During this first week of my core rotation in Family Practice, I was assigned to an elder care facility. Now this is no normal nursing home. This place is 20 acres with an assisted living facility, advanced nursing care facility, outpatient and inpatient rehabilitation programs, another building of general medicine at a hospital level of care (not ICU or surgery types of stuff, but illness that would require hospitalization), an outpatient health clinic and to top it all off one of the best comprehensive pain centers in the country. I am thrilled to have the opportunity to learn from the excellent staff and in such an amazing environment. So far this week, I've worked under an Ear, Nose and Throat (ENT) specialist, cardiologist, pulmonologist, endocrinologists , internal medicine physician with a fellowship in geriatrics, physical and occupational therapists, and obviously family practice physicians. I almost forgot to mention that Farley and I got to spend a few hours with a couple nurses who manage the wound care clinic . We were the only medical students who stayed late and we got to help clean and change the bandages, use a Doppler ultrasound to find difficult pulses (clogged arteries) and probably most importantly we were able to comfort some very scared and sometimes extremely demented patients to help them through the wound cleaning, which can be very painful. Comforting the patients wasn't the most exciting thing we did all week;but honestly, I think it was the most important and helpful task of the week. There is so much more to being an excellent health care provider than just memorizing facts and having book knowledge; to be an excellent health care provider one must be compassionate, competent and caring.
I have been getting along with the patients so well that Farley has nicknamed me "The Granny Whisper". I think the key to my success is that I try to treat all of them as if they are still competent adults, even when they are demented and may not understand what I am saying. I try to speak slowly and loudly, bend down so that I am at eye level (they are often in wheel chairs), introduce myself and state my level of training, then I tell them what I need to do and ask if it is okay. I have had a few patients that are so demented that they cannot respond to me, but I cannot prove that they cannot understand so I still explain what I am going to do (such as listen to their heart with a stethoscope) and ask if it is okay. I had one patient who cannot speak at all. I spoke to her nurse about her a bit and he was shocked that she let me do almost a full physical exam. Apparently, she hits caregivers that she doesn't know. Not only did she not hit me, she was as compliant as one would expect for an immobile patient who can not speak. She even smiled at me throughout the exam. I find it interesting to see other medical students interact with the patients. None of them have been rude or done anything inappropriate; however, many of them don't really have a bedside manner. It amazing how much more compliant Farley's and my patients have been just based upon the way that we treat them.
On another note, life on the beach has been great. The weather in Miami this week hasn't been ideal. The lows has been in the 40s and the highs have been in the 60s. Today we decided to take a walk north on the boardwalk. Here are a few pictures from our walk today:
Considering Miami Beach is basically my back yard, I think I have the best back yard in the world!
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