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Pay your dues (add to the list!)


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In this thread, we list the things you should have to do before being allowed to start PA school. I'll start:

 

1. Wipe someone's ***

 

2. Be yelled at by an angry patient for something you didn't do and have no control over

 

3. Only to later be yelled at by that patient's parent for the same thing

 

4. And later to be yelled at by the RN, who should've addressed the whole mess in the first place!

 

5. Work 16 hours without a break

 

6. Work 12 hours without literally sitting down once

 

7. Come close to tears over a bad grade

 

8. Email at minimum 25 PA's trying to find someone to shadow

 

9. Explain at least 50 times what a PA is

 

10. Spend over an hour trying to explain to your parents/friends/spouse why you DON'T want to be a doctor

 

Keep the list going!!!

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from a prior similar thread:

 

brief hx taking with vital signs

phlebotomy

im injections

splinting/wound bandaging

minor surgical assisting

pt transport

urine testing

minor lab procedures(strep/mono/spinning crits/etc)

labeling/dispensing take home meds

applying o2 devices/suctioning

performing ekg's

giving neb tx and doing spirometry/peak flow testing

vision/hearing screening

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- name at least 10 bodily fluids (bonus points if you've actually encountered them)

- give a patient/family bad news

- have a patient die

- work a pedi code

- work with combative/abusive patients

- disagree with a MD/PA/DO/NP/senior co-worker about appropriate treatment of a pt and have an ADULT, PROFESSIONAL discussion about it

- name at least one area of medicine that fascinates you

- name at least one area of medicine in which you NEVER want to work

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I've "checked" EMEDPA's boxes, but not flyingsquirrel's. Nine years as an Army medic, and all of my patients are still alive and kicking. That's how I generally prefer my patients, anyway. :)

 

I wouldn't want to work in bariatrics.

 

#8 on the OP's list I don't get as a "requirement." Not everyone will have such difficulty finding a PA to shadow. Although, lol at #9. I finally had to sit my husband down and give him an in-depth discussion of the differences between PA and MD because I was gonna go nuts if I heard him describe it one more time as "like a doctor but not." O_O

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[h=2]Re: Pay your dues (add to the list!)[/h]DMGCME-300x250_PREREGanimation.gif

x brief hx taking with vital signs

x phlebotomy

x IM injections

x splinting/wound bandaging

x minor surgical assisting

x pt transport

x urine testing

minor lab procedures(strep/mono/spinning crits/etc)

labeling/dispensing take home meds

x applying o2 devices/suctioning

x performing ekg's (and read)

x giving neb tx and doing spirometry/peak flow testing

vision/hearing screening

X name at least 10 bodily fluids (bonus points if you've actually encountered them) got the bonus - I'm sure

X give a patient/family bad news *(what was the provider doing in this case?) I was/am the provider as a paramedic

X have a patient die

X work a pedi code

X work with combative/abusive patients

X disagree with a MD/PA/DO/NP/senior co-worker about appropriate treatment of a pt and have an ADULT, PROFESSIONAL discussion about it

X name at least one area of medicine that fascinates you

X name at least one area of medicine in which you NEVER want to work

X RUN a code... maybe not for all before PA school, but definitely an experience to build on

experience ride time on an ambulance and see what goes on "on the street" - you will gain a greater understanding of what medics encounter, and why we do or don't do certain things

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This is more of a "crap you should have to put up with before being competitive for PA school," thread.

 

I'll add a few...

- Clean vomit out of/off of your pants/boots

- Have an instructor throw every oddball problem that might possibly occur at some point in your career at you at once: for example - Instructor: "Patient is a mid-twenties developmentally delayed male with cerebral palsy who fell out of a third story window after having had 37 beers and some cocaine; during his fall a friend threw a javelin that impaled him through his right lower quadrant. He currently has what appears to be a skull fracture, multiple abrasions, thirty lacerations on his extremities, and a hangnail. And now he's having an anaphylactic reaction to the fiberglass shaft of the javelin and choking on his gum. Go!"

- OSHA/HIPPA/Bloodborne pathogen training x 10 (just because they're boring)

 

These are a few of mine.

