My long-term care rotation consisted of being at the Veteran Affairs center doing 8-hour shifts five days a week for five weeks. The shifts were during the day (9am-5pm) and I worked during the weekdays. I really enjoyed my five weeks working at the long-term care rotation. The patients I saw were called “Residents” because they actively resided at the VA center. I worked with a singular preceptor throughout my 5 weeks, and I really enjoyed the comradery with my fellow practitioner. The clinician and I had our own set of patients that we saw daily, as well as other patients we saw for acute issues throughout the wards.
Residents have been living at the VA for different amounts of timeframes. Some have been there for years, and other have been there for a few months. A few of the residents we saw were for short term acute rehab. I started the day looking at the Residents charts. At 9:30am we had a practitioner meeting with the head medical doctor to review patient issues and to talk about anything that was urgent or emergent.
After the meeting the practitioner and I would round on our patients to see how everyone was doing. Every month the Residents would go through their monthly medical evaluations, and that is what I was doing throughout my rotation there. There were many different Residents that had a wide array of different types of medical conditions and diagnoses. I would do a full systematic history and physical on every single Resident on my ward. I asked the Resident how they were currently feeling and I asked them if they had any acute complaints. I got the Residents past medical history, social history, review of systems, and I did a full physical exam. Then I reported what I heard and saw to my preceptor and we both went to see the Resident together.
Many of the Residents suffered from very similar comorbidities like PTSD, schizophrenia, HTN, HLD and much more. Seeing the same Residents daily for five weeks was very rewarding. You got to see how much more of an improved life the Residents had from the beginning of the rotation to the end. My preceptor told me about many of our Residents and how much of an upward spiral they went through from a few months back until today.
Going through various history and physicals with the elderly population was very eye opening. Many Residents complained of back pain and muscular problems, only to not be tender to palpation at all on physical exam. Other residents said they were okay, but my preceptor (being their primary provider) knew something was wrong took the Resident’s blood work and urinalysis to make sure nothing was going on with the Resident. Being at that rotation taught me that you needed to keep a keen eye on all the Residents there because their mental status could change overnight.
Overall, I really enjoyed my time at my long-term care rotation. Seeing the same Residents daily was very rewarding and towards the end because you really started to become more friendly with the Residents and they trusted you more with their care and to have more frank discussions with you.
