Orientation/Onboarding Survey

[Cyn13]

If not allowed, please delete.

Hello Everyone,

My name is Cynthia, and I have been a PA in Hospital Medicine for eight years. I am doing a project to help improve the orientation/onboarding process of all APPs in Hospital Medicine at the hospital I work at. I have attached a survey below and would appreciate any input to help improve this process for APPs in Hospital Medicine. I only need APPs in hospital medicine to fill out the survey, but I appreciate any opinions in the comment section. 

This information will not be published. It will be used to help improve this process. If you have any questions, concerns, or ideas, please let me know.  I appreciate any help provided. 

 

https://www.surveymonkey.com/r/5QBJG27

[ventana]

just a word of caution

I was hired by a hospital system and they really had a tough time with my experience level (about 20 years with a huge knowledge base)    They were finally able to understand that I am very different then a new grad or even one with 5 years experience.   They admitted they hardly ever hire a PA with 20 yr experience and were hampered by their pre-defined salary structure.  There average experience for PA/NP is <5 years and hire a fair amount new grads.  

I was hired to take over what sounds like a pretty complex PCP panel of patients including MH, Addiction, Geri co-morbid.  These are the heavy lifting of IM.  They are lead by a progressive doc who understands and they were able to put together a good package, and I am joining them.

 

I bring this up as there seems to be a "lumping us all together" in HR realm of PA and NP.  This is not appropriate and needs to stop.  A highly experienced PA in IM should be close to the income and bennies of a Doc, a new grad who needs mentoring and training and guidance should not.    

Sounds like you are in the position to possibly address this - Think of hiring a 20 yr PA whom ran a critical access hospital as a hospitalist.  Has done 100's of intubations, CPCP, BIpap, central lines, cut down, NG tubes and managed all sorts of different patients. Or the PA whom has done NICU medicine for 15 years and is capable of running the show alone.  These are not the same employee as a new grad.  There needs to be a solid structure to handle these vast differences in skill sets.  

The VA is on the right track with  PA-1 PA-2 PA-3 PA-4 PA-5 but I think there clinical side does not cover enough.  PA1-3 is clinical and PA 4-5 is administrative.

I would propose a PA-1-5 where all levels are clinical and PA-5 should be someone with huge experience functioning basically as a physician, with some leadership roll as well - ie assigned to committee leadership rolls in the facility.  Each step below this is slightly less competent/experienced with PA-1 being a new grad for the first 1-2 years, PA-2 being something like 2-5 years out - or changing specialty. so on an so forth.

 

We are at the point where the middle experienced PA are doing well, but we are limited at the top end.  Hopefully OTP, DMSc and PA's moving into admin in the hospital systems might change this in the long run.  It will take leaders like yourself advocating to the tight wad bean counters, combined with PAs like me migrating to better positions to get this to change in the future

 

 

Keep up the good fight!!

[sas5814]

What Vent said. My last employer really has a subtle disdain for PAs and NPs and really just didn't get it. Ortho had a problem with people showing up post ER with sores under an inappropriately applied splint so they decided ALL PAs and NPs would have 3 days with ortho for training. It sounds good (sort of) but the whole thing was premised on people who knew nothing about splints and casting and ortho in general. My first day, and I can't make this up, was "this is a Stack splint and thins is a ribbon splint, and this is a volar splint." They didn't have a clue how insulting it was to a retired Army PA with significant ortho experience. All PAs and NPs are the same...and they aren't real bright.

That is a long way of saying make your orientation malleable and adapt it to the person being oriented.

 

Good luck!

[Cyn13]

I apologize for the late response. Work and Family!!!

Thank you both for replying. I'll take into consideration what was mentioned here.

The plan is to have a starting point for orientating and helping new APPs adjust to hospital medicine which has a steep learning curve, especially if the hospital has an open ICU. In the hospital setting, PAs and NPs are considered interchangeable at this facility. 

I am hoping with OTP, DMSc, and people on ground, we can finally get the recognition we deserve.

 

Also, Ventana, I have followed your posts since before becoming a PA. Thanks for the work you have put in!! 

[Hope2PA]

Not sure how this would fit with your survey, maybe more associated with Ventas comment. However an issue I’ve seen is when LPNRN-NP all count equally for years of experience and salary. This is true in some hospital systems regardless of speciality or experience. So a brand new NP that worked in schools putting on bandaids, taking temps and monitoring levels for medications on few kiddos can make more than 5 year specialty experience PA. I’m sure you can imagine the pain in training a pretty much clueless provider, level of PA student finishing rotations,, making $15,000 more than you. Admin just shrugs shoulders. 

[Cyn13]

Hello Hope2PA,

I am aware of this issue. In the hospital system I currently work for; they did not count ( as far as I know) nursing experience( this information was from 4 new grads NPs). 

I can't fathom why nursing experience would count towards experience as an NP. Thanks for the info.