I finally saw my first patient in the clinic! I was seeing a patient for a reevaluation physical, which means that they had reached the end of their care plan and we do a physical to see how they have improved since their last physical and create a new care plan based on their current status. I have heard horror stories of interns’ first physicals in the clinic taking 4+ hours, going so long that they need to reschedule for another night, and then spending many hours and days doing the paperwork involved. So, I was a bit wary. My patient had an exam the next day and for her sake (well, yes, and also for mine) I wanted to be as efficient as possible. In the end, I was able to get the entire physical done in 1½ hours! And a good portion of that time was spent waiting for the faculty doctor to sign off on paperwork so we could move on to the next step. The patient left, and I spent another hour finishing up some of the written paperwork. The next day I came in and spent maybe another hour typing it up, getting everything approved with my faculty doctor, and wrapping up any loose ends. I was done that night with everything. Overall, I was pleasantly surprised with how smoothly the whole process went. Of course, there are some things I could improve on, for example some of the exams I did in an awkward order (“Ok, I’m going to have you sit….now stand up and do this for me….now lay on the table so I can do this…now stand for me again…”), but that will improve with practice. It doesn’t help that the paperwork doesn’t have the exams written in the most convenient order for performing them!
The following weekend, I did my first adjustment in the clinic, and it was a bit of a surprise. One of my patients that I wasn’t supposed to adjust for the first time until the following week needed to do a walk in, and I was already on campus for an elective, so I met her in the clinic. It all happened so fast I didn’t really have time to work myself up or get nervous about it. It was an AO (Atlas Orthogonal) adjustment, which uses an adjusting instrument, and is pretty “user friendly” so it wasn’t too nerve-racking.
On Monday I saw her again, and this time we did AO again, also an Activator workup and some trigger point therapy. It was a good experience. I have been enjoying Activator a lot—it is very rewarding, the protocol tells you what needs to be fixed, you adjust it, and then it tells you it’s fixed. It’s great. I also ended up doing my first NUCCA adjustment that night—also a surprise! I was planning on observing the intern I’m taking over for, but when she found out I had just finished the elective and could adjust NUCCA in the clinic now, she told me to do it. I had a hard time getting the patient to clear, so she tried too but also had a hard time…that made feel a little better. Guess it gives some room to grow!
Wednesday I saw another patient for a NUCCA adjustment, and this time it worked. The legs went perfectly even, all of the other post checks evened out, and I was thrilled! I think my patient was even impressed.
Within the course of one week, I’ve done one physical and four adjustments already, and let me just say…this is FUN! It’s great to be able to finally take what you’ve learned and use it toward patient care. I haven’t felt scared or nervous at all; Palmer really does prepare us well. I can’t wait to do more! Bring it on!
Alissa Grover, 7th Trimester Student