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Fear of practicing as a PA


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Hello, I'm new to the forum. I'm reaching out for support because I'm a new graduate,  I searched for jobs for a year in south florida and even opened myself to California. Fear has kept from accepting job offers in rural areas. I got an interview about two weeks ago and the doctor likes me and told me to come in.  He didn't say I was hired,  it seemed like he was trying to see how I worked. So two days after the interview,  while at a assisted living community  with him (it's a geriatric position ), I asked him if he was still interviewing for  PAs or is he just allowing me to shadow him before hiring me? He didn't really give a direct answer,  he just said " no you're good,  you're eager,  compassionate etc". So the second week came and I continued to come and then he asked if I think I would be ready to see patients on my own. Now here's the question and where the fear comes in. I know I am a certified PA and my hand can't be held, but I really want my hand to be held.  I want to go in and see the patient,  do a history,  physic,  and tell the doctor a possible plan and know if it's right or wrong. I'm not ready to travel to the different facilities he serves and see the patient on my own. Geriatrics is intimidating,  and I told him I'm not familiar with many of the meds the patients are on,  I know what they are,  but sometimes I have to look up the name and how could I do that in front of the patient without looking incompetent? Also geriatric patients usually deal with side effects of the multiple meds they're on and Im not familiar with which one could be causing that particular side effect. I'm scared that I'm not competent enough and I really don't have the confidence. I try to tell myself to not be afraid but it's not working. I'm really scared. I'm scared that I will never be ready.  I see myself working in psych but it's hard to get a PA job in psych without the experience and it seems like most psych jobs are for nurse practitioners. Is the doctor being reasonable by wanting me to go to the facilities on my own after 2 weeks of training? He says he doesn't expect me to know the natural history of disease but I'm afraid that I'll be calling him with questions all the time,  and I'll seem very stupid.  Is this abnormal what I'm feeling? I know a lot of new grads are afraid sometimes but my fear seems to be at a whole different level. 

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8 minutes ago, Cup said:

Wait am I reading this right? You've been showing up every day for 2 weeks and now he expects you to go see patients on your own... and you're not even hired or getting paid yet?? 

Right,  I was traveling about 45 minutes to an hour to his office or the assisted living communities and I didn't get paid.  But then again, I wasn't making any medical decisions, so I didn't want to push the salary issue. And he wasn't really straight forward about if I was hired he would just say,  "you're good,  you're eager etc. But because I'm dealingwith fear and he knows I don't have the confidence,  I didn't bring up pay too much.  He did say one time that the salary would depend on my contribution,  so I guess the number is patients I was seeing?

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Yea I'm kinda confused, are you actually hired right now or are you shadowing and doing work for free?

Does the physician know you are a new grad? Cause at my hospital PAs have a thorough 3-month training with other PAs before they work shifts on their own, and even then it takes months to feel somewhat comfortable. 

At the same time, it will feel intimidating at first and you do have to muster up some confidence in yourself. Just make sure to find the right balance of knowing things that you know vs. what you don't know to avoid putting the patient's health in jeopardy. 

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3 minutes ago, PACJD said:

Yea I'm kinda confused, are you actually hired right now or are you shadowing and doing work for free?

Does the physician know you are a new grad? Cause at my hospital PAs have a thorough 3-month training with other PAs before they work shifts on their own, and even then it takes months to feel somewhat comfortable. 

At the same time, it will feel intimidating at first and you do have to muster up some confidence in yourself. Just make sure to find the right balance of knowing things that you know vs. what you don't know to avoid putting the patient's health in jeopardy. 

