acozadd Posted March 25, 2012 Share Posted March 25, 2012 True, but I am at the opposite end now.... Truly, I thought last night when I was working clinically, that I would give 100,000 dollars to throw my stethoscope away and NEVER, EVER touch another patient again. I've even thought over the last 6 months about going back to carpentry....(used to be a framer and then finish carpenter)....A LOT. I'd rather be in a research lab. I'm a minutiae, detail person, and I simply get no enjoyment from seeing patients anymore. Part of which is burnout. I am completely fried and I know it. So, I go through the motions, but with no emotion. Decathexis at it's purest. Don't get me wrong, I am still empathetic for some patients. Critically ill or injured patients, sure. But the fast track stuff......not at all. It sucks the soul out of a person. PhD (or DHSc...same number of research credits, but an applied research focus) vs MD is a difficult comparison, but let's face it.....clinical education is unbelievably easy.... It's rote memorization. As long as you have a good memory (I tend to remember almost everything I read, almost photographic, but not quite) any clinical education process is easy. PRACTICE is hard. Cause they don't present like the textbooks say, but the education is a breeze. I worked full time in PA school the whole way through and flied through with good grades the whole time. Research education is different. It requires abstract thinking. There is some memorization, IE; why you would use a Breslow Day versus a Mann Whitney statistical measure, but the actual research is much more tedious and difficult..... That's my 0.02 cents at least. You could go into ortho and become a carpenter while throwing away your stethoscope... just sayin Link to comment Share on other sites More sharing options...
physasst Posted March 25, 2012 Share Posted March 25, 2012 You could go into ortho and become a carpenter while throwing away your stethoscope... just sayin HAHA....did that was in Ortho for 6 years before going into EM......LOL...... I've actually said for a while, that I loved surgery...I actually really enjoyed it....and if I could ever reconcile my intense love of surgery with my intense dislike of most surgeons....I would go back... Unfortunately, I haven't been able to reconcile those two things.....LOL. Link to comment Share on other sites More sharing options...
physasst Posted March 25, 2012 Share Posted March 25, 2012 You could go into ortho and become a carpenter while throwing away your stethoscope... just sayin HAHA....did that was in Ortho for 6 years before going into EM......LOL...... I've actually said for a while, that I loved surgery...I actually really enjoyed it....and if I could ever reconcile my intense love of surgery with my intense dislike of most surgeons....I would go back... Unfortunately, I haven't been able to reconcile those two things.....LOL. Link to comment Share on other sites More sharing options...
acozadd Posted March 25, 2012 Share Posted March 25, 2012 can a PA with a background in RT operate respriratory equipment without going outside their scope of practice? i know that im going to have to have a sitdown with the risk management department at my facility just to work in the lab once i get my nurses license because of the new responsibities that come from having a new scope. i guesse if you maintain all your education and certifications in your previous career, then you could in theory run in a room and start pushing buttons, but when im a nurse, i dont expect to run into the lab and run tests on my patients just because i can. i anticipate that to touch an instrument, id have to be scheduled and clocked in, otherwise im operating outside the county line. It probably wouldn't be a good use of your time. When you are a nurse you will have 100 other responsibilities whether you are able to do that one task or not. Same with being a PA. In the ED you could manage the vent, or you could call RT and let them do their job as you see the other 40 patients that are patiently dying in triage. Just because you CAN do something doesn't mean it is in your/your patient's best interest to actually do it. Link to comment Share on other sites More sharing options...
acozadd Posted March 25, 2012 Share Posted March 25, 2012 can a PA with a background in RT operate respriratory equipment without going outside their scope of practice? i know that im going to have to have a sitdown with the risk management department at my facility just to work in the lab once i get my nurses license because of the new responsibities that come from having a new scope. i guesse if you maintain all your education and certifications in your previous career, then you could in theory run in a room and start pushing buttons, but when im a nurse, i dont expect to run into the lab and run tests on my patients just because i can. i anticipate that to touch an instrument, id have to be scheduled and clocked in, otherwise im operating outside the county line. It probably wouldn't be a good use of your time. When you are a nurse you will have 100 other responsibilities whether you are able to do that one task or not. Same with being a PA. In the ED you could manage the vent, or you could call RT and let them do their job as you see the other 40 patients that are patiently dying in triage. Just because you CAN do something doesn't mean it is in your/your patient's best interest to actually do it. Link to comment Share on other sites More sharing options...
