I completed my IM rotation at North Shore University Hospital. This was such a gorgeous facility, and everyone was very welcoming and kind. Here we were under the direction of our preceptor Dawn Coburn PA-S, who was an absolute pleasure to work with. I was also working along side students from other schools, who were very kind and friendly, and we became quite close. Since this rotation was Internal Medicine, it really was a little all over the place, in the sense that we were involved in all parts and floors of the hospital, not just confined to a specific area. This was overwhelming at first, since it meant a lot more patients and conditions and running around to do, however towards the end it became more easy flowing and organized.  

In this rotation we were part of every floor and our Preceptor Dawn did an amazing job learning what our interests were and putting us in those particular areas. For example I really wanted to see the IM perspective in the ER and cardiology so I was able to do a lot of shifts in the ER with both PAs and NPs. I also observed a TAVR, which was very interesting since I have not seen that before. Being in the cardiac Cath lab was an amazing experience, and everyone there was so open and willing to teach and explain things. I was also on the hematology-oncology floor, the med-surg floor, the ICU floor, the telemetry floor and the endoscopy suit. As one can imagine, here I was able to get a well rounded view of internal medicine with experience from a broad array of fields in this rotation. In every floor I was in, everyone was very kind and helpful to the students and made sure to ask us questions as well as explain complex scenarios as well.  

At this facility I was able to do one week in the ICU. I worked with NP David Levy, who was such an incredible person. This week was both extremely challenging yet educational, as I learned so much about management of patients with life threatening complicated diseases. One such patient that I connected with was a patient who was actually a nurse at that hospital. She started experience acute episodes of neurocognitive loss and her coworkers brought her in for evaluation. She was then worked up for every neurocognitive disorder under the book, from encephalitis, neurosyphilis, prion disease to west Nile disease and more. All of her results were coming back negative yet she continued to acutely decline in front of use day by day. I went in every few hours and asked how she was doing and did a neuro check with her, and at times she would be sharp but other times she would forget where she was and was unable to identify simple objects. This patient required the work of the whole ICU team as well as professionals from other hospitals, since her case was so complicated. This showed me the importance of connected to your patients and working with a large team.  

This rotation also emphasized the importance of learning and presenting cases by having us join a weekly student presentation meeting with the academic head of the hospital. This meeting had all of the students rotating, the heads of the department as well as multiple providers. We were then randomly called on to present a patient that we saw and discuss differentials and answer any questions that we may be asked. This allowed us to think on our feet as well as gave us confidence to talk in front of a large group of people. Hearing other students present also was a great learning opportunity.  

For procedures here, I did not do that many, as a lot of internal medicine was to teach us management and hand offs. However I did help with a shoulder dislocations and any venipuncture that the nurses needed help with. Here I was able to do patient consults and write provider hand off notes, This taught me key aspects of charting that I will take with me in my future career. Going forward, I do want to do more procedures and practice taking more patient histories in an internal medicine setting. This is difficult however, since a lot of the patients are being handed off to t the IM team, and their histories have already been taken. I was able to present during rounds, so I was able to practice honing my notes to only what is most important in the hand off.  

Over all this was a great rotation. It was very well rounded, and allowed me to experience various parts of the hospital and learn from a variety of people. Everyone I met with were extremely kind and loved to teach. I will take what I learned from this rotation into my future clinicals and future work as well.