1) Types of patients you found challenging in this rotation and what you learned about dealing with them

At the urgent care clinic, we often see patients with a variety of complaints. However, we can only address the most urgent issues during their visit. Sometimes, patients mention concerns that have been ongoing for years and it would be more helpful to see their PCPs for it. In these situations, I have learned to first listen to the patient. Even if the complaint does not seem urgent to us, we can ask them what prompted their visit today for something that has been bothering them for months. Maybe the issue has gotten worse recently and needs urgent attention. We then inform them that we will focus on the issue that is bothering them the most. For their other non-urgent complaints, I recommend they visit their PCP or we can refer them to a PCP if they don’t already have one. This approach ensures we address the patient’s concerns without dismissing their needs. 

2) What do you want to improve on for the following rotations? What is your action plan to accomplish that?

In my future rotations, I aim to improve my skills in inserting IVs and suturing. So far, I have practiced a variety of procedures, such as venipuncture and wound care, during my other rotations. However, I haven’t had the chance to practice IV insertion until this rotation since I did not have my ER rotation yet. I found myself struggling and forgetting steps while inserting an IV on a patient because the last time I did one was months ago. I also lacked confidence in suturing and often feared hurting the patient. Following a provider’s step by step guidance and then doing it on my own has been very effective for me. In my urgent care rotation, there weren’t opportunities to practice suturing, but I will have more opportunities in my ER rotation and surgery rotations. My action plan is to practice suturing over the summer break before starting my ER rotation. I can watch instructional videos and review different suturing techniques. For IV placements, I plan to ask the nurses during my ER rotation if I can practice inserting IVs. With more practice opportunities, I will become less hesitant and more confident in my skills.

3) Skills or situations that are difficult for you (e.g. presentations, focused H&Ps, performing specific types of procedures or specialized interview/pt. education situations) and how you can get better at them

Due to the high volume of patients at the urgent care, I had to deliver quick yet thorough presentations to the provider and make sure that I included all the essential information. This encompassed the HPI, a focused exam, diagnosis, and plan for the patient. The challenge was that each case was unique, requiring me to ask pertinent questions specific to each HPI. For example, one patient might present with abdominal pain, while the next might have a sore throat. Most urgent care providers expect brief, focused presentations so I needed to be well-prepared. Given that this is my sixth rotation, I have presented many cases, though not as frequently throughout the day. To improve, I first mentally organize the information, prioritizing the questions for the HPI and keeping it concise. I also focus on maintaining confidence so I don’t keep getting nervous and pausing. This rotation was a good preparation for my upcoming ER rotation since both of them involve managing a high volume of patients.

4) What was a memorable patient or experience that I’ll carry with me?

One memorable experience I will carry with me involves a patient who came in with a laceration on her finger. The cut was quite deep and the provider and I were trying to suture it. Out of the four stitches we used, two kept coming out and wouldn’t hold the skin together. What I found admirable was the provider’s patience and persistence. He didn’t become frustrated or give up. Instead, he reassured the patient and continued to try for a better suture. This taught me the importance of patience in difficult situations. If we had given up, the patient would have had to go to the ER, which would have been very inconvenient for her. After three attempts the stitch finally held and we were able to close the wound effectively. A few days later, she returned for a follow-up and her finger looked much better. This experience taught me to always be patient, calm and keep trying to help the patient.