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Showing content with the highest reputation on 03/18/2019 in all areas

  1. 3 points
    I was accepted!!!!! And they also got their accreditation!!
  2. 3 points
    Hell no to 70K. Truly rural gigs tend to require management of complex co-morbid patients who, in a higher population location, would be co-managed by "specialty" care. Remember that in rural medicine there is often: a) no specialist access within reasonable travel distance for your patients, or, b): the specialists within reasonable distance are so far and few between that the wait to be seen is 3+ months. You may be largely responsible for managing all of this. e.g, think: psychiatry, nephro, cards, neuro, GI, etc etc. It can be incredibly stressful. If you are going to have to significantly manage patients in these areas that alone should bump your pay up significantly, easily over 100K. Find out from this practice how this type of thing is handled. Good luck!
  3. 2 points
    Congrats!!! So happy for you! Anyone else hear anything?!? I’m soooo thankful they did get the accreditation!
  4. 2 points
    post it here so I know where to join.
  5. 2 points
    We should start a facebook page! Definitely interested in roommate situations!
  6. 2 points
    Accepted in January =] I look forward to meeting everyone and embarking on this crazy journey for next two years with this cohort! I,as well, am more than happy to help anyone who has any questions about interviewing or just the whole process haha I have been wait-listed, rejected, and accepted early so I have some experience on every level. One thing straight off the bat, THERE IS MORE STRESS THAT WE (PROSPECTIVE STUDENTS) PUT ON OURSELVES THAN WE NEED TO. Interviewing, overall, is just an opportunity to show your organic self. Getting caught up in all of the forums, the most common interview questions, mock interviews, is good prep but is also an avenue of creating more stress and anxiety. BE yourself, you know why you want to be a PA, you know what you've done to get yourself there, and you know the blood sweat and tears you have put in to earn an interview opportunity. Show/tell them that, maybe crack a joke (if warranted, feel out the audience haha) and that is what makes the difference. One of my nemesis the previous cycle was getting too caught up in all the the prep work of what I should do and mock interviews and what not to say ... this year I promised myself that if not for anything else I was going to be genuine and me. That tactic came through. Either way, congrats to those accepted! For those that have heard otherwise use the experience to fuel your fire the next time around. We all can become our own worst critic but take it as a learning experience and kill it next cycle. Success is not final, failure is not fatal, it is the courage to continue that counts. - W. Churchill Nothing is impossible because the word itself says IM- possible.
  7. 2 points
    Guyyyyysss! I will be joining you all this fall! I’m so excited for this journey with you all. I want to give it back and I’m willing to do free mock interviews for whoever wants to practice! I’m no professional but I do know what works and doesn’t work as I actually did a mock interview after my western interview! Please message me!
  8. 2 points
    Have you thought about doing locums work ? Seems like that would allow you options to check out locations / sites etc that are of interest to you without making a significant upheaval / commitment right off the bat. Plus, I think that a lot of locums jobs can turn into permanent if the chemistry works. ?? just a thought !
  9. 1 point
    Hello! Just wanted to see if anyone had any reviews suggestions for students who have been accepted and are awaiting the start of their PA schooling. I have already begun looking over some things anatomically, but wanted to inquire about any specific sources such as textbooks, internet sources, etc someone may have found helpful before your PA program began. And would you recommend focusing on anything specific that may pertain to the majority of programs? Thanks so much!
  10. 1 point
    If you’re still looking for reasonable proximity to NYC, look at Connecticut. We aren’t Midwest cheap, but once you get past Fairfield county the cost of living is much more affordable. My town calculates out to being 72% cheaper than Queens (never mind Manhattan). I live on the shoreline, 5 minutes from the beach in one direction and a state park in the other, but I can still hop in the train and head into NYC for a Yankee game or a broadway show (going with my wife to see Harry Potter next month...). Our state practice act hits all six elements of the AAPA, and in general PAs are treated relatively well. If you aren’t quite ready for the cosmic jump to Alaska or Nebraska, we are a nice alternative to NYC (I left an ED job in Queens 16 years ago and would never go back). Sent from my iPhone using Tapatalk
  11. 1 point
    congrats !!!! how did you find out about the accreditation???
