Pictured above: Caroline holding a baby kangaroo a patient brought to their appointment.
Over the course of the summer, I had the opportunity to work a full-time job as a Patient Care Technician (PCT) at an orthopedic office in Dayton. Although I have had previous clinical experience at clinics hosted by RAM, my role as a PCT provided the most hands-on interactions I have had to date. While my exact tasks varied slightly from day to day depending on the provider I was working with and what types of appointments were scheduled, my days always consisted of the following: cleaning and restocking patient rooms at the beginning and end of clinic, rooming patients, documenting patient answers to intake questions, collecting vitals, and relaying any patient concerns to their provider. On an as needed basis, I was responsible for removing ER splint casts, plaster casts, sutures, and surgical staples. Additionally, I cleaned surgery trays and kits for suture or staple removal.
Being in a clinical role with such close proximity to physicians allowed me to get a strong sense of what it is like to be a doctor on a daily basis. I developed an understanding of how it is best to schedule patients in order to prioritize more urgent cases. For example, a first week post-op appointment should not be pushed back at all, but a 2 month recheck appointment can usually wait a few extra weeks if necessary. I also had the opportunity to see the progression of diagnoses. One patient came in for a carpal tunnel suture removal and complained of redness and warmth around a round dark spot. It appeared as though a suture remained undissolved; however, after inspecting it, I noticed that skin had grown over the dark spot and there were no visible suture ties. I called the PA in to examine in and she recognized that the suture was likely still in the process of dissolving and that the dark spot was just blood pooling in the wrist from the other dissolved sutures. The redness and warmth was also explained by this and not indicative of an infection. In another case, I was watching a surgeon perform a trigger finger release surgery. The procedure progressed as expected, but when the surgeon asked the patient to open and close her hand, she noticed that the tendon was slipping off of the knuckle. Although the trigger finger was resolved, this new problem required her to bandage the finger in a more supportive way in hopes of the tendon healing itself before surgery could be considered. Both cases demonstrated the need to be receptive to new patient information and to treat all ailments accordingly.
My favorite aspect of my job by far was the patient interactions that I had. I learned a lot about how to navigate patients’ emotions in a kind and professional way, as everyone who comes to the office is experiencing pain that often affects their quality of life. One patient came in from the ER with a fracture in her forearm and was visibly upset. Halfway through the intake questions, she began to cry and admitted that she was really frustrated with her injury and that she felt treatment would be helpless for her. I handed her a tissue and explained to her what the process of recovery would likely look like. She told me that she was really grateful for the outline I gave her and that she feels like she has been left in the dark for many of her other doctor’s appointments. By the time I left the room, she had calmed down and felt ready for her appointment to move forward. It was incredibly rewarding for me to feel like I was able to make a difference for someone under a lot of stress and it confirmed for me that I have the ability to handle patients in distress. One of the more challenging aspects of patient interaction is evaluating how likely it is that a patient is misusing opioids. Some of the potential indicators that I noticed were when a patient is repeatedly asking the same questions despite not having any diagnosed cognitive deficits and rapid or slurred speech. However, the process of determining whether or not someone is using prescriptions inappropriately is much more complex, and I still do not have enough experience to make that judgement. It is my goal to learn more about how doctor’s go about handling these situations while still respecting the dignity of the patient. When I return to this orthopedic office over winter break, I plan to learn more about how to handle situations where drug abuse is suspect, how doctor’s go about ruling out other conditions, and I plan to shadow surgeons in the OR.