RTRtoPA Posted March 29, 2014 Share Posted March 29, 2014 Hello, I'm 6 months into my first PA job. I have some good days, but most days I just don't enjoy it. I work in IR (the only area I'm interested in), and the job of the PA in this practice consists of much more clinical rather than procedural work. I would prefer a job where I am doing procedures all day. I have found a couple other jobs like that, but the rads want somebody with procedure experience already. I'm hanging in there for now, but I'm regretting ever becoming a PA. I was happier with my old job as a rad tech. Unfortunately, at this point in the game it would be tough to pay my PA student loans with a tech salary. Feeling a little stuck. Pretty standard for a first job? Should I just give it more time? Link to comment Share on other sites More sharing options...
Guest Paula Posted March 29, 2014 Share Posted March 29, 2014 You have limited yourself to only one specialty. That is unfortunate. I encourage you to either talk to your collaborating physician and ask to get trained on procedures, find another job where you will get trained, open up your mind to other areas of PA practice where you can do procedures...i.e. ER, surgery, derm. Staying one year will look better on your resume. Link to comment Share on other sites More sharing options...
Acebecker Posted March 29, 2014 Share Posted March 29, 2014 Agree with Paula. Hang in there for at least 1 year, then start looking. It never hurts to keep your eye on openings for something more along the lines of what you desire, but you'll get more looks with more time under your belt - procedure heavy or not. But limiting yourself to that one specialty right out of school may have been the point at which you were stumbled. Good luck. Link to comment Share on other sites More sharing options...
RTRtoPA Posted March 29, 2014 Author Share Posted March 29, 2014 I appreciate the feedback. I agree that sticking it out for a year would be best for the resume. And also the need to be more open-minded for different specialties. Sounds stupid, but I've honestly been so dead-set on radiology (my pre-PA background, favorite PA school rotation, "comfort zone") that I just had to remind myself that there were a couple other rotations I enjoyed while in school. Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted March 29, 2014 Share Posted March 29, 2014 I can understand your position. A peer at the hospital where I worked accepted a position with the staff radiologists (about 27-28 years ago now) and his interaction was restricted only to pre/post procedure assessments and no direct procedural responsibilities. One has to bear in mind that this was during a time period in which orders for APAP for in-hospital patients also had to be approved by a physician. Needless to say, he didn't stay in the position very long before relocating to the Pacific NW. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted March 30, 2014 Moderator Share Posted March 30, 2014 tthere are better IR jobs out there for PAs. We have an IR pa who only does procedures all day long. biopsies, difficult LPs, thoracentesis, line placement, etc Link to comment Share on other sites More sharing options...
KMD16 Posted March 30, 2014 Share Posted March 30, 2014 Spread your wings. Do not limit yourself. Flexibility and laterality would serve you well. Job security my friend. Sad but true. Best wishes! Link to comment Share on other sites More sharing options...
Moderator ventana Posted March 30, 2014 Moderator Share Posted March 30, 2014 hence why I suggest to NEVER specialize right out of school you just don't know what you don't know..... Honestly I would look at UC, FP, general surgery(if you are surgery person), BUT keep it GENERAL so you can really see what you like Link to comment Share on other sites More sharing options...
Derbingle Posted March 30, 2014 Share Posted March 30, 2014 I can feel your pain. Not to setract but this is a good place considering the topic........A little dif view...from someone whose fighting the realization...im not liking this. Im working on my second year in ER and so far im not enjoying most of my days. I find myself under the 15 min time to be seen since check in rule, nurses who continuosly power struggle with me....for god knows what reason, pharamcy staff who wont ship cetaciane spray down to ER bc im suppose to enter it as hurricaine sprya, that they couldnt locate anyway...., pissed off RT techs who cant beleived I called them for another, (imagine) another albut tx for ashtmatic. Man, i was RT in my day and my ass was in ER in less that 5 min dumping albut into a neb. These people flat dont care now. Im finding people who are trying to do less and less of their job, and also helping each other less and less. I sat across from a patinet who came in it at 3 am for a bug bite demanding pain medicine and i realized.....it hit me....im not being true to myself. Am i at all useful? Maybe...and no matter how much faster I get its still not enougj.....ive creeped up to 25-27 in 15 months on cerner in a 9 hour shift....still not enough for half of my 40 docs. Side bar----How mnay times can a messenger be shot in one night.?...four. Thats my record. It was tonight. The list goes on but the inefficiency and waste that occurs. Ex: we had a suture cart. I loved it. All supplies, one spot. Now decentralized to three spots. (Not a joke i swear) So far im not liking being a PA. I cant be authentic and real bc the expectations of the patients, propogated by the administrators, dont match the reality of life in general, and if I had wanted to be a salesperson, id have gone into buissiness. I can tell the patients wht they really need to hear bc some one with get upset. I feel like im doing no good to 80% of the people im treating. I felt useful in in NSG. I wonder too....what will I do? Im supposed to be thankful. But so far im just going through motions. Sigh. Thanks for starting that thread. Link to comment Share on other sites More sharing options...