  12. 1 point
    30k is not worth the "accreditation issues." That would be a huge red flag for me. When you start a program you are placing your day-to-day life in their hands, a lack of organization can be a huge burden on you, and worrying about accreditation on top of that is not good. You're also "in it for the long haul." Transfering is not an option, and leaving that program and applying all over again would be a nightmare scenario. Even if it was 100% justified, it would likely not be looked at favorably by admissions committees the second time around.
  13. 1 point
    I still think it’s unnecessay to retake it. Your score is competitive, and you surpass the minimum requirement, so schools likely won’t care when you took it as long as it was within 5 years. Save your time and money for CASPA and supplemental applications
  14. 1 point
  15. 1 point
    Congrats everyone who got accepted this cycle! I got on a wait-list. It is sad but i keep my head up because i made it this far. I am coming from a different country and honored to be considered for such an opportunity. Fingers crossed!!!
  16. 1 point
    Hi! I'm in the same boat as well. I have been applying on and off for the past 11 years but only at one local college because of being a single mom w/ 3 kids at home and could not relocate. I have had 5 interviews and numerous denial letters. This year my youngest is finally 18. I am 45 years old with 20+ years of experience as a CT/Xray tech and have a good amount of hours volunteering. I graduated with my AAS and BAS with honors but lovely CASPA doesn't care about that lol! My sGPA is only at a 3.1 cGPA 3.4 and last 60 3.6. I, as well, have been told I would make an excellent PA, along with great LOR's. One interviewer flat out told me, having the heart is not good enough and another asked how I would handle the rigorous program having 3 young kids (IMO he should've never asked me that). I may not be a 4.0 student, but damn I'm not stupid lol! I know it's my GPA that is holding me back. Their concern is my ability to handle the curriculum. I'm not in my 20's and able to go to school full time. I had kids to raise, a full time job, and paid for my classes out of pocket. I have repeated classes either for better grades/expiring. I have never considered anything else than PA b/c that is where my heart is. Until recently, I learned about ABSN's and the numerous programs for NP. I'm at that point in my life that I do not want to be a life long student. I have perseverance, but what I want is to be a mid level provider and be done with school. At what point do you realistically say, this isn't going to happen and move on? My only con about going the NP route, is I honestly prefer the medical model over theory and writing papers. This year I plan on applying to about 10 PA schools and a few ABSN programs. If I do get into and complete my ABSN, I will evaluate then to see if I will continue onto FNP or reapply for PA. Anyways, thanks for letting me share. This is my first post about my situation and it's nice to see/get feedback from other's in the same situation
  17. 1 point
    Glad it's not just me that is constantly refreshing this page to see if anyone has heard anything yet.
  18. 1 point
    full disclosure. I deleted all the off topic banter. Let’s keep it on track and not attacking each other.
  19. 1 point
    Wow... ArmyVetDude... I think “somebody has a case of the Mondays.” No need to be a jerk to BoatSwain. It seems you advocate for PA independence so that the nurse practitioners don’t overshadow us and take our jobs. But is it right to advocate for independence just because the NPs are doing it? No - not a good enough reason. How can a PA or an NP a year or even five years out of school practice without supervision? It’s ludacrous and dangerous. Personally I think the fact that we are supervised only adds to our credibility over NPs. Anyway, I am not independent and if I wanted to be I would have gone to medical school...
  20. 1 point
    I was in a similar predicament as you. I couldn't decide between my nurse manager or one of the charge nurses. I ended up having one of my charge nurses write a letter for me because she was the one I saw and worked with all the time at work. I didn't choose my nurse manager because, although we had a good standing with each other, she has never seen me work, so I would suggest the same to you. Choose a nurse that has worked with you and seen you do the work! Hope that helps.
  21. 1 point
    The program I'm applying to conducts criminal background checks prior to matriculation. Therefore even if I got a lawyer and have the conviction expunged, it probably would to risky to NOT disclose it. I've reached out to my state boards and they indicated my past record won't hinder my ability to get a license. I know people with DUIs have gotten DEA numbers so that shouldn't be an issue. Thanks for the thoughts,
  22. 1 point
    Agree with above comments. No need to retake the GRE. When it all boils down, just any program that is accredited, has a high (95+%) PANCE pass rate (which means they are teaching pretty well), retention rate (which means they aren't failing people a lot; no one should fail PA school barring extenuating circumstances, everyone is already a good student), location, and cost. Rankings are pointless, and university name recognition only goes so far. GRE, GPA, and PCE hours are the big hurdles for most people, you seem to be fine in all of them. Apply broadly, have a couple backups, and you should be good to go. When you start having to pick from acceptances, go with the best fit for you, the vibe you get, the location, and the cost. I have seen people walk away from top 10's (including top 1 and 2) just because they didn't like the atmosphere of the program, and they probably made the right decision for them.
