Personal Narrative: My First Clinical

My second clinic rotation is internal medicine and I’ve had many encounters, both with patients and colleagues, which have made me pause and reflect. One of those encounters, in particular, will still be on my mind long after I finish typing this reflective journal. The patient at the center of it all is a lady I’ll refer to from here on as “Mrs. Flowers.” Mrs. Flowers is an 81 year old female with dementia and diabetes. She arrived on our unit with a diabetic foot infection that had progressed from a simple toe ulcer to wet gangrene. Over the last 2-3 months, gangrenous changes encompassed the distal half of her left foot. During pre-rounds, our medical team unanimously agreed that we would contact surgery for a consult. At time, it was obvious

Week three in clinical was difficult for me, I had a great experience overall but I hated seeing and holding a baby that had passed away at 21 weeks. To know what the family could possibly be going through was heartbreaking. I wouldn’t exactly know what to do if I was with the patient and her family exactly. I do know that I did place her in the room when she was admitted to triage. I do feel good about seeing the scenario play out, while being a student rather than being in the field alone. Other than that I was able to see the beginning stage of labor as well as a C-section. Everyone was so bent out of shape on making sure I eat and that I don’t faint, but it seriously wasn’t bad. As a matter of fact I was too intrigued with the mother rather

The clinic that I am doing my clinical rotation is a small family medical office with one physician assistant and one doctor. It is located in Collier County Naples, Florida. Naples is considered as one of the richest city in Florida with a diverse ethnic group like Caucasian, African America, Asian, Latinos, Haitian, and much more. They see any patients start from 6 years old. Most of the patients who come to the clinic don’t have a medical insurance. They are self-paid. My preceptor is a professor of physician assistant at Nova University in Florida over 20 years.

The sharp scratch of pencil lead sprinting across thick layers of paper, rapid rustles of flipping pages, and the neurotic tapping of pens on hard wooden desk surfaces are sounds that I grew very accustomed to during my junior year of high school. I was taking a class called Clinical Rotations, which allowed me to rotate through different units at two major San Antonio hospitals. Being constantly surrounded by illness, chaos, and frigid sterility wore heavily on my angst-ridden, seventeen year old self. But despite the stressful surroundings and slightly depressing aura, it was during these rotations that I met someone who truly changed my life.

This past Thursday was the first OB clinical day and I was assigned the post partum unit. I was paired with Nurse Donna, who was full of information. Originally we had three couplets, with one baby in the nursrey. As the day went on and families were discharged, all our patients had gone home so we gained three other patients from two other nurses so they could go home for the day. I was able to give two moms their TDAP (tetanus, diptheria, and pertusis) vaccines and learned a new trick when it comes to giving intramuscular shots. Donna told me to have the patient hang her arm down by her side and wiggle her fingers. This not only had the patient concentrating on something other than the shot they were about to get, but it helped activate the

I had such a great day at clinical yesterday. I was finally able to see a vaginal delivery and that entire process. When I arrived in the morning, the mom had just received Cytotec, to help induce labor and ripen her cervix. She was forty-one weeks and zero. Around ten thirty in the morning, she asked for her epidural to manage her pain. We bolused her with fifteen hundred milliliters of lactated ringers to prevent hypotension. Shane was the certified registered nurse anesthesiologist (CRNA) who administered the epidural. It was very cool watching him administer all the needed pain relief medication before he administered the epidural to make sure that it would be placed in the epidural space in the spine. Then administered a small test dose, waited till a few blood pressures were taken, then administered the remaining about through an epidural pump. After the epidural was administered, I was able to administer her foley catheter. I was so happy that I was finally able to place one. I learned a few tricks from Maura (my nurse) as well. She taught me that it was easier to take the top off of the lubricant syringe and to place the tip of the foley inside of the syringe, that way it will not wiggle around and become unsterile. She also taught me to grab from the bottom of the labia and pull up, that way it ensures that I will have a clear entrance to

My Clinical Instructor is Laura Homan at Winter Pediatric Therapy. She works with kid from all ages between infant to adolescent, because this is a pediatric clinic. The types of clients she treats are variety, such as Autism, Down’s syndrome, ADHD, Developmental Delay, Epilepsy, and Gene Mutation. She used a lot of toys from games, puzzles, musical toys, colorful objects, different shapes, and texture blocks to get the attention and participation of her clients. She has been working at this clinic since March of 2016. She has always wanted to work with kid. She wanted to be a teacher at first, but heard about Occupational Therapy in college. So she decided to go for Occupational Therapy program. She fell in love with it when she went for

