Responses

       I currently precept at a county clinic family practice. Though my preceptor sees all ages of life from pediatrics to geriatrics, majority of the patient I encountered during my time with my preceptor are adult (young twenties to early sixties). We had a few pediatric patients as well as Women’s health related cases. Next year in February and March I planned to follow a pediatric FNP and an FNP in Women’s health clinic. This will fulfill the requirements for this course. As of now I completed the SOAP notes for:

· Adult Pulmonary (Asthma)

· Pediatric/Teen HEENT (Common Cold)

· Adult GU (Pyelonephritis)

· Adult Musculoskeletal (OA)

· Adult Wellness Check up

· Adult HEENT (Acute Sinusitis)

 

 

 

 

 

            These graphs shows that I have completed 3 Pediatrics out of 80 required cases, 31 Geriatrics out of 100 required cases and 8 Women’s Health out of the 40 required cases. Overall, I need a lot of more cases to on each criterion. My next preceptor is an Adult Nurse Practitioner. This will satisfy the required 100 geriatric cases, I strongly
 believe. It’s been fun and fruitful experience for me. I learned so much from my preceptor and her team of nurses and medical assistants. I got a good insight of their clinic operates. I had seen over 250 patients in this clinic alone. One of the most memorable patients we encountered was a guy in late 70’s. He is very well mannered and has a very sharp mind for his age. He appears to be strong for his age and is highly involved in his medical treatment. I am amazed on how he lives his life to the fullest based on his story of the things he did when he was young. If given another opportunity and time, I would like to know more about his lifestyle or beliefs to further treat him according to his dogma.

 

The following three complementary tactics could support and strengthen the relationship between a doctor and patient by focusing on the needs and concerns of patients as they define them (Delbanco & Gerteis, 2022):

 

· Clinicians can implement an organized and methodical consideration of each patient as a distinct individual into their practices. In addition to the organ-specific examination of systems we learn in medical school, a “Patient’s Review” that particularly addresses the preferences, values, and needs of each patient can be helpful.

 

· Clinicians can employ survey tools and other methods that encourage patients to report collectively on their clinical experiences in addition to their individual patients, moving beyond their individual patients. Such feedback can be compared to patients’ experiences locally and nationally to give credible and trustworthy information on crucial features of doctors’ individual practices.

 

· Patients and doctors can collaborate to create treatment programs and share information. Getting on the “same page” is becoming more and more possible because to the rapidly proliferating use of electronic health records and the secure patient portals that increasingly go with them.

 

Reference

 

Delbanco, T. & Gerteis, M. (2022). A Patient-Centered View of the Clinician-Patient Relationship

https://www.uptodate.com/contents/a-patient-centered-view-of-the-clinician-patient-relationship?search=patient%20interview&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

 Of the six SOAP notes that I submitted for this course, I have completed the following:

· Wellness visit for an infant (< 12 months).

· Wellness visit for a child (1-12 years old).

· Wellness visit for an adult.

· HEENT for a child.

· HEENT for an adult.

· Cardiovascular (C/V) for an adult.

          For program completion, I aim to prioritize seeing more pediatric, women’s health, and geriatric patients in the family practice setting. In addition, the clinic where I precept sees numerous patients in their practice. Therefore, I am confident that I will complete my SOAP note requirements by the end of the program.  

          Among the clinical requirements for pediatric, geriatric, and women’s health, I provided a table to show what I completed.

Table 1 Clinical Requirements
Specialty	Required Cases	Completed No. of Cases	Needed No. of Cases
Pediatric	80	27	53
Geriatric	100	29	71
Women’s Health	40	14	26

          At the start of my clinical rotation, I was nervous and slightly overwhelmed at the number of patients my preceptor was seeing. I shadowed her for the first two days and tried to learn her diagnostic process and reasoning. She was very accommodating and answered all my inquiries regarding treatment methods and the medications she was prescribing. While seeing her patients, I also tried to orient myself to their computer chartings, like how to order diagnostic tests, put in referrals, and e-prescribing. By my third day, she was letting me see patients on my own, with her on stand-by in cases I needed to consult with her.  

          One of the most memorable patients encounters during this rotation was when my preceptor and I had to inform a 42-year-old Hispanic woman who was accompanied by her husband that she had breast cancer. It was hard not to be emotional, especially when the couple openly wept. However, my preceptor was very professional and maintained a calm and caring environment while she gave them the treatment plan. Four weeks later, I had the opportunity to see her husband at the clinic as a patient for his physical exam. He remembered me from his last visit with his wife and updated me on his wife’s condition. 

          Establishing a therapeutic relationship with patients and their families is imperative in increasing treatment plan compliance and improving health outcomes (Molina-Mula & Gallo-Estrada, 2020). This can also enhance a patient’s autonomy in making sound decisions on their health (Molina-Mula & Gallo-Estrada, 2020). 

References

Molina-Mula, J., & Gallo-Estrada, J. (2020). Impact of nurse-patient relationship on quality of care and patient autonomy in decision-making. 
International Journal of Environmental Research and Public Health, 
17(3), 835. 

https://doi.org/10.3390/ijerph17030835