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  1. How is it that sometimes we find our purpose in tragedy. I lost my grandma to diabetes. Diabetes did not take mercy on her. It took her slowly, until there was nothing else to take. It started with her kidneys, they slowly stopped functioning, so she had to be placed on dialysis. Lucky for her, my aunts cared enough to be trained on the process, and she was able to have it done in her home, that's if you consider that lucky. The next thing diabetes took was her sight. It continued taking from her until there was nothing more to take. As if losing your sight was not enough, it took the sensation off of her feet, then it decided to take her toes and eventually her feet. What happens to a person that needs to be dialyzed every other day, can no longer see or walk? They slowly lose their will to live, until one day, that will is completely gone. It is an extremely difficult thing to watch someone you love, suffer on a daily basis. At the end of their journey, you find comfort in knowing that they are no longer suffering, but you also wonder, is there anything I could have done to prevent this? To my previous question, the PA profession was my answer. I believe that most medical problems can be prevented with the right care and knowledge, and if they cannot be prevented, they can be stopped from progressing. I want to become a PA because I want to keep people and their families from experiencing the pain my family and I went through with my grandma. I know it is not possible to save everyone, but I want the opportunity to at least try. I have always known I wanted to be a part of the medical field. Every time someone asks me, why do you want to be a physician assistant, my response is always because I cannot imagine being anything else. I placed myself in a job that would allow me to experience the duties of a physician assistant. I have seeing the ins and outs. I have been a part of it, not as a PA, but as scribe that works very closely with them in the clinic or in the emergency department. Every day, I am amazed by their skills and knowledge. I learn something new, a new approach, a new technique, a new diagnosis, a new treatment with every shift, and I just want to keep on learning. I have learned how to differentiate a Bell's Palsy from a TIA or a stroke. I have learned the importance of the NIH stroke scale and the importance of properly assessing the score. I can tell you that a sudden sharp pain to your back and a positive CVA most likely means a kidney stone or pyelonephritis due to a urinary tract infection. A pain to your RLQ with a high white blood cell count and a positive McBurney's point could definitely be a sign for acute appendicitis or how an elevated amylase/lipase level accompanied by nausea and vomiting probably means pancreatitis, especially if that pain occurs after eating greasy/spicy foods. I have loved every single minute of working as a scribe. I cannot wait to start this career and apply everything I have and will learn. Physician assistants are not afraid or intimidated by how complicated a patient might be because of how prepared they are. They have this confidence because if they have a question about how to proceed with a patient, they have the benefit of consulting with the attending physician. There are limitations to how much we know, which is why this is one of the great benefits of the physician assistant career. My main goal as a provider would be to offer the best care to a patient, and knowing that I have the opportunity to ask for help or guidance from the supervising attending would allow me to do that. I also like the flexibility of the PA career. As a PA, you have the opportunity to work in different specialties, for me that is essential because I have multiple interests. I love working in the clinic setting as well as the ER, and by becoming a PA, I would have the opportunity to work in both. As a scribe working in the clinic, I have seen the high demand and need for PA's in South Texas, especially in the Rio Grande Valley. The Valley is a highly underserved area, especially when it comes to healthcare. The doctor I work with, has over 1,000 patients assigned to her. If it were not because of the PA's, she would not be able to provide the care they deserve. They make a huge difference. The gratitude they receive from the patients is unlike any other. I love South Texas and know that I can positively impact the community when it comes to their medical needs My goal is to enroll into a PA program that will prepare me with the adequate skills and knowledge that are necessary to provide the best medical attention the people from The Valley deserve. I know that the PA journey will be challenging and difficult, I am counting on it. I know this career requires excellence, and I am prepared to give it all that I have in order to succeed as a physician assistant. I understand my grades my first three semesters are not the best. It was not easy adapting to college after being in the same school for 12 years. Those grades do not reflex who I am as a student, once I adapted and found a new study method that works for me, my GPA improved. . I will continue to work until this goal has been achieved
  2. I was hoping to get some quick thoughts on a patient who is presenting to our office tomorrow for a DOT PE, who has been on Subutex (Suboxone) for 4 years. She does not have a CDL license, however requires an "endorsement" to operate a Van transporting people. She has a letter from her treating physician, who is a board certified psychiatrist, stating she has been stable on the medication for 4 years, and in his opinion has no contraindication to operating a motor vehicle. My gut instinct is to decline this patient. Any thoughts or opinions otherwise?
