I've been working in emergency medicine for about 1 year in a setting with a good mixture of high acuity and fastrack patients at a teaching institution. I've also worked during this time per diem at a low volume urgent care. While this has been an outstanding first job in terms of resume building and learning, it of course has the downside of wild hours, nights, weekends, holidays, etc. at a rather noncompetitive hourly rate/salary. I don't hate the job, but I also don't see myself doing emergency medicine forever. Or at least...not at this salary.
For those who started in emergency medicine, what are your thoughts on transitioning to an urgent care job? I have heard some describe a miserable existence of patient volumes upwards of 60 patients a day, but I am guessing this is very dependent on the institution. Are there other specialties that make for a natural transition from emergency medicine? Am keeping all my options open at this point. Thanks!
By UNM EMPA
UNM EMPA RESIDENCY:
The University of New Mexico School of Medicine, Department of Emergency Medicine is excited to announce that we are accepting applicants now for our 2020-2021 class. Applications will close Jan 15th, 2020. Our class will start the last week of June, 2018 for an 18-month program for 2 residents. This year we have expanded our eligibility to applicants graduating an ARC-PA accredited program prior to May 31st, 2020. We strive to equip physician assistants with the clinical experiences and didactic teaching that will enable them to practice high-quality, evidence based emergency medicine. Our graduates will have comfort and competence in the care of critically ill patients, the broad scope of emergent presentations, and the skills necessary to be leaders in their profession.
Cirriculum (# of 4 week blocks)
Dedicated Orientation Block (1) Adult ED, including dedicated longitudinal block in ED Resus Unit (8) Community ED (1) Peds ED (2) Medical ICU (1) Surgical ICU (1) Combined US/Anesthesia (1) Cardiology (1) Orthopedics (1) Toxicology (1/2) OB/GYN (1/2) Electives (2) Salary/Benefits:
$57,000 yearly salary Access to health, vision, dental, disability insurance with employer matching Contribution to retirement Paid Vacation Paid travel and registration SEMPA 360 conference SEMPA membership $500 per year CME allowance ATLS, FCCS, and dedicated airway course in orientation Setting:
New Mexico's only level 1 trauma center, academic hospital and children's hospital Tertiary referral center for large rural state, with high acuity patients Easy access to outdoor activities, climbing, biking, skiing, as well as wonderful food and culture Nationally recognized faculty in EMS, Critical Care, Wilderness Medicine, Simulation and many other areas Applications Open: October 1st, 2019
Applications Close: January 15th, 2020
Hey PA Forum, I am Pre-PA, please don't kick me out, as I wanted to know from PAs what they think about the field, and where my feelings in the application process stand. I went through my undergrad with not much of a direction, graduating with a BS in Biochemistry but a 2.86 GPA. I worked for 2 years as a "scientist" but I was really just running samples through a machine (medical device) and it did not allow any sort of interesting work. I worked as part of the lab at the Boston Marathon, analyzing runner blood samples in the device, and it was the first time I was exposed to the medical field. This allowed me to appreciate their work, and also, for the first time, feel I could make a difference with my efforts. I capitalized on this excitement, and looked into nursing and PA, and decided PA. I got an EMT certification, and gave CPR to a patient in a trauma room at the nearby hospital as part of the certification. I was so excited, and then I got a job as a CNA in a teaching hospital on a heart failure floor. Everything was coming along. I was also taking pre-reqs this whole time, I completed A&P I,II, Genetics, Biochemistry, all either A or B+. As I worked at the hospital, I mainly bathed patients, and provided care in daily living, working under nurses. But the attitude of the nurses really got to me. Some would bully the technicians in a way, it was never intentional but I could not stand them. All the technicians and nurses were gossipy women and I, more of an introverted male, just felt nothing in common with them, and everything I did was judged. Nurses, and techs and female patients would occasionally hit on me, and it just felt uncomfortable. It became so frustrating for me that these shifts became almost me vs them, in my head. But I kept pushing on, I kept searching for jobs in the ER, because that seemed so exciting to me. I shadowed a resident in the ER, and