During my rotation in Internal Medicine, I had the opportunity to engage with patients at different stages of their hospitalization. I was able to evaluate and follow up with already-admitted patients and assist my preceptors with admissions when new patients were transferred to our floor from the Emergency Department.  In these five weeks I learned how to properly present patient cases to my preceptors, something that I struggled with significantly during my first rotation. I sat down with one of my preceptors and she allowed me to present various cases throughout the day while providing feedback on what she felt I should include and what information could be left out. I also became acquainted with a a new EMR system: Epic. Prior to PA school, I knew how to use ECW and Athena, but I never imagined how complicated Epic would be. I relied on the preceptors on the floor as well as my classmate when I struggled with navigating this complex software. By the time I left, I felt much more comfortable searching up patients using their last name, medical record number, or date of birth. I also knew what information was in which tabs which allowed me to search up all my patients before rounds started. Something I struggled with during this rotation was the language barrier between my patients and I. Many of the patients I evaluated did not speak English so I was constantly looking for an interpreter device. Even though searching for these devices was tedious, they were imperative for acquiring an accurate history which allowed us to develop a sound diagnosis and assessment/plan. There were times I walked into the room and the patient would make a gesture that was completely unrelated to the chief complaint, and I would have never been able to deduce this on my own.

During this 5-week rotation I learned a lot about myself in terms of the kind of PA I want to be and the type of care I want to provide my patients. No matter where I end up, I know I want to have a relationship with my patients. I don’t want to be the PA who simply checks up on her patients once a day to ask a few questions and then disappears. I recognize that I may wind up crunched for time, but I know it would mean more to my patients if I invested in them as people and not just focused on their disease process. I also realized that I need to improve my ability to deliver bad news. There were two scenarios in which I had to deliver a message to patients that they received poorly, and I was unsure of how to proceed. Knowing the right thing to say in these circumstances is part of showing my patients that I care for their well-being. I plan on going over my notes for Interviewing and Counseling so that I can get better at delivering uncomfortable/bad news. Overall, I think the skills I picked up during this rotation will be useful moving forward and I am excited to apply them in future rotations.