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  1. Hi all! Looking for some insight into a very specific situation... prepare yourselves, it's a little complicated haha. Just a little background on my career so far: My first job as a PA was a procedural sub-specialty (pediatric interventional cardiology, i.e. cath lab) I launched into after rotating there as a student. I fell in love with it and didn't want to waste any time getting experience in something more general if I knew what I wanted. I worked there for almost 3 years and for the most part, loved my job. What made me decide to leave was a combination of a few things: my husband and I were both working at the same hospital and we both could feel a lot of changes coming (not for the better)... benefits were being cut every year, positions were being eliminated left and right, and it seemed like the hospital was gearing up for a buy-out or simply closing. In addition, I was not making nearly enough money compared to what I knew I could be making... I had accepted a lower salary knowing that it was what I really wanted to do, but at this point I knew I would never get a raise that would give me enough to make it worth it to stay. I also worked with a small group of people and the nursing staff were all checked out and I was getting tired of being the only one who had the patients' safety in mind (other than my supervising physician). The last straw was losing our CT surgery program which left the cath lab with significantly less volume. My husband and I decided to make a change and move to be closer to family. When thinking about my career future, I would have loved another peds cath lab job, but my dream job would be pediatric CT surgery. Now both of these positions are very specialized and really only limited to major cities, and even the places that have it don't all use PAs. I looked for these types of postings, but there wasn't anything out there, which didn't surprise me. Instead, we figured it would be better to choose a location that had peds hospital for both of us and cath and CT surgery programs for me with the hope for something in the future, in the meantime accepting less than our dream jobs. My husband found the exact position he wanted and I found something related that would give me good experience - working with the same patient population but in a different capacity (cardiac ICU). I figured I could get myself in the door and hopefully work my way into a procedural position (cath or CT surgery) eventually. Now, 8 months into my new job in a new location, I find myself not loving it. I have noticed that this institution is very much a doctor's club and less a proponent of the APP model (at least in the inpatient setting). They seem to all be comfortable with the attending/fellow/resident relationship and don't include me the way that they should; nor do they see me as on the same level as a resident or fellow which is really frustrating. My position seems to be focused on note writing and ordering only, which sucks coming from a position where I was hands-on and had a lot of autonomy. When I spoke to the director of APPs about my feelings and the fact that I'm not loving this position, I asked about more procedural-based jobs and I was told "We don't use PAs in the OR at this hospital. The residents are the priority. That's just the way that it is here." Which is a completely frustrating thing to hear. It's not that I'm miserable in my current job (I'm good at it, I don't hate it but I don't love it), but I do find myself missing what I used to do and the respect and autonomy I was given. When I first started feeling like this, I told myself that I needed to give it more time - that once I got used to it maybe it wouldn't be so bad. Maybe I could prove myself and things would improve. My husband isn't loving his job either btw (for different reasons), but we told each other that unless we were miserable we would try to focus on home life and less on our careers; which btw is something I've never done. Not that I don't have a good work/life balance, but I've always been career oriented. Sooo we said "let's not put off starting a family any longer!" (Something we had done for 3 years while I was focusing on my last job.) I gave myself 6 months in my new job before we started trying... now I am 9 weeks pregnant and we are super excited about starting a family, although my feelings about my career remain the same. So the reason for this post? Now that you have the background, I'll get to the point. After a particularly frustrating week at work, I did what every disgruntled employee does and I started looking for jobs. A blessing and a curse.... I found a posting for my dream job. In another city, after having just moved less than a year ago. And I'm 9 weeks pregnant. Shit... what do I do? Well I've got to apply, right?? It is my dream job after all. And when planning for after the baby comes, it will be me who still works full time and my husband who cuts back his hours to be home with the baby. So if I'm already not loving my job, I'm gonna love it less if I have to go and be away from my baby all day. Btw, we are renting, so a move would be a little crazy, but do-able. My husband has been so supportive. He told me I should apply, so I am currently working on my cover letter and plan to submit in the next few days. But I have been asking myself, what do I do if I get an interview?? I'm not showing yet so it won't be obvious that I'm pregnant, but do I disclose it during the interview and risk not getting an offer? Or do I wait until after I get the offer and make them feel as if I was hiding it? Even if I could start ASAP, I know that credentialing will take 2-3 months and then I'd be starting when I'm 5-6 months pregnant, only to go out on maternity leave 3-4 months into the job. Ughh my brain is spinning. Anyone have any words of wisdom? Or even just words of sympathy? I keep going between excitement for the possibility to then immediate freak-out mode with trying to coordinate everything if I get the job. Any responses are greatly appreciated!! :) Ok, I'll stop typing now.
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