Ambulatory Medicine rotation involves a wide range of conditions and provides exposure to a variety of procedures. The treatment strategy in urgent care differs from the previous rotations I have done. The strategy used here is to figure out if the patient’s concerns can be handled as outpatient or requires care at a hospital. Although sometimes this can be redundant there were also several moments where the patient’s concerns differ. 

At this urgent care I was able to perform several different procedures which included suturing, IM injections, venipucnture, ear irrigation and splinting. I was able to practice these procedures throughout the rotation. However, practice is still necessary to be better at these procedures.  The patients that I found to be difficult were pediatric patients. It required a skill to physically examine them and obtain a history about the complaint. This was a challenge I faced during this rotation. Each pediatric patient presented with a different set of challenges. Some would answer my question and stay quiet while others would go on tangents with other un necessary information. It was difficult to gear these patients back to the pertinent information. It is important to ask the parents for help, to either get the information or even hold them while doing the physical exam. 

A memorable patient for me during this rotation was a patient with a history of Von Willebrand disease who presented with SOB, black stools and unstable vitals.  The provider explained the importance of going to the hospital, but the patient refused to agree. He left the facility AMA. This was a reminder how as a provider it is your duty to do everything possible to help heal the patient. However, at the end of the day the patient should want to be healed. Throughout this 5 week rotation I gained  confidence level for doing procedures. I was very intimidated prior to this rotation. However, taking the leap forward and practicing them helped me gain confidence. This was a great rotation where I was able to develop my medical knowledge along with becoming mentally stronger.