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Hello everyone, I am currently in my second semester of my didactic year. I struggled so much my first semester and ended up having to remediate one class. I feel like I retained nothing from my first semester and can barely recall things. I get so anxious everyday over my future . I have no idea how to face my family if I do fail. Also it would really crush me because this is what I've been working towards for the past 3 years since I graduated high school. Compared to my other classmates I feel like I know the least. Living in fear everyday is really getting to me emotionally and I don't know what to do.
Hi guys, I hope to see if I can get any guidance about my current situation. I am a new-to-practice PA and started my job in CT surgery in February of this year. I graduated in August of last year. I am working in inpatient cardiac surgery and am currently still on orientation, but I am feeling quite overwhelmed and starting to wonder if this is not the right opportunity for me to have taken on as my first job out of school. To provide some background, the team I work on is 95% NPs, 5% PAs. The team is predominantly comprised of NPs that have had years of experience working on either the cardiac surgery floor or in the surgical ICU prior to becoming NPs. There is another new-to-practice PA that came about a year and a half before me, but I am the second new-to-practice PA that they have taken a chance with hiring. There is one other seasoned PA who has prior experience. I say "taken a chance with hiring" because the new-to-practice PA that had come before me was the trailblazer in that my manager was testing the waters to see whether new grads would be able to make it on this floor. PAs are typically in the OR for CT surgery where I work. The new-to-practice PA was on the verge of leaving but was encouraged to stay with the promise of an extension to her length of orientation (from 3 months to 6 months) and with her demanding that changes be made to how orientation for any future new-grad PAs be handled. I am currently being mentored by the seasoned PA, as well as another seasoned NP. I take three of their patients (typical patient load for a provider is about and they try to follow behind me so that we can address aspects that I am missing. While there are some opportunities during the day to talk through some topics, oftentimes the rigors and rounding schedules of the floor only allow for us to touch base briefly and intermittently. There are no residents or fellows on the floor, so it is only the team of NPs and PAs that are running the show while the surgeons are in the OR. Because of this set-up, there is very minimal addition of new knowledge within this team. There are no lectures to attend to ensure that we are practicing evidence-based medicine, each surgeon notoriously prefers different styles of practice based on their training and experiences that is un-Google-able, and I feel that my main sources of learning rely on what I can try to teach myself at home and what my mentor can offer in the limited time that we have during the work day for teaching. I feel that being so many months out from graduation, I am trying to find my way to regain and effectively apply all the knowledge I once had from school into my new role as an inpatient provider, while also trying to learn cardiac surgery, a specialty I had been minimally exposed to during school/rotations. I find myself leaving work feeling completely defeated by how inefficient I am with having managed only three patients (though complex patients) that day, with my head feeling full of everything from navigating the EMR system, to putting in orders for medications that I now need to know the dosages and frequencies for, to remembering the information that my mentors had offered me that day, to remembering how to clinically manage patient conditions instead of managing pretend patients that had once been in non-real-life-threatening multiple choice formats, to realizing that not only the surgeons differ in their practices but the NPs and PAs differ as well. My mentors are frustrated because it seems that I do not remember some topics we discuss, and while I can understand where their frustration is coming from I feel like I am drowning to try to keep up with absorbing all these things that are all new to me. I try to jot down notes whenever they say things, but there is not very much opportunity to ask why certain things are the way they are, nor are there always reasons why they are. Because of this, my memory feels like a "snapshot" memory and I am finding it difficult to then apply what I am being told to another situation that may be similar in the future. While I try to return home with what brain power I have remaining to review what we have gone over, there are ultimately gaps in my knowledge because there may have been aspects that I was not able to jot down quickly enough, or that I maybe didn't understand fully when the factoid was told to me in an isolated incident. I also find myself planning to research a whole laundry list of topics of confusion to find myself going down a deep rabbit hole just to feel like I have grasped the topic, only to find myself not making my way efficiently through my topic list and then returning to work and finding more topics of confusion. In the midst of my mentors' frustrations, it has now reached the point where I am afraid to ask questions because I am afraid that my mentors will say "we've already gone over this" when I truly do not recall it or when I only vaguely remember them saying something about that question but not in an in-depth way. I feel like they think they're being crystal clear and that the things they are telling me should be easy to remember the next time, and I wish I could ask them to be patient with me because it is a lot to digest. My manager's only consolation was "well in your interview you knew that this was not going to be a teaching floor," and I just wish I could find the voice to reply that even though I expected this to be hard, it doesn't make this any easier. I dread going to work and it's very difficult for me to gauge whether this is simply a new grad experience, or if this is an opportunity that was not meant for me right now when factoring in my new grad status and the resources and environment that I currently have to get my footing as a new grad. My confidence and self esteem are in the dumps because I feel like an idiot that can't remember anything from school, let alone remember anything about CT surgery to make my mentors feel that I am making adequate progress as I approach the end of my third month on orientation. If anyone has any advice, I would greatly appreciate it.