Moderator EMEDPA Posted April 4, 2014 Moderator Share Posted April 4, 2014 I know. I have have cared for patients with anaphylaxis in fast track. Do you know who dumped them there? Nurses with over 20 years experience working in the ED! Can you explain this phenomenon? It seems that if a nurse showed up to your program with 20 years experience you could not admit her fast enough. I think we both know that the worst nurses are the ones that get placed in triage, not the ones who actually know what they are doing. triage is the place for the new grad nurses because no one else wants to do it. it is a thankless task. get it right and no one notices. get it wrong(or not as someone else would have done it) and the world yells at you. the "nurses with 20 years experience" are either staffing the acute areas or are out of clinical medicine entirely doing administration.... Link to comment Share on other sites More sharing options...
SHU-CH Posted April 4, 2014 Share Posted April 4, 2014 any significant hce teaches you: how to deal with people - I can learn this selling used cars \medical terminology - I can teach myself this with a CD over a summer sick vs not sick - I would argue different people will pick this up at different speeds. Some people, perhaps never. pharmacology - A year of study here would get one in pretty good shape. basic procedures used in all fields - "All fields?" You could do a colonoscopy and colposcopy competently? the culture of medicine, what the roles of all the players are, etc - This you can master in a bout a month of full time exposure a little bit about a lot regarding disease in general - This perhaps takes a lifetime; the art is long and life is short. these things are of value in ANY field. Link to comment Share on other sites More sharing options...
PACdan Posted April 4, 2014 Share Posted April 4, 2014 any significant hce teaches you: how to deal with people medical terminology sick vs not sick pharmacology basic procedures used in all fields the culture of medicine, what the roles of all the players are, etc a little bit about a lot regarding disease in general these things are of value in ANY field. I agree. Besides working on a critical care surgical floor, I was a regular volunteer EMT-B. I have experience, but never "intubated, put in an IO run a code, cardioverted,, etc." So I have loads of HCE, but not those EM experiences you cited, would you not want me pursuing EM after PA school? Link to comment Share on other sites More sharing options...
SHU-CH Posted April 4, 2014 Share Posted April 4, 2014 I think we both know that the worst nurses are the ones that get placed in triage, not the ones who actually know what they are doing. triage is the place for the new grad nurses because no one else wants to do it. it is a thankless task. get it right and no one notices. get it wrong(or not as someone else would have done it) and the world yells at you. the "nurses with 20 years experience" are either staffing the acute areas or are out of clinical medicine entirely doing administration.... The last one I recall was a 10-year nurse in triage dumped the patient on me. I then had to explain for 10 minutes to a 20-year charge nurse why a patient who is not moving any air can't wheeze. I have also encountered some paramedics whose skills were less than awe inspiring. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted April 4, 2014 Moderator Share Posted April 4, 2014 I'm confused - so your skills are not any better now than they were the week after graduation? Or are you saying PA school should be 20 years long? ;-) my acute care skills? they are probably not as good today as they were when I was a medic. I was a really good medic in some really busy places (LA and Philadelphia). my judgement is much better but I miss more Ivs and intubations now than I did when I did them on a more regular basis. I also can give credit where credit is due now and let the CRNA step in and do the difficult intubation on the 400 lb guy who I would have probably ended up criching as a medic. they are better at it than I am because it is all they do. I can run the show, but am willing to delegate parts to folks who are better at components of it than I am. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted April 4, 2014 Moderator Share Posted April 4, 2014 I agree. Besides working on a critical care surgical floor, I was a regular volunteer EMT-B. I have experience, but never "intubated, put in an IO run a code, cardioverted,, etc." So I have loads of HCE, but not those EM experiences you cited, would you not want me pursuing EM after PA school? I would recommend you (and anyone else considering em) pursue a residency in em . Link to comment Share on other sites More sharing options...
SHU-CH Posted April 4, 2014 Share Posted April 4, 2014 I agree. Besides working on a critical care surgical floor, I was a regular volunteer EMT-B. I have experience, but never "intubated, put in an IO run a code, cardioverted,, etc." So I have loads of HCE, but not those EM experiences you cited, would you not want me pursuing EM after PA school? Putting in an IO is easier than putting in a plain old, garden-variety IV in a lot of cases. An average ER doc can probably count on one hand how many tubes they place in a given year. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted April 4, 2014 Moderator Share Posted April 4, 2014 any significant hce teaches you: how to deal with people - I can learn this selling used cars \medical terminology - I can teach myself this with a CD over a summer sick vs not sick - I would argue different people will pick this up at different speeds. Some people, perhaps never. pharmacology - A year of study here would get one in pretty good shape. basic procedures used in all fields - "All fields?" You could do a colonoscopy and colposcopy competently? the culture of medicine, what the roles of all the players are, etc - This you can master in a bout a month of full time exposure a little bit about a lot regarding disease in general - This perhaps takes a lifetime; the art is long and life is short. these things are of value in ANY field. by basic procedures I meant things like venipuncture, IM injections, etc, thus the use of the word "basic". Link to comment Share on other sites More sharing options...
