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charlottew last won the day on February 27 2016

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About charlottew

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    Physician Assistant

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  1. As for procedures, we do them in critical care (central lines, arterial lines, ultrasound peripherals, occasional LP; intubations/chest tubes/pigtails/PICCs are done by other services). For transplant patient however, the surgeon prefers that the ICU APP's/residents not do these - attending only. Point being, on a transplant service although you are taking care of very sick patients, there is a lot invested in each patient, with a large team, so your autonomy will probably be a bit limited. Even if you had done a residency, I don't think you would get a lot of procedures, on a transplant service.
  2. I don't work in transplant per se, but I take care of transplant (liver, mostly) in the ICU. I'm familiar with our transplant service (we do liver, kidney, sometimes pancreas - but not heart or lung). Transplant has a few NP's on service, no PA's. I believe they see patients in clinic, and also in the hospital post-op. They don't go to the OR at all. Liver transplant patients are some of the sickest patients in the hospital. Also post-op they are at risk of complications because of the immunosuppression (plus how sick/debilitated they were pre-transplant). So they can be challenging to take care of. Also it's a surgical service, so that means dealing with (transplant) surgeons. As for whether a residency is worthwhile, it's often very valuable experience, that you might not be able to get otherwise. It's certainly possible to get a job/have a career without a residency. But if you are really motivated to learn as much as you possibly can as a PA, a residency is a good option. They generally pay at least a living wage, (and loan payments are deferred I believe), so there aren't any 'extra loans' to worry about.
  3. Try Googling. I found some promising stuff without much difficulty. Also I presume you would be the first PA for this practice - because otherwise you can just use the other PA's agreement as your template.
  4. I have heard of critical care residencies that when you finish, if they offer you a job it is at pay of someone with three years experience. Just saying. I would push back a little. If you are willing to leave for somewhere else, you could probably get a better offer.
  5. It's on his website. DPT since 2013, MSN 2017, NP 2019. www.theptnurseguy.com . Lots of schooling.
  6. It does sound like OP was asked to leave, the second. job. "After a few months the employer and I mutually agreed it wasn't a good fit, and I left to explore other opportunities" OP can also emphasize what they learned from the experience (what the 'poor fit' entailed - not enough training, long hours, high patient load, communication difficulties...) - be sure to portray this positively, that is, DO NOT blame the employer for the situation. OP should also reflect on what they're looking for, in the next job - more training, closer commute, more colleagues, fewere colleagues.. Good luck. And yes, eventually employers want to see that you will stick around for a while, so try to find a 'good fit', and stick it out for at least a year or two.
  7. I don't see the DMSc as being as important as the other posters. In my experience the NP's with DNP's have no workplace advantage over non-DNP's, and no work advantage over plain NP's or PA's. The exception is if you want to teach - in that case having the doctorate allows for admin teaching positions. But clinically, I don't see a difference with the doctorate. And the doctorate is a further expense. Unless you can get your employer to pay for it. And, if it does become important as the workplace evolves, you can always go back for it later, maybe when your loans are paid off/finances look better.
  8. If you really want to do ED, then $60k/year doing ED (and hopefully learning some advanced skills) is better than $0/year not doing ED. An alternative is to get a job that pays a full salary (urgent care?) and work a couple of year, then try again for an ED job. Are you a new grad?
  9. We work alongside residents rotating through the units. We staff 1 person/5-6 patients day, 1 person/7-9 patients night. We work 13 x 12h shifts every four weeks. We work every third weekend, and one major summer and winter holiday each year (we count 3 major holidays each summer and winter). Mixed shifts, it comes out to about 40% nights (fewer people at night, also there are a few who choose to work nights only). 24h shifts are allowed (day+night, but not night+day except in an emergency), if you are sufficiently experienced. Our vacation time is fairly generous (4.5 wks/year to start), so that definitely helps make the schedule bearable. You are not allowed to take vacation on your scheduled weekends, however.
  10. I agree with Mike that the typical ED mentality is very different from the typical ICU one. In the ED the most important thing is disposition - that is, is there an immediate threat to the person's life? If not, where do they go - straight home with PCP followup? observation? admission to the floor (if so, which service)? or ICU? Once you have dispo, then your job is done. Along the way you take a history, do an exam, run some tests, arrive at a provisional diagnosis (or at least exclude badness). In the ICU again you need to manage any immediate threat to the person's life, but also you need to be on top of every aspect of that person's physiology. A lot of it is about the details, and getting deep into the weeds. For example, why is the chloride uptrending? What's the hourly urine output? Are they stooling and of what quality? (Very Importantly), what is their volume status? Those are not things that the ED is concerned with, at all. I work in the ICU, when we get EM residents rotating through, I find that some number of them really aren't a good fit for the ICU - they look too much at the big picture and don't pay enough attention to detail (and important things are missed). Other EM people, seem to 'get it'. But they still prefer working in the ED. So to answer the question, does an 18 month APP EM residency provide enough critical care exposure to get an ICU job.. maybe? Although (to belabor the obvious) it seems if you are going to do a residency and you are interested in critical care, it might be better to do a critical care residency.
  11. I'm not the original poster (but I am the OR, the original replier), in my opinion an RT with 14 yrs ICU experience freshly graduated from PA school should be able to get an ICU job without too much of a problem. RT experience is pretty high quality as far as ICU patient management goes. Even better, is if you have at least one ICU rotation in PA school. Only caveat is, how the interview goes.
  12. huh? why wouldn't it be legal? I work in the ICU, and we sign out to residents, and vice versa, all the time. Maybe you could explain better your concerns? Because I do not see a problem, here.
  13. I had a bit of a gap before starting work, I did some part time coverage as an instructor in physical exam class in PA school. You might also consider volunteering at a local free clinic (I know there is a small network of them, in Worcester) to keep up some skills. It does sound like the market is a bit tight for new grads. You might need to apply further away, or consider a residency. Everything in healthcare aside from medical assistant requires a license. You will have trouble getting a medical assistant job, because as a PA looking for work it will be clear that as soon as you get a PA job, you will leave the MA job.
  14. I don't think there's a formal licensing requirement to work as a medical assistant in MA. As a licensed PA, you are more than qualified I would think. The pay would be low, however. I realize you have been looking for a while, but is the job market for new grads really that bad? Have you tried looking a bit farther out from Boston? RI, CT, NH, VT are possibilities. Are you looking for a particular specialty, or setting? I surmise from your posts that you graduated from MCPHS Worcester (as did I). Barbara Hayes has been sending emails out with job listings, there was one last week (in NH) open to new grads, have you spoken to her?
  15. Boston area has a lot of healthcare places, but now also a lot of PA schools. If you don't have local connections or past experience as a PA of course that makes it more difficult. I don't have any magic advice for you - applying to places further away will be easier (Providence RI area, Manchester NH area, Worcester area). Indeed.com, doc cafe, and the MAPA (Mass Assn of PA's) websites have a fair number of listings. Also go to the hospital websites directly and look at their listings. If you are interested in outpatient you could walk into clinics and leave your resume. Good luck! and keep persisting, you will find something. I presume you already have an MA license and a local address..
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