I am not going to lie. Writing the first H&P was kind of difficult because I still did not how an H&P should be written. Prof Malavet explained how everyone has their own unique style to writing an H&P and presenting information. We just have to make sure the core of what we are discussing can be understand by anyone who reads our documentation. We all know how important documentation is now a days.
I purposely chose to compare my first Pre-Admission Testing H&P to my second Pre-Admission Testing H&P so that I can truly see what has improved and what has not since they are both in the same setting. In my first H&P I was not specific enough at times, I would put information in the wrong places, and I was forgetting to ask certain questions that are pertinent. And it showed throughout the H&P. Again, still getting used to writing them, some work needed to be done to improve.
In my second H&P, it’s kind of exciting to see that you can improve even if in the beginning it seemed as if you could not. Those little errors that were previously made were not getting made anymore. My HPI has its own style of telling the story of the patient and if someone were to read it, I believe they would get the whole picture of what is going on. Since this was our second semester of Physical Diagnosis, we were also instructed to include an Assessment and Plan in our H&Ps. I believe this is something I need to work on. What needs to be done now once all of this information was obtained from the patient? Prof Malavet said I need to be a little more specific when writing my Plan so that is definitely something to note.
Overall, I won’t say I’m the best at writing H&Ps, but I can say that I am improving. If I improve just a little and get better and better each time, that is a win in my book. 5 years from now when I look back, it will be very interesting to see how far I have come!