whimsygirl Posted March 25, 2012 Share Posted March 25, 2012 I think I know what TH is saying. As an RRT I do a lot more than just push vent buttons. We round with the doctors, we check labs and CXR's. We institute changes accordingly. Its common to be in a patients room for an hour with the attending, fellow and residents while you run through everything going on with the patient and how we should proceed. when the attending us teaching residents theory they include us. If there its something unusual happening they will usually ask me if I want to observe because they know I like to learn. I'm on the rapid response and code teams for the entire hospital. I make care decisions and implement them. That doesn't mean I should have less regulated supervision - but it can't be ignored either when I'm choosing a physician to work with. It depends on the specialty as well. My experience would be worth little to nothing in ortho. But in pulmonary/critical care its surely a benefit and will play in to the level of confidence a physician would have in me. There are a lot of hospitals where RTs are just treatment jockeys. I choose not to work in a hospital like that. Rts are changing our market by our attitude. As we come in expecting to be an important past of the team we find ourselves being treated as such. The hospitals that don't embrace that culture find it harder to retain therapists. In the PA community, we can't really do anything about what the NPs ate doing. sure we need to be aware, but it seems like so much time its being spent on comparisons. Is that productive? If NPs say we aren't as experienced, just show them its not true. Link to comment Share on other sites More sharing options...
whimsygirl Posted March 25, 2012 Share Posted March 25, 2012 I think I know what TH is saying. As an RRT I do a lot more than just push vent buttons. We round with the doctors, we check labs and CXR's. We institute changes accordingly. Its common to be in a patients room for an hour with the attending, fellow and residents while you run through everything going on with the patient and how we should proceed. when the attending us teaching residents theory they include us. If there its something unusual happening they will usually ask me if I want to observe because they know I like to learn. I'm on the rapid response and code teams for the entire hospital. I make care decisions and implement them. That doesn't mean I should have less regulated supervision - but it can't be ignored either when I'm choosing a physician to work with. It depends on the specialty as well. My experience would be worth little to nothing in ortho. But in pulmonary/critical care its surely a benefit and will play in to the level of confidence a physician would have in me. There are a lot of hospitals where RTs are just treatment jockeys. I choose not to work in a hospital like that. Rts are changing our market by our attitude. As we come in expecting to be an important past of the team we find ourselves being treated as such. The hospitals that don't embrace that culture find it harder to retain therapists. In the PA community, we can't really do anything about what the NPs ate doing. sure we need to be aware, but it seems like so much time its being spent on comparisons. Is that productive? If NPs say we aren't as experienced, just show them its not true. Link to comment Share on other sites More sharing options...
whimsygirl Posted March 25, 2012 Share Posted March 25, 2012 can a PA with a background in RT operate respriratory equipment without going outside their scope of practice? i know that im going to have to have a sitdown with the risk management department at my facility just to work in the lab once i get my nurses license because of the new responsibities that come from having a new scope. i guesse if you maintain all your education and certifications in your previous career, then you could in theory run in a room and start pushing buttons, but when im a nurse, i dont expect to run into the lab and run tests on my patients just because i can. i anticipate that to touch an instrument, id have to be scheduled and clocked in, otherwise im operating outside the county line. I know in my hospital, only an attending, pulmonary fellow or RRT(that is working that shift as an RT) can touch a vent. Residents, NPs and PAs can not. Link to comment Share on other sites More sharing options...
whimsygirl Posted March 25, 2012 Share Posted March 25, 2012 can a PA with a background in RT operate respriratory equipment without going outside their scope of practice? i know that im going to have to have a sitdown with the risk management department at my facility just to work in the lab once i get my nurses license because of the new responsibities that come from having a new scope. i guesse if you maintain all your education and certifications in your previous career, then you could in theory run in a room and start pushing buttons, but when im a nurse, i dont expect to run into the lab and run tests on my patients just because i can. i anticipate that to touch an instrument, id have to be scheduled and clocked in, otherwise im operating outside the county line. I know in my hospital, only an attending, pulmonary fellow or RRT(that is working that shift as an RT) can touch a vent. Residents, NPs and PAs can not. Link to comment Share on other sites More sharing options...