  3. As a child I had moments when I would stare off into space as if my brain was not connected to the rest of my body. My parents were worried so they took me to a pediatric neurologist. The diagnosis was Juvenile Absence Epilepsy and it began a journey of blood tests, EEGs, MRIs and checkups for the next six years of my life. For a child, it was a bit unnerving, but when I began to see the same person at every visit I became more comfortable. I called the woman “Dr. Theresa” and she became the calming presence, someone who monitored my medication and assured me everything was fine. When I learned “Dr. Theresa” was actually a Physician Assistant, I was surprised. She did everything I imagined a doctor would do, she explained my treatment plan, wrote prescriptions, and always took the time to ask about my life and concerns. I was intrigued by this woman who had many similar responsibilities of a doctor. What would have normally been a traumatic childhood experience actually became a blessing. This unique opportunity allowed me to be exposed to a PA at a young age and prompted my decision to become a healthcare provider. I began to volunteer in my community and take every opportunity to learn about this career path. I wanted to be around people who helped others. I volunteered at food drives for homeless veterans, collected clothes for orphanages and foster children and fundraised for the families who lost their homes in the 2003 Cedar Fire in Alpine, CA. I also had the opportunity to work with young children through the 4-H Equine Group within the Helen Woodward Animal Shelter. Most of the children I worked with were Autistic, which allowed me to learn effective ways to communicate in nonconventional ways. For example, one boy used only lyrics from songs by The Beatles to commutate to me, so I had to brush up on Beatles! The sad songs meant he was in pain or a bad mood and the more upbeat songs meant he was feeling excited and happy. This experience became the catalyst for focusing my efforts to become a PA. In college, my most rewarding volunteer experience was working at The Challenge Center, a physical therapy rehabilitation center for patients who suffered from brain and spinal cord injuries, congenital defects or chronic debilitating diseases. Having obtained my Assisted Fitness Trainer certification, I was able to work with patients one-on-one. It was a true test for me to see whether or not I could handle a full patient load while attending school full time. I tracked the progress and charted the stats for each of my patients. I felt like a true healthcare provider during my time at The Challenge Center because I was able to change or “prescribe” the patient’s workout regimen. The workouts made a difference, not only on the patient’s physical abilities, but also on their attitudes and outlook on life. While working in the physical therapy field taught me a great deal about patient care, I felt more passionate about the role a PA plays in healthcare. Wanting to learn more about the profession, I shadowed a Physician Assistant named Alison. I observed her patients’ conditions and how she determined the course of treatment for each situation. She displayed the patience, kindness and professionalism that it takes to be a successful PA. I remember an instance with an elderly woman who was nervous about her biopsy results. Alison explained the outcome to her in a manner that put her at ease. Alison’s dedication to her patients reminded me of the care I received as a child with JAE and reinforced my decision to become a PA. On the academic front, my early academic transcripts show a lack of focus. Freshman year of college was a difficult transition for me. I was exposed to the dual pressures of prioritizing my schoolwork and enjoying the freedom of living on my own. I was not mature enough to know that my early decisions would negatively affect my future chances of getting into PA school. I began taking courses to work toward my undergraduate degree in kinesiology, but knew PA school was the ultimate goal. My grades steadily improved and I ended up with nearly straight A’s during my final two years, even repeating some courses to make my application more competitive. I believe my freshman year struggles allowed me to become more mature, more focused and more determined to achieve my goal of becoming a PA. My dream is now within reach. There will be an extreme need for primary care providers as a result of the restructuring of health care in this country and Physician Assistants will be at the forefront of the movement toward more affordable, accessible, and reliable healthcare. PAs will be the gatekeepers of the health care industry and will positively affect countless lives. I look forward to helping contribute to improving the health of patients in need.
  4. Love to hear some opinions on my personal essay. Im sure there are some grammatical errors as this is first draft. More interested in flow, content, readability, does opening hook you to read more? All advice and input is welcome. Thanks It’s 3 am I wake up to bright lights and a strangers loud voice. “Medical Emergency Engine 2” being a rookie it took me a bit to shake off the sluggish feeling before I realized the address was the a low income housing area common place for medical emergencies in our district. In my first 2 months we had 11 medical calls to this location alone, including 3 codes, 2 overdoses, and a plethora of events I never imagined witnessing. We all hop to our feet and fire up the Engine with the dispatch notes showing stomach pains and shortness of breath. We arrive to find a 41 year old female in the tripod position, extremely diaphoretic, chief complaint of tearing abdominal pain. The ambulance arrived soon after our SAMPLE history and vitals had been taken. Blood pressure 196 over 100, Pulse 122, pains radiating into lower back, history of smoking and COPD. We had just covered the Abdominal Emergency chapter in EMT class, it felt as though the text book jumped up and smacked me on the head falling open to the Abdominal Aortic Aneurysm page. This was the exact signs and symptoms I had studied only days before. As soon as we got her situated on the cot I was placing the final strap under her arms when suddenly she let out an excruciating moan, her eyes went white and body limp. The paramedic asked me to check the carotid for a pulse, she had none. Time raced by as we all leapt into action dropping the gurney to the ground immediately beginning chest compressions and rotating controlling breathing. This cycle continued all the way to the hospital. I never found out the fate of our patient but I couldn’t help but wonder if she had proper preventative care. While working in EMS has numerous rewards I find myself continually yearning for more ways to affect positive change in the health and well being for the community as a proactive not reactive force in the medical field. I was first drawn to the medical field when my father endured a tough year. Early 2003 he had a triple bypass and aortic valve titanium replacement. As serious a situation this was I couldn't help but give him a hard time about sounding like the bionic man, heart clicking about. Right as he was beginning to become his old self a mass was found on a CT scan in his duodenum leading the local specialist to diagnose it as a rare disorder called Amyloidosis of which the outlook was grim. He was referred to the Mayo Clinic for a battery of test. I remember being so scared for my father and praying for healing. The doctor said that the three months between scans interestingly enough showed a miraculous