What Patient Care Experience Did You Have Before PA School?

[0311]

The both PA programs I'm working toward require prior experience with direct patient care. One is 500 hrs and the other 1000.

 

I've been reading some PA blogs and some of the second year students write a if they are very unfamiliar with clinical settings...esp the nursing home/LTC environments. I thought this strange because I am going to be getting my CNA cert next month in order to get involved in patient care and earn those experience hrs. I thought that this was the typical path for those who are not doing a lateral move from nursing to PA but I guess I was wrong.

 

That got me to thinking...what other paths do people pursue in order to meet the patient care requirement? I thought maybe EMT experience would work, but I dunno.

[marilynpac]

If you go to the search engine and put in "health care experience" a whole lot of info has already been done on this...

[just_me]

Every medical profession out there can be and probably has been a path for someone going the PA route. For me I was a phlebotomist, clinical research asssiatant and most recently a medical assistant,

 

Keep in mind that no matter what you do youll never be fully prepared for clinical rotations...you will feel out of element. Its a different environment, different responsibilities, different skillsets etc

[ventana]

Wrong section

 

Mods - can we flip this to pre-pa?

[Just Steve]

probably come off a little pompus but the question just makes me scratch my head

 

Sometimes people don't pick the path of PA, but it picks them. In other words, there are a good number of PA's out there who went into medicine in a variety of roles and after years had gone by, they started looking for "something more". The PA program appealed to them because it complimented their years of experience and brought them to a new level of providing care. For example...the Navy Corpsman or Army/Airforce medic, the paramedic, the nurse, the patient care tech.

 

The common theme of "what can I do to get into PA school" was not the original intent of the program. The physician assistant program was created to capitalize on the previous medical experience of a more "seasoned" applicant. It has since been bastardized into it's current morphology by institutions cashing in on a very popular field of study. In an effort to boost their enrollment numbers, institutions have waived the need for any serious amount of hands on experience so that they can get college bound students into their programs. The school wants to market themselves in a desirable light, so they make programs to attract students (and their tuition) to them. Institutions are hoping that by drilling the student with academic knowledge that it will transition into acceptable hands on application. Studies have shown that after a few years post graduation, it all balances out...prior HCE vs. no HCE in quality of care. But whenever people say "it balances out in a couple of years" I just do some basic math...let's say they are slow in the beginning..average 2 patients per hour. 2000 working hours in a year, 2 years of treatment, that's 8000 people that ONE provider worked on. Now an average class of PA's is what? 40? 40x8000 = 320,000 patients.

 

Lets say there are 140 PA schools out there for easy math. 40% have no, or very low HCE requirements. 56 schools, let's say 30 per class size just to be err on the side of caution. That's 1680 new providers, seeing 8,000 patients each before they get as up to speed as their peers who have quality HCE...that's 13,440,000 patient contacts where the provider was still trying to get their feet underneath themselves, metaphorically speaking.

 

A school requiring 500 hours...I work a 48 hour work week of 4, 12 hour shifts. If I have the energy, I pull a day of overtime a week (there is plenty available). So if I push myself I can do 60 hour weeks pretty easy. A person working on 24 hours/off 48 hours does a 56 hour work week, so it's not tough to do....500 hours is 8.3 weeks of 60 hours a piece...2 months. Speaking as a paramedic, you still don't know which end of a needle has a bevel after just 2 months. I consider the ink on your certification card isn't dry until you run a couple thousand calls (2 years worth, give or take)

 

So the debate of 500 hours verses 1000 hours verses is pretty moot in my book. But to answer your question, I started as a first responder at age 15. Age 17 I joined the Navy as a corpsman and worked inpatient peds/geri/psych, then ER with my EMT basic, then CCU/ICU/cardiac step down. Moonlighted in a civilian hospital as a phlebotomist. Went off to surgical tech school, went to the fleet, served on ships underway in the Atlantic and Persian Gulf doing acute care and surgery. Finished off my 10 years as a Navy Corpsman doing plastics and reconstructive surgery. During my last two years in the service I went to night school and became certified as a paramedic, volunteered at night on the ambulance. Got out of the Navy, was hired by the local fire department as a firefighter/paramedic working on a county of a million people, just north of Washington DC, ran around 1000 calls a year for 7 years. Moved back home to Oregon, hired as a paramedic working in system that provides 911 coverage for about a million people and I am part of the Wilderness Reach and Treat, taking ALS into the backcountry where we are with our patients sometimes overnight in the woods pushing antibiotics, large doses of narcotics, ECG capable, have standing orders for dislocation reductions, paralytics for airway management, the list goes on.

