Moving Forward Means Exposing Open Wounds

Hello Readers,

I know it has been a while since I have updated this blog.  A lot has happened for me in this past month some of it good and some not so much.  Rather than make excuses I thought I would do something a little different.  When I decided to write this blog, I wanted to do it to help others, whether it was to help shine some light on the PA profession or just help someone get through the difficulties of PA school.  Sometimes, I forget that I also decided to write this blog to remind myself of the journey it took to get to where I am today.  Today, I have decided to really let in my readers, to expose myself more than ever.

Where to start... On April 25^th, 2013, I lost my grandfather, he was 90 years old.  Just to give you some background on him.  He was in the US Navy and served much of his time in the Solomon Islands.  He was an amazing person.  He inspired everyone he met.  Most of all, he was the rock of our family.  He was never judgmental, and always patient.  While he did not have much he gave like he was the richest man in the world.  

Two weeks before he passed he took a terrible fall.  He fell backwards onto his back while walking up steps. While nothing was broken he was in a great deal of pain.  About a week later he was sent to a rehab facility to help increase his mobility and begin to work on his activities of daily living.  I know, even if he did not show it, that this depressed him greatly.  I called him the day he got into rehab.  He was so cheerful on the phone, he told me that the people in the rehab were so nice to him and that they told him 95 was old so he was not old yet. He just kept laughing on the phone.  I told him about my job and how much I love it.  The day I called him was my first night working alone in the hospital. My training period was done.  He was so proud.

           Why am I telling this story? This week, I was pretty drained from the funeral and I was pretty down.  Also, transitioning from working days and being in training to officially working by myself on night shift has been taxing.  My confidence was increasing but not all together 100%.  Then this week, there was a patient that developed complications after surgery.  When I came to visit her before saying goodnight, I looked at her and asked if she was ok.  Immediately she began to cry and I took her hand and told her that this was not her fault that these things happen but that I would be there.  I helped answer her questions about her case and what to expect.  She thanked me repeatedly for taking the time with her.  She said she has been so scared not knowing what was happening.  I spend a good 45 minutes with her.  I left feeling happy that I had helped.  
            Reflecting on it today, I remember how fondly my grandfather spoke of the care he was receiving in the rehab facility.  During his difficult time those health care employees were there for him.  Today can’t help but think how proud my grandfather would be of me for helping this woman and many others.  Not only am I working with patients on a floor by myself but that I am doing it well.  I can’t help but think that I got some of this from him.  I am thankful that he was with me during my progression from struggling student to successful PA-C.  I know that going forward I will be ok.  I only hope I can continue to make him proud and live up to his legacy

First 2 weeks on the job

Hello everyone,

    I  have been asked by family members and friends about my new job. So, I wanted to put up an update for everyone out there. I started on March 26th. I thought the best way to do this was post the questions I have gotten and just answer them in a Q/A format. 

     What do I do?  I take care of post-operative orthopedic patients on the inpatient floor of a hospital. Basically, after someone has surgery either a hip replacement or knee replacement etc I take care of them until they are stable enough to go home. This means I monitor their pain level, fluids, make sure they are progressing as they should and look out for really bad complications to surgery (ie a blood clot in the lung or leg, pneumonia etc). I also prepare the patient for what is to come in the following months and days with us at the hospital.  This all starts when I see them in the PACU (where patients go to right after surgery). Patients stay in the PACU until we see them and note they are stable enough to go to their rooms on our inpatient floor. I mostly take care of patients on the inpatient floor of the hospital. Each morning the patient care team does rounds (go as a group to see patients) with someone from social services, physical therapy, billing, and the doctor who did the surgery so that the patient can ask us questions. At the end we ask if they are comfortable and if there is anything they need from us to make their stay better.  Usually patients stay with us 3 days unless there are complications. 

     What times do I work? My regular schedule will be thurs, frid, and sunday nights 7p-7a starting in May.  However, right now I am in training so I am doing day shifts for the first 3 weeks so tues-friday 7a-4p. My last week of training I will be on night shift tues-thur 7p-7a. 

     How were my first two weeks? I love it so far. I really like the people I work with. I mostly work with other PAs but the nurses and doctors have been really nice. I am in training so I have been going around with different people on my team seeing patients which is nice because I can see how each person evaluates a patient. The doctors are really nice to the patients and they like to teach us.  During this past 2 weeks I have slowly become more independent.  The last few days I saw and wrote progress notes on a few patients by myself and followed them through out the day. Constantly throughout the day I am asked questions by nurses. So, they would ask me, this patient looks like they are spiking a fever what do you want do and I will put in an order for something.  This was both very nerve wracking and awesome at the same time. On the one hand, I am trusted in the care of this person and I know I am competent to do so. On the other hand, I graduated in July and this is the first time I am working NOT being a student so stepping up and being in charge is a new thing for me.  

