Some of the many things that I learned on my Urgent care rotation at Nao Medical were about how to take a quick, efficient history, practice physical exam skills, and effective note writing. I had the opportunity to see patients with many different medical conditions, and practiced differentiating emergent vs. non-emergent pathology.
On this rotation, I realized that urgent care often serves as primary care for those who cannot get an appointment with a PCP, as well as to prevent people from going to the ER unless it was necessary. I found that certain problems became emergent if we did not have the necessary resources such as stat labs or forms of imaging even if the condition was not immediately life threatening. I worked alongside many different PAs and Nurse practitioners, depending on which day and location I was on shift at. It was interesting for me to see the different provider styles when it comes to patient interactions and documentation. One of the nurse practitioners who I worked with often, allowed me to write the notes after seeing patients so I got a lot of practice writing numerous full H and Ps each shift, and I feel like I have improved my efficiency in that area.
I also had the opportunity to see many different urgent care conditions including eye complaints, ENT problems, and lung pathology. I felt like on this rotation I became more experienced in differentiating one abnormal from another, in contrast to normal from abnormal. For example, after listening to many lungs in patients with acute cough, I became proficient at identifying wheezing and rhonchi. I also learned to differentiate conjunctivitis from more serious eye complaints based on physical exam, and perforated tympanic membranes vs. infections.
Another skill that I practiced on this rotation was performing and documenting musculoskeletal exams since many patients came to urgent care with acute injuries. I found myself becoming proficient at inspecting for bruising, swelling, and deformities, palpating for tenderness, pulses, and any other abnormalities, and effectively checking for strength and range of motion. The more patients I saw with these complaints, the less I had to look up specific muscle locations, and other details for documentation.
At the Crown Heights location at Nao Medical where I did majority of my shifts, there is the ability to perform x-rays on site. Along with a Nurse Practitioner, I reviewed many x-ray images, and compared them with the read from the radiology team. This was good practice at looking at imaging while considering the likely pathology based on history and/ or mechanism of injury.
In conclusion, I gained a lot from this rotation and learned many new skills. I now appreciate how an urgent care runs, and how to recognize normal from abnormal, abnormal from abnormal, and the treatments for many different conditions. I will take this experience with me and continue to improve on the skills that I have acquired.