 

Any more?

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- Have an instructor throw every oddball problem that might possibly occur at some point in your career at you at once: for example - Instructor: "Patient is a mid-twenties developmentally delayed male with cerebral palsy who fell out of a third story window after having had 37 beers and some cocaine; during his fall a friend threw a javelin that impaled him through his right lower quadrant. He currently has what appears to be a skull fracture, multiple abrasions, thirty lacerations on his extremities, and a hangnail. And now he's having an anaphylactic reaction to the fiberglass shaft of the javelin and choking on his gum. Go!"

YOUR PT IS ALSO A HEMOPHILLIAC AND SPEAKS NO ENGLISH......

the paramedic school sceario was always the multi-pt bus crash....bus full of hemophilliac kids....

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Hmm, got 90 or so % of the bucket list, never phlebotomized or did a Pedi code (thank god). I like the bodily fluids aspect, I have indeed encountered them all before PA school, including a needle stick from a heavy HIV/Hep C pt group.

 

How about handling the intoxicated on ETOH/opiates/crack/meth patients? Getting yelled at/hit on/ridiculed/death threats by someone is always a good rite-of-passage into medicine. Not to mention the skills you gain with difficult patients, especially if you are the keeper of their PRN opiates/benzos for 3 years. One of the "10 commandments" of the med room "thou shalt not ask for narcotics if thou cannot keep thine eyes open."

 

Oh, can't forget about handling psych patients. Calming down an agitated schizophrenic or dementia pt should be another rite of passage. I once spent 45 minutes after I was done passing pills convincing one of my folks that the loch ness monster was not currently residing in the Willamete river and did not pose an imminent threat.

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1. Cry with the family of the patient who just died on YOUR watch.

2. Work that 12 hour shift (plus the obligatory hour or so of hold over), get in your car to go home and realize you haven't eaten or peed all day.

3. Get totally belittled by that salty old doc who has the ability to make you feel 2 inches tall with just "the look". It freaking sucks and teaches you "never be like him". Funny thing is..we all grow up to be just like him eventually.

4. When I grew up in the system, over 95% of the crew I ran with knew the taste of of another's person vomit. Yes, this was before the days of convenient BVM's at an arm's reach.

 

and the most important:

 

5. Experience a bit of "I have no idea of what is going on, and I'm overwhelmed, but we're gonna get through this". The ability to trouble shoot, problem solve, use deductive reasoning, aka: FIGURE OUT STUFF ON YOUR OWN! Grow beyond the need to be spoon fed everything. PA school is the land of Big Kids. NBA players don't walk onto the team with no experience..I am befuddled by applicants who think they can do this job with any sort of proficiency based on a couple of years in an academic setting.

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Ah.... Here's a good one... Along with cops, wrestling with a psyche/drunk/angry pt.

 

Add to that the (obese) diabetic pt who is just conscious enough to fight everyone trying to pin down his limbs while the medics struggle to insert an IV which he promptly rips out anyway.

 

Another fun one from when I first joined an EMT squad: realizing that your crew and the police have left you the rookie in the body fluid covered room to get vitals on the lady covered in feces while they go out to get air

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5. Experience a bit of "I have no idea of what is going on, and I'm overwhelmed, but we're gonna get through this". The ability to trouble shoot, problem solve, use deductive reasoning, aka: FIGURE OUT STUFF ON YOUR OWN! Grow beyond the need to be spoon fed everything. PA school is the land of Big Kids. NBA players don't walk onto the team with no experience..I am befuddled by applicants who think they can do this job with any sort of proficiency based on a couple of years in an academic setting.

 

5. Experience a bit of "I have no idea of what is going on, and I'm overwhelmed, but we're gonna get through this". The ability to trouble shoot, problem solve, use deductive reasoning, aka: FIGURE OUT STUFF ON YOUR OWN! Grow beyond the need to be spoon fed everything. PA school is the land of Big Kids. NBA players don't walk onto the team with no experience..I am befuddled by applicants who think they can do this job with any sort of proficiency based on a couple of years in an academic setting.