UGoLong Posted March 30, 2014 Share Posted March 30, 2014 If they value you where you are, then letting them know that you would like to transition to doing more procedures will cause them to make adjustments. If they don't, then at least you gave them a chance. It's better to let people know what you are looking for so they can make adjustments. You don't have to demand, but good supervisors know that they get better work when people are doing what they are interested in. Good luck! Link to comment Share on other sites More sharing options...
BruceBanner Posted March 30, 2014 Share Posted March 30, 2014 I can relate RTRtoPA. I HATED my first job. I got a great offer in ortho spine and I took it, not knowing any better. The first couple months were easy while I was getting credentialed, but once I was able to be in the OR it went downhill fast. They had never worked with a new grad before, I had minimal OR skills (especially for a technical specialty), and the hours sucked. Call every few days, surprise long nights, different expectations from every attending, nurses who hated me because I didn't know what I was doing....it just sucked all around. They eventually had enough and allowed me to resign. It was a huge blow to my confidence---my first PA job and I basically got canned....but it did work out for the best. I'm in a much more predictable specialty now which is good and bad. I have great hours and never take call or work a weekend, but the patient population is ignorant, demanding, and full of malingerers. So I take the good with the bad. To be honest I dont regret going through PA school. There are tons of people who would kill to be where we are at, but I'm not sure how long I will stay in the profession. At least on a full time basis. Some things to consider: there is HUGE variability between PA jobs. I did an IR rotation in school and those PAs worked 8-4, spent half their day reading novels, and one did procedures only. Also I agree with the others who have said you specialized too soon. Very few people know with certainty what they like coming right out of school. Rotations are not a good predictor of what a job is actually like, in my opinion. As a student the expectations they have of you are fairly low, and you are not dealing with actual day to day demands of clinical practice. I'd try and give your first job 1 year before you jump ship. It will look bad if you don't, trust me. Consider UC or something more general, or perhaps 2 part-time jobs to stay fresh. Don't give up yet, there is a lot of variety out there and you worked too hard! Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted March 30, 2014 Share Posted March 30, 2014 ^^^ Wow, sounds like me. Same exact scenario. One of the partners wasn't too keen on me from the get go for whatever the reason. I grew tired over the years of the same folks literally calling day after day. Surgery, except for simple discectomies for which I'd be in and out in about an hour, sucked. Couldn't see anything, had to fight off dozing while holding the darn retractors, blah! I finally got to the point to where I felt like each patient was a crock until proven otherwise. I went into another specialty. I also got tired of getting blood splashed on my lab coat trying to pull out those darn Jackson-Pratt drains. Link to comment Share on other sites More sharing options...
