Moderator EMEDPA Posted April 16, 2004 Moderator Share Posted April 16, 2004 this is a frequently asked question here so I will divide this into a few stages. Anyone considering a carrer as an EM PA should join the society of emergency medicine PAs. see www.sempa.org1. pre-pa training: if you know that em is what you really want to do early on, now is the time to get your emt cert or if you already work in healthcare try to work in the emergency dept or interact with em folks as much as possible. former paramedics, emt's, and er nurses have a big advantage when applying for that first em job because they have already been part of the culture of em and know their way around.2. 1st year pa school: pay careful attention in all of your procedures labs and during acls if it is offered in your program. if you have an em lecture course attend every lecture and do all of the reading and assignments. take cpr and basic trauma life support now to get ready for acls/atls/pals next year.3. 2nd year pa school: this is the time to start planning for the first job(or even better an em pa postgrad program or residency-see list at the top of this forum). at the start of my 2nd year I started a scrapbook with ads taken out of pa journals for jobs that I thought I might want. try to arrange as much em as possible into your schedule by taking rotations with direct relevance to the field. for instance if you can do trauma surgery instead of general surgery, do it. if you can do peds em instead of general peds, do it. try to take acls/atls/pals while in school if at all possible. it really makes you stand out from a field of folks who don't have them.( that would be advanced cardiac life support/advanced trauma life support/pediatric advanced life support ). if already certified in acls, take the 2 day instructor class. it's really cool when someone asks if you are acls certified and you can say" I am an acls instructor at xyz paramedic school, etc.)try to do rotations at places that use pa's in the emergency dept as this might lead to a job, or at least some good leads. if you know what state you want to practice in after graduation, apply for the interim license several months before graduation. that way on graduation day you just send them your certificate of completion and they have the background check, etc already done. I applied in may, graduated in august and had an interim license 1 week later. some of my classmates who waited didn't have their interim licenses for months.4. new grad: hopefully by now you have taken acls/atls/pals as above. if not, do it right away. check every pa magazine and website around looking for jobs. call all of your empa preceptors for leads. you just need to get your foot in the door, so a position in urgent care or fast track is ok for now. after a year or 2 of experience under your belt you can work your way up the food chain. the empa "food chain" as I see it:top: busy trauma center with broad scope of practice or solo rural e.d. calling all the shotsintermediate: community e.d. with ok scope of practice***er fast track connected to emergency dept with er supervisorsurgent care center affiliated with hospitalurgent care not affiliated with hospital( doc in a box)low:ambulatory care center/walk in fp with some minor procedures*** A fast track for those of you who don't know (also refered to as an immediate care/minor care unit) is a part of the er which handles minor problems like small lacerations, abscesses, rashes, minor orthopedic problems, colds, etc. you have to be on your toes even in these settings. due to this wonderful thing called triage, you may be sent "shoulder pain" which is really an mi in progress, etc..happens all the time. it often seems like no brainer mistakes on the part of the triage nurse( so you're a diabetic, and this shoulder pain with nausea started while mowing the lawn and it goes into your neck...hmmmm wonder what that could be), but remember as an empa you know a lot more than they do so cut them a little slack. 2 1 Link to comment Share on other sites More sharing options...
Guest sbrudd Posted July 2, 2004 Share Posted July 2, 2004 Great resource. Forgive my ignorance, but at what point does one qualify to take ACLS, etc? I have not yet applied. You'll be happy to hear I am gaining experience. Also, I would love to work in or close to an ER dept. What kind of entry level PT positions would you suggest? On another note, HIPAA has really made it difficult to shadow PAs, etc. Have you heard of any work-arounds. It's difficult to make a career decision without observing the profession in action. Link to comment Share on other sites More sharing options...
