Name: Abd-Manaaf Bakere

Rotation 1: Surgery

Rotation Location: Metropolitan Hospital.

Reflection on Surgery Rotation

My first rotation was in surgery department at Metropolitan hospital from January 02, 2024, to February 02, 2024. From passive observer to active participant, each day brought forth new challenges, learning opportunities, and moments of profound growth.

Initially, I found myself at the periphery of the operating room, observing surgeries with fascination. The sight of skilled surgeons maneuvering through intricate procedures left an impression, sparking a desire to delve deeper into the realm of surgical practice. As the rotation progressed, I seized the opportunity to transition from observer to participant, guided by experienced surgeons and residents. This gradual immersion allowed me to familiarize myself with surgical techniques, instrumentation, and the nuances of intraoperative decision-making.

Engaging in hands-on activities became the cornerstone of my learning experience. From practicing the art of suturing to refining knot tying, each task presented a unique opportunity to enhance my surgical skills. Through repetition and feedback, I honed my dexterity and technique, gaining confidence with each successful maneuver. The operating room became my classroom, where every procedure served as a steppingstone towards proficiency.

Central to the surgical experience was the profound interaction with patients throughout their surgical journey. Engaging with patients in the preoperative setting underscored the importance of clear communication, empathy, and informed consent. Witnessing the transformative impact of surgical interventions on patients’ lives reinforced the significance of patient-centered care. Every interaction served as a poignant reminder of the profound responsibility entrusted upon healthcare providers to safeguard the well-being of those under their care.

Surgery, as I soon discovered, is a delicate task between pressure and precision. The operating room is a place where split-second decisions can have far-reaching implications. Through pressure, I learned to maintain composure, channeling my focus towards ensuring patient safety and well-being. Amidst the noise of instruments and monitors, I embraced the challenge of balancing surgical accuracy with the exigencies of the moment, emerging with newfound resilience and resolve.

In conclusion, my rotation at Metropolitan Hospital’s surgery department was a transformative learning experience that left a mark on my professional journey. From the halls of observation to the experience of participation, I emerged not only with improved surgical skills but as a compassionate guardian of patient care. As I embark on the next chapter of my medical career, I carry with me the invaluable lessons learned and the profound experiences shared within the walls of the operating room.

During my long-term care/geriatric medicine rotation at Metropolitan Hospital, I underwent a site visit evaluation by PA Arti Ramkumar, marking significant milestones in my learning journey. Both the mid and final evaluations, conducted via Zoom for nearly 3 hours and in person at NYPQ, respectively, offered comprehensive opportunities for assessment and feedback.

Throughout these sessions, I not only presented my History and Physical write-ups but also engaged in insightful discussions with peers like Emmanuel Ikealugo-Dennis, Fionna Du, and Anja Glumicic. PA Arti Ramkumar’s feedback played a pivotal role in shaping our understanding of patient care, stressing the importance of critical thinking and thoroughness in our assessments.

A notable aspect of our evaluations was the presentation of drug cards, where PA Arti Ramkumar not only highlighted the serious side effects of medications but also encouraged us to explore emerging uses of pharmacological agents. Moreover, during my presenting case involving symptoms suggestive of pancreatic disorders, PA Arti Ramkumar’s feedback prompted me to delve deeper into any missed labs or imaging studies that could enhance my diagnostic skills and enrich my approach to patient care.

The feedback provided was comprehensive, covering various facets of patient management. PA Ramkumar emphasized the inclusion of pertinent information in History and Physicals, such as medication dosage adjustments based on renal function, and ensuring that all medical problems were addressed in the treatment plan. This underscored the holistic approach to patient care, emphasizing that we are not merely treating isolated conditions but caring for the patient as a whole.

During my article presentation on the impact of CPAP on respiratory capacity in CKD patients undergoing hemodialysis, PA Ramkumar offered valuable insights, further deepening my understanding of the topic. Additionally, the challenging case scenarios brought forward by PA Ramkumar, such as the interaction between fluconazole and Plavix leading to a stroke, underscored the importance of vigilance in medication management and understanding potential drug interactions.

Overall, the feedback and discussions during the rotations with PA Arti Ramkumar were invaluable learning experiences that will undoubtedly shape my future practice as a PA. They equipped me with the skills and knowledge necessary to provide comprehensive and compassionate care to my patients, emphasizing the importance of continuous learning and patient-centered approaches in healthcare.

Name: Abd-Manaaf Bakere

Rotation 3: Long term Care/Geriatric

Reflection on Long term Care/ Geriatric Rotation

During my third geriatric rotation at Metropolitan Hospital, from March 11 to April 12, 2024, I gained invaluable insights into the complexities of caring for elderly patients. One key lesson I learned is that effective geriatric care extends beyond addressing immediate medical concerns. For instance, Mrs. Ortiz, an 80-year-old patient with multiple chronic conditions, taught me the importance of understanding her social support system. Despite her physical limitations, Mrs. Ortiz thrived with the support of her daughter who ensured she attended appointments and adhered to her treatment plan. This experience highlighted the significance of considering patients’ social circumstances when devising care plans.

Managing multiple chronic conditions in elderly patients requires a nuanced approach. Mr. Mendez, a 75-year-old gentleman with hypertension, diabetes, and osteoarthritis, exemplified the challenges of prioritizing treatment goals. Collaborative decision-making with Mr. Mendez and his family allowed us to tailor his treatment plan, focusing on interventions that improved his quality of life while minimizing adverse effects.

Geriatric syndromes, such as frailty, fall, pressure ulcers, polypharmacy, and cognitive impairment, are prevalent among elderly patients and can significantly impact their well-being. Mrs. Rodriguez, an 85-year-old woman with frailty and recurrent falls, underscored the importance of a multidisciplinary approach to management. Working closely with physical therapists, social workers, and pharmacists, we developed a comprehensive care plan that addressed Mrs. Rodriguez’s mobility issues, ensured home safety modifications, and optimized her medication regimen to reduce fall risk.

Effective communication is essential in geriatric care, particularly when addressing sensitive topics such as end-of-life care. End-of-life care discussions are often challenging but essential in geriatric medicine. During my rotation, I gained experience in initiating conversations about advance care planning, discussing goals of care, and providing support to patients and their families as they navigated complex decisions surrounding terminal illness and palliative care. By actively listening to patients’ wishes and involving their families in the decision-making process, we were able to ensure their preferences were respected and their end-of-life care were aligned with their values.

Interdisciplinary collaboration is fundamental in providing holistic care for elderly patients. Through my rotation, I had the opportunity to work closely with nurses, social workers, pharmacists, and other healthcare professionals to coordinate care and optimize outcomes for patients. Overall, my geriatric rotation provided me with a deeper understanding of the unique challenges and rewards associated with caring for elderly patients. By incorporating a comprehensive care approach, prioritizing treatment goals, addressing geriatric syndromes, communicating effectively, and collaborating with interdisciplinary teams, I am better equipped to meet the diverse needs of elderly patients in my future practice as physician assistant.