During my long-term care rotation, I had two site evaluations on Zoom, where I presented patient cases, drug cards, and a journal article. In total, I submitted three H&Ps, 10 drug cards, and one journal article. These evaluations provided a collaborative environment for learning, allowing me to receive valuable feedback from my evaluator while engaging in discussions with my classmates.
For the first evaluation, I presented the case of a patient who had fallen and sustained spinal fractures. She was admitted to the subacute rehabilitation (SAR) unit for physical and occupational therapy, as well as pain management. During the discussion, we focused on her acute and chronic conditions, and I was commended for including a detailed plan for managing her chronic conditions. This was particularly rewarding for me, as I realized how crucial it is to consider both the immediate and long-term needs of a patient in the management plan. Listening to my classmates present their cases and participating in a discussion led by the site evaluator also provided great insight. The evaluator presented a case on viral vs. bacterial gastroenteritis, which was a valuable learning experience. It reinforced my knowledge of how to differentiate between these conditions and how to approach the management of infectious diarrhea. This case was unique compared to previous evaluations because it involved discussing a case presented by the evaluator, and I had to actively engage by answering questions and discussing treatment options. I found this format to be especially useful for solidifying my clinical decision-making skills.
In the second evaluation, I presented the case of an 87-year-old male with lung cancer who was on palliative care. We discussed the difference between palliative care and hospice, a distinction that I found very important in geriatric care. This patient was also one I made sure to check in on daily due to his feelings of sadness and existential distress regarding his terminal illness. I took the time to build a rapport with him, which I found essential in providing emotional support. The discussion also focused on the importance of developing strong patient-provider relationships, especially in palliative care, where the goal is to address both physical and emotional needs. During this evaluation, I also presented a journal article on acetazolamide, which is a medication the patient was taking for his glaucoma. The article discussed the adverse effects of acetazolamide, and I was able to incorporate this into our case discussion, helping to refine my understanding of medication management in elderly patients with multiple comorbidities.
Additionally, we spent time going over PANCE-style questions during this meeting, which I found particularly beneficial. With this being my final rotation before taking the PANCE exam, reviewing these questions helped me reinforce clinical concepts and prepare for the upcoming exam. This was a great way to wrap up my rotation and ensure I was ready for the transition to professional practice.
Overall, these evaluations provided me with invaluable opportunities to enhance my clinical reasoning, patient communication, and knowledge of pharmacology. I am grateful for the chance to reflect on the unique aspects of long-term care and how it applies to my future role as a PA.
