Since I passed the written and practical exams for my Health Assessment class, I can now start doing my clinical rotations. I have been paired with a family nurse practitioner who is on a team that manages the medical care for about 70 patients at a subacute and long-term care facility in Northwest Washington. This type of facility would not have been my first choice, but after meeting my preceptor yesterday I can tell I will learn a lot from her this semester. Most of the patients are elderly and have multiple comorbidities. Most commonly coronary artery disease, congestive heart failure, hyptertension, peripheral vascular disease, and type 2 diabetes. We got a couple of people ready for discharge, plus did wound rounds on a number of patients. One guy has this unbelievable wound on his foot. He is only 51 years old and has type 2 diabetes and as a result has developed diabetic neuropathy. This led to a condition called Charcot's foot in which the joints and soft tissue in the foot are destroyed. Click here if you want to see a picture, but I warn you it is not for the faint of heart!
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