remission. The doctor had seen thousands of Primary type Amyloidosis being the leading specialist at the time, but had never seen one go into a state of remission as my fathers had. This impacted me deeply at that young age, creating a passion to serve in the medical field. When I first viewed the recommended hours of paid experience I thought it was another road block to overcome on my way to the PA program. If only I could slap some sense into my younger College freshman self. My attention turned to the Springfield Fire Department, knowing EMT was a part of their intensive training. It showed how much passion and love we can give our community, small things like gathering the patients belongings, helping rescuing a cat, yes I actually saved the stereotypical cat from a tree. Just getting into academy took 9 months of preparation, including written and physical testing, multiple rounds of interviews, in depth CIA level background checks. All leading up the most challenging accomplishment to date, Springfield Fire Academy. Mixing a pseudo military regiment of physical fitness, all day didactic classroom learning with practical skills thrown in intermittently. It was described to me as putting 5 years of on the job firemen training into a 8 month academy. This being interlaced with EMT class at nights from 6-10 and thriving online business taking up the rest of my free time that was not dedicated to studying. This prepared me to become a top student in overwhelmingly foreign material and study load I could not of imagined. Instilled was 5 core values of the Department, professionalism, integrity, compassion, service, and valor of which I will never forget for they provide a framework into every aspect of my life. I never imagined being in some of the situations EMS care provided, the thrill of diagnosing the next patient and meeting new people. I am passionate about the PA profession and plan to use this passion as my driving force to work hard before, during and after the PA program. My journey has built character, determination, team attitude, ethical fortitude, and above all else a desire to effect positive change in the under served community where I grew up. All I ask is for an opportunity to interview to show more of why I will be a top candidate not only for your PA program but also a fellow PA.
  5. "Excuse me, excuse me!" I cried out frantically, as I had just received news that my grandmother had been moved to a nursing facility due to her Alzheimer's condition worsening. I rushed over to the front nurse's station to ask which room she was in and was escorted to her room. Bright fluorescent lights lit up the hallway as I nervously gathered my thoughts on how I could greet my grandmother, the one who had raised me from childhood and became a second mother to me as well. I had brought over her favorite purple orchids in order to brighten her mood and with hope that maybe she could recognize the familiarity of the connection to me. To my relief, my grandmother recognized me instantly, and continued to recognize me till her last day in nursing care. Placing my grandmother in a nursing care facility was the most heartbreaking decision my family had to make, but we put in the effort to visit her every day. About eight months into her stay at the nursing home, she caught pneumonia which deteriorated her health in a blink of an eye. The nightmare didn’t just end here; the weakening of her body opened the door to other various health problems as well, which led to frequent visitations to the hospital. This is where I met my first physician assistant and grew profound respect for them. While my grandmother’s physician came in and out of her room for quick visitations, it was her PA that seemed to help close the gap of disparities in the healthcare system by providing a more personalized care to the patients. I was also able to recognize the clear and solid support that the PA provided in the context of the physician-PA framework. Her PA also first tended to my grandmother’s stomach abnormality and diagnosed the root cause of her abdominal distention and provided the appropriate treatment for it. I was very intrigued to see a mid-level provider take part in such crucial role between the supervising physician and the nurses, working as a collaborative team to ensure the highest patient care possible. Having worked as a buyer in a procurement department for three and a half years, I thoroughly loved the “team-based” approach with the head buyers and my vendors and customers. However, I had left the career as I’ve always felt that the satisfaction from thriving upon sales and profit wasn’t fully there for me. Witnessing my grandmother’s PA work with such compassion and professionalism towards the well-being of a human being inspired my initial interest in the profession. With this new ray of motivation, I recently became a clinical care extender volunteer at St. Joseph Hospital of Orange through COPE’S Health Solution, a program that is designed to give access to direct patient care to pre-health professionals, to see where I stood in terms of interacting and caring for the ill. My duties consisted of providing basic patient care such as feeding, bathing, taking their vital signs, and most importantly, providing unconditional love at their most vulnerable times. However, despite the satisfaction that I received from knowing that even a single minute of my time given to patients can have a significant positive impact in their lives, I also felt a sense of frustration due to the limitations of what I could provide for them as a volunteer. My determination to take my education and skills to the next step where I can provide more than just bedside care increased. I observed the nurses and their assistants and admired them for their recognizable diligence and compassion, but their roles still didn’t satisfy the goals that I was looking. On the contrary, I found it a blessing that I was able to encounter a handful of PAs on the floor who were able to answer many lingering questions for me that I had regarding their profession. I realized that being a PA is what would fulfill my dream in achieving the type of patient care that I wish to provide. Through the intensive and advanced PA training, I will provide medical care without having to be a physician, and still get to partake in a variety of tasks from diagnosing to giving physical exams to more specialized care such as assisting with surgeries. This is very appealing to me because I love doing a variety of different types of tasks that specialize in flexibility. Next year, I look forward to starting my education as a PA student. Overall, my interests and experiences have prepared me well to pursue a career as a PA. My strong academic background in science and extensive knowledge of the human body will help me excel in my PA school courses. Additionally, my sensitivity towards patients and interest in their well-being will allow me to become a compassionate PA. Volunteering at St. Joseph on various floors has also allowed me to learn the difference between each health provider and has also confirmed my belief that PA would be the best fitting for my personality and personal goals. I discovered my desire to counsel patients in maintaining proper health for preventive care as well, rather than just on post-care treatment. As a future PA, I am excited to work as part of a team that ensures every patient receives the care he or she needs in the most efficient and comfortable manner. I look forward to spending the new few years of my life learning from and growing with peers that have similar aspirations.
