PAs working with residents in academic medical center

[cthompson1782]

I am lead APP for an inpatient neurosurgical team at a major academic center.  We work closely with residents and seem to have limited interaction with our attendings.  Due to our current responsibilities and minimal communication with attendings, my team is suffering from major burnout.  I was wondering if those of you who work inpatient in a surgical setting with residents could provide info about your daily duties.  In my position we get AM signout from the residents and manage all floor patients during the day while the residents are in the OR.  We're first page for all patients.  However, we're often the last to know the plan.  If problems arise we often go directly to the attendings, but they rarely seek us out.  I have already addressed my concerns with our department head, and he's tasked me to find out how other major academic center APPs function.

 

I'd appreciate any input that you can offer.

 

Thanks,

Carrie

[kittryn]

I am lead APP for an inpatient neurosurgical team at a major academic center.  We work closely with residents and seem to have limited interaction with our attendings.  Due to our current responsibilities and minimal communication with attendings, my team is suffering from major burnout.  I was wondering if those of you who work inpatient in a surgical setting with residents could provide info about your daily duties.  In my position we get AM signout from the residents and manage all floor patients during the day while the residents are in the OR.  We're first page for all patients.  However, we're often the last to know the plan.  If problems arise we often go directly to the attendings, but they rarely seek us out.  I have already addressed my concerns with our department head, and he's tasked me to find out how other major academic center APPs function.

 

I'd appreciate any input that you can offer.

 

Thanks,

Carrie

...and your question is...?

 

(just kidding.it sounds pretty typical, and the attendings will back the residents staying in the OR because they are training to be, well, surgeons).

 

PAs get the grand privilege of running the floor and doing consults.

 

I actually talked to one resident one time, in a social setting, and he said, "wow, man! you could come on nights and do all the discharge summaries!!!".

 

yeah. I'd kill for a job like that....

[KMD16]

Every institution is different.

[Randito]

I would say that my situation is very different. I work in abdominal organ transplant. We do not have any fellows, but 2 residents that change every month. Because of this, I would say that myself and the 1 NP that I work with have a very close relationship with our attendings. They see us as the constant presence on the unit. We round with the attending every morning and are constantly texting back and forth, often times even with the surgeons that are not doing inpatient rounds as they want to know what is going on with any patient that they've operated on. 

 

I go home at 5-6 pm and we have acute care surgery residents covering the floor at night with our junior transplant resident as the first contact. The residents definitely have priority in terms of the OR, I've gone once in the last 2 months. But this is ok with me, I knew what I was signing up for and may ask for more OR exposure once I'm more comfortable on the floor. 

 

I'm fortunate that I have a close relationship with our surgical director and feel that he really values my contribution. He has offered to facilitate skills training for me and asked me to voice any concerns that I have. Part of this is that we are a small service and the loss of anyone on the team is felt by everyone.