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Nurse practitioner student doing their fourth week of clinical rotation at a gerontology primary care office
From the perspective of a nurse practitioner student doing their fourth week of clinical rotation at a gerontology primary care office: Describe your clinical experience for this week.
Did you face any challenges, any success? If so, what were they?
Describe the assessment of a patient, detailing the signs and symptoms (S&S), assessment, plan of care, and at least 3 possible differential diagnosis with rationales.
Mention the health promotion intervention for this patient.
What did you learn from this week’s clinical experience that can beneficial for you as an advanced practice nurse?
Sample Answer
Fourth Week in Geriatric Primary Care: Navigating Complexity and Celebrating Small Victories
My fourth week in clinical rotation at a bustling gerontology primary care office has been incredibly enriching and, at times, humbling. The pace is different from acute care settings; here, the focus is on longitudinal relationships, complex polypharmacy, and the subtle presentations of illness in our older adult population. This week, I’ve had more autonomy in conducting initial assessments and formulating differential diagnoses, which has been both challenging and incredibly rewarding.
Challenges and Successes
Challenges: One significant challenge this week was managing the sheer volume of information. Many older adults present with multiple comorbidities, a long list of medications, and often, vague or overlapping symptoms. For instance, differentiating between cognitive changes due to a urinary tract infection (UTI), a new medication side effect, or worsening dementia required meticulous attention to detail and careful questioning. I found myself frequently reviewing medication lists and cross-referencing past medical history, which can be time-consuming. Another challenge was sometimes overcoming patient and family hesitancy to discuss sensitive topics, like urinary incontinence or cognitive decline, due to embarrassment or fear.
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