Gouverneur Site Evaluation Summary

Presented

• Patients:I presented comprehensive History and Physicals from patients I had the opportunity to work with in SAR-Gouverneur Skilled Nursing Facility. I purposely chose patients with a complicated history so that I could best test my H & P skills. Patient history included but was not limited to patients s/p infective endocarditis of a native valve and another s/p mechanical fall whom found out she had breast cancer while hospitalized.
• Feedback: I met with and discussed my organizational skills about History and Physicals with my site evaluator. I was not adding important details in an easy-to-find fashion. 
• Changes: Since then, I have downloaded and am working with a template to better organize my thoughts; I also must add the state of the health a patient is in  if they do have a stable/chronic/resolved condition.
• Article: The article itself came from a trusted source, BMJ, but I did not present it in an organized fashion; I went on tangents because I did not want to read directly from what I had written.
• Feedback:Although I did practice presenting the article many times, I must be cautious to present with more organization and to mention only pertinent details in the future and to place these details in the correct portion of the document.
• Changes: I presented ” “Early Versus Late Surgical Intervention or Medical Management for Infective Endocarditis-A Systematic Review and Meta-Analysis” based not on the patient I presented, but the other patient that I’d written my other History and Physical on; next time I will ensure the article I present aligns with the patient I am presenting.
• Pharm Cards: I presented a total of 10 pharmacological cards of drugs I encountered while on rotation including: finasteride, alendronate, ceftriaxone, ondanesatron, furosemide, santyl, ribavirin, amlodipine, nafcillin and cefazolin.
• Feedback: While meeting with my site evaluator, I learned that it is more important to focus on the most “abnormal” adverse reactions of the above listed drugs. I really need to focus on what to monitor for next rotation. Additionally, I need to study the MOA of drugs better.
• Changes: I will only mention extreme adverse events; I will also further explore how drugs work and how they are excreted in the body.