  6. "Excuse me! Excuse me!" I cried out, frantically, as I had just received news that my grandma had been moved to a nursing facility due to her Alzheimer's condition worsening. I rushed over to the front nurse's station to ask which room she was in and was escorted to her room. Bright fluorescent lights lit up the hallway, as I nervously gathered my thoughts on how I could greet my grandma, the one who had raised me from childhood and became a second mother to me as well. Would she recognize me today? Hopefully, these flowers aren't too much, I murmured to myself. I had brought over her favorite purple orchids, in order to brighten her mood and maybe she could recognize the familiarity of the connection to me. To my relief, my grandma recognized me instantly, and continued to recognize me till her last day at the nursing care. At the end of year 2014, my grandmother spent the last few months of her life fighting a debilitating case of pneumonia which also opened the door to other various health problems. Throughout her treatment, both her physician and the physician’s assistant took turns overseeing her treatment. This was my first actual encounter with a PA, and during this time I learned a great deal about what PA’s do to support their patients, particularly relating to the lung and kidney infections for my grandma. I found it extremely intriguing to see a mid-level provider take part in the important role amongst his/her supervising physician and the nurses, working as a collaborative team to ensure the highest patient care possible. Having worked as a buyer previously for 3.5 years, I thoroughly loved the “team-based” approach with the head buyers and my vendors and clients. However, I had left the career as I’ve always felt that the satisfaction from thriving upon sales and profit with wasn’t fully there for me. Witnessing my grandmother’s PA’s soothing compassion, professionalism, and accuracy with her treatment led me to develop interest for the profession. Inspired by the experience my grandmother had with her PA, I took a few basic science courses to test my interest in science and excelled in all of them. Taking Anatomy, Physiology, and Microbiology class further helped me discover my passion for the human body and the phenomenal importance of understanding it to lead healthy lives. It urged me to learn more about the medicine and the root causes of diseases and illnesses where I can actually help patient by treating and diagnosing them. I discovered my desire to counsel patients in maintaining proper health for preventive care, rather than just on “treatment.” To utilize this knowledge in a medical setting, I volunteered at the COPE’S Clinical Care Extender program in St. Joseph, a program that is designed to give access to direct patient care for pre-health professionals, to see where I stood in terms of interacting and caring for the ill. My duties consisted of providing basic patient care such as feeding, bathing, and taking their vital signs, but most importantly, showing the patients that everyone in the healthcare field is an extended family member to them that provide not only care for their illness, but also unconditional love at their most vulnerable times. However, despite the satisfaction that I received from knowing that even a single minute of my time given to patients can have a significant positive impact in their lives, I also felt a sense of frustration due to the limitations of what I can provide for them. I wanted to offer more than just bedside care. I observed the nurses and their assistants and admired them for their recognizable diligence and compassion, but their roles still didn’t satisfy the answers that I was looking for. I was curious as to why certain human beings were more prone to certain diseases and how each different individual’s body responded differently to certain treatments. Even though I felt that there was some sort of lackluster with my scope of volunteering at St. Joseph, I also found a blessing for me as I was able to encounter a handful of physician assistants on the floor who were able to answer many lingering questions for me that I had regarding their profession. I was able to realize that being a physician assistant is what would fulfill my dream in achieving the type of patient care that I wish to provide. I would have more power and control to assisting patients rather than just doing bedside care as a nurse. This shines a part of my personality because I love doing a variety of different types of tasks that specializes in flexibility. I could utilize my attention to giving medicinal help without having to be a doctor, and instead partake in diagnosing and giving the best therapeutic care from small needs like physical exams to bigger care like assisting with surgeries. This type of freedom in the healthcare world makes me love the idea of becoming a PA. As a PA, I will work as part of a team that ensures every patient receives the care he or she needs. I am excited to be a PA that makes a difference in the lives of others, and I look forward to spending the new few years of my life learning from and growing with peers that have similar aspirations.
