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SLPmom

Can I get through Clinical year if hospitals give me anxiety?

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First, this forum has been invaluable to me as I continue to teeter on the fence - deciding whether to jump without a parachute and completely change my career at 43 

I do believe I would be a great PA. I have 20 years experience in healthcare as a Speech Pathologist, but I always avoided the hospital setting due to my dislike of hospitals. I have worked in many other medical settings, such as Acute Rehab, outpatient Rehab, and outpatient of a children's hospital. But I really dislike the intense stuff that I would see in a hospital (trachs, vents, catheters, vomit, contagious diseases, coma stim, etc). I want to become a PA to further my career, and end up in the NICU (doesn't bother me as much), or working in an ENT office or a Dermatology office. I know I cant reach those goals without getting through PA school, and I am terrified of not being able to tolerate the ER & Surgery rotations. 

Did anyone make it through PA school without needing to encounter the fears listed above? Did anyone else have these fears and become somewhat desensitized? There must be many other aspiring PA's who don't want to end up in acute medical care? They say to "face your fears", but even watching some medical shows gives me anxiety at times. Its the only hurdle that I haven't gotten past in my mind, and the one reason I have not enrolled for my prerequisites yet. Once I begin, there is no turning back. I want to be sure. I also don't want to allow my fears to stand in my way.

Advice? Thoughts? Insight? 

Thank you 🙂

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Expose yourself to everything you hate and fear now, because it would entirely suck to get admitted, get through didactic, and be unable to complete clinicals.

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To become a PA, you have to have completed rotations in core areas, including surgery. You can go to the ARC-PA website and see what that entails.

Some people come to school with fears, like will I pass out my first morning of gross anatomy?

You might want another career path if this has stopped you from even taking prereqs. NP training gets badmouthed here sometimes because of their more limited clinical training, but it might suit you better. As I understand it, you can be, say, a family NP without setting foot in surgery. My guess is that the initial RN training part will still put you in hospitals however.

Why not shadow in the hospital and see how real your fears are? Having to care for patients is different than watching them, hopeless to intervene and provide care. I wasn’t sure I could be an EMT and now I’ve completed 32 years in the field, the last 15 as a paramedic. Some fears are unfounded, but real until you face them and see.

Good luck.


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Saw this on Facebook this morning. Equally true for other practitioners:

“For those who are afraid to become a nurse because they have a weak stomach,It won’t be the vomit or needles or blood or urine or feces that turns your stomach. You’ll get used to that. You’ll come to accept it’s just part of the job and get to the point where you’re thinking of the 38 different things you have to do while absentmindedly cleaning up a bowel movement. What will turn your stomach will be 40 shallow breaths a minute in a patient in respiratory distress. A freshly born infant that is limp and blue and hasn’t cried yet. Tripled troponin levels on your sweating and anxious patient as you realize they’re having a heart attack. Feeling cord during a cervical check, then trying to hide from your patient the shaking in your voice as you call for help. The pale skin of a Jehovah’s Witness with a hemoglobin of 4 as she declines a blood transfusion and says goodbye to her family because they haven’t found the source of the bleed and she’s running out of time. A blood alcohol level of .18 on a 4 year old who is barely responsive and being intubated after getting drunk on mouthwash and then hitting his head. An elderly woman in the ICU signing her DNR while her sobbing daughter begs her to reconsider, knowing if treatment is stopped then her mother will die. A child in the pediatric ICU who hasn’t had a visitor in months. Not being able to find the heartbeat on a pregnant mom who hasn’t felt the baby move in a while. In the face of everything else that comes with being a nurse, I promise you’ll get used to the poop.” - Andrea Pellerin


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Saw this on Facebook this morning. Equally true for other practitioners:

“For those who are afraid to become a nurse because they have a weak stomach,It won’t be the vomit or needles or blood or urine or feces that turns your stomach. You’ll get used to that. You’ll come to accept it’s just part of the job and get to the point where you’re thinking of the 38 different things you have to do while absentmindedly cleaning up a bowel movement. What will turn your stomach will be 40 shallow breaths a minute in a patient in respiratory distress. A freshly born infant that is limp and blue and hasn’t cried yet. Tripled troponin levels on your sweating and anxious patient as you realize they’re having a heart attack. Feeling cord during a cervical check, then trying to hide from your patient the shaking in your voice as you call for help. The pale skin of a Jehovah’s Witness with a hemoglobin of 4 as she declines a blood transfusion and says goodbye to her family because they haven’t found the source of the bleed and she’s running out of time. A blood alcohol level of .18 on a 4 year old who is barely responsive and being intubated after getting drunk on mouthwash and then hitting his head. An elderly woman in the ICU signing her DNR while her sobbing daughter begs her to reconsider, knowing if treatment is stopped then her mother will die. A child in the pediatric ICU who hasn’t had a visitor in months. Not being able to find the heartbeat on a pregnant mom who hasn’t felt the baby move in a while. In the face of everything else that comes with being a nurse, I promise you’ll get used to the poop.” - Andrea Pellerin


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6 hours ago, UGoLong said:

... My guess is that the initial RN training part will still put you in hospitals however...

