My internal medicine was at NYPQ and was a very enjoyable experience as I was able to get exposed to multiple different cases and teams working throughout the hospital. I was also able to do new procedures during this rotation as well including ABGs and NG tubes. ABGs were something I struggled with before as I was not able to do many of them in my other rotations, but working with certain PAs here and seeing techniques each provider had helped me better this skill. As everyone has their own way of doing certain procedures, I was able to find a way that worked best for me.

There were also things I struggled with during this rotation as well, including placing NGs tube. I freshened my memory during this rotation by practicing both suction NGs tube and feeding NG tubes and the difference in each and why both are made they are. Even though I was familiar with the uses, the placement is something I need to work on. This can be improved by working on placing them on models that are accessible at school, and taking every opportunity I get in my next rotation. I want to say a partial reason is nerves getting in my way but I defensively need to be more confident in my technique.

Patients I found challenging would definitely be during my stroke call, as trying to get a focused H&P from patients that are presenting with confusion, weakness is not the easiest thing to do.  Managing these patients, especially in ischemic stroke cases was very challenging as we need to know when there symptoms arise to see if we can offer certain treatment options. But as I worked with the Stroke PAs, I was able to see that there are certain things you can check/do to find this information and moving forward can carry them out myself during these encounters. Discussing with someone they were recently in contact with, people who may have spoken to them over the phone, etc.

Something I gained here that I can definitely take moving forward to my next rotation that’s also in NYPQ would be my patient charting and how to easily get information I needed for a patient I am going to see. EPIC is something I had always had trouble wrapping my head around but during this rotation I was able to get a better understanding on where to find specific notes, imaging etc. This is something that definitely saves time and allows me to better care for the patient in a timely manner.