Going into this Ambulatory Care rotation at Centers Urgent Care (CUC), I was extremely excited; not only had it been a couple of months since I had been on site for a rotation due to the pandemic, but I had my background as a medical assistant and scribe in urgent care, so it was a setting I was familiar with and excited to get back into.

Overall, I had an incredible time on this rotation. I really appreciated the urgent care setting because of the wide variety of cases. Of course there was a lot of COVID-19 antibody testing owing to the nature of the times we are in, but in the same shift I came across this, laceration repairs, orthopedic complaints, UTIs, ENT complaints, and so much more. I found that, while I initially thought I might not enjoy urgent care, this is a setting that I would definitely enjoy to work in as a clinician because of this variety. I think it would be a great way to keep all of one’s skills and knowledge fresh and keep from getting bored.

My preceptor, Sharjeel Shaw, PA-C, was such an asset in this experience. He was extremely hands on and very willing to teach. For example, in one of the laceration repairs I was handling, he found that a simple running suture would have been more appropriate than simple interrupted sutures that I had been used to placing up until that point. He brought me out to the provider station, showed me a video of the technique we would be using, and then demonstrated on the patient. After he anchored the suture and set the first few steps of the running suture up, he allowed me to finish it once he was confident that I understood the technique. He used this “see one, do one” method throughout the four weeks of the rotation for local anesthesia, digital blocks, electrocautery and evacuation of subungual hematomas, cauterizing wounds with silver nitrate, fluorescein stains, and more. Being able to perform these procedures under Mr. Shaw’s direct supervision with live feedback was so valuable, because it allowed me to be confident in these procedures going forward through the rotation and have bolstered my confidence going into the following rotations.

Being that this is was an urgent care clinic, there was not much time to be doing complete H&Ps. With this in mind, I chose to do SOAP notes for my write-ups in this rotation, which also reflected the style of the EMR (eClinicalWorks). I was initially apprehensive about this because outside of the few times I had written SOAP notes for assignments during the didactic phase of the program I had not really had much experience with SOAP notes and I wanted to do my best. This was actually a blessing in disguise though because I feel like I have really improved in my documentation skills and could probably write up a SOAP note in a few minutes with all the pertinent information. I have also come to appreciate SOAP notes much more and, unless instructed otherwise, would probably use them going forward in the rest of my rotations and clinical practice whenever appropriate.

There were several memorable patient experiences throughout this rotation. One of the first ones I have was in the first week of the rotation for a patient who came in for COVID-19 antibody testing. There is typically not a lot done in this type of visit outside of the blood draw; I collected the patient’s vitals, asked her some ROS questions to make sure she wasn’t displaying any signs or symptoms of COVID-19 in the last 2 weeks, listened to her heart and lungs, explained to her some information concerning the antibody test and its results, and, of course, drew her blood for the test. Typically this kind of visit takes up to 10 minutes as long as there are no abnormal vitals or any difficulties with the blood draw. This experience was not memorable for me because of what I did for this woman, but because she liked how I did what I did for her. She told me she really liked the way I spoke to her about the test and explained what I was doing step-by-step and thought my technique was good, so she actually went home and came back with the rest of her family so I could do the same for them. This experience validated for me that my patients would like me and felt confident in what I was doing enough that they would trust their loved ones to my care. That was a nice experience for me because, as a student, there is always some apprehension walking into a patient’s room and introducing myself; I always have a series of “what-ifs” going through my mind: what if this patient does not want to be seen by a student, or what if something goes less than ideally and that causes a problem for myself and my preceptor? This patient interaction so early on really helped me relax and validated my belonging there.