1

The initial RN training would put them in a bad spot because we rotate through a lot of acute care clinical sites, and most of the time, it's the students doing a lot of the grunt work haha (trachs, vents, enemas, wound care etc). I somehow managed to avoid trachs and vents but other students weren't so lucky. That said, I don't think I have such a phobia as the OP but I will say, just don't think about it and force yourself to learn from it.

My ER Clinical instructor once told me you should at least once, choose to do something you're afraid of and you'll learn to appreciate it. So slowly expose yourself little by little and you'll overcome or tolerate these phobias.

I know I'm only going to be an RN and not a PA, but I have no desire to work in acute care with the ER being the exception. I'm in the process of interviewing at Urgent Cares/ERs.

 

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Just wanted to add that you'll likely have multiple rotations in a hospital.  Surgery and ER obviously but also in patient for sure.  My school has psych, women's health, and peds with in hospital components - that's 6 out of the 7 core rotations.  Family med is the only one you will most likely be safe to assume it's outpatient (but even then....you never know).  The latter 3 may not be as acute/intense as say surgery or ER but they can be.  

As someone who absolutely did not want to go into surgery and was dreading my surgery rotation...it didn't give me anxiety.  You have to learn to look at it as a learning experience.  Maybe you aren't going to do surgery, but you'll have patients who see you before or after or have it as part of their history and you need to understand what happens.  There is also just a lot of medicine involved - not just cutting and suturing.

The only way to know for sure, like Rev said, is to try it out now.  Ask to shadow (even if you aren't shadowing docs or PA/NP just get exposure to the floors etc).

I appreciate that you're gathering as much information as possible to make an educated decision, but it is clear you have a lot of hurdles to tackle before you're ready for PA school.

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MT2PA I don’t think I have any more hurdles than anyone else considering P.A. school. I think the fact that I do have 20 years of clinical experience in healthcare will be an advantage to me. You were dreading your surgery rotation and ended up liking it. I suppose I could shadow, but it seems kinda silly to shadow in a hospital when I could get a part time job as an SLP in a hospital and work there while getting my prereqs done. I’ve applied for a job as an SLP in the NICU and also just basic inpatient SLP and waiting to hear back.  I’ve worked in a hospital before. Didn’t love it, but I already crossed those hurdles 20 years ago lol. I am actually looking forward to those few rotations that you mentioned that may be inpatient (psych, women’s health, peds etc). The only two I’m “dreading” as you put it, is ER and Surgery. But I’ve decided that those fears should not be hurdles that prevent me from going to P.A. school. I know I would make a great P.A. and I’m ready to further my career from speech therapy to being able to treat other concerns. 

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I didn't say you have more hurdles than others, but based on previous threads it seems you have more research to do before you have an understanding of it all (i.e the thread about BS to MS bridge programs).

But hey, you do you.  You said you were terrified of not being able to tolerate certain rotations.  If all you want is answers saying 'Of course you can do it' then by all means, read only those responses.  All I have is the information provided - you are sometimes anxious watching medical shows - so yes, based on all the information I have from all of your threads and questions, the path to PA is not an obvious one for you.  I'm not saying it's impossible.  You came here with questions.  I am providing honest opinions....not sugar coating what you want to hear.

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I wasn’t interested in going from “BS bridge to MS”. I already have a Masters Degree. I was just curious what those programs were about. I was interested in using my clinical profession to help gain experience and I know that there are many successful proficient PA’s who have been working for decades without a Masters Degree. My thread clearly created a bit of a debate, but I was just asking a question. I’ve done plenty of research and I have learned so much from this forum. Just because I get anxious watching medical shows on gun shot wounds or surgeries does not mean I won’t be a successful Dermatology or ENT PA. I’m just a little nervous about the ER and surgery rotations. Just as you said you were dreading your surgery rotation....It seems you are greatly misunderstanding my posts and questions. Or taking them personally, getting offended? Not really sure. But hey, you do you. Not looking for sugar coating. But your responses come across as condescending (in my opinion). So yes, I will focus on the other supportive informative responses. 

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Just a suggestion before you invest the time/money to make this switch.  Volunteer your time with a hospital and make them aware of your purpose for doing so and see if they can place you in the ED.  You won't be involved with care but you can see a lot and still be helpful by transporting patients to the floor, getting warm towels/blankets, ice chips, helping to clean up urgent care/trauma rooms, etc.  They'd probably kill for a responsible adult that doesn't move at 1 mph like all the elderly volunteers that I used to see come through my departments.

Edited by GetMeOuttaThisMess

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After just seeing your follow up post, be aware that even derm or ENT are going to have their moments.  Procedures in both of those settings that you specified, whether you do them or not, so you'll be exposed to messy situations regardless.  The two settings that you used as examples are also highly competitive, just as they are for the physicians to get into their residencies.

