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How long until you are safe being a solo provider?


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No straightforward answer.

I started staffing a low volume ED solo 4 years out from school.

In retrospect, I think I was too dumb to know better.

As for an UC, I think the same time frame could be done.

Really depends upon training, level of confidence, experience, etc.

Some may never be ready, some may need less time.

G Brothers PA-C

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No matter how much experience you have there is always the possibility of getting burned in my opinion, and that is not exclusive to PAs.  And don't assume that just because you are in an urgent care setting that you will not have very sick patients showing up or being triaged to you for whatever reason.

 

I think that by 3-5 years in you should have a good baseline competency, but that is just my gut

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Is there a near-by ER backup?  After four years of providing solo-coverage many days in FP on a reservation (doc came once a month) I started working in UC exclusively.  I had experience in UC/ED before starting the UC job, tho. Lasted 3 years there and on the weekends it was just me, an LPN and the receptionist.  But the ED was 1/2 block away and connected to the clinic by a tunnel.

 

It all depends on the experience of the PA and how good of a staff you have to work with and how quickly can you get a patient to the ED if needed?

 

In retrospect of me working solo FP immediately out of school was naive too, but WOW what a good learning experience.  It was however a part-time job and my other part-time job was UC within an ED so I could transfer knowledge gained in the UC/ED to the FP job.   There was much professional stretching and I was continually challenged to know my stuff and learn more and more.  

 

I agree with GBrothers and PeeA. 

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it really depends on the individual, their background, and their individual skill sets. A former 911 paramedic or er nurse could likely do it after 3 years. other folks might never be up for it without significant other training, a residency, or a job with graduated levels of responsibility. I started solo coverage of a 24 hr urgent care 5 years out of school with 15 years of em experience behind me at that point and it worked out ok. my first year I had several codes in the middle of the night, etc. I still work some shifts there and also do solo coverage of a rural er where I direct ems and am responsible for floor codes, etc as the only provider in the facility at night.

for someone without prior em experience to do solo coverage I would recommend the following as a MINIMUM:

ACLS, ATLS, PALS, DIFFICULT AIRWAY CLASS. anything that can walk into an ER can walk into an urgent care. I have had gunshot wounds, several codes, seizures, septic children and adults, significant traumas(knife in neck bleeding like a stuck pig), psych and substance related emergencies, CVAs, anaphylaxis, SVT, rapid afib, MIs, etc.

I actually do more at the 24 hr urgent care than I did in several community em jobs because I am the only one there and my scope is only limited by what walks in the door.

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Thanks all for the input. The reason I ask is I am beginning in an EM job which is 4d q wk but I want to work 5d q wk. I found an UC I can prn at however it would need some solo coverage. I have a lot of experience as a CNA and did rotate through SICU , ICU and trauma as electives. Would it be a mistake to take the UC prn as an elective?

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