Share your experience of the first day!

[Nycpac33]

PAs... share your experiences of your first day on the job @ ur first job out of school ??

[Boatswain2PA]

Thrown to wolves, single coverage at a 9000 visit/year ED.  The nurses kept me from killing anyone.

[True Anomaly]

First patient ever as a PA- walked up to a guy sitting on a hallway stretcher, said that "Two guys came up and just hit me".  Couldn't say why it happened- "Just these two guys came up and hit me".  Ended up with an open bilateral mandible fracture.  The kicker was that he drove from Pittsburgh to Philadelphia before he felt like it was enough of a problem to see someone

It was that day I learned about the terror of the "two guys" who just seem to go around assaulting people for no reason...

[GetMeOuttaThisMess]

I'm too old to remember.  It would've been a spine patient but it was 34 years ago so there was no way in Hades that I was seeing them by myself.  I'm looking forward to remembering my LAST one however!

[EMEDPA]

4 hours ago, True Anomaly said:

First patient ever as a PA- walked up to a guy sitting on a hallway stretcher, said that "Two guys came up and just hit me".  Couldn't say why it happened- "Just these two guys came up and hit me".  Ended up with an open bilateral mandible fracture.  The kicker was that he drove from Pittsburgh to Philadelphia before he felt like it was enough of a problem to see someone

It was that day I learned about the terror of the "two guys" who just seem to go around assaulting people for no reason...

SOCMOB (standing on corner minding own business) when...

[EMEDPA]

my first day was at an urgent care dept that housed an FP residency. my first SP was the residency director. he told me "this year you are an intern. there are no stupid questions. my door is always open. see me anytime". great guy. taught me a lot. I was there 2.5 more years. by the time I left I was precepting incoming interns.

[charlotte]

2 hours ago, EMEDPA said:

my first day was at an urgent care dept that housed an FP residency. my first SP was the residency director. he told me "this year you are an intern. there are no stupid questions. my door is always open. see me anytime". great guy. taught me a lot. I was there 2.5 more years. by the time I left I was precepting incoming interns.

What a great experience!

[bike mike]

First day after completing residency: responded to 4 code blues and was first assist putting one on ECMO. 

[sas5814]

Well I am Army trained and the Army, in its infinite wisdom, takes the greenest youngest newest PAs and sends them to the most remote locations far far away from hospitals so I was in a Field Arty unit in Germany. My Doc was about 10 miles away and the closest hospital was about 60 miles away. First patient, first day of sick call, senior NCO comes in complaining of blood in his urine. He was wrong. He had urine in his blood.

Started thinking back to my urology rotation. This guy needs to see urology quickly, needs an IVP and a cystoscopy. Call the urologist at the hospital in Frankfurt. He asked me 3 questions and told me to put him on Bactrim and if he wasn't better in a week call him back. He got better.

My first inkling that all the "absolute" things I learned in training weren't so absolute.

[SedRate]

While you guys were off being studs on your first day, I just followed my orthopod around like a little puppy dog.

[GetMeOuttaThisMess]

3 hours ago, sas5814 said:

Well I am Army trained and the Army, in its infinite wisdom, takes the greenest youngest newest PAs and sends them to the most remote locations far far away from hospitals so I was in a Field Arty unit in Germany. My Doc was about 10 miles away and the closest hospital was about 60 miles away. First patient, first day of sick call, senior NCO comes in complaining of blood in his urine. He was wrong. He had urine in his blood.

Started thinking back to my urology rotation. This guy needs to see urology quickly, needs an IVP and a cystoscopy. Call the urologist at the hospital in Frankfurt. He asked me 3 questions and told me to put him on Bactrim and if he wasn't better in a week call him back. He got better.

My first inkling that all the "absolute" things I learned in training weren't so absolute.

34 years, I don't think I've seen a single male w/o a pre-existing condition (self-cath for pick a reason) that had a primary UTI that wasn't STI in origin or prostatitis.

[jmj11]

I went to small arms and self defense training, required for all new PAs in the federal prison system.

[thinkertdm]

2 hours ago, jmj11 said:

I went to small arms and self defense training, required for all new PAs in the federal prison system.

Ha- new PAs in the VA system get shown the hot button under the desk.

I don't remember much of my first day- except the very last fellow, who came in (I think) with a cc of "arm pain" or something like that- only to find out that his "pain" was actually lack of movement- apparently he had not been able to move his arm for the past few days?  But then it got worse?  He wasn't making much sense and neither was his family, but I got the gist he wanted a splint or something for this new onset arm paresis.  He then said he had a stroke a week earlier.  

It was literally the last patient of the day, on a Friday, in my family practice clinic, my sp left an hour earlier (I'm leaving a bit early, you ok?).  This was really where the "art" comes in.  Since I knew diddly of this guy's Neuro status, and he didn't appear to be actively having a stroke, I was at a bit of a loss.  I had an excellent nurse who was able to call an ambulance, while I convinced him maybe he should go.  

 

[Guest Elpatodog]

Only 16 years ago I was working in the UP of Michigan. I was introduced to Dr. Reddy from South Africa and he said on my first day “ If you need anything just knock on the wall and I will come out and I am a general surgeon so I can fix anything”

I saw 22 patients my first day. Dr Reddy was a wonderful Doctor. The staff at the clinic became friends that I still keep in contact with including one of the doctors.

[delco714]

34 years, I don't think I've seen a single male w/o a pre-existing condition (self-cath for pick a reason) that had a primary UTI that wasn't STI in origin or prostatitis.

Bladder cancer (undiagnosed) can start with symptomatic uti. This is a grey area from what you mentioned. The other guy still needs the workup.

My first real day I was rounding by myself as a new grad in urology, on call and hopeless.

My mentor colleague went on a conference that week.