  23. 1 point
    Hang in there, most of the Pro-Assistant PA's will be retiring soon. As I tell my kids about the world in general, my hope is in you. My generation of PA's failed the next generation when it comes to a proper name change. They were short sighted, full of fear and in the end impotent. Don't be like us. Don't apologize to anyone for changing this irrelevant and outdated name and pushing for more independence. Our hope remains in you.
  24. 1 point
    In response to Paula and others expressing a high amount of skepticism about the research firm, here is my view. I highly doubt that WPP will take one million dollars from a client and then deliver a final report that amounts to a steaming pile of crap. They have their own reputation to protect and have to stand behind their work. A comprehensive and independent investigation by a competent, highly respected research firm is not going to recommend that "assistant" is an acceptable word to keep in the title of graduate-trained clinicians who practice medicine. Anyone looking at this issue from an objective standpoint, not vested in the special interests of the various factions of health care will see that. The part we are paying for is a dispassionate look at what might work, what the perceptions are in the profession, and outside the profession. I hope I am not being naive and overly optimistic. But that is how I am currently thinking about it anyways. No matter what anyone thinks about the investigation, I think it is important for all of us to take that survey though. And to support our advocacy organizations in the mean time. Remember, lately AAPA doing some real work. They batted down NCCPA (who was literally threatening to let the practice act in IL expire in order to get their way). They have been running public campaigns like "You're PA Can Handle It". They are funding individual state academy efforts to pass OTP legislation. One thing I have learned from working with my current state's academy is that literally no one else in my state cares about PAs, our practice act renewals, our ability to get licensed in a timely manner from the board, our employment opportunities, etc., other than our advocacy organizations. If we blow them off because change isn't happening soon enough, they don't have money or numbers to do anything and then no one does anything (you cant do this alone). Even if HOD votes to support a title change, all that will become is an AAPA policy. Individual state chapters then have to do the actual work of getting legislation passed. and that is super hard to do.
  25. 1 point
    One thing that really helped me get out of my shell was my PCE experience. I was kind of forced out of my shell and forced to talk to people who come from so many walks of life. By the time interviews came along, it wasn’t too bad. They really do expect you to be yourself and to show them that you’ll be a good fit for their program!
  26. 1 point
    Well after spending the day in the ER and having a family member admitted I noticed one thing.... The first 5 seconds of your visit are the most important for raport building.... and to put someone at ease. Lots of people coming in and out of the room, only one actually stopped, fully introduced themselves and explained their roll in the delivery of care. That one was received the best by the patient and myself (I was there as family, no name tag, keeping quiet in the corner so no one knew my position/education/title) Those first 5 seconds are critical and so many people waste them by just jumping into history, or even worse exam (way to fast!) So stop outside the door take a deep breath knock, ask if okay to come in walk in slowly, close the door behind you - hospitals are noisy places introduce yourself, your title, and your role ie I am the hospitalist provider Shake a hand or make and effort to touch the patient is a gentle introductory way - if received well indeed shake the hand, if not received well just stop looking for contact Pause briefly and let the patient and family absorb who you are, what you are, and what you are likely doing there.... Max 5-10 seconds and yet it sets the stage for a successful interaction...
  27. 1 point
    FAPA was involved in this process. I’m not speaking on behalf of them (FAPA) but the addendum process was felt to be the better method in this instance and the academy and board was definitely aware of the process/bill.
  28. 1 point
    Rank doesn't matter. Where do you want to work/live after school? After that, cost, PANCE scores, cost. Then everything else you're worried about.