  7. Thank you in advance, to anybody that looks this over. I greatly appreciate it! As a child, I would frequently go sailing with my father. We would cast the lines, pull in the fenders and guide the boat out of the bay. Working together we would adjust the sails to allow the wind to guide us. I grasped the knowledge that the breeze moved the boat, but did not understand the full mechanisms as to how. As our sailing trips increased, I gained more skills, and my knowledge vastly improved. One day I woke to realize those peaceful moments had passed; the sails lost the wind and slowly begin to slack. I was forced back to reality. “I am initiating a massive transfusion in the Emergency Department on a female, Jane Doe, age unknown”, the ED physician tells me over the phone. My shift in the Blood Bank just started. I glance at the clock noting the time. We, as a team, have less than ten minutes to complete the first round of blood products needed for the patient. I reach for the “massive transfusion” paperwork to begin filling out, while simultaneously designating the technicians to fulfill duties I assign; thaw plasma and cryoprecipitate, get a cooler together for blood products. I quickly get to work setting up six uncrossmatched red cell products. The patient’s age is unknown indicating the need for O-negative red cells. Eight minutes later the Emergency Department technician is at the Blood Bank window waiting for any products ready. I issue the products, place the necessary units in the cooler and pass them off to the technician. The technician scurries away. I have completed my part, or piece of the puzzle, with the patients’ medical care, providing timely and efficient service. I, however, want the responsibility of a bigger piece of the puzzle: direct involvement with patients. Continuing my education in a Physician Assistant program will allow me to accomplish this. Working in a rapid response laboratory has been satisfying, knowing I provide information that could help a provider with a diagnosis. The real challenge I face in the laboratory is being closed off from the patient world. I miss the direct involvement of a patient, placing a name to a face, and the impact that you can make on a patient or even more empowering; the impact the patients makes on you. A career as a physician assistant is where I will accomplish the pieces of the puzzle, making the picture look complete. Working in this field will allow me to work as a team with medical professionals while working directly under the supervision of a physician. A key factor for me pursuing PA is the variability to change specialties. I will go into the program with an open-mind, and willingness to learn many different specialties. This is where I will find my true passion within medicine and even better I am not limited to one area of specialty. Other careers, such as a medical doctor or nurse practitioner do not have the option of changing specialties so easily. My education has led me exactly to the path I want to pursue; my determination is what will get me there. I have a passion for medicine and just like sailing when I was a child, I still enjoy the challenge, working as a team, and succeeding in my goals. A career as a PA, will give me the capability to raise the sails once more and let the wind guide me. This route allows constant wind that keeps the sails full and the boat in forward motion. It is with this motion I find peace!
  8. I am Incognito but not first-time poster......logging in under another name. I need advice. My contract comes up for renewal in 2 months and I will be having a meeting with the (fairly new) clinic administrator (CA) soon. Since this administrator was hired a lot has changed and the culture of the clinic has become quite dysfunctional (more-so than before). The Issues: We only communicate by email now and that is what the CA expects. No more discussion between the clinic staff and no more meetings with staff to discuss clinic issues. Initially we had an email from the CA of when monthly meetings would be held, what time (lunch hour) and that we were expected to be there. The first month the CA never showed up to several meetings and the scheduled meetings lasted for two months and now none for the last 9. Apparently the schedule she developed has gone by the wayside although she has never emailed us or informed us of the change in schedule. New phone system installed in early August and we found out we could not call our local EMS. The CA knew this but did not inform the staff who matters (the nurses, PA and MD). I had an emergent patient last Thursday and because we DID NOT KNOW about the 911 issue there was a delay in care for the patient. The CA was contacted about the problem and she says "I know that you can't call 911 and I guess we will have to get the lawyers involved." We call 911 now on our cell phones. The other system calls a central system in Colorado and we are 1,000s of miles away. The MD does not notify me when he is going to be gone and neither does the CA. He is gone alot...about 50% of the time developing his side business and is allowed to travel to CA, IL and to a local medical entity in his effort to sell his and his partners genetic testing kit. I do not know if he continues to get salary on the days he is gone. He never works Fri per his contract but is supposed to work M-Th. The last time he was gone I confronted him about why I was not notified and asked him to let me know verbally when he will not be at the clinic. He, however when I am gone, will have a retired NP come in to work because he "can't work alone..he has too much work to do." I on the other hand handled the clinic by myself and some of those days were killers.... One day with 25 pts. in a 7 hour day....frankly quite unsafe. I requested my contracted CME off to attend a national conference starting next week. I requested it 2 months ago and also requested to go to a state PA chapter CME in October. I also reminded him in Aug. I needed to know. It was not approved as of last Thursday but the NP was working for him that day and she said she was asked to work during the time I will be at the conferences in Sept and Oct. I was shocked and told her I did not have approval to go, had not registered, no plane tickets, etc.. She mentioned this to the MDs nurse at the end of the