whimsygirl Posted March 25, 2012 Share Posted March 25, 2012 PAMAC - I completely agree. Link to comment Share on other sites More sharing options...
whimsygirl Posted March 25, 2012 Share Posted March 25, 2012 PAMAC - I completely agree. Link to comment Share on other sites More sharing options...
GatorRRT Posted March 25, 2012 Share Posted March 25, 2012 can a PA with a background in RT operate respriratory equipment without going outside their scope of practice? i know that im going to have to have a sitdown with the risk management department at my facility just to work in the lab once i get my nurses license because of the new responsibities that come from having a new scope. i guesse if you maintain all your education and certifications in your previous career, then you could in theory run in a room and start pushing buttons, but when im a nurse, i dont expect to run into the lab and run tests on my patients just because i can. i anticipate that to touch an instrument, id have to be scheduled and clocked in, otherwise im operating outside the county line. Really nothing too difficult about pushing a button on a vent or slapping on an oxymask.......but when it comes to placing someone on a bipap mask, drawing an ABG or giving a neb tx, I'll be leaving it to the RT. Link to comment Share on other sites More sharing options...
GatorRRT Posted March 25, 2012 Share Posted March 25, 2012 can a PA with a background in RT operate respriratory equipment without going outside their scope of practice? i know that im going to have to have a sitdown with the risk management department at my facility just to work in the lab once i get my nurses license because of the new responsibities that come from having a new scope. i guesse if you maintain all your education and certifications in your previous career, then you could in theory run in a room and start pushing buttons, but when im a nurse, i dont expect to run into the lab and run tests on my patients just because i can. i anticipate that to touch an instrument, id have to be scheduled and clocked in, otherwise im operating outside the county line. Really nothing too difficult about pushing a button on a vent or slapping on an oxymask.......but when it comes to placing someone on a bipap mask, drawing an ABG or giving a neb tx, I'll be leaving it to the RT. Link to comment Share on other sites More sharing options...
GatorRRT Posted March 25, 2012 Share Posted March 25, 2012 That's not what I mean. If I'm working in a critical care/pulmonary setting as a PA, the vent is my responsibility if I'm caring for the patient. RT's can't legally make vent changes unless they're operating within a specific protocol. If I'm in a patients room and the vent needs adjusting, why would I call the RT when I'm already in the room? I'm not saying I wouldnt let the RT know I made a change, or if I have a question in regards to how the patient is doing I won't consult the RT. I guess my point is, changing vent settings would/should be within a PAs scope of practice if they are in a pulmonary/critical care setting. Link to comment Share on other sites More sharing options...
GatorRRT Posted March 25, 2012 Share Posted March 25, 2012 That's not what I mean. If I'm working in a critical care/pulmonary setting as a PA, the vent is my responsibility if I'm caring for the patient. RT's can't legally make vent changes unless they're operating within a specific protocol. If I'm in a patients room and the vent needs adjusting, why would I call the RT when I'm already in the room? I'm not saying I wouldnt let the RT know I made a change, or if I have a question in regards to how the patient is doing I won't consult the RT. I guess my point is, changing vent settings would/should be within a PAs scope of practice if they are in a pulmonary/critical care setting. Link to comment Share on other sites More sharing options...
GatorRRT Posted March 25, 2012 Share Posted March 25, 2012 As for placing pts on bipap, drawing ABGs and doing nebs; these are things that RTs are experts in, which is why I would defer to them. Link to comment Share on other sites More sharing options...