Thank you,  so I guess I'm not crazy lol  I thought I was being unreasonable for wanting more training. I was very confused about  what his decision was. So the day after the interview he told me to come,  then the next day I asked him if I was being observed by him before he made a decision or is he still interviewing PA,  but no clear response. He never discussed pay voluntarily until I asked him the question above. Two days before this, after the interview,  he called me and asked if I liked geriatrics and how would I handle a situation in which a patient told me they wanted to die. I gave my response which he liked,  and then that's when he started telling me to come in. But I think I made him concerned because he saw that I didn't have a lot of confidence. I would see patients and everything and the patients would speak well of me and say I was professional,  thorough, and explained things but when I would interact with the doctor I guessed he picked up on the fact that though I asked him a lot of good questions , I was not sure about my own knowledge even when it was correct. Then I made a fool out of myself when it came time to write a prescription which I won't even go into the details... But anyway I think I need to volunteer as a PA or something at a free clinic because I just don't feel ready and the anxiety Is getting to me. I'm really ashamed to admit this

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if you want you hand to be held, go a large, reputable hospital. They won't let you do much at the beginning. Or go for a residency program. Small private practices are usually after $$$ and usually have no time to teach you much. 

How long ago did you graduate? 

 

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7 minutes ago, BayPAC said:

if you want you hand to be held, go a large, reputable hospital. They won't let you do much at the beginning. Or go for a residency program. Small private practices are usually after $$$ and usually have no time to teach you much. 

How long ago did you graduate? 

 

I graduated August 2017, got my license January 2018, and then had a hard time finding jobs that didn't require An experienced PA.  As for hospital jobs when I see the job posting online they always ask for PAs with experience but should I try going to the human resources department or some other department where I can actually speak with someone? 

Also I am very interested in psychiatry,(just a little afraid of what certain patients with conditions like paranoid schizophrenia might do). Residency may be a good option for me though I would hate to add to my debt. I've met some psychiatrist that were willing to take new grads but they were out of state and at the time I didn't have money to move and they didn't offer relocation assistance, and some of them had bad reviews online 

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3 minutes ago, BayPAC said:

if you want you hand to be held, go a large, reputable hospital. They won't let you do much at the beginning. Or go for a residency program. Small private practices are usually after $$$ and usually have no time to teach you much. 

How long ago did you graduate? 

 

Agree. Large teaching hospitals usually have a set training for new grads and new hires, and even after the the training they will make sure you are comfortable and have the proper mentoring. If you really feel that anxious, instead of volunteering or shadowing to gain confidence, I would highly recommend looking into a reputable residency program. It will provide a structured, hands-on training and you will at least get paid a little. 

 

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2 minutes ago, PACJD said:

Agree. Large teaching hospitals usually have a set training for new grads and new hires, and even after the the training they will make sure you are comfortable and have the proper mentoring. If you really feel that anxious, instead of volunteering or shadowing to gain confidence, I would highly recommend looking into a reputable residency program. It will provide a structured, hands-on training and you will at least get paid a little. 

 

Yes I think I'm just going to go ahead and apply to a residency. 

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He graduated a year ago, this is a crazy long time (I know Florida is competitive, but all my classmates found jobs quickly 2 years ago). Given the time between school and working, the longer you wait, the more you are going to forget and the more confidence you will lose. At this point, you need to find a job in a system where you have good supervision for the first few months or even a residency program if you can get in. If you're in California now, why don't you look at hospitals in Bakersfield and Fresno and Barstow or things of that nature? Should be easier to get a job in those more rural cities.

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Yea i didn't read that, a year since graduating is a long time. Not trying to sound critical, but was there a reason why you waited that long? Were you looking for jobs only in a specific area or speciality? Because having difficulty in finding a job after a year of looking seems a bit much. 

Just trying to understand better to offer help ?

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1 minute ago, AbeTheBabe said:

He graduated a year ago, this is a crazy long time (I know Florida is competitive, but all my classmates found jobs quickly 2 years ago). Given the time between school and working, the longer you wait, the more you are going to forget and the more confidence you will lose. At this point, you need to find a job in a system where you have good supervision for the first few months or even a residency program if you can get in. If you're in California now, why don't you look at hospitals in Bakersfield and Fresno and Barstow or things of that nature? Should be easier to get a job in those more rural cities.