day. The following day the nurse came and told me that the MD verbally approved me going to the conference. I told her I did not have written approval and still can't make any plans per our accounting dep't and protocol. Today the MD was back in office and both of us were busy. He made no effort to talk to me. I made an effort to talk to him...there's a long story behind this. Still no written approval. Over the last 6 months or so there have been staff changes. The CA has recruited people to come work at the clinic and some did not have interviews. She hired them out from the previous clinic she worked at. One hiree is an RN who came for an interview and was hired immediately on the spot and the following day an announcement went out for us to welcome her to the clinic. The Rad Tech had no interview. The clinic had a grant funded position for an LPN who worked with the pregnant women and families and managed all of our immunizations and the state Vaccines for Children program. She was the backup clinic nurse and worked when the other nurses were on vacation or sick. She is also an EMT and breastfeeding educator and Doula. She is highly qualified and an excellent nurse. She was told in my presence and in the presence of the other clinical staff that she would be my nurse when the NP retired (I had no dedicated nurse until June 1) and the NPs nurse was going to triage and case management. Her grant ended May 31st. Lo and behold! When June 1st arrived the CA came to the MD and told him the LPN was out of a job and would have to re-apply for the position when it was posted. This apparently was on order of the Board who wanted the position opened up rather than a lateral transfer since they had some family members they thought might like the job. The MD comes to me to tell my my LPN was out of a job at that moment (she had already left for the day). I blew a cork and sternly (I did not yell) told him that was unacceptable to tell her one thing and then turn around and let her go. I stood up for her and he ran back to the CA and they decided she could stay until the announcement came out and then could apply. She stayed and the CA promised her she would notify her when the job would be posted. She did not notify her and the LPN found it out by default at an EMS meeting 2 days after it was posted. She applied anyway and interviews were 8/28. She was told the following day at the end of the day she did not get the position. A lesser qualified LPN was hired because of Board preference . I was livid. DId I tell you I have not been asked to interview any of the nurses or MDs that have been in for interviews? I confronted the MD about that too and feel I should be included in the interviews because these are staff that I work with. Shouldn't I have the opportunity to interview a nurse or physician who might get hired? In the last 6 months the atmosphere at the clinic has become one of staff being afraid they will lose their jobs. We have all learned to tiptoe. I had 2 other discussions with the MD....one he called me into his office and said I was adversarial. I think he does not like it when I challenge him. He is medical director. Shouldn't he be the one to make decisions? Yet he can't even sign off on our clinic policy manual to approve policies and we HAVE NO MANUAL because he won't sign the policies. No policies for the 18 years he has been there. I have been at the clinic nearly 3 years. I have been told that I am the only one who has challenged him. His nurse told me I was hard to work with the last couple of months. She does not like it when I refuse to write scripts for patients of the MD for patients I have NEVER met and there are NO CHARTS on file for them. They are his golf buddies and the people who call him at home for refills. He asked me why I refuse to write scripts for his patients and why I would only give a 3 days supply of lipitor for one of his patients (huh, I really don't know what he is talking about) and I told him I won't for those with controlled substances or for certain meds for certain patients BUT I have renewed scripts for the basic meds like HTN, Lipid meds, etc. In May I finished up with a project of supervising two nurses (one Rn, one LPN) of that same grant funded position and the supervision was to make sure the project goals were completed. Any nursing issues went to the MD since I cannot "supervise" an RN by state law. THe RN has a sketchy background and was teaching the LPN the wrong way to give immunizations, wrong needle sizes, told her keeping the inventory wasn't all that important, told her to dispose of live vaccine in the waste basket, and several episodes of insubordination to me and going directly to Tribal president to get approval for travel, and a bunch more junk too lengthy to describe. The management team at the time asked me to supervise her specifically as there were many complaints. I did my job and the outcome was for her to be let go. THE MD had no balls to let her go and then decided to put her on a 30 day probation...never happened because he delayed talking to her and then the new CA was hired. He deferred it to her and she decided a 90 day probation was appropriate but then changed her mind and transferred her out to the child care center as a parent educator under a different grant. She did not have to apply for the position. After all of this I now feel it is time to leave. Am I being petty and small thinking this way? I love the patients and have a wide SOP and work up lots of sick and complicated patients. That is what I love. I have applied to a new job much closer to home and should have an upcoming interview in the next 2 weeks or so. At one of the meetings with the MD he kept asking me "Do you want to leave? If you do you need to tell me now! I need to know if you are going to leave??? I could not answer him and was taken aback. My only thought was "If I leave he will have to work M-F" and might have to work alone and that is the only reason he doesn't want me to leave suddenly. Should I just put my head down and go to work and ignore the CA/MD and try to work within the dysfunction? I may not get hired at the other job. He may not give me a good reference. I feel like "The Help". Sorry this is so long. Thanks for any insights. I am very confused and of course this is my one-sided perception of things.