 

This is it. If you can do this you don't need to have fulfilled a checklist of tasks to be a good applicant. Experience is important, but only to the degree that it gives you the ability to do this ^^^^. I don't think that the "tasks" that people have listed are in of themselves important. They are important because they are often the things that give you the maturity to do all of this ^^^^.

 

But to keep it lighthearted:

 

1. Have at least 2 break-in attempts at the home you are working at overnight as a home health aide (along with pulling in the driveway and catching one of them in the act!!)

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I want to add to this list!!!

- for an entire shift clean up a patient who has C-Diff (I have NEVER needed the lab results to tell me it was C-Diff!!!)

- have a frail 105lb- 98 year old dementia patient show sudden strength of hercules to turn around to bite and spit on you

- being thrown up or pooped on

- Having to leave your vented patient (who got hit by a drunk driver) and their family to cover 1:1 patient who tried to strangle themselves with a bra because their spouse left them for someone else - 2 years ago.

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- have a frail 105lb- 98 year old dementia patient show sudden strength of hercules to turn around to bite and spit on you

 

I can never figure out (and will never know I guess) how they get such miraculous strength out of nowhere. I had an 80-something on hospice that was in and out of lucidness, she had this vice grip that nobody could get out of and once scratched the RN, leaving these deep gashes. My fingers turned blue the last time she grabbed me.

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Collection of a fresh placenta for the lab to analyze after an abruption. Oh and being part of a code on a preterm infant. Just a couple of my L&D experiences.

 

Mmm, nothing like placenta smell to start your day.

 

I just want to add that anyone who can avoid working a pedi code, SHOULD. Trust me on this one.

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Ok, I'll play... I've done the stuff with the X's

X-Wipe someone's butt

 

X-Be yelled at by an angry patient for something you didn't do and have no control over

 

X-Only to later be yelled at by that patient's parent for the same thing

 

X-And later to be yelled at by the RN/MD, who should've addressed the whole mess in the first place!

 

X-Work 16 hours without a break

 

0-Work 12 hours without literally sitting down once

 

X-Come close to tears over a bad grade

 

0-Email at minimum 25 PA's trying to find someone to shadow – this one's probably my downfall... I thought working with them directly for over a decade would suffice :)

 

X-Explain at least 50 times what a PA is

 

X-Spend over an hour trying to explain to your parents/friends/spouse why you DON'T want to be a doctor

 

X-Explain over and over yes PA's can write prescriptions.

 

X-brief hx taking with vital signs

 

X-phlebotomy

 

X-IM/SQ injections

 

X-splinting/wound bandaging/casting

 

X-minor surgical assisting

 

X-pt transport

 

X-urine testing/c micro

 

X-minor lab procedures(strep/mono/spinning crits/etc)

 

X-labeling/dispensing take home meds

 

X-applying o2 devices/suctioning

 

X-performing ekg's

 

X-giving neb tx and doing spirometry/peak flow testing

 

X-vision/hearing screening

 

X-name at least 10 bodily fluids (bonus points if you've actually encountered them) – blood, sweat, tears, aqueous humor, vitreous humor, snot, saliva, sputum (not sure if that counts since some are semi-solid, lol), bile, vomit, urine, semen, vaginal secretions, rectal secretions, & diarrhea...& yes I've encountered every one :)

 

X-give a patient/family bad news

 

X-have a patient die

 

0-work a pedi code – I'm thankful I haven't had to do this one yet.

 

X-work with combative/abusive patients

 

X-disagree with a MD/PA/DO/NP/senior co-worker about appropriate treatment of a pt and have an ADULT, PROFESSIONAL discussion about it

 

X-name at least one area of medicine that fascinates you - Wilderness Medicine - Mission/Emergency Response Medicine

 

X-name at least one area of medicine in which you NEVER want to work - Concierge Medicine

 

X-start an IV

 

X-perform x-rays (Bonus if for an Orthopedist)

 

X-catheterize an infant female - it's tougher than it sounds :)

 

X-scrub/circulate in the main OR

 

X-process a poop specimen delivered in a sandwitch bag or a margarine tub

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