Stress and Surgery Day

It has been a while since I last wrote on here. School has been a little crazy lately. We are coming to the end of the didactic phase, August 5th is our last day. There is still a lot before then, and stress is high amongst myself and my classmates.

This past friday was fun though, we had surgery day! Each of us were in groups and assigned to a "surgery" later that day. We had to look up everything about that surgery in order to report back to our preceptor for intense questioning about the surgery, complication, indication, etc. While preparing for that we did rounds with our attending. We saw 4 patients, they were our teachers, who all pretended to have complications post surgery. I think our teachers enjoyed this part, they went all out: having pretend IV lines placed, foley catheters with yellow highlighter colored urine, fake incisions, the works. It was pretty funny. After we saw those patients we wrote up notes on them. Anytime during this day there were two people on call who got called to dispense orders for those 4 patients. That part was the hardest because we had to think on the spot over the phone how to treat our patient. Once, we were called in and had to examine the patient. Finally, we ended the day writing up a post-operative note for our patient having surgery. My groups surgery was a carotid endarterectomy.

The day was really fun and not as stressful as I was expecting. It was a nice way to ease into our real surgery rotation during clincals. I think the students had as much fun as our teachers. Oh, and we had to come in at 6am to start rounds on surgery day making the experience even more realistic.

Well, we have a hard 2 weeks ahead of us, hopefully we will all come out unscathed and ready to take on rotations on August 15h.

Casting and Splinting Lab

            After being in Las Vegas for 5 days, we got back into the swing of school rather quickly.  We woke up bright and early to attend a casting and splinting lab.  Anytime we get to get out of the classroom and do things hands on is refreshing.  We were taught how to do 3 different upper extremity splints, one lower splint, and one cast.  I have to say that I was most nervous about the casting, not because putting it on was difficult but the whole taking it off with a saw had me nervous.  Needless to say, my partner and I left that to the end, as did the majority of my class. 

            I think I did a pretty good job with splinting.  It was nice to have our teachers check over our work and give us tips and encouraging us on how well we were doing.  Doing a splint on the leg was the hardest part for me because the ankle was hard to wrap.  My finished product with that turned out not so great.  However, it did present the opportunity for a good laugh.

            Then it came time to cast and TAKE OFF THE CAST L.  Having witnessed my partner complete this task with no problems I felt more up to the challenge.  I must have really looked nervous though because immediately my teacher Sean pulled out a cast that had already been removed from on of my classmates arms.  He picked up the saw and quickly showed me how the saw went through the cast without going through the stockinet underneath.  For those that are unaware, a stockinet is put over the arm/leg first before putting on the casting material. Sean also showed me by putting the saw on the stockinet and demonstrating how it did not go through it.  Throughout this whole process he reassured me that I would not cut my partner and that I would do great.  That really put me at ease and I will probably never forget that he did that for me.  Sure enough, I cut off the cast without a problem.  Jen 1; Saw 0.  From what I hear all my classmates performed this flawlessly.  Another accomplishment for the books!

LAS VEGAS CONVENTION

            Every year there is an AAPA convention for all PAs and PA students.  This year it was in Las Vegas, Nevada.  Fortunately, each year PCOM tries to allow time for their students to attend, and over half our class was able to attend.  We were required to see at least 2 presentations and present on one to a faculty member and some classmates.  I ended up going to 5 and I couldn’t help but take as many notes possible on each presentation that I saw.  Its incredible how much I have already learned and how much more there is to learn.  It was interesting to see what presentations people decided to attend.  Some wanted to see topics that were already taught to us to see if they would learn anything extra.  I took the opposite approach and wanted to learn new subjects.  The two presentations I loved the most were: maternity and trauma and a how to break the Google habit.  We are learning our OB-GYN unit this coming term so this was a nice preview to that class.  Breaking the Google habit was interesting because it gave us ideas on how to get our patients to NOT search on Google but instead use more useful sites like www.medlineplus.org.

            On Wednesday night there was a PCOM cocktail dinner at the Hilton, right next to the LV convention center.  Here we were able to meet alumni and talk to them about being out in the field.  It was also nice to relax with friends, alumni, and faculty.  During this event the director of our program made a speech in which he quoted some of his own calculated statistics about PCOM PA Students.  He calculated that every year PCOM PA graduates see over 1,000,000 patients a year.  He also calculated the top specialties chosen by PCOM PA alumni.  It is amazing to think that PCOM PAs help so many people in the US each year and in so many different fields.  

            While going to Las Vegas was filled with its own perks, I really treated this as a stepping-stone to the future.  Everything is beginning to come full circle.  Soon we will be out treating patients, graduating, and going to future conferences.  I cant help to feel so lucky that I was chosen to become a part of such a great class and school that allowed me the opportunity to truly practice something that I have grown to love.

Officially 1 year in PA school

             It is so amazing how time flies in life.  A year ago I was starting orientation at PCOM; this nervous student that had no idea where to go or what to expect.  Here I am today, in my final didactic term at PCOM, less nervous but fully aware of the possibilities that await.

            Nothing makes this process more real than welcoming the incoming class of PA students; the Class of 2013.  My classmates and I are officially no longer the newbies on campus!  It is strange to think that there are people that look up to us now and ask us for advice.  I remember when I was at orientation I admired the class above and could not wait until I was then someday.  Now that I am I can’t help but feel proud of my classmates and myself.  Also, I feel a strange sense of obligation to help the incoming class on their journey as much as possible.  So, I decided to help with some of the aspects of orientation.  A handful of my classmates and I each got a group of 6 students from the new class and did activities with them that they then presented to their other classmates and family members.  I really had a great group of individuals with diverse backgrounds and personalities.  I couldn’t help but sense their nervousness yet sense of belonging during this whole process.  I really enjoyed being a part of orientation and making the new students more comfortable.

