Number 1,
Throughout my clinical rotations, I have witnessed several previously unfamiliar procedures. For example, a patient diagnosed with benign paroxysmal positional vertigo (BPPV) was encountered during my very first initial clinical rotation. The patient reported feeling dizzy even when moving very slowly. Benign paroxysmal positional vertigo (BPPV) is the most common cause of vestibular system-related vertigo (Lindell et al., 2020). This disorder is caused by the migration of otoconia from the utricle to the semicircular canal (Lindell et al., 2020). According to Lindell et al. (2020), BPPV symptoms include vertigo, disorientation, and nystagmus, which are triggered by posture changes such as reclining or rotating in bed. The preceptor successfully performed the particle repositioning maneuver (PRM) such as Epley’s maneuver on the patient. During my current clinical rotation, I confronted a similar patient with vertigo and nausea symptoms. The possibility of benign paroxysmal positional vertigo (BPPV) quickly struck me, and I discussed my opinion with my preceptor, and he permitted me to perform the Epley’s maneuver technique. I had to refresh my memory, though, so I quickly watched YouTube before implementing the technique. The patient felt a sense of relief.
Throughout my clinical rotations, I had the opportunity to witness the performance of suturing procedures for lacerations as well as the removal of lesions, skin tags, moles on adult patients, and performing Pap smears. I still want to acquire additional practical experience in a variety of procedures, including but not limited to cast application, incision, and drainage, and enhance my confidence in performing these procedures.
(Barton, 2022, Figures 3A) (Barton, 2022, Figure 3B)
References
Barton, J. J. (2022). Benign paroxysmal positional vertigo (M. J. Aminoff, D. G. Deschler, & J. L. Wilterdink, Eds.). UpToDate. Retrieved May 24, 2023, from
Lindell, E., Kollén, L., Johansson, M., Karlsson, T., Rydén, L., Falk Erhag, H., Wetterberg, H., Zettergren, A., Skoog, I., & Finizia, C. (2020). Benign paroxysmal positional vertigo, dizziness, and health-related quality of life among older adults in a population-based setting. European Archives of Oto-Rhino-Laryngology, 278(5), 1637–1644.
Number 2
I unfortunately, really haven't had any opportunity procedures except for cryotherapy on a plantar wart. I really wasn't even aware that this was done at a primary care office. I watched my preceptor cryo 1 wart and I did the second one. It was interesting and actually fun. I like anything hands on. Cryotherapy is the use of extreme cold to freeze and remove abnormal tissue. Besides warts it can also be used on skin tags and some cancers, including prostate, cervical and liver cancer. (Cleveland Clinic, 2020) I also observed many steroid injections performed in various joints via ultrasound in the office. My first preceptor was a primary care physician that had a secondary sports medicine specialty so he performed an average of 4 injections a day.
I started at a new family practice for this clinical due to the fact that this new clinical site sees a lot of pediatric patients and I am with a nurse practitioner now instead of a physician. My first Primary Care clinical site did not have many peds patients. I had 11 pediatric cases in the 4 months I was there. The downside is my new clinical site does not perform many procedures either in the office. I am planning on going to do a specialty rotation my last 3 weeks of the program to get more experience with procedures. I would love to have experience before I graduate with suturing, stapling and irrigation and drainage.
References
Cleveland Clinic. (2020). Cryotherapy. .
