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Long Term Care Rotation Reflection

I was thoroughly surprised by how much I enjoyed my long term care rotation at Forest View Center for Nursing and Rehabilitation in Queens. Coming from my emergency medicine rotation, I was sure that I would miss the fast pace and excitement of the ER. Instead, I found that I really appreciated getting to form a connection with the long term residents of the center. Instead of only treating acute issues, I mostly saw patients who had multiple chronic conditions that required frequent monitoring. This care strategy changed my focus from “treating conditions” to “caring for patients.” 

I got to follow a wonderful nurse practitioner who shared her love for geriatric medicine with me. She coached me to focus on the patients’ general wellbeing and the importance of keeping the patients comfortable and content. Discussing cases with the doctors, nurses, physical therapists and occupational therapists highlighted the importance of a collaborative care team. The open communication between all the staff helped ensure that issues did not go unnoticed and patients received the interventions they needed. 

The most challenging aspect of the rotation for me was dealing with end of life care. As a PA student, I am always thinking of differential diagnoses and possible treatment options. However, the goal for patients on hospice care is to provide comfort to the patient and their families. I felt very helpless watching these patients and knowing there was nothing I could do to help. Getting used to working with patients with dementia was also a struggle for me. I had to learn to conduct a really thorough physical exam, because the patients often could not articulate what was bothering them. I learned from the nurse practitioner to talk slowly and clearly and make eye contact with patients who are restless. This helps the patient realize that you are there to help them and they usually calm down.