Mikala Monroe

Journal Week 2

1-15-24; MLK

1-16-24; 7:45 - 12:00; 1:00 - 4:15 = 7.5 hours

The first day of this week was more of me just following the PA Brooke around as she went in

with patients. I didn’t do anything other than that really. I learned how to fill up the nitrogen

tanks as well as set up rooms for visits as well as seeing how they call patients back to the rooms.

I observed several biopsies done for patients who have possible squamous and basal cell cancer.

I also observed the PA freezing off precancerous spots with nitrogen. There were some patients

with keratosis who wanted those spots removed so those spots were frozen off as well. I

observed a C&D, which is when a patient's biopsy comes back as surface level cancer, they

scrape the area and then cauterize it multiple times. I was present in the room during this

procedure 2 times before but the 3rd patient produced a stronger smell and it made me feel ill

like I was about to fall out so I had to excuse myself from the room. I am familiar with this

feeling since it happens to me quite a bit, so I didn’t know it was related to the smell until the PA

told me it was and that it would probably take me a while to get used to it.

1-17-24; 7:45 - 12:00; 1:00 - 5:00 = 8 hrs 15 min

During my second day this week I was following a nurse practitioner around as she went in with

patients, she does pretty much the same stuff as the PA so this didn’t concern me. I followed the

NP because the PA goes to Warner Robins on Wednesdays. I felt like I did more hands-on work

today because the women there understood that it would help me learn faster. I felt like I needed

to learn this way yesterday but I didn’t really have a welcoming sense of being able to ask

questions or work hands on with them. They started me off filling syringes with 0.5ml of Sodium

Chloride and then 1.7ml of Lidocaine. Next the medical assistant in biologics walked me through
Mikala Monroe

how to put in patient information in their charts and how to listen to the NP as she’s examining

the patients. I was also able to call in patients from the waiting room and ask initial information

such as if they have any new concerns that they want the NP to look at.

1-18-24; 8:00 - 12:00; 2:30 - 4:00 = 5.5hrs

Today was a lot better for me, I got to go with the nurse practitioner and her team to the skincare

physicians office in Gray which was a little closer to home. It is a lot slower in this office since

there aren’t that many patients throughout the day. One of the medical assistants gave me some

notes with dermatology terms that I will hear a lot while I’m here so I was able to make quizlets

during the times we weren't seeing patients. The most fun experience I had today was getting to

remove sutures on two patients, one who had to have an excision, and the other who had 3 punch

biopsies on her legs.

1-19-24; 8:00 - 12:00; 1:00 -

Today has been a lot more simple. I have just been doing the same thing as the other days,

following the nurse practitioner around as she does skin checks on patients. We’ve had a few

patients getting SKs removed which are completely normal and non concerning, but some people

like them removed because they can itch or for aesthetic reasons. There have also been a few

people getting AKs removed which are precancerous spots on the skin that if you don't remove

or freeze, they will eventually become cancerous. I learned the difference in appearance between

SKs and AKs which is that SKs have an actual base that they grow from but AKs do not, they

kind of have a more abnormal shape. I also removed some simple interrupted sutures which are

different from the ones I removed yesterday, those were mattress sutures since I only had to cut

them once. We weren’t that busy since it’s friday so I’ve also been able to learn the vocabulary

they provided me.

Mikala Monroe

Day Time In Lunch Time Out Hours Worked

Tuesday, 7:45 A.M. 12:00 P.M. - 4:15 P.M. 7 hrs 30 min

January 16th 1:00 P.M.

Wednesday, 7:45 A.M. 12:00 P.M. - 5:00 P.M. 8 hrs 15 min

January 17th 1:00 P.M.

Thursday, 8:00 A.M. 12:00 P.M. - 4:00 P.M. 5 hours 30 min

January 18th 2:30 P.M.

Friday, January 8:00 A.M. 12:00 P.M. - 2:45 P.M. 5 hrs 45 min
19th 1:00 P.M.

Total Weekly 27
Hours