Clinical Practicum 4- PRIMARY CARE

Primary Care - Chronic Care Clinic

I spent my last clinical rotation at the Spartanburg County Detention Center in Spartanburg, South Carolina. Cristy Barbee FNP-C was my preceptor. During this rotation I had the opportunity to work with long term incarcerated inmates with complex chronic medical care. The chronic care clinic provided me the opportunity to give continuous primary care to male and female inmates with complex persistent diseases. In the prison I have been able to collaborate with the professional staff to provide essential medical, dental, and mental health (psychiatric) services in a manner consistent with accepted community standards for a correctional environment. Health promotion was encouraged through counseling provided during examinations, education about the effects of medications, infectious disease prevention and education, and chronic care clinics for conditions such as cardiovascular disease, diabetes, and hypertension.

The environment in the jail medical department can be very unpredictable and requires imagination, flexibility, and an ability to string together solutions to problems that no one has ever seen before. I have been faced with unique situations: botulism from cellside hooch (i.e., homemade liquor), resistant TB, preterm labor in women high on heroin with no prenatal care and creatively fashioning a splint that is not a safety risk.

My time in the jail has challenged me to deal with many implicit biases I have toward this population and learn how to give patient-centered compassionate care to each person I encounter. I trust this to be the most valuable lesson I have cultivated during my time here.