Needless to say it was crazy..as was the rest of the week.. And the next 6 months.

[jmj11]

13 hours ago, Elpatodog said:

Only 16 years ago I was working in the UP of Michigan. I was introduced to Dr. Reddy from South Africa and he said on my first day “ If you need anything just knock on the wall and I will come out and I am a general surgeon so I can fix anything”

I saw 22 patients my first day. Dr Reddy was a wonderful Doctor. The staff at the clinic became friends that I still keep in contact with including one of the doctors.

Where were you at in the UP?  I worked there (loved the area) in the 1990s and had one horrible job experience after the other, almost left PA-dom, but found much greener pastures as soon as I left the UP. In the 1990s I found the UP to be a very unfriendly PA place.

[Guest Elpatodog]

I am not quite sure how to reply to someone on a topic when asked a question so I am hoping I did this correctly.

I am  answering jmj11 question :)

I worked in a couple of towns. A town called  Wilson( powers/Spalding) and Ewen and Menominee. I lived in the town called Stephenson.  All the clinics were owned by same entity. I worked at these clinics from 2002 -2005.

[jmj11]

1 hour ago, Elpatodog said:

I am not quite sure how to reply to someone on a topic when asked a question so I am hoping I did this correctly.

I am  answering jmj11 question :)

I worked in a couple of towns. A town called  Wilson( powers/Spalding) and Ewen and Menominee. I lived in the town called Stephenson.  All the clinics were owned by same entity. I worked at these clinics from 2002 -2005.

I know all those towns. I worked around Marquette and Houghton. In the mid-90s, Houghton / Hancock for PAs was like a Stephen King novel, things of nightmares. For example, the physician who was assigned to be my boss (after I signed a contract) told me on the first day, "I think all PAs are idiots and should be in prison for practicing medicine without a license. As long as I'm your boss, you will never touch a patient. Had to start immediately looking for the door out (but I had just broke ground on a new house in the area). Total nightmare.

[SedRate]

9 hours ago, jmj11 said:

I know all those towns. I worked around Marquette and Houghton. In the mid-90s, Houghton / Hancock for PAs was like a Stephen King novel, things of nightmares. For example, the physician who was assigned to be my boss (after I signed a contract) told me on the first day, "I think all PAs are idiots and should be in prison for practicing medicine without a license. As long as I'm your boss, you will never touch a patient. Had to start immediately looking for the door out (but I had just broke ground on a new house in the area). Total nightmare.

Whoa, that is terrible! On another note, I have family in Marquette. It's too cold for my blood, though. 

[sas5814]

11 hours ago, jmj11 said:

I know all those towns. I worked around Marquette and Houghton. In the mid-90s, Houghton / Hancock for PAs was like a Stephen King novel, things of nightmares. For example, the physician who was assigned to be my boss (after I signed a contract) told me on the first day, "I think all PAs are idiots and should be in prison for practicing medicine without a license. As long as I'm your boss, you will never touch a patient. Had to start immediately looking for the door out (but I had just broke ground on a new house in the area). Total nightmare.

That is totally bizarre. How did you get into a relationship with any doc who feels that way? Why would he agree and sign off on it and, if it was driven by some corporate/hospital policy, why would they allow that to happen? Makes me cringe to even think about it.

[camoman1234]

1 hour ago, sas5814 said:

That is totally bizarre. How did you get into a relationship with any doc who feels that way? Why would he agree and sign off on it and, if it was driven by some corporate/hospital policy, why would they allow that to happen? Makes me cringe to even think about it.

How did you survive this? How long did you stay and what did you do (see patients or be a scribe)?

[sk732]

First day of real work was in the Base Urgent Care centre...first patient has strep throat, wrote up a script for Penicillin and it actually took me about 5 minutes of thinking and rethinking if I should sign it or not, since it was my first big boy Rx as a PA.  I usually sign my scripts now before I start the body of it...

SK

[jmj11]

11 hours ago, sas5814 said:

That is totally bizarre. How did you get into a relationship with any doc who feels that way? Why would he agree and sign off on it and, if it was driven by some corporate/hospital policy, why would they allow that to happen? Makes me cringe to even think about it.

It is too complicated to try and to explain. I was heavily recruited by a hospital CEO and Medical Director. I went in under the pretense that the medical director (a decent man) was going to be my SP. I made many trips to the area, asked all the right questions and was lied to each time. It was a plan all along to create a fake Rural Health Clinic (which required a PA). After I signed the contract, and after I moved my family to the area, they then informed me that Dr. X would be my SP, the one who hated PAs but loved Rural Health Care money. In the end, we went to court as I sued them. They settled out of court.

[SedRate]

11 hours ago, jmj11 said:

It is too complicated to try and to explain. I was heavily recruited by a hospital CEO and Medical Director. I went in under the pretense that the medical director (a decent man) was going to be my SP. I made many trips to the area, asked all the right questions and was lied to each time. It was a plan all along to create a fake Rural Health Clinic (which required a PA). After I signed the contract, and after I moved my family to the area, they then informed me that Dr. X would be my SP, the one who hated PAs but loved Rural Health Care money. In the end, we went to court as I sued them. They settled out of court.

Wow. What an unfortunate way to start your PA career. I'm sorry to hear that.

[jmj11]

21 hours ago, camoman1234 said:

How did you survive this? How long did you stay and what did you do (see patients or be a scribe)?

I stayed about 10 months, fighting the system, only because I had just moved my family there and we had starting building a house. My SP "caught me" seeing his patient and then had the hospital move me to tiny office, separate from his, where I could not touch a patient. Why would they hire a PA? By going from a regular clinic to a RHC (moved a few hundred years outside the city limit and hired a PA) they would make several hundred thousand dollars a year more as a practice.