GatorRRT Posted March 25, 2012 Share Posted March 25, 2012 As for placing pts on bipap, drawing ABGs and doing nebs; these are things that RTs are experts in, which is why I would defer to them. Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted March 25, 2012 Moderator Share Posted March 25, 2012 [h=2]That’s not many details Oneal. I can show you many details if you would like, but what’s the point? You apparently don't like PA students that have prior HCE or you are this way to everyone. Don't be mad at me because I have a good HCE background and will do very well with those skills as a PA. Why humility? hu·mil·i·ty / [hyoo-mil-i-tee or, often, yoo-] Noun: the quality or condition of being humble; modest opinion or estimate of one's own importance, rank, etc. Origin:1275–1325; Middle English humilite < Latin humilitās. See humble, -ty2 Seems like you have some arrogance... or something to prove...? I don’t see anything wrong with thinking my past HCE is great as is relevant to a career as a PA. I think you might lack confidence, HCE, etc. and try to make up for by putting others down. That’s very sad in my eyes and I feel for you.[/h] Dude my HCE is way beyond yours, and I think it is very important, so don't think it's that. If you want to know all the details you're welcome to PM me. You always tout yours like its the cat's meow, like your better than other people. When you say "I ran the ventilator because so and so couldn't" you sound pompous. I could tell you that I've had to rescue RT numerous times in codes when they couldn't get the intubation, but I refrain, well except to illustrate my point. As to my thoughts on the abilities of nonHCE holders, I respect the talents that we all bring to the profession as I think diversity makes us strong. Look, I probably shouldn't have been so harsh. The way you come off and the way you are likely do not meet. It happens to me all the time. So with that I apologize for being a nag. I don't mind you listing your HCE, I would just leave out the part about other MDs, DOs, CRNAs, AAs. That was the part I really had a problem with. But do whatever you like, it's none of my business and I'm not your keeper. Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted March 25, 2012 Moderator Share Posted March 25, 2012 [h=2]That’s not many details Oneal. I can show you many details if you would like, but what’s the point? You apparently don't like PA students that have prior HCE or you are this way to everyone. Don't be mad at me because I have a good HCE background and will do very well with those skills as a PA. Why humility? hu·mil·i·ty / [hyoo-mil-i-tee or, often, yoo-] Noun: the quality or condition of being humble; modest opinion or estimate of one's own importance, rank, etc. Origin:1275–1325; Middle English humilite < Latin humilitās. See humble, -ty2 Seems like you have some arrogance... or something to prove...? I don’t see anything wrong with thinking my past HCE is great as is relevant to a career as a PA. I think you might lack confidence, HCE, etc. and try to make up for by putting others down. That’s very sad in my eyes and I feel for you.[/h] Dude my HCE is way beyond yours, and I think it is very important, so don't think it's that. If you want to know all the details you're welcome to PM me. You always tout yours like its the cat's meow, like your better than other people. When you say "I ran the ventilator because so and so couldn't" you sound pompous. I could tell you that I've had to rescue RT numerous times in codes when they couldn't get the intubation, but I refrain, well except to illustrate my point. As to my thoughts on the abilities of nonHCE holders, I respect the talents that we all bring to the profession as I think diversity makes us strong. Look, I probably shouldn't have been so harsh. The way you come off and the way you are likely do not meet. It happens to me all the time. So with that I apologize for being a nag. I don't mind you listing your HCE, I would just leave out the part about other MDs, DOs, CRNAs, AAs. That was the part I really had a problem with. But do whatever you like, it's none of my business and I'm not your keeper. Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted March 25, 2012 Moderator Share Posted March 25, 2012 ^yeah, exactly. and just so you know, im not saying anything about RTs only pushing buttons because most of us know theres much more to it than that. i guesse like acozzad said, there is a better use of time and talent for a PA to not be dabbling in the previous career because thier world deals in more variables than just the respiratory side of the work. i dont think i could argue that a solid background wouldnt be helpful in certain circumstances. but i get rusty when i go on vacation and come back to work, i cant imagine insisting im a rock star in my lab after stepping away for 2 years for PA school. i think there is little reason to think that being a PA and going back to RT makes one a super RT anymore than being an RT and going to be a PA will make one super PA. gives great exposure, but i think the arguement could be made that you have to be more careful not to get stuck in a mindset that biases you toward the focus you had in your HCE previous to your PA career. my lab science career has made more topics a breeze for me than its been a