A Day in the LIFE: We meet most mornings at 5:30a to sign out, then round, write notes then round with the attending and team. Then we do discharges, go to the OR for our assigned cases, answer nursing / pt questions. Then at 5:30p we sign out to the night Post Grad PA/ PGY1 then day people leave. This service is very busy and we do not have much down time. Also 1 Post Grad PA / PGY1, each week for 1 week during the day, carries the "consult / HOT" pager. This means that they are paged for all new consults from the ED - floor - outside hosp/direct admit. They return the call, then go to [for ex] the ED, see the patient, do a H&P, devise an "assessment & plan" contact the "senior" and verbally present the pt, 'senior' sees the pt and then a plan is finalized. May do a consent if surgery in needed, put in orders, admit pt. etc. Two days a week we come in at 5am because we have grand rounds, M&M and conference.
TRAUMA: We respond to Trauma calls to the ED: we are "doctor Right" during the trauma. I've been on 2 so far, a level 2 and Level 1. The level 1 was most similar to what I would say you can see on "Trauma Life in the ER" show on Discovery Health channel -- intense!
THE OR: My 2nd OR experience: 1st Assistant, 1st with this Surgeon: a simple enough procedure: I&D of Abscess. However after the positioning / draping / etc. The surgeon tells the scrub tech: "Scalpel to "me" "I was like "what"? did I hear that correctly? Yes, I did! :D I got to do the majority of the case! How sweet! Never did I anticipate that! The surgeons here are very willing, have patience and are interested in teaching. Nothing that I had experienced, as a PA student, in a surgical rotation! That alone has convinced me that I've made the correct decision; knowing I will continue to gain invaluable experiences over this next year. So very happy that I decided to do this! :cool:
CALL: So we take over night in house call. During the week we have 1 person assigned to overnight call, they start Sun 5:30am and leave Mon. 6am. Then work T-W-Th overnight. They carry the "HOT" pager & do all consults, answer all home calls, nursing calls etc. They are supported by a senior, in house. Weekend Call: is only different in the fact that person comes in 5:30a Fri, Sat or Sun gets sign out, rounds, and stays all day and overnight until the next 5:30am, then goes home: post call; always supported by a 'senior' in house.
Okay, reality check: :rolleyes: it is very hard, long hours: ~80+ / week with day to overnight shifts of 30 hours! We are held to the same hours & expectations of the PGY1's. However I don't think I would have gained this same experience from jumping into a surgical job right out of PA school!
The program at my hospital is similar, except everybody puts in at least 100 hours a week. The ACGME work-hour rules for the academic programs where I've worked are largely ignored. They expect you to lie about your work hours. Its a "dont ask, dont tell" system. If you cant handle the hours, then the old school surgeons will label you unworthy and work to get you out of the system.
As the chief PA on my service, I staff most of the consults that the PGY-1s/PAs get called for. I set the OR schedule in terms of resident/PA coverage. After the residents/PAs do their morning rounds at 4AM, they staff them either with me or the attending, but usually the attending is in on a case already and so they run the patients with me.