 

I applaud you getting your CNA..it's very humbling work that will serve you well in your future endeavors. Keep your ears and eyes open and your hands busy to soak up as much knowledge and experience as you can. Given the choice between an EMT basic and a CNA, I'd tell people get to be a CNA in a hospital where docs round every day on their patients and try to round with them..listen to what they are discussing, then go look up on your own anything you didn't understand. As an EMT basic, most busy systems have the basic driving the ambulance, or even worse, the wheelchair van taking granny for her teeth cleaning. While it's a task that needs to be completed, you won't learn nearly as much as being in a hospital with hands on care. In systems where the EMT basic takes direct patient care, they patients have either been triaged by an ALS provider and found to be sub acute, or the volume of calls is so slow it would take you 5 years before you start to get the swing of things in a competent manner.

 

The school I have been accepted to has a requirement of 4000 hours of direct patient contact in the years immediately prior to applying. The average applicant to U of Washington has just over 6 years of experience. Needless to say, it's a good match for me.

 

Did that answer your question?

[EMEDPA]

emt/er tech x 5 yr then

paramedic x 5 yrs, both 911 and critical care

[EMEDPA]

 

Sometimes people don't pick the path of PA, but it picks them. In other words, there are a good number of PA's out there who went into medicine in a variety of roles and after years had gone by, they started looking for "something more". The PA program appealed to them because it complimented their years of experience and brought them to a new level of providing care. For example...the Navy Corpsman or Army/Airforce medic, the paramedic, the nurse, the patient care tech.

 

The common theme of "what can I do to get into PA school" was not the original intent of the program. The physician assistant program was created to capitalize on the previous medical experience of a more "seasoned" applicant. It has since been bastardized into it's current morphology by institutions cashing in on a very popular field of study. In an effort to boost their enrollment numbers, institutions have waived the need for any serious amount of hands on experience so that they can get college bound students into their programs. The school wants to market themselves in a desirable light, so they make programs to attract students (and their tuition) to them. Institutions are hoping that by drilling the student with academic knowledge that it will transition into acceptable hands on application. Studies have shown that after a few years post graduation, it all balances out...prior HCE vs. no HCE in quality of care. But whenever people say "it balances out in a couple of years" I just do some basic math...let's say they are slow in the beginning..average 2 patients per hour. 2000 working hours in a year, 2 years of treatment, that's 8000 people that ONE provider worked on. Now an average class of PA's is what? 40? 40x8000 = 320,000 patients.

 

Lets say there are 140 PA schools out there for easy math. 40% have no, or very low HCE requirements. 56 schools, let's say 30 per class size just to be err on the side of caution. That's 1680 new providers, seeing 8,000 patients each before they get as up to speed as their peers who have quality HCE...that's 13,440,000 patient contacts where the provider was still trying to get their feet underneath themselves, metaphorically speaking.

 

A school requiring 500 hours...I work a 48 hour work week of 4, 12 hour shifts. If I have the energy, I pull a day of overtime a week (there is plenty available). So if I push myself I can do 60 hour weeks pretty easy. A person working on 24 hours/off 48 hours does a 56 hour work week, so it's not tough to do....500 hours is 8.3 weeks of 60 hours a piece...2 months. Speaking as a paramedic, you still don't know which end of a needle has a bevel after just 2 months. I consider the ink on your certification card isn't dry until you run a couple thousand calls (2 years worth, give or take)

 

So the debate of 500 hours verses 1000 hours verses is pretty moot in my book.

 

totally agree.

I appaud your decision to attend medex. it is one of the few old school programs left. I never have to worry about a student from medex but other programs are pretty variable with a lot more hand holding...

[Craigk]

ER Tech 1yr, LPN 10yrs, RN 9yrs....Total HCE I rounded it to about 30,000hrs. Didn't try to factor in overtime and the 9 months that I worked 6days every week, Fri, Sat, Sun in ER and Mon, Tue Wed in SICU, just left that 3d per week. I'm probably around 35-40,000 hours but no matter.

[Evolute]

probably come off a little pompus but the question just makes me scratch my head

 

Sometimes people don't pick the path of PA, but it picks them. In other words, there are a good number of PA's out there who went into medicine in a variety of roles and after years had gone by, they started looking for "something more". The PA program appealed to them because it complimented their years of experience and brought them to a new level of providing care. For example...the Navy Corpsman or Army/Airforce medic, the paramedic, the nurse, the patient care tech.

