{"id":7562,"date":"2016-01-19T09:40:11","date_gmt":"2016-01-19T17:40:11","guid":{"rendered":"https:\/\/familymedicine.uw.edu\/medex\/?post_type=post&amp;p=7562"},"modified":"2016-01-19T09:40:11","modified_gmt":"2016-01-19T17:40:11","slug":"from-ems-to-continuity-of-care","status":"publish","type":"post","link":"https:\/\/familymedicine.uw.edu\/medex\/magazine\/2016\/01\/19\/from-ems-to-continuity-of-care\/","title":{"rendered":"From EMS to Continuity of Care"},"content":{"rendered":"<p><strong><span style=\"font-size: 18pt\">Nicole Jakeman \u2013 Tacoma Class 2<\/span><\/strong><\/p>\n<p>Prior to entering the MEDEX physician assistant training program as a member of Tacoma Class 2, Nicole Jakeman worked in two areas of healthcare that appear to be polar opposites \u2014 emergency medicine and massage therapy.<\/p>\n<p>\u201cThey are,\u201d she agrees. \u201cAnd that\u2019s the reason I chose them, for that balance.\u201d Nicole studied to become a Licensed Massage Therapist while working in EMS, where she spent about eight year.<\/p>\n<p>Currently in her clinical year with MEDEX, we caught up with Nicole during her 4-month family medicine preceptorship with Dr. Peter LoGerfo in Puyallup, WA. This is a long way from her role as a paramedic, where she\u2019d jump into an emergency medical situation and triage, addressing the most immediate needs, then passing the patient off to a hospital facility.<\/p>\n<blockquote><p>\u201cIt&#8217;s been a really good experience being able to see patients return, and find out how they&#8217;re doing,\u201d she says. \u201cWe\u2019re able to tweak their care if something&#8217;s not quite right. We can make adjustments.\u201d<\/p><\/blockquote>\n<div id=\"amw_galleria_slideshow_1\" class=\"amw-galleria-slideshow\"><\/div>\n<script type=\"text\/javascript\">jQuery(document).ready(function(){ jQuery(\"#amw_galleria_slideshow_1\").galleria({\"dataSource\":[{\"image\":\"https:\\\/\\\/familymedicine.uw.edu\\\/medex\\\/wp-content\\\/uploads\\\/sites\\\/3\\\/2016\\\/01\\\/Nicole-Jakeman-4-1024x683.jpg\",\"big\":\"https:\\\/\\\/familymedicine.uw.edu\\\/medex\\\/wp-content\\\/uploads\\\/sites\\\/3\\\/2016\\\/01\\\/Nicole-Jakeman-4-1024x683.jpg\",\"thumb\":\"https:\\\/\\\/familymedicine.uw.edu\\\/medex\\\/wp-content\\\/uploads\\\/sites\\\/3\\\/2016\\\/01\\\/Nicole-Jakeman-4-150x150.jpg\",\"title\":\"Nicole 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Jakeman-14\",\"description\":\"\",\"altTag\":\"\"},{\"image\":\"https:\\\/\\\/familymedicine.uw.edu\\\/medex\\\/wp-content\\\/uploads\\\/sites\\\/3\\\/2016\\\/01\\\/Nicole-Jakeman-17-1024x683.jpg\",\"big\":\"https:\\\/\\\/familymedicine.uw.edu\\\/medex\\\/wp-content\\\/uploads\\\/sites\\\/3\\\/2016\\\/01\\\/Nicole-Jakeman-17-1024x683.jpg\",\"thumb\":\"https:\\\/\\\/familymedicine.uw.edu\\\/medex\\\/wp-content\\\/uploads\\\/sites\\\/3\\\/2016\\\/01\\\/Nicole-Jakeman-17-150x150.jpg\",\"title\":\"Nicole Jakeman-17\",\"description\":\"\",\"altTag\":\"\"},{\"image\":\"https:\\\/\\\/familymedicine.uw.edu\\\/medex\\\/wp-content\\\/uploads\\\/sites\\\/3\\\/2016\\\/01\\\/Nicole-Jakeman-15-1024x683.jpg\",\"big\":\"https:\\\/\\\/familymedicine.uw.edu\\\/medex\\\/wp-content\\\/uploads\\\/sites\\\/3\\\/2016\\\/01\\\/Nicole-Jakeman-15-1024x683.jpg\",\"thumb\":\"https:\\\/\\\/familymedicine.uw.edu\\\/medex\\\/wp-content\\\/uploads\\\/sites\\\/3\\\/2016\\\/01\\\/Nicole-Jakeman-15-150x150.jpg\",\"title\":\"Nicole Jakeman-15\",\"description\":\"\",\"altTag\":\"\"},{\"image\":\"https:\\\/\\\/familymedicine.uw.edu\\\/medex\\\/wp-content\\\/uploads\\\/sites\\\/3\\\/2016\\\/01\\\/Nicole-Jakeman-8-1024x683.jpg\",\"big\":\"https:\\\/\\\/familymedicine.uw.edu\\\/medex\\\/wp-content\\\/uploads\\\/sites\\\/3\\\/2016\\\/01\\\/Nicole-Jakeman-8-1024x683.jpg\",\"thumb\":\"https:\\\/\\\/familymedicine.uw.edu\\\/medex\\\/wp-content\\\/uploads\\\/sites\\\/3\\\/2016\\\/01\\\/Nicole-Jakeman-8-150x150.jpg\",\"title\":\"Nicole Jakeman-8\",\"description\":\"\",\"altTag\":\"\"}],\"width\":\"auto\",\"height\":0.76,\"autoplay\":false,\"transition\":\"slide\",\"initialTransition\":\"fade\",\"transitionSpeed\":0,\"_delayTime\":4000,\"_hideControls\":false,\"_thumbnailMode\":\"grid\",\"_captionMode\":\"on_expand\"}); });<\/script>\n<p>In this small clinic setting Nicole is able to observe the stages patients go through, and see the outcomes of treatment. \u201cIt&#8217;s been a very satisfying experience. With EMS you don&#8217;t learn a lot about the final diagnosis with your patient. Just drop them off, and you&#8217;re onto the next one. But being here and helping people through some difficult times\u2014 or some exciting times, like delivery\u2014we then see them come back, and watch the infants grow.