  29. 1 point
    I am actively planning early retirement. I have crossed over from wanting to get out, to needing to get out. My advice to young PA's is this: 1. Get out of debt as fast as you can, period. 2. Do NOT get back into debt buying a big house and an expensive car. 3. Save Save Save. Max your IRA and 401k each year and learn to live with what is left. 4. Retire early before your moral and physical injury becomes permanent. It is too late for a lot of us, but not for you. It's no coincidence what this profession does to your physical and mental health.
  30. 1 point
    Why are you retaking the GRE. That's well above average
  31. 1 point
    The way I went about it was to have a bunch of stories thought out that I can use as examples to show any trait I feel made me a good fit for the program. Also, remember to always tie your answer back to 'why YOU are a good fit for PA school.' This avoids you just rambling off when you give responses. Being shy and an introvert isn't something to feel worried about. That's who you are! But when you do get an interview, remind yourself how much you want it. You can be shy and still have an amazing personality that you can show through the stories/examples of things that you have been through, either at work or in your personal life. Look up interview questions and relate your answer to a personal example. GOOD LUCK!
  32. 1 point
    My best advice is learn to fake it and that is going to require you to work with the public. You aren't going to be an effective provider if you are shy. I was shy and introverted through High School and through many years of working in retail management can fake it with the best of them. I still prefer chilling at home versus partying on the weekends but you would never think watching me interact with people that I had ever been either of those traits. If you are confident you cannot eventually overcome being shy but still want to help people in medicine I would look into research based medicine. Good luck to you!
  33. 1 point
    I got in!! I'm so excited to meet everyone. If anyone would like some tips or any help I can give please feel free to message me and I'll be as detailed as possible! I know what it feels like to want help and I'm so grateful for those that have helped me. So I'd be honored to pay it forward.
  34. 1 point
    Hey Guys! Just wanted to give you an update. From what I've just heard today 3/14 is the last interview date. Good luck to everyone who has already interviewed!
  35. 1 point
    Normally I would say go with the cheaper program however in this case the cheaper program has shown some red flags and I think you should heed those warnings. If they can't even put their best foot forward when they are trying to draw students, what makes you think they will once students are there?
  36. 1 point
    Recently gave up my seat to this program so hopefully there's some movement on the waitlist!
  37. 1 point
    This is probably the most important point in this whole thread. Far too many PAs are content to gripe continuously about nothing getting done and complain about the leadership, but they make no effort to actually work with their professional organizations (either AAPA, your state CO or your specialty organization). The PAs running these organizations aren't appointed from Mount Olympus; they are other PAs who cared enough to volunteer their time and effort to try and make a difference, typically at personal expense. We would have a lot more lobbying power if more of us got involved in advocating for our profession. OK, getting off my soapbox now....
  38. 1 point
    There was an LPN that was in an immunology class I was taking that was upgrading to RN/BN...first day of the course, the two profs were having an open forum on what we knew about infectious diseases, ones that we knew, what caused them and if they were vaccine preventable or not. Came to me and I said "Yellow Fever, viral, vaccine preventable." Nursing Sister/Brother Know It Tall spits out "That's bacterial" Prof looked back to me and I asked if he'd like me to name the virus for him...at which point person in the back with their nose in the air states "It has to be bacterial because there is a vaccine for it". I had to turn around at that point and ask if they knew the etiologies of influenza, measles, mumps, polio, rubella, chicken pox, smallpox, because by her/his logic, they shouldn't have vaccines being that they are viral diseases... Funny, but I'll say it again - I learned in Grade 3 and 4 health class what diseases we were vaccinated for as kids, why and what caused them. It's much like the person that tried to tell me this afternoon that I'd only be getting $0.95 change from the $5.25 I gave her for the $2.15 coffee I bought...our education systems are sucking arse. Oh, and leave religious stuff out of public education - want to teach cretinism, oops, creationism, save it for a private religious school or Church/Mosque/Synagogue school. SK
  39. 1 point
    They're conducting interviews through April per the admissions coordinator.
  40. 1 point
    After residency, I take two weeks off to recover, and then I start my permanent position at a MICU. I'm very excited to be working there! Down the road, I'd like to precept and teach, but also flesh out a few hobbies and get back in shape. I also definitely see myself picking up extra shifts from time to time in the various units I've rotated through in order to keep up the unit-specific skills I've gotten to learn through the year. (Being used to working pretty much every day, I think I'm going to have to really adapt to having so much free time!)