 

The common theme of "what can I do to get into PA school" was not the original intent of the program. The physician assistant program was created to capitalize on the previous medical experience of a more "seasoned" applicant. It has since been bastardized into it's current morphology by institutions cashing in on a very popular field of study. In an effort to boost their enrollment numbers, institutions have waived the need for any serious amount of hands on experience so that they can get college bound students into their programs. The school wants to market themselves in a desirable light, so they make programs to attract students (and their tuition) to them. Institutions are hoping that by drilling the student with academic knowledge that it will transition into acceptable hands on application. Studies have shown that after a few years post graduation, it all balances out...prior HCE vs. no HCE in quality of care. But whenever people say "it balances out in a couple of years" I just do some basic math...let's say they are slow in the beginning..average 2 patients per hour. 2000 working hours in a year, 2 years of treatment, that's 8000 people that ONE provider worked on. Now an average class of PA's is what? 40? 40x8000 = 320,000 patients.

 

Lets say there are 140 PA schools out there for easy math. 40% have no, or very low HCE requirements. 56 schools, let's say 30 per class size just to be err on the side of caution. That's 1680 new providers, seeing 8,000 patients each before they get as up to speed as their peers who have quality HCE...that's 13,440,000 patient contacts where the provider was still trying to get their feet underneath themselves, metaphorically speaking.

 

A school requiring 500 hours...I work a 48 hour work week of 4, 12 hour shifts. If I have the energy, I pull a day of overtime a week (there is plenty available). So if I push myself I can do 60 hour weeks pretty easy. A person working on 24 hours/off 48 hours does a 56 hour work week, so it's not tough to do....500 hours is 8.3 weeks of 60 hours a piece...2 months. Speaking as a paramedic, you still don't know which end of a needle has a bevel after just 2 months. I consider the ink on your certification card isn't dry until you run a couple thousand calls (2 years worth, give or take)

 

So the debate of 500 hours verses 1000 hours verses is pretty moot in my book. But to answer your question, I started as a first responder at age 15. Age 17 I joined the Navy as a corpsman and worked inpatient peds/geri/psych, then ER with my EMT basic, then CCU/ICU/cardiac step down. Moonlighted in a civilian hospital as a phlebotomist. Went off to surgical tech school, went to the fleet, served on ships underway in the Atlantic and Persian Gulf doing acute care and surgery. Finished off my 10 years as a Navy Corpsman doing plastics and reconstructive surgery. During my last two years in the service I went to night school and became certified as a paramedic, volunteered at night on the ambulance. Got out of the Navy, was hired by the local fire department as a firefighter/paramedic working on a county of a million people, just north of Washington DC, ran around 1000 calls a year for 7 years. Moved back home to Oregon, hired as a paramedic working in system that provides 911 coverage for about a million people and I am part of the Wilderness Reach and Treat, taking ALS into the backcountry where we are with our patients sometimes overnight in the woods pushing antibiotics, large doses of narcotics, ECG capable, have standing orders for dislocation reductions, paralytics for airway management, the list goes on.

 

I applaud you getting your CNA..it's very humbling work that will serve you well in your future endeavors. Keep your ears and eyes open and your hands busy to soak up as much knowledge and experience as you can. Given the choice between an EMT basic and a CNA, I'd tell people get to be a CNA in a hospital where docs round every day on their patients and try to round with them..listen to what they are discussing, then go look up on your own anything you didn't understand. As an EMT basic, most busy systems have the basic driving the ambulance, or even worse, the wheelchair van taking granny for her teeth cleaning. While it's a task that needs to be completed, you won't learn nearly as much as being in a hospital with hands on care. In systems where the EMT basic takes direct patient care, they patients have either been triaged by an ALS provider and found to be sub acute, or the volume of calls is so slow it would take you 5 years before you start to get the swing of things in a competent manner.

 

The school I have been accepted to has a requirement of 4000 hours of direct patient contact in the years immediately prior to applying. The average applicant to U of Washington has just over 6 years of experience. Needless to say, it's a good match for me.

 

Did that answer your question?

 

Well stated.

 

Congrats on MEDEX. Which site are you attending? If you have any questions about the program feel free to ask I can't guarantee I can answer them all but I'll try.

 

MEDEX grad 2008

[Joelseff]

If you go to the search engine and put in "health care experience" a whole lot of info has already been done on this...

What She said......

