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

During surgery rounds in the morning, the team would see patients as a group. I noticed that many patients felt overwhelmed by being surrounded by a large number of people first thing in the morning. There was a lot happening simultaneously, several people asking how the patient was doing, performing physical exams and checking if all the equipment was functioning properly. I particularly remember one patient who needed a dressing change every morning. Initially, all the students would try to do it at once and he was cooperative. However, as his hospital stay continued, he became increasingly frustrated and eventually told the team he only wanted one student to handle his dressing change. This experience taught me that post-surgery recovering stays can be long and overwhelming for patients. While dressing changes during rounds provide excellent learning opportunities, it is crucial to respect the patient’s preferences. We should not insist on doing something they’re uncomfortable with. Instead, we can help by going in their room with less people during rounds or by taking turns to perform the dressing change. Respecting the patient’s wishes helps create a better care environment and supports their recovery.

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

As I finish my last rotation, I reflect on how much I have improved in various skills throughout my training and I am eager to carry these forward as I begin my career as a PA. However, there are still areas I want to work on, even as I transition into practice. As a new graduate, I want to feel comfortable asking for help to avoid making mistakes. During rotations, expectations were often clearly defined. I start working independently, I know it will be important to speak up and ask for assistance without feeling ashamed. The first few months will be a learning curve and it’s essential to focus on continuous improvement every day. I plan to communicate with my attending or team that I am new to the role and may need guidance throughout the day. For instance, if I don’t know where certain equipment is located, instead of wasting valuable time searching, I can ask a colleague. At the same time, I will strive to be as independent as possible, balancing self-reliance with the willingness to seek help when needed.

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

As I begin my career, one skill I aim to improve is performing different types of sutures. During other rotations, such as in the ER, I primarily did interrupted sutures. However, during my surgery rotation, I was introduced to subcutaneous sutures, which is the first time I watched it being done. After the residents demonstrated it a few times, I successfully did it twice. While I was able to complete the sutures, it took me a while since I was still learning. I know that suturing will likely be a more frequent task when I start working, so I want to become more proficient. I plan to watch youtube tutorials to learn additional suture techniques and practice on a skin pad at home. This preparation will help me perform sutures more effectively and efficiently when treating patients in the future.

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

One memorable patient I encountered during my surgery rotation was someone who remained under the surgery service for a long time because he had not had a bowel movement following an open exploratory laparotomy for SBO. The patient’s noncompliance also contributed to his prolonged hospital stay. Each morning during rounds, the team discussed new imaging or tests to determine why the patient was not having a bowel movement. Unfortunately, most of the tests available at the hospital returned normal results. One morning, the team grew frustrated with the lack of progress and began discussing the possibility of transferring the patient to another hospital with access to more advanced testing. However, others on the team were determined not to give up and decided to involve the GI team and seek input from other healthcare professionals for suggestions. After 24 days in the hospital, the patient finally began passing bowel movements consistently and was ready for discharge. From this experience, I learned the importance of persistence and collaboration in patient care. If all options seem exhausted, it’s important to seek help from others. Additionally, addressing the patient’s noncompliance through a direct and supportive conversation also played a key role in his recovery.