My fourth rotation was Long Term Care in Forest View Rehabilitation Center, located in Forest Hills. Long Term Care was definitely a different experience for me compared to my previous rotations because up until now, I was more used to acute care. My usual routine in the past was: a patient comes in with a complaint, we run tests and prescribe medications, send them home and wait for test results or response to treatment before moving forward. This was not the case for LTC! In this rotation, many of these patients had already been treated at the hospital, and were sent to the nursing home for physical therapy, occupational therapy, monitoring, etc. In this setting, we work to nurture the patient, and help them get as close to their baseline as possible before sending them home. In the interim, providers in LTC must deal with any complications that may come up.

My rotation mainly consisted of seeing patients with my preceptor during rounds, conducting physical assessments, and working on charting and thinking through the patient’s care plan with my preceptor.

One thing that I had wished that I could have done during this rotation was follow the wound care team to see how they assess and care for pressure ulcers, DTIs, amputations, etc. Unfortunately, because there was a shift in staff and a new wound care team was being established, I was not permitted to follow them. Instead, I would ask my preceptor if we could spend more time assessing wounds if we ever came across them, and then I would follow up with additional research I did on my own regarding the type of wound it was, what causes it, what stage it is in, and the appropriate management. In this way, I was able to make the most of the unfortunate predicament I was in.
Moving forward, I would like to improve on interpreting lab work in order to differentiate things such as Iron deficiency anemia and anemia of chronic disease. In the LTC setting, many patients are wrongfully diagnosed with iron deficiency anemia and are given medications that do not help them at all. Additionally, I would like to improve upon my understanding of how different diseases and underlying conditions can all play a part in the patient’s current presentation. When working with the elderly, there are so many diseases (i.e. diabetes, CKD, stroke) that are important to know thoroughly in order to truly understand a patient’s condition