  41. 1 point
    strong work! It may be a slower learning curve than working at a super busy place, but you will avoid the inevitable burn out that goes along with working 200 hrs/month and seeing 30 pts/12 hrs.
  42. 1 point
    I have no idea about the waitlist. I'm not really sure about how many people got off the waitlist for my class either but we did have one person get accepted 2 days before class started so don't give up hope until the first day of class has officially started.
  43. 1 point
    @Notfall Hours vary a lot between rotations. My off-service rotations were 9-5 M-F. My ICU rotations have averaged 4-5(+) 12-hour shifts per week. My last two rotations have included 30-hour call, so that changes the math a little bit. It's a one-year residency, and basically I live at the hospital. So, back to report on two high-intensity rotations. I already completed echo, which was kind of boring but has already been paying dividends in terms of my ability to do a good quick bedside echo, check IVC, etc. November was my month in the trauma surgical ICU. Things were *very* different there from what I'd been used to. This was the first surgical ICU I've been in that's actually run by surgeons, rather than having intensivists as attendings. (And I can tell you now that I VASTLY prefer intensivists.) Trauma is a different world, with a very different patient population and very different set of problems. I learned a lot about resuscitation-focused medicine, and I also really enjoyed working with PM&R. My team was amazing, and that was the only thing that made that month bearable. Our patient load was absolutely insane, and so the stress level was very high. I definitely hit a low point during the month where the hours and the workload caught up with me. My very first call night I had a patient actively hemorrhaging from an open pelvic fracture while the NP was dealing with a patient actively hemorrhaging from a stab wound to the heart. This month has been MICU. Because of the hospital I'm at (the community/county hospital), the patient population is predominantly lower income with a lot of barriers to care, so we see a lot of complicated people with advanced disease, stuff that I don't usually see at the other hospitals. I have a really great team, and I've liked the attendings a lot. In this hospital, once you're admitted to an ICU, you belong to that team, no matter where your physical location is. Because of this, we wind up with a lot of patients "boarding" in the ED. This can be really challenging, and these patients are really hard to keep up with. Big things change, and you don't find out for a while. I spend a lot of my time taking the elevator back and forth between our unit and the ED. Doing call shifts has been really good for my skill of admitting patients. That has been one of my weaknesses/fears. I find getting a new patient that another ICU provider hasn't seen yet very intimidating. Any new ICU admit is full of crash potential, and it's my job to work them up fresh. What you're told by the person transferring the patient to you isn't always the full story. Sometimes they don't even have any labs or imaging yet. Coming up with an extended differential, placing all the right orders, and decided what the priority problem is can be very challenging. Somehow, up to this point in residency, I've done very little admitting of fresh patients, probably at least in part because my shifts have been majority days, and many new admits come at night. So I'm glad I'm getting this chance. One of the really fun developments in these rotations has been seeing my progression from pure learner to part-learner, part-teacher. My team is comprised of one PGY-3 and two interns, neither of whom have been in the ICU before. It's been pretty cool getting to teach the interns ICU things and help them with procedures. I've even gotten to share some knowledge with my senior, although he's great and has a good amount of ICU experience himself--I learn a ton from him about medicine-y things. This year has been amazing but quite exhausting. I think it finally caught up with me, because I'm typing this from home where I'm stuck sick with the flu (yes, of course I got my flu shot, but they're not perfect). I feel very guilty not being there with my team for their call shift tonight, but I do think I needed to slow down a bit. As this year has progressed, the way I've learned has changed a lot, and these days I spend literally no time actually "studying." It's been all experiential learning, and while I wouldn't give up a single minute I spent in the hospital to go read a book, I am looking forward to dropping the pace and having dedicated study time again. Now that I'm this deep in, a whole new world of potential knowledge has opened up for me! Oh, and I might want to develop a few hobbies, too.
  44. 1 point
    Hi all! My name is Ashley Bell and I am faculty at the Texas Tech program. I started here in August 2017, with the class of 2019. I am happy to answer any questions or concerns you may have. I can also put you in contact with current students if you wish to hear their perspective. You can send me an email at Ashley.t.bell@ttuhsc.edu.