  9. I have been reading a lot of material on different forums and websites about the best narrative. All this is getting very confusing. I would appreciate even grammar suggestions. I'm a little over the character limit. My soul mate asked me on our 5th marriage anniversary - “I know how much you love your shadow. I know you will repent all your life for not able to do anything for him. You are trying hard to find some solution for your father’s health issue. I need a wedding anniversary gift from you. Please treat my NASH. I would like you to do my liver transplant, if required.” I am not going to get the things that are lost but I can try to prevent this to happen in someone else’s life. 14th September 2008. It was the auspicious day of Ganesh Visarjan, 11th and the last day of Ganesh Chaturthi, a Hindu festival celebrated by people all around the world. It is believed that lord Ganesh dwells on earth for his devotees. My family didn’t knew that He will take my parent’s heart with Him. I lost my shadow who had just turned 17, but if somebody knew to perform resuscitation, he would be with me today. On 3rd October 2013, I had received an email from Dr. Maheswar Rao, gastroenterologist saying “Please take an appointment of Dr. Luis Balart, specialist Gastroenterologist. Prepare yourself well and read about NASH (Nonalcoholic Steatohepatitis) with cirrhosis of liver”. We started consulting different Gastroenterologist. CT scan, endoscopy and blood tests were performed. Biopsy was performed by Dr. Balart in New Orleans, LA and term NASH was concluded. I have voluntarily supported the rescue effort team of doctors in 2001 earthquake which occurred in Gujarat, India which was about 7.7 on the Richter scale. 20,000 people were killed, 167,000 injured and nearly 400,000 homes were destroyed. People were helpless, in pain (physical as well as emotional) requiring medical attention and crying for help to find their relatives. For the first time in my life I had learned the importance of life. I have volunteered at Memorial Hermann in Emergency Department, Pediatrics, March of Dimes and information desk to experience personal interaction, develop interpersonal skills and create communicative approach with the patients. The gratitude obtained by working with patients was rewarding. While shadowing Dr. Rachana Bhala, a gynecologist, I used to discuss in detail about the different cases, important aspects and practical approaches towards various disease conditions. Both, tutoring at Houston Community College and voluntary work at Memorial Hermann Medical center tremendously helped to surpass the language and cultural barrier and improved communication skills in conveying my ideas effectively. Beginning from high school, I was interested in science field and participated in several individual and team-oriented writings and science fair competitions at both district and state levels which has helped me to acquire more knowledge about science subjects and has improved my self- confidence. Education in pharmacy school developed a strong background in several disciplines of life sciences such as Human Anatomy and Physiology, Biochemistry, and Pharmacology. The knowledge I garnered here helped me in understanding the theoretical concepts and practical approaches of medical biology quickly and comprehensively. During the pharmacy internship training program, my practical exposure to the clinical facets of disease conditions created interest in the field of medicine. First ray of light – Vihaan, my son was born on 27th November 2012 after struggling of 12 hours. She was a PA who mentally, psychologically supported and guided me and finally my gynecologist was called 15 minutes before that ray of light entered in my hospital room. 12 hours of labor pain made me understand the role of Physician Assistant. The most enticing feature of being a PA is you are always supported by your physician who can guide you to the right direction. PA profession will also give me the flexibility to go into other medical fields. My family and professional training experiences have developed fascinating perception about the impact of the medical profession contribution and responsibility towards the maintenance of healthy living of patients. I am ready to accept the challenge to travel my journey from class room to clinical settings, assume additional responsibility and undertake the challenge associated with carrying for sick people on day to day basis and assisting others to maintain their level of health. Thus, my interest, motivation, strong background and competitive attitude to meet the rigorous challenges of the PA school curriculum has inspired me to become a PA. The United States of America has always been at the forefront for research and development in the field of science and medicine and in their efforts to provide quality education to students and shaping them into well-equipped PAs. Therefore, I am inclined to obtain the best quality education in medicine in United States of America to reach my career goal and achieve professional success. Every year many people die in India during Ganesh Visarjan, about 2-5% of the population of USA have NASH and 10-20% with fatty liver condition. If given an opportunity to wear the white coat I would like to save at least one life in my career to make my shadow feel proud of myself in my life time. Thanks for considering and taking your time!
  10. Is there a PA or admissions committee member on here that I can PM my essay to review please? I have been working on it for weeks and I still can't pull it together into a perfectly crafted essay. I bought the online book from insidepatraining.com last night re: writing essays, which has been helpful, but I feel like I need an expert to let me know what they think. Key points I have for my essay: 1. My experiences growing up in an underserved area (rural Iowa) and living abroad as an adult in 2 separate countries helped shape the values I developed and the person I would become. 2. My experiences working as a paralegal within personal injury and family law afforded me unique experiences. Personal injury: I reviewed medical records, talked to clients about their physical recovery. Family law: I dealt with clients/opposing parties with mental illness and substance abuse problems. I reviewed drug screens and reviewed court-ordered psychological and psychological reports. Spent time cross-referencing the DSM-IV. 3. My family's illnesses changed their lives and had a profound impact on my own. (Father had 3 heart attacks, sister diagnosed with schizophrenia). This made me interested in healthcare. It also made me aware of the need for PAs in rural medical treatment. 4. I went back to school took pre-reqs, gave up a comfortable lifestyle, and got a job at a hospital that has provided me with valuable patient care experiences. 5. My shadowing experiences helped me see how I can utilize the skills honed within the legal field, as a PA. Help please!
