Beginning my rotations in ambulatory care provided me with valuable insight into the expectations and workflow of outpatient and urgent care settings. I appreciated the opportunity to witness a diverse patient population with a wide range of presenting complaints, demographics, and complexity. Throughout this rotation, I learned how to navigate the fast paced environment of an urgent care setting, while also managing acute complaints, developing differentials, and creating treatment plans.

Something new that I was exposed to throughout this rotation was how to properly manage chronic conditions. Although many patients presented with acute complaints, there were several patients who also had comorbidities that were not being properly controlled. I learned that managing hypertension and diabetes involves a step wise approach, while considering patient adherence and changes to their blood pressure and A1C values. Initially, I was unsure of how to manage patients on multiple medications and to determine when to adjust dosages or add and discontinue medications. However, having this exposure has encouraged me to further learn the guidelines for hypertension and diabetes treatment as well as properly assessing the patient as a whole. 

This rotation also strengthened my patient education skills. Previously, I would just present my proposed treatment for the patient’s chief complaint. However, I learned the importance of educating the patient on non-pharmacologic interventions that can improve their symptoms. For example, I counseled patients on diet and exercise modifications for their mildly elevated blood pressures or pre-diabetes, offering suggestions on diet options and activities. For viral illnesses, I have educated patients on why antibiotics are not indicated for their conditions, and how hydration, rest, and supportive measures would resolve their symptoms. 

I also obtained very valuable and constructive feedback from my preceptors, particularly regarding improving the thoroughness of my HPIs. In the urgent care setting, I was initially focused on the patient’s current complaint. I realized as I went on throughout the rotation, I needed to pay attention to the patient’s past medical history, vitals, and other relevant medical information to provide more comprehensive care. This taught me to assess the patient as a whole rather than just assess their current issue, even in an urgent care setting. Although at times it was very busy, having comprehensive examinations of the patient allowed me to not miss any important differentials. 

I was also able to start practicing many procedures throughout this rotation. I had the opportunity to do several venipunctures, administer injections of all types, manual blood pressure measurements, perform and interpret EKGs, and do suture removals. I feel more confident in my ability to perform these skills as I move onto my upcoming rotations and anticipate improving on them. 

Overall, I enjoyed this rotation and gained a lot of valuable knowledge from it. I initially was not very fond of urgent care due to its fast and busy nature. However, I grew to appreciate it as I became more comfortable and developed relationships with many of the patients who I saw regularly. This rotation also taught me that to be a better provider, I should take my time with each patient and properly assess them. I have learned that with the proper knowledge and skill set, I could be capable of working effectively in an ambulatory care setting.