[Joelseff]

probably come off a little pompus but the question just makes me scratch my head

 

Sometimes people don't pick the path of PA, but it picks them. In other words, there are a good number of PA's out there who went into medicine in a variety of roles and after years had gone by, they started looking for "something more". The PA program appealed to them because it complimented their years of experience and brought them to a new level of providing care. For example...the Navy Corpsman or Army/Airforce medic, the paramedic, the nurse, the patient care tech.

 

The common theme of "what can I do to get into PA school" was not the original intent of the program. The physician assistant program was created to capitalize on the previous medical experience of a more "seasoned" applicant. It has since been bastardized into it's current morphology by institutions cashing in on a very popular field of study. In an effort to boost their enrollment numbers, institutions have waived the need for any serious amount of hands on experience so that they can get college bound students into their programs. The school wants to market themselves in a desirable light, so they make programs to attract students (and their tuition) to them. Institutions are hoping that by drilling the student with academic knowledge that it will transition into acceptable hands on application. Studies have shown that after a few years post graduation, it all balances out...prior HCE vs. no HCE in quality of care. But whenever people say "it balances out in a couple of years" I just do some basic math...let's say they are slow in the beginning..average 2 patients per hour. 2000 working hours in a year, 2 years of treatment, that's 8000 people that ONE provider worked on. Now an average class of PA's is what? 40? 40x8000 = 320,000 patients.

 

Lets say there are 140 PA schools out there for easy math. 40% have no, or very low HCE requirements. 56 schools, let's say 30 per class size just to be err on the side of caution. That's 1680 new providers, seeing 8,000 patients each before they get as up to speed as their peers who have quality HCE...that's 13,440,000 patient contacts where the provider was still trying to get their feet underneath themselves, metaphorically speaking.

 

A school requiring 500 hours...I work a 48 hour work week of 4, 12 hour shifts. If I have the energy, I pull a day of overtime a week (there is plenty available). So if I push myself I can do 60 hour weeks pretty easy. A person working on 24 hours/off 48 hours does a 56 hour work week, so it's not tough to do....500 hours is 8.3 weeks of 60 hours a piece...2 months. Speaking as a paramedic, you still don't know which end of a needle has a bevel after just 2 months. I consider the ink on your certification card isn't dry until you run a couple thousand calls (2 years worth, give or take)

 

So the debate of 500 hours verses 1000 hours verses is pretty moot in my book. But to answer your question, I started as a first responder at age 15. Age 17 I joined the Navy as a corpsman and worked inpatient peds/geri/psych, then ER with my EMT basic, then CCU/ICU/cardiac step down. Moonlighted in a civilian hospital as a phlebotomist. Went off to surgical tech school, went to the fleet, served on ships underway in the Atlantic and Persian Gulf doing acute care and surgery. Finished off my 10 years as a Navy Corpsman doing plastics and reconstructive surgery. During my last two years in the service I went to night school and became certified as a paramedic, volunteered at night on the ambulance. Got out of the Navy, was hired by the local fire department as a firefighter/paramedic working on a county of a million people, just north of Washington DC, ran around 1000 calls a year for 7 years. Moved back home to Oregon, hired as a paramedic working in system that provides 911 coverage for about a million people and I am part of the Wilderness Reach and Treat, taking ALS into the backcountry where we are with our patients sometimes overnight in the woods pushing antibiotics, large doses of narcotics, ECG capable, have standing orders for dislocation reductions, paralytics for airway management, the list goes on.

 

I applaud you getting your CNA..it's very humbling work that will serve you well in your future endeavors. Keep your ears and eyes open and your hands busy to soak up as much knowledge and experience as you can. Given the choice between an EMT basic and a CNA, I'd tell people get to be a CNA in a hospital where docs round every day on their patients and try to round with them..listen to what they are discussing, then go look up on your own anything you didn't understand. As an EMT basic, most busy systems have the basic driving the ambulance, or even worse, the wheelchair van taking granny for her teeth cleaning. While it's a task that needs to be completed, you won't learn nearly as much as being in a hospital with hands on care. In systems where the EMT basic takes direct patient care, they patients have either been triaged by an ALS provider and found to be sub acute, or the volume of calls is so slow it would take you 5 years before you start to get the swing of things in a competent manner.

 

The school I have been accepted to has a requirement of 4000 hours of direct patient contact in the years immediately prior to applying. The average applicant to U of Washington has just over 6 years of experience. Needless to say, it's a good match for me.

 

Did that answer your question?

 

...and what HE said....

[ohiovolffemtp]

Firefighter/EMT since 1983, firefighter/EMT-intermediate since 1988, firefighter/paramedic since 2002. EMS instructor since 1993. ACLS, BLS, AMLS, PEPP, PHTLS, etc. instructor for many years. Starting PA school in a few months at age 53.