     So, all in all a great week. I am becoming more confident each day and getting used to electronic medical records.  All the patients seem to love us which is nice.  This group really does put the patient first.  I could never really see myself in school pursuing orthopedics or inpatient medicine. I always thought I would go into family medicine or pediatrics, but I really love this job so far. I hope that continues as I transition from day shift to night shift over the next few weeks of training. 

Good things come to those who wait

Hello Readers!

     Today I received some great news! I was approved by the state on March 13th and I was just given hospital privileges today! My official start date is March 26th! I will begin with 4 weeks of training and then be on my own at nights starting at the end of April.  I am so excited. I did not anticipate it taking this long to start working, however, I am more thankful than ever. Stay tuned for more news and stories once I start the job.

Happy Thoughts

          I felt like my last entry was a Debbie Downer, so I thought I would write another entry.  About a month ago I was told by my boss who is also a PA that in order to help prepare me for the job I should go to a meeting near the hospital.  This meeting was for patients of the Orthopaedic practice I will soon working for.  Basically, the meeting was 2 hours and explained everything about knee surgery.  The presentation was run by a Nurse Practitioner and a Physical Therapist. Together these two women did a wonderful job in explaining everything from pre-admission testing to post-operation expectations.  Each future patient and their families were handed a packet with the presentation as well as other information.  I found the presentation to be informative but not too complicated that it would overwhelm a patient.  I even learned a few things myself.  In this presentation the NP passed around a model knee and explained the anatomy and how the surgery would be done.  She then passed around the artificial joint and explained the materials that were used to construct it.  The Physical Therapist went into detail on the exact stretches and exercises that would be used to get the knee fully functioning.  At the end patients were able to ask questions.  I should also mention that many of these patients had already signed up for surgery, but there were also people in the audience who were on the fence.  In the latter group of people I found that they were really appreciative of the presentation and the information that was given.  I am not sure whether they decided to have surgery or not but the point of the presentation was not to force anyone into making a decision.  Instead, it was focused on making people as informed as possible on knee replacement. The good and the bad. Nothing was sugar coated.

      As I left the presentation, I could not help but to feel happy.  I am so excited to work with a group of individuals who care so much about their patients. It means a lot to a patient when someone takes the time to explain.  Patient education is essential and really is not utilized as much as it should.  I have found that patient compliance tends to increase when you educate them.  Having surgery is a scary thought to anyone.  Alleviating even a fraction if that can make a huge difference in perspective.  It may not take 2 hours like this presentation did to help alleviate the burden, in the office it may take 5 minutes. However, those 5 or so minute are precious and should be used effectively.  To any PAs out there, NPs, MDs, DOs etc, I hope that you take time to educate and put your patients first.  That is the way I like to practice and I am so glad that my employers feel the same.

Waiting to Start Work

Hello Everyone!

       I know I have not written in a while but I have found I am at a loss of words. I am still waiting to start my position in Orthopaedics!! So, I don't have any amazing stories to tell, but, I do have some more advice that I thought I would share.  This advice is more for new graduates or soon to be PA school graduates.  Here it is... The state of Pennsylvania takes FOREVER to process paperwork.  I am currently waiting for my supervising agreement, this is an agreement that is made with your supervising physician denoting your responsibilities in your job. Thus, what you can and cannot do in your position. It is signed by your supervising physician, other physicians in the practice and you.  This paperwork takes a minimum of 60-90 days in the state of Pennsylvania. I am mentioning this because I did not know this prior to applying in Pennsylvania. It seems that all my classmates working in PA have had the same problem.  You cannot work as a PA in the state of Pennsylvania without this agreement being processed.  Some of my classmates have just been observing while others are just waiting like myself, it depends where you work.  Unfortunately, my hospital will not allow me to just observe without this agreement being passed.  Again, this seems to be just a problem in Pennsylvania. One person in my class sent her paperwork in for licensing and her supervising agreement to Maine and it was processed in 24 hours.  New Jersey takes a while to get a license, however, it seems once you get that nothing else takes long.  It is a very frustrating and confusing process. There is nothing worse than going through the hardship of PA school, passing your boards, getting a license in your state and then not be able to work.  I know this sounds really depressing but if there is anyone out there reading this who is in my same position, please keep your head up.  While having all this time is great it can get a little boring when you do the same things every day. I have taken trips to see family, read some journal articles to keep up with CMEs (continued medical education) etc to keep busy. It could be worse, I could still be looking for a job, so I do consider myself fortunate.  I really hope this entry helps someone, if I would have known this then I think I would have prepared differently but I am doing well under the circumstances. All the best to my readers!