  45. 1 point
    To all reading these messages do not be fooled As a current student at this program I object to what has been said. During the interview process I was nervous about bringing my family all the way to Texas. Since being here I have not regretted this decision once. I had other options that may have seemed more "prestigious," but I chose Texas Tech based on how I felt during my interview and conversations I had with 2 close friends that were currently in the program. I didn't take the word of some nobody on the internet to dictate my decision. To be honest I would be pretty upset if I was kicked out of the program (which is what I think happened with the posts above). So to anyone reading into these posts I want you to ask yourself "what recently graduated PA cares to go on a chat board for incoming students just to rip on the program they just "graduated" from?" Furthermore, the school must have been really terrible for these guys to keep the name in their profile. Lastly, I challenge anyone to find a better pharmacology professor in a PA program than Dr. Tenner, or someone more caring than Mr. Taylor, or more knowledgeable than Ms. Bell. Sincerely, A student from a program SO bad you'll name your profiles after it
  46. 1 point
    I'm not here to start an argument, just to give a different perspective as a current student. There have been very few issues (aside from the ridiculous Midland rent) and the one big issue that we brought to attention of the staff was dealt with very promptly and as professionally as it could have been given the timing. The only people that are no longer here after 2 semesters are the ones that simply did not meet the GPA standards. Probation was several years back, from my understanding it was because of the turnover rate of staff and/or paperwork issues, you may have heard about UTMB experiencing something similar this past year. That has all since been addressed and the current staff is a wonderful group. One thing that I really appreciate about this program in particular is that they listen to us and make the changes we suggest to try to make their program better. That's very rare to see and that's my input on this matter. Good luck, y'all!
  47. 1 point
    Well, I survived a month of "off-service rotations" (aka nephrology and ID--good for learning but I'm glad I picked the field I did) and got back into the CVICU. I was surprised by how much I really loved it. Some of it had to do with the great team, and some of it had to do with the interesting patient population. I had several ECMO patients, lots of post-CABG, some vascular cases, some esophageal resections. The interesting part about this unit is that on weekdays they have an additional APP who's just there to take new admissions, usually fresh from the OR. I enjoyed working that shift because taking postoperative patients is all about the art of resuscitation, finding that right balance of fluids, pressors, inotropes, and pacing that gets them back online. For the uncomplicated cases, it's very satisfying when you get them to a good stable point, extubate them, and by the next morning they're sitting up in the chair looking great. On the other end of the spectrum, this unit had some *really* sick patients, some of whom had been transfers in from outside hospitals that just didn't have the resources to take care of them. We actually had one patient who died less than an hour after they were admitted, simply because they were so very sick. Working nights in this unit was great, and the NP I was working with really let me run the show, which was fantastic. I'm reaching a point where I really want to spread my wings. At the start of residency, if you'd asked me if I'd accept a permanent nights position, I'd have said only if I had no other choices. But now, and after talking to a lot of other providers who did nights early in their career, I'm thinking I'd prefer a night position. During the day, there is great teaching, it is true. There are attendings and fellows and residents who each have their own opinions, and hearing all those opinions is really beneficial to shaping your own viewpoint. But it can also be frustrating at times. I haven't gotten to actually run any of my own codes. When a patient crashes, other people arrive in the room quickly, and they outrank me and often don't know me very well, so I'm hardly directing things. But at nights, it's totally different. When the nurse notices a change, they come to be directly and I get to make and enact my plan right away, no "waiting to discuss it during rounds." I think I've grown exponentially more on the nights that I've had than the days, even with the safety cushion of having another provider there. I really want to keep that growth going, and I want to rack up experiences with unstable patients, managing them on my own. Upcoming is two weeks of echo, which I'm looking forward to because I really do want to practice my skills so I can become a better bedside echocardiographer, but I'm also dreading it because when I'm out of the ICU I really miss it.
  48. 1 point
    I'm guaranteed a job within their system. Other residencies I looked at offered a signing bonus for residency grads if they stayed. Most systems that have residencies know how valuable you are to them afterwards and try to recruit you.