I'm in Florida now. Yes I'm not sure why it took a while for me to find a job. I tried my best to prepare for interviews,  was professional etc. I just have to move forward now. The first job I was offered was in a hospital but they definitely didn't provide supervision like the should. I was going to work with patients who were not sick enough to be in a hospital but not well enough to be in a nursing home,  I don't know what you would describe that as,  but it wasn't a typical hospital. However they expected me to be able to run codes,  treat patients on ventilators, and there was even a guy who overdosed on cocaine and in jeopardy of multi organ failure but was recovering. During the interview I got really bad vibes and they said I would be the only mid level there,  doctor would be available by phone,  and we would have conferences to facilitate learning.  My professor from my PA program told me I did the right thing by turning it down because it was too much for a new grad and even for her and she's been practicing for more than 5 years

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6 minutes ago, Eve3362 said:

I graduated August 2017, got my license January 2018, and then had a hard time finding jobs that didn't require An experienced PA.  As for hospital jobs when I see the job posting online they always ask for PAs with experience but should I try going to the human resources department or some other department where I can actually speak with someone? 

Also I am very interested in psychiatry,(just a little afraid of what certain patients with conditions like paranoid schizophrenia might do). Residency may be a good option for me though I would hate to add to my debt. I've met some psychiatrist that were willing to take new grads but they were out of state and at the time I didn't have money to move and they didn't offer relocation assistance, and some of them had bad reviews online 

you can do a fellowship program and get paid.. maybe 60-80K? I don't know. Psychiatry is a good field, pay is good. If you do outpatients, you will rarely see unstable patients with paranoid schizophrenia. 

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3 minutes ago, PACJD said:

Yea i didn't read that, a year since graduating is a long time. Not trying to sound critical, but was there a reason why you waited that long? Were you looking for jobs only in a specific area or speciality? Because having difficulty in finding a job after a year of looking seems a bit much. 

Just trying to understand better to offer help ?

No problem,  I didn't get licensed until January of 2018, so without the license I couldn't expect to get  Job, but I still wasapplying. I didn't have a car when I first graduated,  (transmission went out ) so I was trying to look locally and even trying to find locum tenens jobs in Florida and California,  but with those they usually want someone with experience,  and for the ones that didn't which were rare,  they wouldn't provide housingor car rental in California. I did have a few interviews in south Florida for new grads but I wasn't selected. Then I started to open myself to the option of relocating in Florida and I did apply to a variety of specialties 

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8 minutes ago, BayPAC said:

you can do a fellowship program and get paid.. maybe 60-80K? I don't know. Psychiatry is a good field, pay is good. If you do outpatients, you will rarely see unstable patients with paranoid schizophrenia. 

OK,  is fellowship synonymous with residency? 

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40 minutes ago, Cideous said:

This is a no brainer.  DO A RESIDENCY (ER is a good place to build confidence and exposure).  It will make all the difference in the world for your confidence, all while keeping you out of trouble.

Honestly, I think ED is a bad place for this person. It requires a certain personality. Maybe I’m wrong, but dare I say we have a little cowboy in us. I would recommend the family medicine residency at the university of Iowa/Carolinas, the hospitalitist  residency at Missouri/regions/Carolinas/mayo/etc, there are psych residencies as well. Psych I know is at Missouri, Baylor, Iowa are good.

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2 hours ago, LT_Oneal_PAC said:

Honestly, I think ED is a bad place for this person. It requires a certain personality. Maybe I’m wrong, but dare I say we have a little cowboy in us. I would recommend the family medicine residency at the university of Iowa/Carolinas, the hospitalitist  residency at Missouri/regions/Carolinas/mayo/etc, there are psych residencies as well. Psych I know is at Missouri, Baylor, Iowa are good.

there is also a primary care fellowship near lake Shasta , ca.

https://www.shastahealth.org/nppa-fellowship

" a little cowboy". More than a little....:)

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3 minutes ago, Eve3362 said:

Can a physician from a different specialty supervise a physician assistant in another specialty? Like can a internal medicine physician supervise a psych PA?

nope. The SP must have the same skill set as the PA they work with.

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