Rotation # 9 – Site Eval Reflection

I really enjoyed my site evaluations with Dr. Davidson, she has extensive experience and knowledge of geriatric conditions, and she gave me the best critiques of my H&Ps so far. One patient I presented was an immigrant from Africa complaining of insomnia and lower back pain, which may have been a somatic manifestation of stress that her family was causing her, but still needed to be worked up for more serious etiologies. We discussed many medications, such as oxybutinin for urge incontinence, and diclofenac gel for joint pains. We also discussed Beer’s Criteria and medications that should be avoided in the elderly that may cause severe adverse reactions like hypotension and delirium. We discussed the issue of polypharmacy that many geriatric patients face, and the importance of medication reconciliation. We also discussed learning the importance of checking the patients feet for leg edema or diabetic nephropathy that could potentially lead to falls. Overall, it was very informative, and I will take much of her advice for my H&Ps forward into my PA career.