Advice for brand new cardiology PA - pearls, warnings, anything!

[moestown1016]

Hey! I started one week ago with a cardiology group. The group has a huge office and tons of physicians and about 6 PA's that work in an office and then in 5 major hospitals (all but one PA is in hospital). My job is to do rounds and consults on the weekends. I have been shadowing for a week, taking notes, typing up my notes, working through Dubin, trying to learn the meds and all of the endless topics and problems encountered in cardiology. It is a HUGE task!

 

If you have any advice for me, suggestions, pointers, warnings - anything at all - I would greatly appreciate it. From what I've gathered I am supposed to give a quick clinical "snapshot" of the patient on a progress note along with any orders that I think would be best for the patient - the doc comes after me and looks it over - adds or subtracts whatever he/she wants.

 

I'm working on a thorough outline of what my progress note should look like and what I need to check every time...its overwhelming.

 

Any advice? :confused:

[Moonwalk]

Regarding progress notes:

 

This is the outline that I have used for many years:

 

S(ubjective): (Patients complaints--and/or denies chest pain/SOB/palpitations, etc.)

 

O(bjective): Temp/Pulse/Resp./BP Intake Output Weight

Heart - (Regular, Grade II SEM) Lungs - (clear)

Neck Veins - Edema-

(other relevant findings)

Cardiac Telemetry - current rhythm and 24 hour review

Today's lab results

Today's EKG (or new EKG since yesterday)

Today's Chest X-ray (or new CXR since yesterday)

Other new test results:

Assessment: 1) diagnosis 1 (such as chest pain, MI RO/d)

2) diagnosis 2 (such as new onset atrial fibrillation

3) diagnosis 3 (such as HTN, currently well-controlled)

Plan: Plans for further testing and treatments. (Such as: plan adenosine myoview stress test today, continue beta-blocker and aspirin, switch to oral Cardizem. If adenosine myoview test is strongly positive, will likely need cardiac catheterization).

 

Your name and title

[rielits]

I survived my first year as a cardiology PA. I found this book very helpful: Clinical Cardiology made ridiculously simple by Michael Chizner, MD.

[kmac79]

My best advise is just be patient with yourself. It is overwhelming in the beginning...but it will all come together. I've been a cardio PA for 3 years now. Started in cardio right out of school and thought "what the heck did I get myself into?!" I would say it took me a good year/year and a half before I really started feeling comfortable that I somewhat knew what I was doing. I've found that my docs are my best resources. They love to teach, so if you have docs that like to teach, use them. I also use the outline Moonwalk listed above. I find that it really helps if you make a problem list at the end of your note. It keeps me organized and I can address every problem I need to. It is a lot of stuff to learn...just hang in there!! Good luck!