Guest ERCat Posted November 11, 2015 Share Posted November 11, 2015 Finally... The licensing and credentialing process is now complete. It has been a four month process and I've been dying to start working the whole time. I officially have three weeks till I start my job in the ER, as I just learned I am being added to the December schedule. I've been excited for months, doing many things to prepare myself, but last night I woke up at 2 AM with a knot in my stomach and have felt anxious all day. I have been extremely motivated to be a rock star PA in the ED -- a good provider for patients and a good member of the ED team that people want to work with. I want to follow the most cutting edge, evidence based practices, I want to be compassionate, I want to be thorough. I want to show that I am smart. I have actually studied quite a bit since I graduated four months ago. Have been doing an online ER Bootcamp, brushing up on x-rays, flipping through my Minor Emergencies text book and I even started looking through Bates. Even an ER conference in another city. As a result I feel like I have a leg up on book knowledge as compared to many new grads who aren't as motivated to hit the books. If someone asked me about the latest guidelines on a topic or certain medical legal pitfalls I could confidently answer... but in reality I have problems applying that knowledge. My terror limits me. For example...When shadowing and working with a PA a few weeks ago for a potential per diem job, we had a back pain patient and I led the encounter and I found myself freezing up -- when asking the patient questions, feeling nervous and then not knowing what else to ask next so just nervously doing extra steps on the physical exam to make it look like I knew what I was doing to buy myself time to think. When the patient asked questions I felt inside I had an answer and it sounded right but I found myself not saying anything and instead looking at the PA to formulate a response. I have a certain shyness and uncertainty and nervousness that makes my smart mind go dumb. At this point I feel I am so unsure of myself I would need to ask my SP questions about everything. I think a lot of it is the fact that I read SO MUCH on the details that it hampers me. When many people see the big picture they simply apply their knowledge to individual scenarios... But I am so detail focused I am afraid to miss an important thing (I.e. A med interaction, a contraindication to a procedure, the super uncommon differential diagnosis) that it almost keeps me from acting. I want to KICK BUTT in the ER but I am not sure how to overcome this fear. I am also afraid of realizing I don't know something when I am in front of a patient. What if I am right in front of them and they ask me a basic question I should know but don't? What if I am in the middle of a procedure and realize I forgot the next step or forgot how to do something? I am also afraid of the fact that I will have to look up information for every single case for a while -- even for something as simple as a URI -- to make sure I am not missing relevant parts of the history and to ensure I am offering the right treatment. I don't understand that after all my studying I still froze up with that back pain patient and didn't know what the next step should be. I realize I sound like an anxious mess. Anyone have any words of wisdom? Link to comment Share on other sites More sharing options...
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