            Later in the week we had a BIG/LITTLE DINNER.  Here individuals from our class were assigned a little from the new class.  This event was great during the year when we were littles.  It was a great opportunity to get personal feedback on the program and what to expect.  This year was no exception, and my classmates were flooded with questions during dinner and we confidently handled them all.  I really like my little; she and I bonded right away.  Many of my classmates had similar experiences with their littles. I am confident that they will make great PAs and I can’t wait to hear/see their progress throughout the year.

            I will never forget those individuals in the class of 2011 who helped me throughout this while process and followed up on my progress.  In just over a month, July 27^th, they will be graduating, thus passing the torch on to us to be the leaders.  I hope that they are as proud of us as we are of them. 

Starting My Last and Final Didactic Term

At the beginning of each term our class meets with one of our teachers to go over our thoughts on the previous term.  Our class discusses as a group our likes, dislikes, what we would like changed, and what we would like to stay the same in our program.  I have always liked this because I really do feel that our thoughts are heard and our changes considered.  It is a very non-judgmental process.  It is also interesting to see if your own thoughts are on par with others in the class.  It is nice because our teacher always ends with telling us that we are just where we need to be in this program.  He instills confidence that we ARE ready to move on to the next stage in the program: clinical rotations.  It is always nice to be praised after each term.  Sometimes you get so wrapped up in “GO” mode that it is nice for once to relax and take it all in.  Confidence is something that comes in this program but gradually.  I am sure when we get to clinicals we will think that we don’t know anything, when in reality we know more than we think.

This term’s meeting felt different than all the others.  Our teacher started out by talking to us about the advice he received before going on clinical rotations.  I found the advice helpful and thought I would share it to all of you.  He told us to enter every rotation by introducing yourself to your preceptor, nurses, PAs, and anyone you will be working with even if its not a medical professional.  He said that not only will you seem friendly but also this is something these individuals will remember about you.  This will make you stand out.  It shows that you care who you are working with.  I thought this was really good advice and one that I will take with me when I go on rotations.  I know it is simple but if you think about it, how many people actually do this?  My guess is not as many as there should be.

I will leave you all with a quote that our teacher also left us with.  I loved it so much that I had to actually get from him later.  It is from Ambroise Paré who was a French royal surgeon and a pathologist in the 1500s.  He said, “Guérir quelquefois, soulager souvent, consoler tougours,” which means, “Cure occasionally, relieve often, comfort always.” 

Awaiting Next Term

             Last week our class met with the class above us to discuss upcoming rotations.  Each student in our class was paired with an upper-classman with the same rotation.  The upper class was helpful in explaining what to expect, how to study, what books we will get, and what to expect from certain preceptors and the areas we will be working in.  It is always nice to bond with the upper class.  I am not sure if this happens in all programs but in my experience, the seniors have been beyond helpful.  I have never felt like I am bothering them with questions.  They seem to welcome questions and enjoy giving advice. 

            With rotations on the brain and as this term comes to a close (next Thursday), it is hard to not think about next term.  Next term is our LAST term of the didactic phase.  After that, rotations!  It is scary to think how time flew and all we have accomplished thus far in this program.  As a matter of fact, PCOM is beginning to prepare for the incoming PA class orientation in June.   Already I have been receiving e-mails from incoming students asking what to expect, what books to buy, etc.  I love getting these because I know that when I was in their position I was feeling an overall sense of panic as well.  It’s only natural.  I am sure this is the same feeling the seniors have toward my class, they only want to help and “pay it forward” as you will. 

            As much as I am looking forward to the last term, there is a lot to still do for this current one. We have finals next week and all of us are pretty worn out.  Just to give you a preview: this morning I poured coffee into my cereal bowl and cereal into my coffee mug.  I would be lying if I said this was the first time something like this has happened.  I have even put peanut butter in the freezer.  Being tired seems like the norm now-a-days, BUT I know it is all for a purpose and, at least I know I am not alone.  I have my friends, family, classmates, teachers and upper classmen to push me along.

Treat Patients NOT numbers

This term we have a radiology course, which has to be one of my favorite classes at PCOM.  We have been taught different sections from many health care providers in the area.  Each teacher has lectured to us the Dos and Don’ts when reading an image from their own experiences and how they came to “master” films in their respective fields.  Each comes with a more fascinating story than the next.  I have learned so much in this class; it really is amazing.  I remember looking at my first chest x-ray and thinking that I only knew one thing: where the heart was.  I have to say I felt pretty dumb, but our teachers assured us that they were not expecting us to be experts.  In just a few months I can now say that I feel confident that I can read x-rays and CT scans.  While I am in no way an expert, I feel I at least know the anatomy and the correct approach as to avoid missing essential details and diagnoses.  I also know to always look for the most common fracture, THE SECOND ONE!  I know that reading images will be critical when going on rotations.  Having this skill will hopefully impress preceptors and maybe help save a life.

Many times on tests and quizzes I can identify the fracture or the correct location of pneumonia on x-ray but the question may state: “what would you expect to see on this patient?”  These used to be the hardest questions for me to answer.  Sometimes we tend to forget that this radiograph belongs to someone who needs our help.  It is not just a picture, just like lab values are not just numbers.  All these tests and images to help aid in diagnosis and further treatment our patient.

This has been a recurrent theme at PCOM in general, not just radiology – “Always treat the patient, not numbers.”  It is really simple but something we tend to overlook.  I hope that if you are in PA school, nursing school, medical school or in any health profession that you remember this and never forget it!  I know I won’t.