I was extremely excited to go into my second rotation; not only was North Shore University Hospital (NSUH) one of the rotation sites I was most eager to go to, but it was also going to be my first inpatient experience outside of our hospital visits from our Physical Diagnosis 1 and 2 courses. I had gained some confidence from my patient interactions from my first rotation, so I was ready to take that even further in this rotation.

Rotating at NSUH was one of the most amazing experiences I could have imagined. I was exposed to so much; I spent some time in the emergency department, endoscopy, hematology/oncology, the cardiac catheterization lab, the electrophysiology lab, the general neurology/epilepsy/stroke teams, interventional radiology, and the MICU and was able to observe some TAVRs, TMVRs, and mitral clips, in addition to rotating in the internal medicine service. Most of the time I worked under PA Dawn Coburn, but I was also able to learn from a whole bunch of other great PAs, NPs, and physicians.

This was a great learning experience because I was able to see and help manage so many conditions I had never heard of or did not think I would ever see, including Churg-Strauss Syndrome, necrotizing myositis, leptospirosis, and chronic thrombotic microangiopathy. I was also able to learn a lot about the MICU setting, which we do not touch on a lot in the didactic portion of our program. That, in itself, is extremely complex and could use an entire rotation on its own, but this experience made me feel like it would be great if we had even one day where we learned about the basics of the MICU, especially ventilation and when it appropriate to call an ICU consultation. I was especially grateful of my time with the neurology teams because I am very interested in neurology and hope to explore that when I graduate. Since I was able to experience medicine from so many different perspectives, I will be able to carry all of these experiences with me to the rest of my rotations.

In addition to time on the floors and with the different teams, the rotation at NSUH also included a weekly meeting with Jonathan Sobel, DMSc, PA-C (past AAPA president and current Senior Administrative Director of Advanced Clinical Providers at NSUH) and Victor Dyreyes, PA-C (Director of Physician Assistant Services at NSUH) where the PA and NP students got together in a conference room and each student presented a case and answered any questions that might have come up concerning that case. This was a really great way to get all of the PA and NP students together since we can often be so isolated from each other and was also a great learning opportunity since almost all the students were on different rotations. Unfortunately, the last week’s meeting was cancelled due to COVID-19 concerns.

There are definitely a few patient experiences that stick out to me either because I was able to spend a lot of time following that patient or their case was very interesting to me. One that struck a very strong chord with me, though was with a 21 year old man with a history of anxiety who came in complaining of fever, abdominal pain, and shortness of breath and presented to a different hospital twice earlier in that same week and was discharged without any answers. He presented to NSUH because he felt like he needed new ears to listen to him and was admitted for possible pneumonia versus vaping related lung injury and enteritis. My preceptor assigned this patient to me and I went to see him as soon as he was brought up from the emergency department. Immediately, I knew this patient would require more support than just that of a medical team. He looked absolutely terrified to be in the hospital and was completely alone at 21 years old. After I got his history and physical exam he told me how grateful he was to speak with someone that he felt cared about his well-being and was close to his age. Since he did not have insurance, I made sure he was in touch with the unit’s social worker to provide the information on how he could get set up with that and perhaps with an outpatient therapist/counselor so he would have someone to talk to once he was discharged. I made sure to follow up with him every day until his discharge and helped him get his family to come visit him while in the hospital. This experience definitely helped solidify that patients sometimes need more than just a treatment plan; they also need to be listened to and supported in whatever way is possible.

In this rotation, I really wanted my preceptor to notice my attention to detail and dedication to my work. I checked for new lab results and consultations/recommendations for the patients I was assigned regularly and made sure to update my preceptor with any changes that needed to be addressed. I made sure to provide the proper level of detail when I wrote handoffs, progress notes, discharge notes, or gave sign-offs to other providers. I also stayed late whenever possible so I could get the most out of this experience.