Guest annrita Posted July 2, 2004 Share Posted July 2, 2004 I had no problem shadowing a PA for once - twice a week for 6 mo. Pts were asked permission and not one said "no." Most were very curious (about me being there) and offered to let me get in there to look and ask questions. (Out-pt ortho dept.) The PA I shadowed has been there for a number of years, most of the patients know him and respect him -- as do the staff/drs/nurses/residents, etc. I learned a great deal during my experience - really loved the time, realized I actually liked ortho -- something I would have bet $ against. Everyone was great there!! It greatly reinforced that this was the profession I wanted to go into. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 3, 2004 Author Moderator Share Posted July 3, 2004 about acls: most nurses and paramedics who go to pa school have already taken these courses. the better pa programs either require acls during training as part of an emergency medicine course or offer it on an optional basis. Link to comment Share on other sites More sharing options...
Bandit Posted July 3, 2004 Share Posted July 3, 2004 when I was a student I took two rotations in ER with the same group. never took a day off. Both rotations were four weeks -- I was there from 8am to 12 midnight 29 straight days. Every time a doc turned around I was there to say " never left!" It helped I was ems befor school, but work ethic will open doors. Link to comment Share on other sites More sharing options...
Guest sbrudd Posted July 3, 2004 Share Posted July 3, 2004 What are some entry level positions in the ER that would give me some good experience and might be PT? I am still taking pre-reqs. So I can't work full-time this year. Right now I am an MA in Ob-gyn. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 4, 2004 Author Moderator Share Posted July 4, 2004 er tech is the way to go for entry level er positions. you can be involved in every case. work with docs/pa's/nurses/paramedics/etc to see who all the players are and what they do. it's a great job(salary sucks, but you can't have it all) I was an er tech/emt for 5 years before medic(emt-p) school and worked my way up the ranks. after a while I was staring iv's and doing all the rn level skills. they even scheduled me to work if an rn was sick.I never made more than $8.50/hr as an er tech though(keep in mind this was 20 yrs ago). I hear er techs now make $10-16/hr or so. basic er tech skills: brief hx taking with vital signs phlebotomy im injections splinting/wound bandaging minor surgical assisting cpr during codes pt transport urine testing minor lab procedures(strep/mono/spinning crits/etc) labeling/dispensing take home meds restraining psych pts applying o2 devices/suctioning taking resports from ems personnel on arriving pts performing ekg's giving neb tx and doing spirometry/peak flow testing vision/hearing screening adv er tech skills(more typically done today by nurses): iv's/iv meds foleys abg's ng tubes Link to comment Share on other sites More sharing options...
Guest sbrudd Posted July 4, 2004 Share Posted July 4, 2004 I would assume you would need some kind of certification to qualify for this. Would that be EMT Basic or Intermediate or something else? Thanks so much for the help. I will look into it. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 5, 2004 Author Moderator Share Posted July 5, 2004 Emt-basic Plus On The Job Training Link to comment Share on other sites More sharing options...
JenGintheED Posted July 5, 2004 Share Posted July 5, 2004 Not to contradict you EMED, but in my experience this varies by location. I started out as an ER tech with EMT-B training in SC. Then I moved to NC where I "wasn't qualified" despite 2.5 years ED experience and .5 years EMS experience- only CNAs were hired as ER techs. I got a job in EMS instead, and sure enough, all 6 hospitals in the county had CNAs only in the ER, no EMTs. Now I'm in AZ where HRs say they only hire CNAs but a former NC coworker, a paramedic, is working as an ED tech. Sbrudd, it may pay to check with the local hospitals before enrolling in a course. If you can speak to an ED nurse manager instead of HR, you will get the info pretty straight and may even get him/her to tell HR to hire you (how I got my first job, when HR said they weren't hiring). Best wishes! Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 5, 2004 Author Moderator Share Posted July 5, 2004 like I said it has been almost 20 yrs.....but the 5 locations I work at all use emt's as techs for whatever that is worth..... Link to comment Share on other sites More sharing options...