\u201d<\/p>\n<p>Already, she\u2019s attended at some deliveries, and seen those mothers bring in their two-month-old children for checkups. \u201cI get to see how the family is developing and adjusting,\u201d she says. \u201cIt&#8217;s very exciting.\u201d<\/p>\n<p><span class=\"dropcap\">P<\/span><strong><span style=\"font-size: 18pt\">eter\u00a0LoGerfo, MD operates a successful <\/span><\/strong><span style=\"font-size: 18pt\"><span style=\"font-size: 12pt\">family practice<\/span><\/span> in the South Sound region, with an emphasis on obstetrics and newborns. He has many loyal patients that have been with him during his whole practice, almost 20 years now. Some patients travel as much as a couple hours to come and see Dr. LoGerfo. \u201cIt\u2019s because he&#8217;s been such a great provider for them,\u201d says Nicole. Her time at this small clinic allows her to observe a continuity of care, and what it means to develop trust and relationship with patients.<\/p>\n<figure id=\"attachment_7585\" aria-describedby=\"caption-attachment-7585\" style=\"width: 600px\" class=\"wp-caption alignleft\"><a href=\"\/\/depts.washington.edu\/medex\/wp-content\/uploads\/Volunteering-for-military-spouse-appreciation-convention.jpg\" rel=\"attachment wp-att-7585\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-7585 size-medium\" src=\"\/\/depts.washington.edu\/medex\/wp-content\/uploads\/Volunteering-for-military-spouse-appreciation-convention-600x563.jpg\" alt=\"Nicole volunteers as a massage therapist at a military spouse appreciation convention.\" width=\"600\" height=\"563\" \/><\/a><figcaption id=\"caption-attachment-7585\" class=\"wp-caption-text\">Nicole volunteered her massage services at a military spouse appreciation convention.<\/figcaption><\/figure>\n<p>And then there\u2019s the teaching which, after all, is why she\u2019s there. \u201cDr. LoGerfo takes the extra time to meet with me before clinic hours to review things where I need a little practice, like understanding lab values and how that affects outcome of the treatments,\u201d she says. \u201cHe works with me on medications, making sure I understand finer details of prescribing. It&#8217;s been an excellent learning environment.\u201d<\/p>\n<p>The earlier move from paramedic to a massage practice was a conscious decision to step back from the adrenaline mode that comes with EMS. The massage background gave Nicole some additional tools in addition to allopathic medicine. \u201cI&#8217;m bringing a lot of my massage therapy ways into practice here,\u201d she tells us. Dr. LoGerfo&#8217;s gives her the opportunity to refer patients to massage therapy or acupuncture. \u201cHe\u2019s allowing me to consider other natural types of interventions. I think the patients are very open to that. A lot of patients are wanting a holistic approach to their care, and it&#8217;s been exciting to be able to blend them.\u201d<\/p>\n[smartslider3 slider=6]\n<p><span class=\"dropcap\">N<\/span><strong style=\"line-height: 1.5\"><span style=\"font-size: 18pt\">icole grew up in Tacoma<\/span><\/strong><span style=\"line-height: 1.5\">, so attending the MEDEX Tacoma site was an easy choice. She came to the decision after an earlier experience with a PA. \u201cMy grandmother was sick with dementia, and it was a PA that helped get us find the right kind of care for her, and that transition to end-of-life care,\u201d she says. That physician assistant was very significant to Nicole and her family. \u201cI saw the time she took to make sure that the diagnosis for my grandmother was correct, and that really impressed me. That was something that I wanted to be able to do as well, so going to MEDEX was really a dream come true.