whoRyou Posted April 4, 2014 Share Posted April 4, 2014 ... but I am willing to do so without whining about it.. Or hand holding ... http://www.physicianassistantforum.com/index.php?/topic/35-interview-tips/page-22. Granted WE ALL mature at different times in our lives. Some had to grow up faster than others and some had the luxury of being carefree. 'Some' know exactly what they wanted to be when they grew up and for majority of us it took a lot of trials and tribulations, but WE should not be condemned if it took us longer than others. It is called L I F E. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted April 4, 2014 Moderator Share Posted April 4, 2014 Putting in an IO is easier than putting in a plain old, garden-variety IV in a lot of cases. An average ER doc can probably count on one hand how many tubes they place in a given year. very location dependent. at a big academic ctr this is true. at my per diem rural em job the pas and docs intubate a lot more. Most of the full time docs probably intubate 3-4x/week and put in a few central lines/week because there is no one else around to do it. at the big academic ctrs you have to wait in line for procedures. Link to comment Share on other sites More sharing options...
PACdan Posted April 4, 2014 Share Posted April 4, 2014 Putting in an IO is easier than putting in a plain old, garden-variety IV in a lot of cases. An average ER doc can probably count on one hand how many tubes they place in a given year. We had the kit on the ambulance, but I wasn't allowed to touch it. I put in many IVs, in many strange places, in the hospital. Funny how that works. :) Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted April 4, 2014 Moderator Share Posted April 4, 2014 Putting in an IO is easier than putting in a plain old, garden-variety IV in a lot of cases. agree. and until you have done a few it looks scary as hell. Most folks can't get themselves to trying the first one, or are not allowed to do the first one.. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted April 4, 2014 Moderator Share Posted April 4, 2014 We had the kit on the ambulance, but I wasn't allowed to touch it. I put in many IVs, in many strange places, in the hospital. Funny how that works. :) thank you for proving my point. Link to comment Share on other sites More sharing options...
PACdan Posted April 4, 2014 Share Posted April 4, 2014 thank you for proving my point. To be fair, B's couldn't put in IVs either. So I could do less as an EMT, than I got to do as a tech on my floor. Link to comment Share on other sites More sharing options...
SHU-CH Posted April 4, 2014 Share Posted April 4, 2014 by basic procedures I meant things like venipuncture, IM injections, etc, thus the use of the word "basic". Ok. I can teach someone with average intelligence IM injections in 45 seconds. Phlebotomy, maybe give me 15 minutes for easy sticks. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted April 4, 2014 Moderator Share Posted April 4, 2014 Ok. I can teach someone with average intelligence IM injections in 45 seconds. Phlebotomy, maybe give me 15 minutes for easy sticks. agree. however, I think you grossly underestimated the time course for the other things on my list.(dealing with the complex set of emotions on display from the sick and their families is different than selling cars for example). I guess we will have to agree to disagree. Best of luck with your program. Link to comment Share on other sites More sharing options...
WIPA-C Posted April 4, 2014 Share Posted April 4, 2014 Or hand holding ... http://www.physicianassistantforum.com/index.php?/topic/35-interview-tips/page-22. Granted WE ALL mature at different times in our lives. Some had to grow up faster than others and some had the luxury of being carefree. 'Some' know exactly what they wanted to be when they grew up and for majority of us it took a lot of trials and tribulations, but WE should not be condemned if it took us longer than others. It is called L I F E. I have not condemned anyone. Matter of fact, I don't care if one chooses to attend PA school at 21 or at 50..I was just saying that I'm tired of people making it seem as if it's a crime that I've always had a career choice since I was younger, and I worked towards it. Link to comment Share on other sites More sharing options...
whoRyou Posted April 4, 2014 Share Posted April 4, 2014 I am a Biology major, and I learned how to read EKG,AND I also have some knowledge about how medications work (from taking human physiology, Animal physiology and Advanced human physiology). Now, I cannot compare my knowledge on those materials to an RN's knowledge, but at least I have a good understanding that I can build on while attending PA school. Rome wasn't built in one day (While attending PA school, I might need to work harder than "experienced" RNs or parademics, but I am willing to do so without whining about it).. I have not condemned anyone. Matter of fact, I don't care if one chooses to attend PA school at 21 or at 50..I was just saying that I'm tired of people making it seem as if it's a crime that I've always had a career choice since I was younger, and I worked towards it. Sonia: I was not implying you are condemning anyone. In fact, just the opposite with what you said. I am just stating the fact that some did not have the opportunity or took a chance when they were younger to take classes like an EKG. I think it is great and I just wish I had learned medicine and took a chance earlier in my life. I just do not want to be condemned because I want to be a career-changer later in life. I just remembered when I took A&P I was one of the 'very' few in class to offer to dissect while the others 'whined' or grimaced all while I am thinking why are you here. Link to comment Share on other sites More sharing options...
