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life as a PA as a emergency medicine as a specialty


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Pretty subjective question....you talking money, time off, feeling challenged at work, working environment, flexibility of working hours? j

 

Emergencies and critical care are always staffed...24/7. Weekends, holidays, days, nights...no breaks. If you don't mind working weekend nights and playing all week long, may not be a bad deal. If you want to work only week days to hang with your family in the evening and weekends...welll....that may be a little more problematic...one person's reward is another's curse

 

get your question more specific for better answers

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Hi,

 

I found critical care much more manageable than emergency medicine. Patients have extensive documentation, mostly are obtunded, so they offer few complaints. More work is represented by tweaking of drips, more of the ‘eternal medicine’ frustrations.

 

The challenges are different in the ED and involve more interpersonal issues. The pace is urgent and driving. However, when it’s done, it’s done. A new day in the ED brings a new slate of problems; in the ICU it is often the same marginal patient with questionable outcome.

 

Codes in the ICU are often kind of a slow-motion progression, and often a bit non-standard with intubated, aggressively supported patients. Rarely do codes follow a routine ACLS algorithm. However, if you don’t mind working odd hours, docs will delegate a tremendous amount of responsibility, especially for procedures.

 

The pleasure of diagnostic thinking is less common in the expensive care unit; decisions are a bit more dependent upon specialists and rely upon a lot of consensus opinion, which is odd. Allocation of scarce resources is a frequent topic in the unit. More end-of-life discussions are conducted, to help pull the plug for less viable patients. In the grand scheme of things, common patterns occur commonly. Death is common.

 

The broad spectrum of medical care for humans is integral in working the ED. Esoterica is the nature of ICU.

 

Just my opinion.

 

-Tom

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Hey,

 

If ICU has appeal, consider lurking on the chat sessions with: <http://www.ccm-l.org/>

 

The Critical Care Medicine-List has chat rooms which require a (free) subscription, and it certainly pre-dates PAForum, (so there are somewhat more primitive format issues,) but it may be what you are looking for. Although eccentric and sometimes politically incorrect, CCM-L takes critical care discussion to a certain ‘bleeding edge’ of global medical issues. I found it helpful when my hospitalist work became a primarily ICU coverage time.

 

The folks involved are quite the mix from around the world. Discussion come from ethicists, intensivists, pathologists, surgeons, CT, ICU & ED types. Roles are spoken from docs, RTs, RNs, and PAs (like Lorick Fox), all offered from their common perspectives.

 

If the discussion starts in South Africa, and the respondent is in NZ, it helps to be aware of European spellings of English words as well as measures of common lab work (as when Serum Creatinine would be described as μmol/L versus our US mg/dl). The critical care regulars are certainly a non-standard group. Anyway, once you get to know their idiosyncrasies, it’s an interesting collection of personalities (as is here, on the Forum).

 

Clinical problems mix with ethical dilemmas. CCM-L Archives are popular, since many of the scenarios are unprecedented, even compared to ICU survivals of 10-15 years ago. Over the years, some of these discussions have been kept, a bit raw and eclectic. And esoteric.

 

Ethical management of ventilator-supported mom, pregnant with 33-week gestation fetus, receiving teratogenic drugs, among other insults. Or the intubation and management tweaks applied to marginally survivable patients, with the usual criticisms of the ED. An ongoing discussion for the units, seems to be the reality that every patient is in variation of a shock state, so this is another urgent thought-process as well.

 

Does this seem interesting? It is a different way of thinking about medical care.

 

-Tom

 

 

 

 

 

 

 

 

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