My 4throtation – Long term care was very rewarding in that I got to spend five weeks getting to know several patients in and out and watching them improve through physical and occupational therapy. Unfortunately, some patients had cognitive and functional decline during their visit due to being severely ill. Every morning I would round on patients on my own and then round again with the doctor; this was beneficial in giving me some confidence in seeing patients on my own and presenting the cases to the supervising physician. I attended wound rounds every Wednesday which consisted of rounding on patients mainly with pressure ulcers. I have never seen pressure ulcers until this rotation and they are extremely overwhelming to look at. This proves how important it is to ensure bedbound patients get repositioned often in order to avoid pressure ulcers. I got to see pressure ulcers from stage I to stage IV and the main locations were the sacrum and heels (always check the feet!). Another great learning experience was Geripsych which was held every other week. The Geripsych meetings consisted of the medical team discussing a patient who presents with some psych condition/issue; mainly topics revolved around refusal to eat, depression, feelings of resentment towards family members who put them in a rehab center and extreme frustration on losing ability to function independently and conduct ADLs on their own.
During my first week at my LTC rotation, one of the patients asked me to bring her juice and so I did but before I could give it to her, one of the nurses stopped me and informed me the patient is on a thick consistency diet which I didn’t even think to check. This was a great learning experience and moving forward I made sure to check everyone’s diet and speech/swallow evaluation prior to getting them any kind of food.
Overall, it was a great experience, I realized many of the patients just want someone to talk to and sometimes I’d have to redirect them a few times. I also got to practice writing H&Ps by writing many admissions, discharges and progress notes and removed numerous staples.
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