I had my LTC rotation at HHC Gouvneurs long term facility in Lower east side Manhattan. This rotation was truly such a great experience for me because of the amazing staff and physician I was able to work with. The atmosphere was very welcoming and helpful, and you felt the care they gave to all their resident patients. The main floor I worked on was the sub acute rehabilitation floor, here the patients would come after major procedures in order to heal for several weeks before they went back home or went to a nursing home.  

My most memorable patient encounter was with an elderly Asian woman who came in after having a craniotomy done after getting a subdural hematoma due to a fall. Even with her limited English, she became very comfortable with me, and I was able to check on her for several days. I also helped remove her staples from her scalp as well as helped with whatever else she needed. During her stay with us, she ended up having severe hyponatremia, so I was able to help the Doctor in the clinical thinking of how to best manage her electrolyte levels.  

One thing I enjoyed about working in a long term facility was that we were able to follow these patients for several weeks, and monitor their progression and response to our treatment and maintenance plans. Often times, in an ER or urgent care setting, it is hard to follow up with patients since you are with them for such a short period of time, but here this elongated stay allowed for a more proficient healthcare experience, as well as it built a better relationship and rapport with the patients. Along with the patients, speaking to families and educating and counseling them was a very important part of long term care. The Doctor I was with, taught me ways to say things that are both blunt and to the point, along with being empathetic and compassionate.  

I was unable to do that many procedures here, as most of the patients were here in a rehab setting and the nurses took all the blood. However, I was able to help with wound care and changing ulcer dressings, as most of the patients were bed bound, and had multiple sacral ulcers. I was also able to assist and observe the physical therapist. They had a different approach to each patient, in how much they would exert them and in which way. This really drove home the importance of individuality and patience in patient care.  

Overall a lot of these patients were very complicated in that they had numerous problems that they were dealing with along with the current issue they were there for. Because of these, it was important to learn how to plan on what we could do for them without affecting anything else in their health.  

I was able to write a lot of admission notes and patient comprehensive notes for the residents. This was challenging at first, because I had to sift through their history and highlight what was important. But the doctor had me make my own assessment and plan, and then we would discuss it after. This allowed me to use critical thinking in how we could best manage the patient and have them discharged as soon as possible. I was also able to work with the social work team, in helping the patient with their home and stay set up after discharge.  

This really was a great rotation, and it taught me so much about not only medicine in the elderly, but also the importance of compassion, patience and empathy.