  11. PM&R.....non operative spine center. Brand new position...they have never had a PA....Was worried that it would be chronic back pain, and train wrecks from all over the country, but apparently not. The director stated that 90% of appointment slots were reserved for patients of the clinic or system with ACUTE spine issues. Also, we are a consultative service. While we might see an occasional chronic spine pain patient, we will see them once, and write our thoughts and recommendations in a letter to their primary, or if necessary, refer them on to the Pain Rehab Center. We do NOT manage these patients chronically. Many of them will have their charts/imaging studies reviewed by myself or the attendings, and we will send them a letter discussing the fact that we cannot offer them an appointment, as we cannot offer any treatment that has not been attempted. They were interested in me because of my ED and Ortho backgrounds, my research doctorate, leadership background and abilities, and the fact that I have a second masters in Sports Medicine in addition to my masters in PA. Will see 6-8 patients per day. 1 hour appointment slots, and will have every other Friday off for research/admin time. During the interview. I had a few thoughts, and what I said was: I am not an assistant, I am a competent medical provider, if you want an assistant, hire someone else. If you want an autonomous provider who can increase the number of patients seen, with a high degree of independence, I'm your guy. Also, I don't like the term mid level provider. It can be construed as insulting. If I am a mid level, what does that make the nurse? I prefer non physician provider. I also told them that I will address them by first name, except in front of patients. I'm too old to play games with the ego boosting "Dr" so and so. BUT the real reason, is to establish an environment of mutual respect...see....THEY HAVE NEVER HAD A PA...I will be the first, so I have to establish the rules up front. As I told them, formal titles convey a sense of respect to patients, however, in the hallway, or in private, they can hinder true teamwork and open dialogue. I envision a true team, with all of us working together. If they don't envision that, than they should hire someone else. I also demanded, or rather strongly requested: 1. to be involved in the executive, practice, and research committees of the Center. I need to be involved in the decision making processes of the Center. 2. a respect for my external professional obligations (speaking, committee obligations, board requirements, etc.) and a healthy respect for my research obligations. 3. The ability to secure protected time (they will give me 0.1 to start) for research time with grant funds...(up to 0.5)... 4. A new laptop (MacBook Pro) and a new iPad3. 5. Finally, I requested an office. Now, you need to understand that while all the physicians in this Center have an office, office space is EXTREMELY limited and there are multiple attending physicians at the Clinic who do NOT have an office. They not only found me an office, but they found me one with a window. I gave my notice to the ED 2 weeks ago, I start in PM&R on August 15th.
  12. This is 2nd draft. Thanks for reviewing my essay and offering your opinions! I appreciate it!!! Everyone has a story and mine is a huge factor in my pursuit to become a physician assistant. Growing up, trips to the hospital were a regular part of my daily life because the two most important men in my life were hospitalized for extended periods of time. My father suffered a life altering stroke and to this day requires around the clock care and my grandpa suffered from Cancer. For this reason, the hospital has always been a place of comfort and for me. I was not the kid afraid of going to the doctor. I was the kid that secretly played with the instruments and marveled at it all. My personal experiences compel me to help others and knowing first-hand the effect that medical professionals have on peoples’ lives compels me to do this in the medical field. In high school I recognized my enjoyment for the systematic approach of science and how applicable it is to everyday life. This fostered my interest in the medical field, as it is a good balance of science and the human aspect. I was introduced to the Physician Assistant field by my primary care physician, Dr. Duran MD, and was instantly intrigued. As I began to learn more about the Physician Assistant field from other health students and professionals, I learned of the amount of hard work and dedication it takes. I was determined to have a career in the medical field so I began searching for colleges that would allow me to achieve my goal. My undergraduate education at Cornell College has provided me with the skill necessary for the demands of Physician Assistant School. Cornell College academics are rigorous, fast paced, and challenging. I was first and foremost a student but athletics allowed me to become a better leader, stay involved in the community, be an ambassador for Cornell, and learn how to work well with others to accomplish a common goal. Playing volleyball, softball, working, and pursuing a degree in Biochemistry and Psychology made student life more challenging at times and my struggle in Organic chemistry II is a testimony to this. I learned just how quickly you can go downhill in a class at Cornell. Within a six day period I went from passing to failing. I felt defeated but more determined than ever to overcome this challenge. After taking the class again and receive an above average grade, I felt a sense of accomplishment. From this experience, I learned how to better prioritize and stay on task, the value of good studying habits, and what you can achieve with hard work. Although I have stumbled a bit, I haven’t let it stop me from pursuing my goal of become a Physician Assistant. There are some key experiences that have helped solidify my interest in becoming a Physician Assistant. In the Anatomy and Physiology class I took at Cornell College, we acted as medical investigators on hypothetical cases. We had to diagnosis and devise a treatment plan. Following extensive research, we presented our case to the class. Specifically, this experience advanced my skills to decipher medical jargon and present information to the average person. Because this is what medical professionals are constantly doing, having an early experience like this will help in a PA program, especially during clinical rotations. My interest in science, however, extends beyond this. During my senior research project, I worked with two other students examining intragenomic DNA variation within the coral genome. We developed a new protocol and decided what experiments we wanted to perform. I take pleasure in the more research side of the field while closely working with others to solve a problem. The Physician Assistant field is similar in that way. During my job shadowing opportunity at the family clinic in Mount Vernon, IA, I got a glimpse into what I aim to be. I especially liked the team atmosphere, the range of patients the PAs were able to care for, and how personable the job allows one to be. This is definitely an environment I foresee in my future. The more I learn about the field from professionals and PA students, the more I know that I am a good. I’m analytical, hard working, self-less, determined, and passionate, some of the qualities an aspiring PA should possess. I understand that the path to becoming a Physician Assistant will be challenging, but my past experiences, my studies in Biochemistry and Psychology, as well as my passion and commitment to my future have prepared me for the intense academics I expect to experience in a Physician Assistant program. This is my dream and I will continue to strive after it. I’m ready for this, am confident in my abilities, and could not image a career in anything else.
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