I spent my fourth rotation during long term care at Gouverneur, which was a skilled nursing facility that was part of the NYC Health and Hospitals. This rotation helped me learn more about the geriatric patient population. This facility had two sections that were a subacute rehab and long-term nursing home which is where I spent most days. Some of my days each week were split into both of these floors as an effort to gain experience in both.
On the subacute rehab floors, these patients were transferred from local hospitals for continued therapy using physical or occupational therapy to help with their ADLs and gait stability. My main preceptors these days were either Dr. Polina Gilchyonok and or Dr. Esha Gurnani. I would head to the nursing station every morning to see the hospital discharge summaries of the newly admitted patients, where I would write down the importants facts of each case. I would then see them myself, gain a better history and understanding of their situation, while also performing physical exams. I would then present these cases to Dr. Gurnani, where she would go over them in detail with me and we would go see the patients again for a second time.
One of the things that I felt was very helpful during this rotation was the fact that I was working on completing full H&Ps for each of these patients and coming up with a treatment and plan, where me and Dr. Gurnani would have discussions on if they were correct and appropriate for each patient. Also during this rotation, I had interim medical visits, where they served as a way to address any issues that patients staying longer than 3 months had. I worked closely with various different professions ranging from nursing, PT/OT, social work and speech language therapy. This was one of the unique things that this rotation had to offer as I was able to see how each had an interprofessional role to help each other and give the best care possible to these vulnerable geriatric patients. I was able to get some hands-on work with the nursing staff with either performing or aiding in inserting a straight catheter and performing blood draws.
I feel like I came out of this rotation learning more about the importance of various roles in medicine, how each came together to work as a whole and provide the best care possible.