  49. 1 point
    And I thought I was tired last month... I just completed my CCU month, with the longest hours I've had so far in residency. It was a rough month, and not my favorite, but totally worth it in the end. Having a cardiologist for an attending, rather than an intensivist (or anesthesiologist or surgeon--but they're different, too) means everything revolves around one concept: hemodynamics. I had never given the subject the thought it probably deserves, and I can honestly say that after a straight month of it, I see patients in a totally different light. I've dealt with heart failure patients before, but this unit was chock full of them, and it made me realize how many mistakes I'd made in the past with them. The other big learning point of the month was PA catheters (aka Swan-Ganz). Nobody else in critical care likes them right now (well, maybe sometimes CTICU/CVICU), but I'm glad to have spent a month with them to learn their strengths and weaknesses (it's all about the trends, baby--otherwise they're pieces of shit and random number generators at best). I also got to finish out my month with a week of nights, which was fantastic. The providers I was with at night were residency grads themselves, and they wanted me to get the full experience, so I got to keep the unit phone and any time a decision needed to be made they would direct the nurse to me for my plan. Even without any crazy events the first three nights, having to take care of all the little things for an entire ICU worth of patients was a great learning experience. The last night, we had a patient roll in hot (right at shift change, of course, and of course much hotter than advertised by the transferring unit) and I got to make a lot of management decisions on a pretty tenuous patient. I'm realizing now that this patient would have terrified me even just two months ago, but the thing about residency is you grow in such leaps and bounds, that suddenly you're in a totally different place than you'd started and you're not entirely sure how you got there. All I know is, these days I run a lot fewer decisions by the people around me, because I know what I know, and I can mostly handle most patients. I also know what I don't know (btw, I think this is one of our greatest strenghts as PAs), and I've gotten better at knowing who to ask and how to hold things together until I can get an answer. I was also encouraged by a PA on the unit to start looking for ways to grow as a mentor, and I got a few opportunities to do some teaching with a PA student and medical student who were rotating with us. Now for most of the next two months, I get to live that cush consult service life. 9 to 5! What will I do with all this free time? Might be a good time to reset some healthy habits (I'm looking at you, midnight hospital grilled cheese).
  50. 1 point
    Congrats PAstudent234! I'm so glad I did it, and I'm sure you will be too! kidpresentable: I did 6 weeks each in MICU and neuro ICU. All other rotations will be one month. Thank goodness neuro is long behind me. I was trying to be positive in my last post, but it really wasn't my thing, which, combined with the flow of the unit, resulted in me feeling quite bored much of the time. Now I'm finishing up my month of transplant/surgical ICU. This has been my first rotation on the resident team, meaning I'm placed with physician residents and have my own individual load of 3-7 patients depending on how many of us are there that day. Somehow I've gotten practically no procedures this rotation (but I did get my first paracentesis!), but I don't really mind because the learning and growing has been incredible. The stress of the hours is starting to get to me, and yesterday I had my first day off after 9 straight days of work. The difficult part of this process is believing in myself and my ability to grow and adapt. Being on my own with patients means I feel responsible for every good and bad outcome, as well as for every crisis they face. This past week was humbling with the number of things that arose that I simply wasn't ready to deal with on my own yet. It created a lot of fear and self-doubt in me, and I wondered honestly if I had made a mistake, if I wasn't cut out for critical care after all. But after some talks with a recent grad of my program, I realized I was holding myself to an unrealistic standard. Yes, I should set the bar high, but it's ridiculous to set it so high I expect to be able to handle the same situations people with years more experience are able to. I've realized what a big leap it can be to get certain types of knowledge (mainly ACLS) from my brain into action, and that it's okay that I need to see things play out once or twice in real life before I'm ready to lead the decision-making. For example, now that I've seen a very unstable (and very unexpected and very unresponsive) SVT, the knowledge of what to do is burned into my brain in a totally different way than it was when I was studying ACLS guidelines over and over. I'm just under halfway through this program, and it dominates my life in a way that makes it feel as if this is all I have ever done, but I often have to stop and remind myself that I'm just shy of 5 months in, 4 months actually in the ICU. Kudos to all of you critical care PAs who just jumped right into an ICU job. I cannot imagine taking on this challenge without residency. At times, I am utterly exhausted, mainly by the stress of my own incompetency. But when I get it right, when a new concept clicks, when I put together a really good plan for a patient and they start improving measurably, I'm floating on air for the next hours or days and it feels like I've found the one thing I was meant to do. tl;dr - What a ride.


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