New Grad, ICU

[Potatolife]

Hello, everyone new grad PA-C. I just needed some quick input about an ICU interview I went to. I'm going to delete this post in a few hours, so any input would be appreciated The head of the ICU called me and said they were looking to hire a PA for their MICU team. This is a teaching/residency-heavy hospital, so I would be joining the residents. He said I am pretty much functioning as a resident, but with the hours and pay of a PA. I round with the residents (they're 3rd / 4th-year residents), have a few patients on my own, and I have to report back to him before implementing any plans. After we see the patients on our own, he rounds with us and we decide on a plan together. He told me they had 1 PA like 15 years ago, but she now runs a different ICU. They pretty much want a PA to fill in some gaps in the resident schedule. They said they will eventually hire a second PA later on. I did tell him I am a new grad, and I've never worked as a PA before but I have worked in the hospital system prior to PA school. He told me that's okay, if I'm willing to learn he is willing to train me. I will be trained exactly like a resident on central lines, venous catheters, ventilators, lectures/discussions, etc. He told me he's not just going to throw me in there, and that the residents come into the ICU knowing nothing and by the end of their rotation they are well-versed. He told me every 5 weeks there is a different set of residents so I am pretty much re-learning the same information forever lol. I am very interested in the ICU, so I am going to accept the offer if I get it. I just wanted to see your input because I've never seen a position like this. The 4 attendings were very nice. One of the doctors told me this is a great opportunity for me to learn, esp because I don't have anything going on right now and I'm young so I can take on the rotating schedule of the ICU. They're also married to PAs (lol) and they told me this won't be like an outpatient office where I'm the only one running it and I'm bombarded with 30 patients. They emphasized their support and how they work as a team. I know ICU is a steep learning curve, and I am willing to put in the work.

Schedule: 40 hours a week (mostly days, some nights). Eventually, I would take be on call when I feel comfortable with the ICU and that would be included in my 40 hours. He said I'll never go above 40 hours and there will always be another resident with me on nights (if I'm needed for nights).

I was happy with the pay/benefits, so I'm not going to include them

They are interviewing several other people, so he said he will let me know in 1-2 weeks. Any input / comments would be appreciated

[MediMike]

This sounds like a fantastic opportunity and I would jump on it in a heartbeat.  Teaching hospitals are the best places to start off in the ICU due to the abovementioned reasons.  There is the expectation of staffing patients with the attending, there is close oversight, you develop relationships with the residents and people will have your back and you've got an entire team to bounce ideas off of.

There is protected time for learning and the material being taught is likely well polished from being delivered multiple times.  You will see some incredibly complex cases and learn how to manage patients with (hopefully) the latest and greatest evidence.  The chance to immerse yourself in academic culture right out of school is invaluable in my mind.  Having PAs/NPs in the unit also helps with continuity, both for the patients but for the culture as well as both residents/fellows and attendings rotate in and out.

Strongly recommend you take it.  The 40hrs/wk thing is a little weird, is it (4) 10hr shifts? (5) 8s? Also make sure that you do get priority in learning procedures as there is occasionally some pushback as residents will sometimes take priority.

[polarbebe]

I agree with @MediMike   I would highly recommend accepting the position if offered.  
 

As long as the physicians keep to their word and your role is as a resident and not a procedural/order automaton.  
 

I have heard where ICU APPs just perform procedures and other ancillary duties and carry no patients.  This requires little critical care knowledge or management.

The ICU PA role should be to accept signout from the prior team, pre-round and review all data/notes, present the patient during rounds and offer management suggestions in addition to performing invasive procedures/interventions.

Good luck.