On November 30th, 2015, I ventured to the Santa Monica Convalescent Center to spend time with patients in the dementia ward. At first, I thought I would not enjoy spending almost two hours with people who were unable to be cognitively present due to varying degrees of dementia and Alzheimer’s, which impairs their ability to retain memories and sometimes returns them to an almost baby-like mindset. However, I soon formed several bonds with many of the residents there. A woman named Kathy, a volunteer from nearby Presbyterian church, handed out copies of well known Christian hymns and soon everyone was chiming in as best as they could. I then sat down across from a woman named Alice and asked her about her life. She is an elderly African American woman who answered my questions with very opinionated and interesting answers.

My first clinical I felt my greatest accomplishment was not being shy and hesitant. The first day we had clinical was the first day that I got the opportunity to float to another floor, I was very nervous at first. Going into a new place for anyone is different at first because you don’t know what to expect. I think what made my experience so great was the endoscopy nurses and doctors, they were some of the nicest and helpful people I’ve met so far. I got a wonderful opportunity to learn next to the doctors doing the procedures and also see other roles of the healthcare team like the nurse anesthesiologist.

Today was the second day of my 6-week placement at Ward 3A-Logan Hospital, I have originally been paired with a demand casual pool RN, however, the said RN is not confident enough to handle me as her student nurse at the time. After the scrum at 7am, and the handover on the 4-bed bay + sides, I politely ask her if I could take one patient as it was one of the instructions of my CF during the orientation on day 1, but I was answered with “I’m not really familiar with the area and I’m from the demand casual pool...” Having sighted my CF at the corridors, I excused myself from the RN and discussed the matter to my CF, and she allowed me to be buddied with a very good EN, informing me that “she is an EN” before letting me to the bay and introducing me to my new buddy EN.

This week I had rotation at Genesis and also Cumberland Hall. Genesis was very different that what I expected. When I think of a “rehab” I think of people all sitting around with major withdrawal symptoms, a very strict schedule, multiple one-on-one session, and with no smoke breaks. At Genesis, throughout the day the client was able to do their own thing until the scheduled group session and smoke breaks. I was placed on the male unit and I was very surprise of the self-awareness that I experienced. Just listening men talk and tell their stories brought on a whole new prospective and quickly changed the image of the addict stereotype. While I was there we also established that all the clients was first timers and all fathers, and afterwards I was able to sit and think about how grateful I am to have my father who’s not an addict. I have had the luxury of always having a clean and sober father; which I had taking for granted.

The sharp scent of chlorine fills my nostrils as I crane over the microadjuster, determining whether my Platinum/Iridium wire tip is done reacting. Waving away the fumes, I observe the bubbles fizzling out, turn the voltage off, and twist the tip out of the machine. At 163 nanometers wide, it’s the sharpest tip I’ve etched this summer.

Our clinicals at Cadbury at Lewes is quickly approaching an end and we are still learning new things each day. Everyday we do something new and so another skill is checked off. Yesterday, we got numerous things done, it was a very busy day.

I was able to make connections between the clinical and the lectures. I was able to apply the knowledge I learned from lectures and our assigned textbooks, readings, and videos to clinical. Over the course of the semester, I became much more comfortable being on the floor at the psychiatric hospital. I was able to see the symptoms the patient presented with and make connections as to what their diagnosis was. as well as the as well as see the therapeutic effects of the medication they were taking. My clinical provided me with exposure to patients with borderline personality disorder, schizophrenia, major depressive disorder, eating disorders, and bipolar disorder. I was nervous about clinical simply because I didn’t know much about mental

Throughout my clinical experiences I have encountered a large variety of school cultures and environments. I've been lucky enough to work with both public and charter schools and have first-hand experience with grades one through four. While I have taught and observed all of the typical subjects including math science, reading, and social studies, I have also worked in the schools to educate students in theater as well as health and physical education. From all of these experiences I learned that my greatest passion is in working with young students, grades K-2, in underprivileged schools.