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Throughout my clinical rotations, I have gained diverse experiences witnessing various medical procedures, both diagnostic and therapeutic. One of the initial encounters was with a patient diagnosed with benign paroxysmal positional vertigo (BPPV), which is recognized as the most common vestibular disorder leading to vertigo (Lindell et al., 2020). BPPV typically results from displaced otoconia migrating into the semicircular canals, provoking vertigo, disorientation, and nystagmus, especially with changes in head position (Lindell et al., 2020). During this case, the preceptor performed the Epley’s maneuver, a particle repositioning technique that effectively alleviates symptoms by guiding the otoconia back to the utricle. I observed and later participated in similar procedures, which reinforced my understanding of vestibular disorder management (Barton, 2022). Additionally, I witnessed suturing for lacerations, lesion removal, skin tag excisions, moles, and Pap smear procedures, broadening my procedural exposure and confidence in clinical practice. I aim to further enhance my skills in cast application, incision, and drainage to ensure comprehensive competence before my graduation. Each of these experiences has contributed significantly to my practical knowledge and clinical confidence.

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Throughout my clinical rotations, I have encountered a variety of procedures that have expanded my practical skills and understanding of patient care. One notable case involved diagnosing and managing benign paroxysmal positional vertigo (BPPV), a common cause of vertigo among older adults and characterized by the migration of otoconia, which leads to dislodgment within the semicircular canals (Lindell et al., 2020). My involvement began when I observed my preceptor perform Epley’s maneuver, a particle repositioning technique that effectively alleviates vertigo symptoms. This procedure’s significance lies in its minimally invasive nature and high success rate, which makes it the preferred initial treatment for BPPV (Barton, 2022). I later had the opportunity to assist with or perform the maneuver under supervision, an experience crucial for developing confidence in performing vestibular procedures.

In addition to the management of vertigo, my rotations provided opportunities to learn and practice a plethora of procedural skills such as suturing, lesion removal, and skin biopsies. These experiences allowed me to refine my manual dexterity and familiarity with various instruments and techniques essential for minor surgical procedures (Barton, 2022). The importance of these skills cannot be overstated, as they form the foundation for effective outpatient surgical care. Improving my competence in these areas remains a key goal in my ongoing clinical education, with hopes of gaining further hands-on experience in cast application, incision and drainage, and other minor operative procedures.

Moreover, during my rotations, I observed cryotherapy performed on a plantar wart, which was a novel procedure to me. Cryotherapy involves the application of extreme cold to destroy abnormal tissue, including warts, skin tags, and some precancerous lesions (Cleveland Clinic, 2020). Witnessing the procedure firsthand provided insights into the application of this technique as a non-invasive treatment option within primary care. I also observed multiple steroid injections into joints, performed under ultrasound guidance by a physician with a sports medicine background. These injections are instrumental in managing musculoskeletal conditions, including tendinopathies and arthritis (Cleveland Clinic, 2020). Although my current clinical site with a nurse practitioner afforded fewer procedural opportunities, I am planning an elective rotation to supplement my hands-on experience, particularly in suturing, stapling, irrigation, and drainage, to ensure readiness for independent practice upon graduation.

Overall, these diverse procedural experiences during my clinical rotations have been invaluable in developing both my technical skills and clinical judgment. Exposure to varied interventions has reinforced my understanding of their indications, techniques, and potential complications. As I progress toward my graduation, I am committed to gaining further competencies in minor surgical procedures to enhance my readiness as a primary care provider who can confidently manage a broad spectrum of patient needs.

References

• Barton, J. J. (2022). Benign paroxysmal positional vertigo (M. J. Aminoff, D. G. Deschler, & J. L. Wilterdink, Eds.). UpToDate. Retrieved May 24, 2023, from https://www.uptodate.com
• Cleveland Clinic. (2020). Cryotherapy. Retrieved from https://my.clevelandclinic.org
• Lindell, E., Kollén, L., Johansson, M., Karlsson, T., Rydén, L., Falk Erhag, H., Wetterberg, H., Zettergren, A., Skoog, I., & Finizia, C. (2020). Benign paroxysmal positional vertigo, dizziness, and health-related quality of life among older adults in a population-based setting. European Archives of Oto-Rhino-Laryngology, 278(5), 1637–1644.