I had my site evaluation on Zoom with professor Davidson. In total, I prepared 10 pharm cards, three H&Ps and a related journal article. For my first site visit, I chose to discuss a patient who had presented with knee pain. This was a challenging case because the patient had multiple comorbidities, including Parkinson’s dementia. Therefore, the patient was unable to give an accurate report of when his symptoms began. We talked about the importance of monitoring long term care patients for any changes in baseline status. Dr. Davidson also highlighted the importance of documenting the specific location of an injury, for example “peri-patellar” or medial/lateral. In addition, she explained that it is helpful to include the date of when a patient was diagnosed with a chronic condition, because this helps one get a sense of the likely progression of the disease.
Dr Davidson recommended I use the textbook, Basic Concepts in Pharmacology: What You Need to Know for Each Drug Class, for preparing my pharm cards. I found this to be helpful in solidifying my knowledge of drugs by class and for placing them in the context of the pathophysiology.
For my second site visit, I prepared two H&Ps. One was regarding a newly admitted patient with contact dermatitis. The other was about a patient with a chronic foley catheter who developed a UTI. I found a related article that studied the effectiveness of indwelling urinary catheter washout procedures.
Throughout the site visit, we focused on the importance of understanding the needs that are unique to the geriatric patient population. For example, it is important to know the infectious processes that are more prevalent in long term care facilities.I appreciated my professor’s feedback on my H&Ps and article. Dr. Davidson has a wealth of information drawn from years of experience in the field that I was eager to learn from. I will continue to work on improving my documentation for writing H&Ps as well as my skills in working with geriatric patients.