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  1. Hello, I am looking for realistic advice on becoming a surgical PA First Assist. I viewed similar topics within this forum but wanted a more personalized response. This will probably be a long post . Here is a little about my background; I’m a 27yr old currently holding only my GED with a certification as a NA. I’ve worked as a CNA for 3years with 2.5 years working on a post surgical unit at my current hospital. I am transferring to sterile processing next month where I plan to work as I attend a CST program. I thought this would be a good field to work in since I will be working directly with the surgical instruments and preparing the kits and trays for each surgery throughout the day. I also plan to obtain my CRST ( certified registered sterile technician) by taking the exam after some more experience on my new job. I originally wanted to go to school to be an OR Nurse or go for my CRNA but after being allowed to observe a few surgeries at work realized I’d rather be more hands on during procedures. My end goal then became wanting to be a first assist. After speaking with a coworker currently waiting for admission to PA school about it, they suggested becoming a surgical PA. I’m already starting out so late in life... Is it a waste of time to go through the certification of becoming a Surgical Tech? Is it feasible to start a journey to PA so late? I want to be sure that surgery is for me and more than just an interest so figured being a Surgical Tech would help with my decision...I’ve already taken so many detours on the road to furthering my education. I don’t want to delay any further. I have also looked into the RNFA route but prefer the flexibility when it comes to specialties being a PA. All feedback is welcome. Sorry for the long post, and Thanks in advance!
  2. I started a new job in orthopedic surgery 4 months ago with an orthopedic surgical group. Some of the surgeons allow residents to train under them in the OR and clinic. So far, the residents have been cool and I’ve learned some stuff from them. However, I sometimes get the sense I am jockeying for position as the first assist. Ultimately, my role is to assist the primary surgeon. For instance, during shoulder scopes the resident will stand at the head of patient (lateral positioning), then the surgeon, and then I’m towards the feet of the patient. I noticed I’m pretty useless down there. Last week, I was respectfully assertive and stood at the head so I could actually assist. Total joints are a different story...I’m across from the surgeon and the resident is next to the surgeon by the head. My question is, what should my approach be? Should I appropriately establish myself as first assist? The resident and I will sometimes switch as to who is the main assist. I’ve also found myself be a little more in tune with opportunities to be steps ahead of the primary surgeon ready to be there to assist the next move...but I’m not in the main position and I watch the resident miss an opportunity. I would imagine that as I gain more experience and earn the trust of the surgeons, maybe my role will be more clear? I want to do my job well but not be a d***. Any orthopedic PAs or surgical PAs work with residents in the OR? How do handle things?
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