Starting the New Year

Happy New Year Everyone !

         I hope everyones holiday season was restful and enjoyable.  I know that I had a wonderful Christmas with my family and friends.  I am thankful that my family is happy and healthy.  I had yet another Christmas with my 98 year old great grandmother and 89 year old grandfather.

        This new year has been great so far.  I have not started my job in Orthopedics yet but I have done a lot with my new team.  I was able to meet my supervising physician who seems very nice.  We had a drug rep dinner in philly where I was able to learn about new pain management protocols.  At this dinner I got to meet a lot of other physician assistants and nurses that I would be working with.  Everyone seemed very welcoming and friendly.  The team I am working with all pretty much know each other so I was the only new addition.  However, not once did I feel left out, someone always introduced me to another team member or just took time to chat with me.  One physician assistant even knew once of my teachers at PCOM!  It was a very informative and enjoyable evening.

        This past week I had 3 days of orientation.  The first 2 days were long 8 hours days.  I have to say, I am not used to spending that long in a classroom.  It used to be nothing.  I learned everything safety, hygiene, hospital history, communication skills etc.  There were guest speakers from the Gift of Life organization and A Women's Place. Everyone from this hospital seem so nice and welcoming, it made orientation a breeze.  I was the only physician assistant at orientation, however, I got to meet many nice people who will be working at the many different campuses. We did team building exercises and question and answer.  I look forward to seeing familiar faces in the hospital soon.

         I am not sure when I will start working, it all depends on the state to process my paperwork.  In the meantime, I am keeping busy filling out paperwork for work and reading up on potential cases. I can't wait to get started with this job, these past few weeks have gotten me pumped!

Trials and Tribulations of the Job Hunt

          Yesterday, I had the pleasure of meeting up with 2 former PCOM PA classmates! I have seen a few PCOM people since graduation.  It is unfortunate that many are in different states otherwise we would meet more often.  Over dinner we discussed the cons of job hunting.  Unfortunately, there are not many pros.  It was a pretty prevalent theme that job searching was not fun.  However, I am not a very aggressive job hunter and at times you really need to be.  It was definitely a learning process. It is important to follow up sending applications with a call but also it is just as important to know the line between aggressive and annoyingly pushy.  For example one of my classmates has even shown up to ground rounds in order to get a job.

          We also discussed stories of the let downs we have had in "the processes".  Many of us have had leads to jobs or the prospect of an interview that fell through.  For example, I was offered an interview a few weeks before taking the job I have now. The email stated they wanted to set up a phone interview that week.  I gave them my schedule and waited for them to contact me, a few days went by and and heard nothing so I called and emailed and still heard nothing.  To this day, 2 weeks later, I have yet to hear about setting up an interview. Luckily, I was offered a job somewhere else.

          Similarly, I was called in November by a place I interviewed in back in August.  In the voicemail it seemed like I had gotten the position and that they wanted to speak to me.  This was a Family Medicine job close to where I live, basically what I was dreaming for.  I called them back within 10 minutes and left a message. Over the course of 2 months I repeatedly called and left messages with no call back. How companies can do this to applicants is beyond me, but unfortunately it happens.  Some of my classmates have had similar stories.

          Another problem my classmates have faced is "the choice".  This is when you have more than 1 job offer and you are forced to choose within a certain amount of time.  During this time you could also be waiting for a call back for a position that you have always wanted.  So, the question is do you wait for the job you have always wanted with the potential of not getting the position BUT losing an opportunity on the job you were offered. Conversely, do you give up on the job you hoped for and take the job you were offered.  It is a tough game out there. I am lucky enough to no have the problem but the 2 girls I met with are in that predicament.

          Lastly, there are many places you will interview that will just never call you back.  I have had many interviews that I thought went great and I never heard anything.  It is definitely discouraging. I almost wish they would have called and told me I did not get the position. This way I could have asked what I could have done better for future interviews.

          This blog was not meant to discourage anyone, it is merely to show that this is what happens in real life.  If you know then you can prepare accordingly.  So, don't put all your eggs in one basket! Thankfully, it seems that my 2 classmates have job offers.  In this economy and job market, we have to be thankful for jobs. I know I am, especially right before the New Year.  It must be the holiday spirit in the air!