BruceBanner Posted March 30, 2014 Share Posted March 30, 2014 ^^^ Wow, sounds like me. Same exact scenario. One of the partners wasn't too keen on me from the get go for whatever the reason. I grew tired over the years of the same folks literally calling day after day. Surgery, except for simple discectomies for which I'd be in and out in about an hour, sucked. Couldn't see anything, had to fight off dozing while holding the darn retractors, blah! I finally got to the point to where I felt like each patient was a crock until proven otherwise. I went into another specialty. I also got tired of getting blood splashed on my lab coat trying to pull out those darn Jackson-Pratt drains. Haha me too! I forgot about those stupid JP drains. Sprayed me every time. We had some patients that were literally on their 4th fusion---and each time their life got worse. Convinced me never to get back surgery unless absolutely necessary. I agree about the OR as well...discectomies were kinda fun but we some mega-fusion cases that were over 8 HOURS. The surgeon was stressed and mad I couldn't anticipate him, but it's like, c'mon man...you've been doing this for 20 years! I just graduated. Ugh, bad memories. Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted March 31, 2014 Moderator Share Posted March 31, 2014 I can feel your pain. Not to setract but this is a good place considering the topic........A little dif view...from someone whose fighting the realization...im not liking this. Im working on my second year in ER and so far im not enjoying most of my days. I find myself under the 15 min time to be seen since check in rule, nurses who continuosly power struggle with me....for god knows what reason, pharamcy staff who wont ship cetaciane spray down to ER bc im suppose to enter it as hurricaine sprya, that they couldnt locate anyway...., pissed off RT techs who cant beleived I called them for another, (imagine) another albut tx for ashtmatic. Man, i was RT in my day and my ass was in ER in less that 5 min dumping albut into a neb. These people flat dont care now. Im finding people who are trying to do less and less of their job, and also helping each other less and less. I sat across from a patinet who came in it at 3 am for a bug bite demanding pain medicine and i realized.....it hit me....im not being true to myself. Am i at all useful? Maybe...and no matter how much faster I get its still not enougj.....ive creeped up to 25-27 in 15 months on cerner in a 9 hour shift....still not enough for half of my 40 docs. Side bar----How mnay times can a messenger be shot in one night.?...four. Thats my record. It was tonight. The list goes on but the inefficiency and waste that occurs. Ex: we had a suture cart. I loved it. All supplies, one spot. Now decentralized to three spots. (Not a joke i swear) So far im not liking being a PA. I cant be authentic and real bc the expectations of the patients, propogated by the administrators, dont match the reality of life in general, and if I had wanted to be a salesperson, id have gone into buissiness. I can tell the patients wht they really need to hear bc some one with get upset. I feel like im doing no good to 80% of the people im treating. I felt useful in in NSG. I wonder too....what will I do? Im supposed to be thankful. But so far im just going through motions. Sigh. Thanks for starting that thread. If I may say, in order to help you dealing with your situation if you're not looking for another position.... When it comes to lazy staff that you work with, the vast majority of the time if they are written up multiple times either by you or other providers, those situations do get addressed. Administration and other superiors do not want people to slack, but they operate in a world where paperwork is needed in order to make movements on someone. Sometimes the suits can be helpful to you :) When it comes to the patient with "different expections", there is nothing wrong with mentioning that: 1. The ER is sometimes not the best place for the patient's problem, and our job is sometimes referring to the appropriate specialist- albeit in a way that doesn't make them feel defensive. 2. You (I would hope) maintain the ability to treat a patient's pain as you see fit. As much as people complain about "we have to give them whatever they want", I have never heard of an ER director or an administrator say that patients automatically get narcotics/opioids for pain, no matter how minor their condition is. Most providers agree about which patients need opioid analgesia- that's not where the problem lies. The problem is in either the frequent flier or the person with unrealistic expectations on getting overly strong analgesics for minor conditions- in other words, using a gun to shoot a fly instead of using a flyswatter. If you're actually in the position where you are being forced to hand out massive quantities of percocet for a bug bite just because the patient asks for it, I'd quickly find another job. The times that patient satisfaction surveys have been used at my job, the pain question is worded as "Did the provider address your pain?"- NOT "Did the provider completely relieve your pain with the drug you asked for?". Two totally different questions. I always address a patien's pain as I see appropriate- sometimes, they don't agree. But I get backup on my decision. I am seeing movements, albeit small at this time, to combat the "pain is the fifth vital sign" mess we've gotten ourselves into over the past 10-15 years. It's swinging back the other way. I know that doesn't help you right now, but I hope it gives some hope to not completely abandon a speciality you liked at first. Link to comment Share on other sites More sharing options...
KMD16 Posted March 31, 2014 Share Posted March 31, 2014 Interesting read! Link to comment Share on other sites More sharing options...
SocialMedicine Posted March 31, 2014 Share Posted March 31, 2014 consider residency where you can get dedicated procedure training/experience. Link to comment Share on other sites More sharing options...
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