Amina Posted April 4, 2014 Author Share Posted April 4, 2014 This thread has taken an interesting turn.... Link to comment Share on other sites More sharing options...
Will352ns Posted April 4, 2014 Share Posted April 4, 2014 This thread has taken an interesting turn.... But....don't they all. :) Link to comment Share on other sites More sharing options...
SHU-CH Posted April 4, 2014 Share Posted April 4, 2014 I guess we will have to agree to disagree. Agreed! Someone else here was lamenting the changes from the PA profession's founding philosophy. I'm not sure I like all of the changes either, but the fact is that they are here. We have come a long way from Don, Vic, Dick and Ken learning medicine sitting on milk crates in a back room at Duke. The profession will be younger, overwhelmingly female, increasingly diverse and increasingly fragmented into specialties in the coming decades. People in PAFT have new ideas about the nature of "supervision." To me, it is still exciting to be in on the ground floor of a profession that is still shaping itself and finding its way in the world. Change is coming. We can either run with it or get run over by it. Link to comment Share on other sites More sharing options...
SHU-CH Posted April 4, 2014 Share Posted April 4, 2014 So many interesting points in this thread. I have enjoyed reading all well thought out opinions and back and forth and applaud everyone for having a lively debate without it devolving to childish antics. For what it is worth, the PA profession attracts a very different personality than many other medical professions. Someone who is an egomaniac is not going to apply to PA school. We may be passionate and we may be mildly snarky at times, but the most uniformly good-hearted people I have met in medicine have been PAs. We look out for each other. Link to comment Share on other sites More sharing options...
Sirpaul1990 Posted April 4, 2014 Share Posted April 4, 2014 some might argue that there are too many seats then....if the requirement to be a pilot was 10,000 hrs as a copilot and only 500 people/year met that criteria would it be ok to then lower the # to 1000 hours(or no hours) just to fill the # of pilot slots? that is basically what the pa profession has done by accepting folks without adequate hce and saying "well, it's ok they got a A in ochem after all...." there are plenty of great PA school applicants out there with quality hce. the problem is once you value gpa>hce any clown with a 3.5 gpa as a bio major can get a seat over a seasoned 10 yr paramedic or RN with a 3.3 which is just wrong in my opinion. I take students both from programs that require extensive hce and those that require none. those from low/no hce program require a lot more handholding than folks who started pa school knowing how to read an ekg, understand common lab values, know common medications, etc. EMED, I think you fail to mention that even though people may have 10+ years of experience in health care, doesn't mean they're good at what they do. You always talk in the forums about people with all of this HCE and that's great and all, but it means nothing if the person didn't learn anything from it. You should be focusing on quality instead of quantity. I've met some very good clinicians and some very bad ones, too. You're calling the people with higher GPAs clowns simply by the fact that they have less experience, but the clown is the person who doesn't consider the quality of the person they are and the experience they provide to the team. That's more important in my opinion. When I come into a room and I see two clinicians - one with 10-years exp. and one with 2-years exp. - but the one with 2-years exp. treats the patient with respect, kindness, and sincerity and still knows how to perform his or her clinical duties, they are the better clinician. There are clinicians who couldn't care less about patients and just do their work to get by with a paycheck or for the experience for PA school. That doesn't make them a better applicant. Also, why does everyone resort to calling every PA applicant a bio major? Not everyone studies biology anymore EMED. It's 2014 - get real! I studied biomedical engineering. I also agree with SHU-CH, you also fail to realize that the people that are coming into the profession may be young, but without us, the profession as a whole would not succeed. The PA profession is changing demographically and shifting toward a younger generation for a reason - because the younger generation is being called to take care of a generation growing older. With the ACA, millions more of Americans now have health insurance and we will need many more health care providers, so would you like to turn away applicants because they are not "seasoned" enough EMED? I'm sure your own experiences with hiring seasoned PAs has not been great, but it's not worth punishing or criticizing the entirety of the applicant pool because of a few personal instances. Maybe your interview process isn't working for you? I agree that schools allowing students without ANY health care experience whatsoever is absurd, but saying that students with "low" HCE and "high" GPAs are "clowns" is just flat out rude. Link to comment Share on other sites More sharing options...
PACdan Posted April 4, 2014 Share Posted April 4, 2014 All us Doogie Howser, P.A.s' running around, no wonder the old guard is a bit miffed. :) Second thought: You must get the Doogie Howser reference (don't wiki it) to be able to apply to PA school. Third thought: God I'm old. Link to comment Share on other sites More sharing options...
GreatChecko Posted April 4, 2014 Share Posted April 4, 2014 You must get the Doogie Howser reference (don't wiki it) to be able to apply to PA school. Yes! This here is the true solution to the prereq problem! Link to comment Share on other sites More sharing options...
Recommended Posts
Archived
This topic is now archived and is closed to further replies.