SurgPA05 Posted July 7, 2004 Share Posted July 7, 2004 EMED: I wasn't aware that PA students could take the ATLS course...in fact I thought there were issues with certified PAs not being able to become ATLS certified because of restrictions from the ACS saying that only physicians/residents could become certified....it is entirely possible that I have bad information so if you would be so kind as to elucidate the ATLS mystery to me I would appreciate it. Thanks. JL Link to comment Share on other sites More sharing options...
Guest devin323 Posted July 7, 2004 Share Posted July 7, 2004 I heard that ACS restricts "non-physicians" from taking ATLS as well. Link to comment Share on other sites More sharing options...
Guest Blueshirt121 Posted July 7, 2004 Share Posted July 7, 2004 Whether allowed or not, wouldn't you think it'd be an important part of schooling a PA? I know nothing because I am only starting out as a student but would intubation fall under ATLS? Are PA's allowed to participate in stuff like that? Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 7, 2004 Author Moderator Share Posted July 7, 2004 *** as of 10/08 pa's can get a cert card in atls***** I took atls as a 2nd yr pa student and every 4 yrs since. not all sites will allow pa/np folks into the courses due to limited # of spots but larger trauma ctrs usually set aside a few spots/class for non-physicians. if in the pacific northwest, try harborview hospital in seattle and emanuel hospital in portland, they both put on a great course.when I was at hahnemann they allowed pa students to take the class as a cme course. blueshirt: intubation is part of acls and a skill every pa should feel comfortable in doing. em pa's such as bandit and myself utilize this skill in our jobs whenever necessary. Link to comment Share on other sites More sharing options...
Guest Blueshirt121 Posted July 7, 2004 Share Posted July 7, 2004 Regarding EM PA's...is the love for being an EM PA the fact that it's "where the action is," as opposed to another discipline or is it some other reason, like more autonomy, better pay, better shifts...etc? And what are "Locums" as was mentioned before? Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 7, 2004 Author Moderator Share Posted July 7, 2004 things I like about em great variety of cases and autonomy flexible scheduling good pay(best of any specialty in 2003 aapa survey) great benefits/retirement/cme locums positions are temporary jobs( 2 weeks to 3-6 months) much like the agency nurses do. the best locums company for pa's are comphealth and passllc. check out their job opportunities at www.comphealth.com and http://www.passllc.com and choose physician assistant from the menu for a list of jobs/places.also check www.staffcare.com for another source of locums jobs. these are great if you are single and want to travel or kid free with an understanding spouse or as a bridge to retirement(as you can work as often or infrequently as you want- in theory you could do 3 mo on, 3 mo off or any other arrangement of work/vacation). this is probably what I will start doing after age 55 for 10 years or so. work saipan for 3 mo, germany for 3 mo, alaska for 3 mo, etc. 1 Link to comment Share on other sites More sharing options...
Guest LUMPY Posted April 11, 2006 Share Posted April 11, 2006 Emedpa, Great Info! I Have Been A Flight Medic In The Civilian And Military For 10 Years Now And I'm Wondering If You Ever Get Burnt Out? I've Been In The Er As A Pa For A Year Now And Feel Like I Want To Do Something Easier(emotionally). Am I Just A Puss Or Do Other Guys Feel This Way? I Love Working With My Hands And Love A Great Trauma Like The Next Guy, But Sometimes It Gets A Little Much.... Like Neonates And Kids.. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted April 11, 2006 Author Moderator Share Posted April 11, 2006 Emedpa, Great Info! I Have Been A Flight Medic In The Civilian And Military For 10 Years Now And I'm Wondering If You Ever Get Burnt Out? I've Been In The Er As A Pa For A Year Now And Feel Like I Want To Do Something Easier(emotionally). Am I Just A Puss Or Do Other Guys Feel This Way? I Love Working With My Hands And Love A Great Trauma Like The Next Guy, But Sometimes It Gets A Little Much.... Like Neonates And Kids.. I feel that way sometimes when I work > 180 hrs/month but when I work around 150 most of that magically goes away..... and I have been at this for almost 23 yrs.... Link to comment Share on other sites More sharing options...
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