Reply to the following 2 Discussions

· Infant: wellness exam 

· Child: wellness exam, HEENT 

· Teen: wellness exam  

· Women’s: need 1 more, (1 of 2 completed) 

     A memorable patient encounter was being able to speak to a Spanish speaking diabetic patient who always had his wife speak for him at every visit. When I started to communicate with the patient, his eyes became really big, and he just started talking and talking and talking. It was so funny because the other staff and even his wife were surprised that he even spoke that much because usually he is just very quiet and sits there and lets his wife handle everything. Nobody had ever heard him speak more than a few sentences. We were able to talk about his diet, exercise, and monitoring his blood sugars at home and he seemed so relieved to be able to communicate and verbalize back his teaching and understanding. It was a great experience. While I am not fluent in Spanish, I speak enough to have a conversation and I think it meant a lot to this patient that I was willing to converse in his primary language. I think if I were to change anything, it would be to provide him resources in Spanish that he could use to help manage his diabetes at home. Language barriers can have a major impact on the cost and quality of healthcare and usually happen between providers and patients who do not share a native language. Health disparities and unequal treatment related language barriers are associated with unequal access to healthcare and outcomes (Shamsi et al., 2020). 

Post #2 Reply to Ashlesha

Hello everyone, I can’t believe we are done with our First rotation, it has been challenging, and thinking of getting a break, and I am glad we have a break for one week. So far is not bad! I learn how to manage work, home, and clinical. I like the role of FNP and am excited to be an FNP and serve in my area. I learned how to assess patients, perform Physical examinations and history taking, screen for preventive services, follow vaccinations and disease conditions and deal with that by following different guidelines, writing prescriptions, and manning controlled medications.

My first four weeks felt brutal and hard to handle, but I now learned how to manage and acquire patient trust, make good rapport, and care for them. I know to provide free and order-free samples to help patients get affordable services. In this rotation, I learned with my preceptor to care for all ages, including pediatrics, adolescents, adults, geriatrics, and women's health, and related guidelines for disease conditions. Each state has guidelines to follow to care for the patient to cover health insurance. I was confused about my role, but my preceptor stood by my side and helped me gain confidence by gradually giving independent cases and discussing the treatment plan with me as a future provider, aiding me in gaining self-confidence. She is always willing to clear my doubts and discuss issues by referring to the clinical guidelines, utilizing evidence-based references, and discussing new advancements and changes in current practice (Pearson & Hensley 2019). My whole program needed 21 soap notes, and I wrote six in 1 infant, one teen, and four adults according to the requirement in this class.

            Now, I am comfortable going into the patient room, doing a physical examination, building a good rapport with patients, and discussing plans, treatment, and health education with referrals and follow-up. I recognize my strength in thinking critically and providing care for all aspects, not only pharmacological, so I can easily manage non-adherent medications and non-compliant patients. In this rotation, I have seen many diabetes, thyroid issues, HT, Cholesterol, Skin conditions, minor emergencies, Arthritis, Vitamin deficiencies, and Respiratory, Psychiatric, and chronic pain conditions. I learned and experienced analyzing and diagnosing problems accurately and determining immediate treatment if necessary. I remember one patient who had DM-II and came to the clinic one day with the concern of Hypoglycemia due to an Endocrinologist started on Lantus S/C injection at night and went to ER twice for Hypoglycemia, sometimes following guidelines is challenging, next time if I see that patient I wish to teach him to check Blood sugar every night and if low or he doesn’t have a plan to eat that consider to not administer Lantus daily with self-evaluation because DM is an endocrine disorder and not follows by daily orders it depends on what patient eat, let him give more responsibilities to check sugar and if low than decide to get Insulin or not.  Sometimes it takes work to provide care and instructions to those unwilling to care for themselves, and it is hard to follow clinical guidelines. This is a skill that cannot achieve in one day. It takes effort and time, and I understand that. Also, in the future, I look forward to getting experience in minor procedures such as suturing and more exposure to speculum examinations. Overall, my experience is good, and I plan to stay with the same preceptor for my second rotation.