Respond to the 2 following discussion posts separately with separate reference lists. References to be no older than 5 years.
1. [Judy Nguyen]
For this course, I have learned how to carefully listen to my patients’ complaints, their signs and symptoms, and how to properly diagnose and treat them. During clinical rotation, writing soap notes was an important assignment that helped me understand the importance of collecting data and listening to the patient. It really helped me to critically think and analyze all the problems and come up with different differential diagnosis. For this course, I’ve also learned a lot about mental health issues which I find to be one of the world’s most health problems across the US. I’ve also got to focus on other health problems, such as Cardiac disease, ADHD, Neuro, alcoholism, Endocrine, and respiratory which I did my SOAP Notes on. I will be focusing on Women’s Health as well as more Geriatrics for next course and am hoping to through more systems.
The most memorable encounter this course is a patient who has terrible chronic pain. Despite all the office visits and pain medications that this patient was taking prior to seeing my preceptor, taking strong opioids barely helped with her pain. Throughout the months that this patient worked with my preceptor, I can see how much improvement she has made. It was through naturopathic remedies. My preceptor focuses on treating his patients with non-pharmaceutical interventions as much as possible which I believe works. Another patient that I will remember working with is a gentleman who had ADHD and depression. He was at risk for suicidal ideation and after a couple months of office visits, I can see how much his life has changed around. He is no longer at risk for SI and his screenings for PHQ 9 and GAD 7 dropped significantly. My preceptor spoke high about low-dose Naltrexone (LDN) to his patients. It has been shown that LDN is safe and effective in reducing chronic inflammation, autoimmunity, fatigue, and chronic pain and depression (the Metabolic Institute, 2018). I do believe I still have a lot of learning and self-development. I hope that these last couple of courses will help me grow.
References:
Benefits of low-dose naltrexone | The Metabolic Institute. (2018, September 3). https://themetabolic-institute.com/benefits-of-low-dose-naltrexone/
2. [Mandeep Kaur]
Prioritizing specific categories for SOAP notes is crucial to ensure that the required amount is completed before finishing all four clinical rotations. My clinical rotation this term was in high-volume family practice, so the categories that I completed the SOAP Note for include one well child visit, one women health, one adult genitourinary, one adult pulmonary, one geriatric musculoskeletal and one geriatric pulmonary. I will need to focus on pediatric, adult, women’s health cases and complete more geriatric SOAP notes.
I had many memorable patients encounters this term. I had an excellent preceptor who went out of his way to make it an incredible learning experience. The ones that I probably found most memorable were the ones I could do by myself. I enjoyed taking a shot at trying to do the interview, the assessment, and coming up with a diagnosis and treatment plan. One, in particular, was an otitis media diagnosis that was very difficult to see. But I got it spot on, and my preceptor quietly high-fived me right there in the room because it was exactly as my verbal assessment stated. That gave me a tiny bit of confidence to try to build. I would do differently in cases like this to better stabilize the patient against the parent’s chest to assure that I can get a good look. Even though I still got a good look and had a correct assessment, it took me longer to get than my preceptor. The child was very fussy with a high fever. However, you still must look at and visualize the tympanic membrane. My preceptor was able to show me a better way to brace the child against the parent to create slightly better ease in completing the assessment. That was helpful and will be beneficial in the future.
I never thought I would enjoy the well-child visits as much as I did. I thought maybe I would be bored or something. But I wasn’t, and I thoroughly enjoyed them. Interacting with children who were well and meeting all of their milestones was refreshing. I also enjoyed speaking with the parents and helping answer any questions they had. Based on the Bright Futures Guide, my preceptor had me memorize all of the well-child milestones from birth through 5 years (Hagen et al, 2017). He would quiz me frequently on the milestones as well as the vaccination schedule (CDC,2022). He would open the chart with the previously given vaccinations listed, and then he would say, now tell me what they need. It was a real-life experience that taught me a ton. I am very grateful.
References
Centers for Disease Control and Prevention (CDC). (2022). Child and adolescent immunization schedule: Recommendations for 18 years or younger. U.S. Department of Health & Human Services. https://www.cdc.gov/vaccines/schedules/downloads/child/0-18yrs-child-combined-scedule.pdf
Hagan, J.F., Shaw, J.S., & Duncan, P.M. (2017). Bright futures pocket guide (4th Edition). American Academy of Pediatrics.