\u201d<\/span><\/p>\n<figure id=\"attachment_7584\" aria-describedby=\"caption-attachment-7584\" style=\"width: 251px\" class=\"wp-caption alignright\"><a href=\"\/\/depts.washington.edu\/medex\/wp-content\/uploads\/Nicole-informed-her-parents-that-she-was-accepted-into-MEDEX-by-dressing-up-in-Husky-purple.jpg\" rel=\"attachment wp-att-7584\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-7584\" src=\"\/\/depts.washington.edu\/medex\/wp-content\/uploads\/Nicole-informed-her-parents-that-she-was-accepted-into-MEDEX-by-dressing-up-in-Husky-purple-424x600.jpg\" alt=\"Nicole informed her parents that she was accepted into MEDEX by dressing up in Husky purple.\" width=\"251\" height=\"356\" \/><\/a><figcaption id=\"caption-attachment-7584\" class=\"wp-caption-text\">Nicole informed her parents that she was accepted into MEDEX by dressing up with her children in Husky purple.<\/figcaption><\/figure>\n<p>Nicole is a single mom with two children who were two and three at the time she entered the rigors of the MEDEX didactic year. \u201cThat first year in the program was a lot of balancing,\u201d she says. Her family was very supportive and got her through it. Then there was the support of her classmates. \u201cI had a great situation in that I was neighbors with three of my classmates, and so we had a built-in study group. We pulled together and got each other through. It was great.\u201d<\/p>\n<p>She\u2019s done a little PA proselytizing on her own during this current family practice preceptorship. A few of the patients she\u2019s seen have been volunteer firefighters, something Nicole did in her EMS days. \u201cThey&#8217;ve talked to me about transitioning to become a physician assistant, applying to MEDEX and what that&#8217;s like. And I&#8217;ve told them it&#8217;s excellent. It&#8217;s a great opportunity. This field is wide open and there are lots of choices. Here, I&#8217;m seeing how I can be a part of the provider team.\u201d<\/p>\n<p>\u201cI&#8217;m right where I&#8217;m supposed to be,\u201d she concludes.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>As she steps back from the adrenaline mode required by an earlier career in Emergency Medicine Services, Nicole Jakeman is enjoying the luxury of continued patient care that comes with her family practice preceptorship in a small South Sound clinic. With a second career as a Licensed Massage Therapist, Nicole discovers that her preceptor and patients alike are open to other natural types of intervention.<\/p>\n","protected":false},"author":1,"featured_media":7625,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[21],"tags":[47,35,48,49],"class_list":["post-7562","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-clinical-experience","tag-class-2","tag-clinical-year","tag-nicole-jakeman","tag-tacoma"],"cp_meta_data":{"_edit_last":["1"],"_thumbnail_id":["7625"],"student_name":["Nicole Jakeman"]},"_links":{"self":[{"href":"https:\/\/familymedicine.uw.edu\/medex\/wp-json\/wp\/v2\/posts\/7562","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/familymedicine.uw.edu\/medex\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/familymedicine.uw.edu\/medex\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/medex\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/medex\/wp-json\/wp\/v2\/comments?post=7562"}],"version-history":[{"count":0,"href":"https:\/\/familymedicine.uw.edu\/medex\/wp-json\/wp\/v2\/posts\/7562\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/medex\/wp-json\/wp\/v2\/media\/7625"}],"wp:attachment":[{"href":"https:\/\/familymedicine.uw.edu\/medex\/wp-json\/wp\/v2\/media?parent=7562"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/medex\/wp-json\/wp\/v2\/categories?post=7562"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/medex\/wp-json\/wp\/v2\/tags?post=7562"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}