chiaroscuro27 Posted July 21, 2012 Share Posted July 21, 2012 Just wrapped up my first shift in the ED as a PA-C. Wow...that's all I can say! It was all I thought it would be. I was scared to death going in, and on pins and needles the entire shift. I saw chronic back pain, cholelithiasis, cellulitis from an insect bite with a surprise 600 blood glucose thrown in for good measure, and a fx 5th MTP. I had my first drug seeker, too! The nurses were great with clarifying my orders and communicating the patient complaints. I'm not at all used to the idea of giving orders; I'm going to have to get over that quickly. All in all it was a great first day. I am honored to be among the fold and excited about being in a nurturing teaching environment where I am treated like a clinician and able to do so much. Link to comment Share on other sites More sharing options...
jen0508 Posted July 21, 2012 Share Posted July 21, 2012 goodness, your credentialing went fast! Mine wont be done until the middle of next month :( I'm glad you had a good first day. We definitely need to stay in touch and share our experiences :) Link to comment Share on other sites More sharing options...
chiaroscuro27 Posted July 21, 2012 Author Share Posted July 21, 2012 Sure thing, Jen. I'd like that! Yeah, the licensing process went a lot smoother than I thought, and credentialing was a breeze. Glad to have it all over and done with. Link to comment Share on other sites More sharing options...
jmj11 Posted July 21, 2012 Share Posted July 21, 2012 I remember my first day on the job . . . thirty years ago. I was scared to death. The thing I love, and it comes very, very gradually over years, is where natural intuition takes the place of memorization. Rather than following the "exam I learned" you start to feel and look for the things you know should be wrong in the condition you are evaluating. The thing that I hope you will be spared from, now 30 years later, is the political crap that we had to go through. I had nurses resigning when I was hired (refused to work in the same practice as a PA). I could on and on. So, enjoy. The first paycheck is a euphoric. Link to comment Share on other sites More sharing options...
Cideous Posted July 21, 2012 Share Posted July 21, 2012 Wait till you make your first save....nuts. You won't sleep all night. I had a 48 year old lady drop dead right in front of me who i shocked back to our side of the veil. Good luck and remember... if someone looks really sick...they probably are. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 21, 2012 Moderator Share Posted July 21, 2012 Congrats and good luck! Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted July 21, 2012 Moderator Share Posted July 21, 2012 Congrats on your first shift! The best combination of scary and exciting there is. Having a great support staff makes it so much easier. Link to comment Share on other sites More sharing options...
chiaroscuro27 Posted July 21, 2012 Author Share Posted July 21, 2012 Thanks everyone! Link to comment Share on other sites More sharing options...
mainiac Posted July 21, 2012 Share Posted July 21, 2012 Just wrapped up my first shift in the ED as a PA-C. Wow...that's all I can say! .... I had my first drug seeker, too! ..... I'm not sure where you are (ie. State wise) but maybe worth checking out to see if it's available where you are? I found this out when I was a PA-S doing my rural ED rotation..... They're maybe a state website that you can find a recent (1 yr) history of a patient's narcotic perscriptions! Of course you have to register & prove who you are & you have a DEA. I'd suggest asking around where you work. Next you can check with your State licensing or State PA association. I found it very helpful, when you get that gut feeling! It's nice to have a check 'n' balance & find out you are correct! Best of Luck! Link to comment Share on other sites More sharing options...
katief262 Posted October 5, 2012 Share Posted October 5, 2012 I start my first job in a rural ED this month (when credentialing finally goes through). I can definitely relate to your post though, scared to death. Your post made me feel better :) Link to comment Share on other sites More sharing options...
browndog Posted November 5, 2012 Share Posted November 5, 2012 Comming up on 3 years now and I still approach every shift with a healthy amount of fear and a generous amount of prayer. So much to know. So easy to miss something. Link to comment Share on other sites More sharing options...
chiaroscuro27 Posted November 5, 2012 Author Share Posted November 5, 2012 Yes browndog, so true. I am getting a lot more comfortable each day, but the fear factor is still there. One part of the job that I struggle with, especially in a rural town where everyone knows everyone, is allowing the nursing staff to sway my clinical decision-making because they have a history with my patient. There have been a lot of close calls because I considered not calling in ultrasound late at night for that suspected gallbladder issue, or not getting the stone study on a known drug seeker who really looked like they were in pain. So yes, I realize more every day the huge amount of responsibility I have and how easy it is to miss things. I'm glad, though, that I chose the ED! I was so close to taking a 9-5 transplant surgery position. The ED gives me the challenge I want, but also allows me to live my life and forget about work once I clock out. Link to comment Share on other sites More sharing options...
RPa695 Posted November 6, 2012 Share Posted November 6, 2012 Great to read this! I'll be starting in an ED in January (paperwork is awful!!) and am so excited, but of course nervous. Thankfully my hiring physicians seem awesome and understand a new graduate won't be without questions! Link to comment Share on other sites More sharing options...
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