[xxbowiexx]

i was a CNA and felt that my background has helped tremendously in the clinical setting. I have no problem interacting, relating, and taking care of patient 2/2 my CNA experience.

[Febrifuge]

ER Tech about 2500 hours spread out over almost 4 years, most of it part-time. The PA profession definitely picked me, rather than the other way around.

 

This experience was invaluable in PA school, because I knew for a fact I was capable of being really good at the skills, and the job, so getting a lousy score on a test here and there didn't destroy my confidence and make things worse.

[hrjames]

I rarely post, but I'll chime in here.

I had 6 months as an orthodontic assistant and 6 years as a drug rep. I'll argue that being a drug rep was great experience before PA school. I knew the structure of an academic medical center and all those years of bringing doughnuts to grand rounds (and M&M and resident case conferences, etc, etc, and staying for the lecture) actually stuck with me. Not to mention making pharm lectures easier.

 

[ETA: I don't advocate becoming a drug rep to meet PA school prerequisites for experience, but if a person is already on that path, the experience has merit. Now if you're interested in a lot of money and a soul-less existence, however, then by all means...]

 

I'm nearly 7 years out of school and I think I'm a great PA. So do the docs I work with, who treat me with respect.

 

There were quite a few of the more traditional students in my class - years as a paramedic or ER tech. I became good freinds with several of them.

We complemented each other well. I am fairly cerebral (read: geek) and honestly found the didactic year fairly easy. I could help them figure out renal physiology. They helped me learn to start an IV and how not to panic for the ACLS practical exam (among many other things).

 

When we all went out on rotation I think I had a harder time with the technical ones (surgery), but I showed up ready to learn every day and truly gave 100%. Procedures are not my forte, no, but I do them every day and am competent, thanks to the lessons I learned on those rotations. I excel more with internal medicine problems.

 

There is room in the profession for many levels and many types of experience. A seasoned paramedic is likely to slide into an ER job pretty easily, but the lab rat will probably feel very comfortable in ID.

I think the keys are a base level of intelligence combined with a stellar work ethic. Without these, success doesn't seem likely no matter what your prior experience may be.

[acozadd]

 

Studies have shown that after a few years post graduation, it all balances out...prior HCE vs. no HCE in quality of care. But whenever people say "it balances out in a couple of years" I just do some basic math...let's say they are slow in the beginning..average 2 patients per hour. 2000 working hours in a year, 2 years of treatment, that's 8000 people that ONE provider worked on. Now an average class of PA's is what? 40? 40x8000 = 320,000 patients.

 

This seems like a completely arbitrary number... Whose to say that the individual that was a nurse prior to PA school will be able to handle a higher patient load than someone who was a CNA? Whose to say that someone without any work experience but an undergrad degree in athletic training wouldn't be more prepared to be an ortho PA than a nurse on the heart unit for 30 years?

 

I understand the importance of prior HCE and believe every PA student should have some basic level of previous experience, but I feel like the comments on this forum in particular are completely all too generalized in thinking that just because you were (xyz) that you will automatically be more prepare than someone who wasn't.

 

As I always say, some transitions are logical (medic--EM PA) but in many of the specialties, the person with stellar previous experience will have no more experience than someone who has little to no previous experience. Take someone who was an assistant in an OB clinic compared to a medic of 15 years. Both become ob-gyn PAs, who is more likely more prepared to start? They probably both had the same training in school, and it's unlikely that the medic background really applies all that much to women's health. The lowly assistant might have a few years of more focused knowledge of how things work in OB.

 

Just my 2 cents.

[EMEDPA]

Why would a medic ever work in ob?....:)

[acozadd]

Why would a medic ever work in ob?....:)

 

Well two of my faculty were former EM nurses/flight nurses and both went into women's health after PA school, so just an example. You get the point-- in terms of a generalist then the nurses/medics will have a step up. But when you consider how PAs have branched beyond primary care and more are specializing, previous experience may not always be applicable depending on the chosen specialty.

 

Anyway, not trying to start any arguments, we are all on the same page with agreeing that previous healthcare experience should be a requirement and is certainly useful for a PA student. A combination of a good work ethic/desire to learn, some common sense/natural intelligence, and previous experience all factor in to how a student will do in PA school and beyond.

 

FWIW- why anyone would chose women's health... don't ask me. Pretty sure every guy in my class sat through those lectures with glazed over eyes...