hinderance. however, it also doesnt provide all the answers, and even biases me in ways i need to pay attention to. i dont assume that someone cant come along and know less about the lab side of medicine than me, and still provide superior patient outcomes than i do.... all based on the talents of the individual. i've seen those kinds of things regularly. my point is that in my case, ive seen my hce help me a lot, never hurt me, and still not lead to superior performance compared to some of my dilligent peers. Agree 100%. My experience placing central and arterial lines, swans, working vents, intubating, preop patients, runnings codes, doing pain management, spinal taps, all that jazz will be helpful to me, but I know infectious disease (for example) will be a hurdle for me and I'm going to wish I was that new grad kid with a 4.0 in microbiology. Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted March 25, 2012 Moderator Share Posted March 25, 2012 ^yeah, exactly. and just so you know, im not saying anything about RTs only pushing buttons because most of us know theres much more to it than that. i guesse like acozzad said, there is a better use of time and talent for a PA to not be dabbling in the previous career because thier world deals in more variables than just the respiratory side of the work. i dont think i could argue that a solid background wouldnt be helpful in certain circumstances. but i get rusty when i go on vacation and come back to work, i cant imagine insisting im a rock star in my lab after stepping away for 2 years for PA school. i think there is little reason to think that being a PA and going back to RT makes one a super RT anymore than being an RT and going to be a PA will make one super PA. gives great exposure, but i think the arguement could be made that you have to be more careful not to get stuck in a mindset that biases you toward the focus you had in your HCE previous to your PA career. my lab science career has made more topics a breeze for me than its been a hinderance. however, it also doesnt provide all the answers, and even biases me in ways i need to pay attention to. i dont assume that someone cant come along and know less about the lab side of medicine than me, and still provide superior patient outcomes than i do.... all based on the talents of the individual. i've seen those kinds of things regularly. my point is that in my case, ive seen my hce help me a lot, never hurt me, and still not lead to superior performance compared to some of my dilligent peers. Agree 100%. My experience placing central and arterial lines, swans, working vents, intubating, preop patients, runnings codes, doing pain management, spinal taps, all that jazz will be helpful to me, but I know infectious disease (for example) will be a hurdle for me and I'm going to wish I was that new grad kid with a 4.0 in microbiology. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted March 25, 2012 Moderator Share Posted March 25, 2012 NO you won't. trust me. because that kid will be puking on their shoes at the smell of the pus they know how to quantify while you will be doing the procedure to alleviate the condition....I.D. really isn't all that difficult. you learn what is normal and what isn't and who gets the abnl infections...and you carry a pocket copy of sanfords.... Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted March 25, 2012 Moderator Share Posted March 25, 2012 NO you won't. trust me. because that kid will be puking on their shoes at the smell of the pus they know how to quantify while you will be doing the procedure to alleviate the condition....I.D. really isn't all that difficult. you learn what is normal and what isn't and who gets the abnl infections...and you carry a pocket copy of sanfords.... Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted March 25, 2012 Moderator Share Posted March 25, 2012 NO you won't. trust me. because that kid will be puking on their shoes at the smell of the pus they know how to quantify while you will be doing the procedure to alleviate the condition....I.D. really isn't all that difficult. you learn what is normal and what isn't and who gets the abnl infections...and you carry a pocket copy of sanfords.... I suppose you're right and shouldn't judge the difficulty until I do it, but to clarify again, I do believe in strong HCE. Getting over the basics like not puking, placing IVs, ect are essential in getting to the next level. But I still think diversity can be a good thing. Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted March 25, 2012 Moderator Share Posted March 25, 2012 NO you won't. trust me. because that kid will be puking on their shoes at the smell of the pus they know how to quantify while you will be doing the procedure to alleviate the condition....I.D. really isn't all that difficult. you learn what is normal and what isn't and who gets the abnl infections...and you carry a pocket copy of sanfords.... I suppose you're right and shouldn't judge the difficulty until I do it, but to clarify again, I do believe in strong HCE. Getting over the basics like not puking, placing IVs, ect are essential in getting to the next level. But I still think diversity can be a good thing. Link to comment Share on other sites More sharing options...
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