RAthePA Posted March 17, 2022 Share Posted March 17, 2022 Hey all I know I'm far from the only person feeling this way, but I'm a new PA working in correctional medicine for about 3 months. Some days aren't so bad, but overall, my anxiety is out of control. Patients in the correctional system are underserved, so often complicated medical histories, and highly litigious patients. Primary care was never something I was super interested in and I did my electives in trauma and critical care, and saw myself working inpatient internal med or ER. I'd say my workplace is decently supportive. Coworkers are kind and willing to answer questions, but there isn't always someone nearby to put a second set of eyes on a patient if I need it. My orientation was more to the facility than consisting of any actual medical mentoring/training. I find that I doubt myself and worry about missing something constantly, and on top of that worrying if and when I will get sued. I have gotten set up with a therapist and SSRI for the anxiety, but still in the early stages so not feeling the benefits yet. I'm unsure if I am so unhappy because of the normal anxiety/being an overwhelmed new PA, or if it's truly because I am not interested in primary care. I've been looking at job listings and it's honestly hard to even imagine what else I'd want to do because I'm just no longer excited by practicing medicine. Would love to hear advice and perspectives on how long it took you to feel comfortable and get over the initial overwhelm. Quote Link to comment Share on other sites More sharing options...
CAdamsPAC Posted March 17, 2022 Share Posted March 17, 2022 1 minute ago, RAthePA said: Hey all I know I'm far from the only person feeling this way, but I'm a new PA working in correctional medicine for about 3 months. Some days aren't so bad, but overall, my anxiety is out of control. Patients in the correctional system are underserved, so often complicated medical histories, and highly litigious patients. Primary care was never something I was super interested in and I did my electives in trauma and critical care, and saw myself working inpatient internal med or ER. I'd say my workplace is decently supportive. Coworkers are kind and willing to answer questions, but there isn't always someone nearby to put a second set of eyes on a patient if I need it. My orientation was more to the facility than consisting of any actual medical mentoring/training. I find that I doubt myself and worry about missing something constantly, and on top of that worrying if and when I will get sued. I have gotten set up with a therapist and SSRI for the anxiety, but still in the early stages so not feeling the benefits yet. I'm unsure if I am so unhappy because of the normal anxiety/being an overwhelmed new PA, or if it's truly because I am not interested in primary care. I've been looking at job listings and it's honestly hard to even imagine what else I'd want to do because I'm just no longer excited by practicing medicine. Would love to hear advice and perspectives on how long it took you to feel comfortable and get over the initial overwhelm. My first job out of PA School was in a correctional institution also. This was 34 years ago and you are describing my experience, except I was the only PA School grad working with FMGs grandfathered into the PA profession by Washington state. That said I spent my days doing good medicine and documenting what was done or any "institutional impediments" to providing good care. You cannot change anything except your attitude , don't let fighting windmills become your mission or beat you down. I devoted myself to getting the hell out of there with dignity while feeding my family after not working for the previous two years! Get your resume polished up and keep applying for other positions understanding that you sure as hell don't want to stay where you are doing the job that you dislike! I went from a prison to an Ivy League Medical Center Emergency Department with a great mentor and unlimited learning opportunities. 1 Quote Link to comment Share on other sites More sharing options...
jmj11 Posted March 17, 2022 Share Posted March 17, 2022 Sounds like a common story. I graduated from the University of Kentucky in 1982. At that time, there were virtually no jobs in Kentucky and indeed, the Kentucky Nursing Association was working hard to pass an anti-PA law, so physicians weren't hiring until the dust settled. I was starving and wanted to propose to my girlfriend, so after 9 months and 135 attempts to get a job without one interview, I took a federal prison job. I had rotated through a BOP medical facility as a student, and it was a positive experience. However, the job I took was very stressful. We were slotted for 1 MD, and 9 PAs. When I came aboard we had one MD (the worst doctor I ever worked with, complete idiot), and I was PA number 5. However, soon after I arrived, two PAs quit and the work load was insane. I had an inmate stab another one 10 times in my office (hit ribs over and over then went to his abdomen and created a deep bowel wound) and coming after me next (if the guards had not arrived in the nick of time). I had vowed that I would stay for one year, but then I had an offer from a plush practice paying me double what the BOP was paying. I left after six months and never looked back. 1 Quote Link to comment Share on other sites More sharing options...
Jofriend Posted March 17, 2022 Share Posted March 17, 2022 1981 grad. First job was also in corrections. Keep your head up and get out. My next job was in a well regarded HMO. It takes grit to work in that situation and I think that people recognize that. Quote Link to comment Share on other sites More sharing options...
sas5814 Posted March 17, 2022 Share Posted March 17, 2022 I think you are in a horrible field for new grads. As you stated they are complicated, highly litigous, and highly manipulative. It take an old soul with a thick skin and lots of experience to manage these patients. Best advice is get out. Don't give up because you are getting flogged. We have all had jobs we didn't like or didn't fit in to. There is a better place out there somewhere. 1 2 Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted March 17, 2022 Moderator Share Posted March 17, 2022 RA where you at? Corrections - did it for almost 5 years - really enjoyed it (but not for new grads!) Administration drove me out cause I would not tow their BS line around "addiction is a choice, just stop" Quote Link to comment Share on other sites More sharing options...
SedRate Posted March 18, 2022 Share Posted March 18, 2022 Agree with all the above. Hold your head up and keep doing what you need to to survive and practice good medicine as best as you can while getting through this steep learning curve. Look for a shift job that has good mentorship possibilities. Quote Link to comment Share on other sites More sharing options...
MediMike Posted March 18, 2022 Share Posted March 18, 2022 I've got nothing really to contribute here besides pointing out the slight irony of OP expressing concern and anxiety about their job and then getting told stories about people being in over their heads and folks getting shanked in the exam room 3 1 Quote Link to comment Share on other sites More sharing options...
Mayamom Posted March 18, 2022 Share Posted March 18, 2022 12 years in corrections. Not sure why I stayed so long. You need to find a new position. They are very litigious and file complaints if they don't get what they want. Your anxiety will improve once your out of that environment. DM if you like. Quote Link to comment Share on other sites More sharing options...
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