ruralem Posted July 16, 2015 Share Posted July 16, 2015 Hey Everyone I am a new grad PA with rural EM experience an an ER tech in my previous life. I have always wanted to practice in emergency medicine, and feel my personality fits the field nicely. I have done 2 EM rotations, and have ACLS/PALS/ATLS certs. Feel good with most procedures, except the low volume/high risk ones (intubation, thracostomy, crich - which I feel I could do in a pinch, but would certainly prefer more practice with). I have gotten good feedback from providers I have worked with regarding my clinical skills. I have a possible job offer from a rural clinic in a 1,500 person town in the mountain west. It is certainly not a receiving facility, and is more of a critical access shop. The job involves ED call, clinic and nursing home coverage. There is a doc in town, but shifts would be worked mostly alone with phone supervision. This is definitely my dream job - I'm not much of a city person, however, I don't want to be in a situation where I put my patients and my license at risk. I know I can handle a lot of what comes through the doors, but as a new grad, I know would be shuffling trying to manage many patients (taking extra time to research and make sure i'm not missing things). I don't want to make a bad decision for myself, but mostly for my future patients. it isn't the stabilize and transfer I am worried about - it is the patients who are on the cusp of sick vs. not sick. Basically, I am asking for honest advice from folks who have been in a situation like this. I don't want you to think I am some cocky new grad who thinks he knows everything. If there is anything I am confident about, it is that there is a lot I don't know. I just don't want to pass up a good opportunity that I think I would be good at. Thanks in advance. Link to comment Share on other sites More sharing options...
Guest Paula Posted July 16, 2015 Share Posted July 16, 2015 I say go for it as long as you have a competent physician as your collaborator who will back you up and be available if needed. With clinic and nursing home coverage you will learn lots there. How much time in the clinic? Do they provide a training time where you can work closely with the physician in the ER? Who else works ED call? What is the yearly volume of the ED? If it is completely crazy busy and you have no time to think or respond to whatever comes in, then you might want to get 2 years or so experience elsewhere before taking this job. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 16, 2015 Moderator Share Posted July 16, 2015 agree with Paula. a few folks here on the forum with strong ems backgrounds have managed jobs like this before. Just make sure you have someone to call if it hits the fan who can be there asap. Link to comment Share on other sites More sharing options...
ruralem Posted July 16, 2015 Author Share Posted July 16, 2015 Thanks for your reply, Paula. It is mostly clinic, with ER call pretty much all the time. They certainly see less than 10 patients per day in the ED, most days closer to 4. Still have the opportunity for any acuity patient to come through the doors Basically, the daily deal is round on hospital patients (less acute/obs can be admitted), see clinic/SNF patients, bop over to the ED when needed. Sounds like lots of call. There are associated with a larger hospital, so shifts can be worked in their ED or OR to get lower volume procedures up to date. Link to comment Share on other sites More sharing options...
delco714 Posted July 16, 2015 Share Posted July 16, 2015 I'm incredibly sure you could do that crich in a pinch. Otherwise agree with E above. Too much a leash as a new grad is dangerous for everyone involved. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 16, 2015 Moderator Share Posted July 16, 2015 go for it, sounds like the dream job. they must realize there will be a learning curve and treat you accordingly. Link to comment Share on other sites More sharing options...
ruralem Posted July 16, 2015 Author Share Posted July 16, 2015 Thanks for the advice everyone. Any tips going in to something like this as a new grad? I don't want to fall into my own bad habits. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 16, 2015 Moderator Share Posted July 16, 2015 Thanks for the advice everyone. Any tips going in to something like this as a new grad? I don't want to fall into my own bad habits. make up a binder for yourself with info that you need at the tips of your fingers at all times, but won't use very often. in mine I have inclusion/exclusion criteria for TPA, stroke scales, a nice protocol medic25 sent me for reversing anticoagulants,contact #s for local stroke and stemi ctrs for transfers, etc Link to comment Share on other sites More sharing options...
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