loved every minute of it. I really enjoyed it because it was exciting; very different than anything I had seen; the machinery of the body was in a life threatening situation, and it was very rewarding to fix it. I also really loved all things space, and always was researching things about space. However I wasn't able to get a position in the ER, and I just felt like the oddball out all the time; and the feminine and social aspect of medicine was driving me nuts. I felt like everywhere in healthcare was this; and had this veneer or being the savior for patients, I just felt I was beating up the wrong tree for my own goals. I shadowed 5 PAs, and enjoyed the ER experience the most. I decided I wanted to try something in engineering due to my love of space. So after 9 months of being a tech, I moved to Houston, with my sister (couldn't go home, father is an alcoholic and made life at home toxic). I decided to try everything I enjoyed to figure out if this field was for me. I started taking engineering classes, a geology class, and started to learn programming, and am volunteering in a lab where I help a professor research bacteria on the Space Station. I have been stressed out, figuring out if this career is for me. I went to healthcare career fair, and interviewed for an ER Tech job, to try it out again, and am hoping it is less daunting on me. I also am thinking about pursuing biomedical engineering, as it may combine my interests, but I am nervous, because it seems a bit antisocial. I was wondering if I could get some advice about my situation, and if I have it all wrong about actually being a PA. Thanks!
Study from Beckers: Overworked Nurses may be linked to a forty percent increase in risk of Patient DeathsBy surgblumm
Thumper was a respondent on the Becker site and "Optimal" in this setting refers to optimal exceeded workloads which many of us have.
Not unlike Thumper, I agree that this is an issue that has ramifications such as this study but affects many more caregivers such as the different techs, nursing assistants, PAs and NPs in the hospital setting and emergency room clinicians as well as surgical staff, including the surgeons themselves. The nurses are the first to suffer as a large group as they are understaffed and instead of a 6:1 ratio of nurse to patient, a night shift nurse can have a 16:1. Did the patients magically change their admitting diagnosis or are these the same patients with the same problem and the addition of poor sleep in their surroundings compounded with post-operative pain. They are under-treated, seen ,perhaps twice a shift,even if they are hitting the call button. From a NA standpoint,patients are not turned, properly fed or soiled beds or diapers are not changed adding to skin and soft tissue breakdown and decubitus ulcers. The nurse needs to be "The Flash" to dispense medications and these type of errors can be deadly. Yes, personnel costs money but the litigation's and need for additional time in the hospital at its own expense is far more. My mother-in-law was a DON at three hospitals and found this happening in all three and was frustrated by administrations refusal to hire more people. Surgical personnel are more scarce because so few are trained in this discipline and it is not unusual for a surgical nurse, surgical technologist, surgical PA or NP and the surgeon themselves to work more than 80 hours to a hundred hours per week. Let me prove this as a malpractice attorney and I would have a field day of serving the institution and the caregivers who legally are working while intoxicated due to lack of sleep. Do we really care? If these providers started a pact and documented these atrocities ,hospitals would be put out of business. As a PA who cares, I would join the pact because our patients are failing because of lack of revenue to pay employees but fat paychecks for administrators.
I'm currently a PA-S graduating in a few months. I'm posting in the general discussion since I wanted to get opinions from PA-C's, particularly w/ urgent care experience. I've applied for a number of EM jobs, and am in the process of applying to urgent care positions as well. I've decided work life balance is very important to me, and Urgent Care seems to fit the bill from what I've seen.
My question is, do you guys think Urgent Care is an appropriate field for a new graduate? I will have had 2 rotations in EM by that point, and will not be solo at any of the UC locations. However, I've heard some members stating it is a poor choice, since you have more "autonomy" and need to have a good sense of what is high acuity and what isn't (which comes from experience). Given that it fits the lifestyle I want, should I still consider it?