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43 minutes ago, SLPmom said:

I wasn’t interested in going from “BS bridge to MS”. I already have a Masters Degree. I was just curious what those programs were about. I was interested in using my clinical profession to help gain experience and I know that there are many successful proficient PA’s who have been working for decades without a Masters Degree. My thread clearly created a bit of a debate, but I was just asking a question. I’ve done plenty of research and I have learned so much from this forum. Just because I get anxious watching medical shows on gun shot wounds or surgeries does not mean I won’t be a successful Dermatology or ENT PA. I’m just a little nervous about the ER and surgery rotations. Just as you said you were dreading your surgery rotation....It seems you are greatly misunderstanding my posts and questions. Or taking them personally, getting offended? Not really sure. But hey, you do you. Not looking for sugar coating. But your responses come across as condescending (in my opinion). So yes, I will focus on the other supportive informative responses. 

Dreading and questioning an ability to complete a rotation are two different things.

Good luck to you.  

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Disliking a particular rotation/field of medicine vs having anxiety to the point you doubt you will last the rotation are two different things? 

There is nothing wrong with not having interest in particular rotation and dreading having to go through that.

However, having anxiety about a core rotation like ER to the point you might not be able to perform, that would be concerning, and it doesn't matter how many years of other healthcare experience you have. I hope your anxiety is not to the point you would be unable to last the rotation and it is just the dread of going through something you have no interest in. 

You've got great advice here already. Invest in that shadowing time in these areas now, to see where you really stand. Can you get through the anxiety and still perform even though you don't like it? If yes, then you are good. 

Good luck. 

 

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So I spent the entire weekend shadowing my best friends husband, who is an ER Physician (one perk of being older - many of your friends are doctors and you have good connections!). I will say that my anxiety level was a good 7-8 the entire weekend - lol - but I made it through the weekend and it gave me the confidence I needed to move forward in this application process. While I did NOT enjoy the patient with the stomach virus (or possible bowel obstruction), or the patient with the post operative infection....I really felt comfortable with some of the other cases that related to my experience. Rather than just being called in as an SLP to do a Bedside swallow study or Modified Barium Swallow study, as a physician (and PA) you actually get to look past only the speech/swallowing issues and look deeper at the patient as a whole. I really enjoyed that! And in consulting afterwards with my friend, I would have known exactly what to do with those patients. I don’t think I will suddenly decide to work in the ED or Surgery after those rotations, but after this weekend, I am certain that I can push through the discomfort that some of the cases give me and succeed as a whole. I also believe that the more exposure I get in the areas that I am most uncomfortable, the more desensitized I will be. I spoke to a dozen other doctors during the weekend and picked their brain, told them my concerns etc. They all said they experienced similar feelings at some point in their training and it’s very common. The physician I shadowed (my friend’s husband) said I have great medical instincts and really encouraged me to continue with my dream of furthering my career in healthcare. He definitely felt that my two decades of experience in direct patient care in various healthcare settings is a HUGE advantage to me than if I were just switching fields entirely from something unrelated. I learned this weekend that the 20 years of experience that I’ve had with my patients over the years, and all of the different healthcare settings that I have worked in, has truly provided me an invaluable base of knowledge about healthcare. Speech and language was in some way intertwined with almost every case that I observed, as cognitive function and expressive/receptive speech and language, neurological function, and swallowing are basically everything. Thank you to everyone for your supportive and insightful responses on this thread and all of my others. The suggestion to shadow a physician in the ER was an excellent one. And I’ve decided that I am going to continue pursuing my dream. I’m not going to let a few fears make me doubt myself and my ability to complete this program and be an amazing Physician Assistant. But the BEST thing that came out of this is that the SLP that works in this hospital asked me if I would be interested in working there 1-2 days per diem. They have an SLP leaving on maternity soon. It would be mostly inpatient and outpatient, but much opportunity to consult in the NICU for feeding/lactation support, which is basically my dream job and one I’ve been trying to get into for years. It will allow me to continue getting my feet wet in a hospital setting & provide me even more direct patient hours while I take my prerequisites. I only work 2 days per week right now, so it is the perfect balance while I begin prereqs. Again - thank you all so much. I will keep you posted during my journey. Planning to apply by June for the 2020 year for PA school! :))))

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Wonderful! Your story is living proof that a few hours of actually doing something is better than months of ruminating. Best wishes!


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These huge life changing decisions definitely take some months of ruminating and self exploration. 😉 especially at 43 years old. But yes - this certainly did help me solidify my decision. 

Edited by SLPmom

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This is great to hear. Good luck @SLPmom . Also, I will let you in on a secret. We don't play age game with @UGoLong . I think he has everyone beat on when he started PA career. 😉

Again glad to hear things are working positively for you. Good luck. 

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