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New grad PA miserable in Critical Care


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I took a new position in critical care and thought it would be a great opportunity as a new grad to learn and grow my skillset. I was under the impression that the orientation period would be similar to a residency, that I would be getting a structured learning format, and tons of support and teaching on the job. However, much to my dismay, my experience has been quite the contrary. Many attendings and APPs do not wish to teach, scoff at my lack of experience and knowledge base, and expect me to perform at the level of a near second year resident. I am also terrified to make any mistakes given the volatility of the patient populations, and am looked at as "unconfident" because of this. I am now on a performance improvement plan just two months in, because I do not meet their expectations.

Although I have been trying to read up on materials to make up for the gaps in knowledge, I just don't feel like I am cut out for the position and am not a good fit for the ICU. Is it normal to feel like a failure at your first job, and should I just look for a less stressful environment or consider going outpatient? My confidence has been so shot, I feel as though I will fail in any environment I'm put in now. 

Edited by ScrubsForever
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59 minutes ago, ScrubsForever said:

Is it normal to feel like a failure at your first job,

Possibly. Depends on you, your pre-PA experience, what you put into and got out of PA school, and the job.

59 minutes ago, ScrubsForever said:

should I just look for a less stressful environment or consider going outpatient

Possibly, but I would urge you to instead focus your search on finding a job that is new grad friendly with good mentorship. Better yet, network to find a good fit. 

 

59 minutes ago, ScrubsForever said:

I was under the impression that the orientation period would be similar to a residency, that I would be getting a structured learning format, and tons of support and teaching on the job.

 

 

59 minutes ago, ScrubsForever said:

I am now on a performance improvement plan just two months in, because I do not meet their expectations

This seems off and a bad fit. The ICU is a tough place for a new grad especially with no mentorship or guidance. However, this is not a residency. It sounds like both you and your employer/team aren't meeting expectations or didn't know what to expect/not-so-great interview to weed out and clarify these details. 

Edited by SedRate
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A new grad probably shouldn't go into critical care without doing a good critical care residency. And a new grad probably shouldn't stay in any position that is not willing to train them.

I recommend you not beat yourself up or even decide that critical care is not for you. Instead, it's time to move on.

Best wishes.

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Unfortunately, with the desire to 1) practice medicine right away, and 2) not starve, a lot of new grads seem to swing at the first pitch. I know I kinda did, but I applied to an organization that I knew about, and so kind of did the best thing without knowing precisely why I did it.

It sounds like you weren't a critical care RN prior to PA school. This is one of those problems where the distribution of a) open PA jobs, and b) pre-PA experience are not well aligned. Hang in there! It's not the end of the world.

One of my working theories is that by year 10 of PA practice, PAs will have assorted themselves into the jobs they were supposed to have been in all along. At least, that's how it worked out for me.

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  • 1 month later...

Hey Scrubs Forever, 

 

Leaving a comment so that you know you are not alone. I am 10 months out of school and have already been fired from my first job for being unable to meet "performance expectations". They started me at 20 patients a day and expected me to see 27 patients a day by 6 months. I received 40 hours of training prior to independent practice, and I was the only full time APP at the clinic. Despite all the tears, stress, studying after work, and showing up every day seeing every patient on my template, they determined that I was not bringing enough money into the company and did not feel that additional training/support was justified. The worst part was that in the last 2 weeks of that job, my overtime hours were the lowest they had ever been and I was finally developing some confidence in my ability to handle complaints I hadn't seen before. My confidence as a clinician has also been crushed, and I am intimidated at the thought of trying again.

 

Remember that at the end of the day, healthcare is for profit and businessmen don't care about the quality of patient care. 

Find a job that will respect you and your clinical training. You are not a failure, that company failed you.

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11 hours ago, tessmay1 said:

Remember that at the end of the day, healthcare is for profit. 

Find a job that will respect you and your clinical training. You are not a failure, that company failed you.

Sad but true. 

I'm sorry to hear about your experience. Hold your head up and good luck with your next endeavor. 

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