radiology skills with the radiologist who reads all the X-rays and CTs from our facility and others. He was so nice and such a great teacher! I learned a lot, and I'm really excited to develop a skill set that most PA students probably don't have the opportunity to develop. Plus, it was nice to drive around Montana a little more. Even though the part of Montana that I'm in (north central) is pretty much flat, it's still beautiful. I'm hoping to explore a little more tomorrow!
Saturday, February 22, 2014
Sunday, February 16, 2014
Hello from Montana!
I'm so, so sorry I didn't post sooner! I was really busy getting settled in, and then the hours in the clinic this first week were pretty long and demanding, so by the time the day was over I just didn't have it in me to write anything.
So! Let me first explain the setup here. There is a nursing home facility with about 50 residents, a six-bed hospital, a two-bed ER, and a fully functioning clinic all located within the same building. The medical professionals in charge of this facility are one doctor, one PA, and one nurse practitioner. That means they do everything! They are simultaneously internists, pediatricians, gynecologists, ER providers, and long-term care providers. These three people are basically responsible for everything and everyone within a 90-mile radius, because that's how far it is to the nearest larger town. As the only student, this is an amazing opportunity!! Yes, I'm technically here for family practice and pediatrics rotations, but I'm also getting to brush off my ER skills and getting to learn some long-term management skills.
I'm mostly in the clinic, as are the providers. A typical day there lasts from 9 to 5ish, plus then finishing any lingering paperwork, and we see about 12-15 patients per day. I really like this patient load, because it gives you plenty of time to talk to patients and make sure you're really taking care of them well. So far, most visits have been for seasonal sicknesses - flu, sinusitis, bronchitis, etc. - and there are occasional checkups or follow-ups. I see a pretty good mixture of adults and kids, which is good - I have zero knowledge of how to interact with small kids in a medical setting! I think that will definitely be my biggest challenge while I'm here. It's an intricate dance of making sure the child feels comfortable around you so they let you do the exam, and also making sure the parents trust what you're doing and saying. Hopefully I'll be much better at it by the time I leave!
Most clinic visits aren't super exciting, but I have been able to do a fair number of procedure-type stuff in just the first week! I got to staple someone's head after they slipped on ice and fell and hit their head on stairs, and I got to suture a thumb that got sliced open by a carpet cutter at work. I've also done pelvic exams and Pap smears! Really, this rotation is kind of functioning as a review of most rotations I've had so far, plus adding the pediatric element. It's great!
Everyone here, patients and providers alike, is super nice and I think I'll really enjoy being here for the next two months or so. It's definitely a small community, though, and I can't really even go to the grocery store or the post office with that small degree of anonymity that you take for granted in suburban or urban life. Everywhere I go, people know that I'm not from there, and most times they even know that I'm the PA student at the clinic, because they heard one was coming and I don't look familiar! But that's okay, everyone is very welcoming and they seem happy to have me here. :)
So! Let me first explain the setup here. There is a nursing home facility with about 50 residents, a six-bed hospital, a two-bed ER, and a fully functioning clinic all located within the same building. The medical professionals in charge of this facility are one doctor, one PA, and one nurse practitioner. That means they do everything! They are simultaneously internists, pediatricians, gynecologists, ER providers, and long-term care providers. These three people are basically responsible for everything and everyone within a 90-mile radius, because that's how far it is to the nearest larger town. As the only student, this is an amazing opportunity!! Yes, I'm technically here for family practice and pediatrics rotations, but I'm also getting to brush off my ER skills and getting to learn some long-term management skills.
I'm mostly in the clinic, as are the providers. A typical day there lasts from 9 to 5ish, plus then finishing any lingering paperwork, and we see about 12-15 patients per day. I really like this patient load, because it gives you plenty of time to talk to patients and make sure you're really taking care of them well. So far, most visits have been for seasonal sicknesses - flu, sinusitis, bronchitis, etc. - and there are occasional checkups or follow-ups. I see a pretty good mixture of adults and kids, which is good - I have zero knowledge of how to interact with small kids in a medical setting! I think that will definitely be my biggest challenge while I'm here. It's an intricate dance of making sure the child feels comfortable around you so they let you do the exam, and also making sure the parents trust what you're doing and saying. Hopefully I'll be much better at it by the time I leave!
Most clinic visits aren't super exciting, but I have been able to do a fair number of procedure-type stuff in just the first week! I got to staple someone's head after they slipped on ice and fell and hit their head on stairs, and I got to suture a thumb that got sliced open by a carpet cutter at work. I've also done pelvic exams and Pap smears! Really, this rotation is kind of functioning as a review of most rotations I've had so far, plus adding the pediatric element. It's great!
Everyone here, patients and providers alike, is super nice and I think I'll really enjoy being here for the next two months or so. It's definitely a small community, though, and I can't really even go to the grocery store or the post office with that small degree of anonymity that you take for granted in suburban or urban life. Everywhere I go, people know that I'm not from there, and most times they even know that I'm the PA student at the clinic, because they heard one was coming and I don't look familiar! But that's okay, everyone is very welcoming and they seem happy to have me here. :)
Sunday, February 9, 2014
Made it to Montana!
I'm all settled in and ready for my combination family practice and pediatrics rotations! The town I'm in is pretty small, and I haven't had much of a chance to explore yet, but I don't think there's much to it. So far I've only gotten a tour of the clinic and hospital, and I've been to the grocery store. The town seems nice, and the people are really friendly! I met a bunch of people on my tour today, even though it's the weekend, and they all seemed really welcoming. I'm excited to start tomorrow! I'll be sure to post an update about my first day. :)
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