Letting pre-req classes age while getting HCE

[Lemon Bars]

When I made the decision to go back to school to pursue PA, I got right on the pre-requisite classes and also took an EMT-B course. Now I'm in my last semester of pre-requisites and I've got some HCE including two camp EMT jobs and now nursing assistant. I feel like I need more and higher quality HCE to be a competitive applicant, especially because my 3.0 overall GPA is pretty low.

 

My question is: If I spend the next year or two taking a phlebotomy course and trying to get on as an ER tech, then some of my pre-requisite courses will be three or four years old. Is this a problem? Or is pursuing the ER tech idea a good one. I really need the practice at patient care because honestly I suck as a beginning nurse assistant. I'm real slow and uncomfortable around all the wires and tubes and the supersick patients. I'm also unfamiliar with much of the equipment used in the hospital setting.

 

I don't really even want to work at a hospital I wish I were a back office medical assistant instead. Ultimately I'd like to work as a PA in a walk-in urgent care clinic. There is so much to learn I want to learn how to do EKG's and casts and listen to breath sounds but mostly all I get to do are vital signs, diaper and bed changes, over and over and over.

 

What's my best course of action here?

[Friction]

You should be fine with the pre-reqs being 4 years old. Most programs don't want them to be more than 5-10 years old, just depends what programs you're looking at.

 

I worked for the last year as an ER Tech here in the Phoenix area. Here an EMT/CNA can work as a tech w/o any phlebotomy training, at least at Banner Health. Not sure how it is in other states, I'm sure some of the other ER Techs can answer that, but in Arizona we had a pretty broad scope (IV saline locks, blood draws, urinary caths, splinting, EKGs, etc.) I personally think medical assistant would be a better choice of school than phlebotomy if you're going back for HCE.

[beattie228]

Agree with Friction. Nonissue as long as they're within in the 5 year mark for programs with that requirement or the 10 year mark for others. Great idea, IMO, for you to get some more experience under your belt in order to solidify your application. As far as your uncertainty around patients and medical equipment, it honestly just gets better with experience. Like any other job, you'll get more proficient the more time you spend in that position. Observe the folks around you and ask questions of the veteran medical staff.

[Lemon Bars]

Okay, thanks guys!

[WanderlustPA]

all I get to do are vital signs, diaper and bed changes, over and over and over.

 

This is exactly why I took the approach of completing pre-reqs first, then applying w/o HCE just to give it a shot, and if it didn't work out, go get the HCE. I got in without any. Oh, and I also had a cumulative GPA below 3.0, though my pre-req GPA was 3.97. A lot of people on this board disagree with this approach, but if that's all you're doing, it seems awfully pointless to me.

[Lemon Bars]

Thanks for your repy, huntstyle! My pre-req GPA is high, about 3.87 at the moment. Maybe I will get in somewhere!

[Friction]

Thanks for your repy, huntstyle! My pre-req GPA is high, about 3.87 at the moment. Maybe I will get in somewhere!

 

Even if you can get in somewhere, I am willing to bet you will find next to no one on here who thinks beginning PA school w/o any HCE is a good idea.

[Moiraine57]

I dunno. Depends what the HCE is. High quality HCE is probably the way to go, but is being a CNA that invaluable you'll be lost without it?

[Deadliftyourspirits]

Before being an ER Tech all I had was my EMT-B (NJ). They trained me in phlebotomy, EKG's, etc.

 

When I first started as an ER tech I was intimidated by everything/everyone, i.e., the doctors, the PA's/NP's, the nurses, the pts, the pt's family, the wires, the tubes, everything. Now I go in and most things I do are second nature and I walk around with confidence.

 

Many things in life have a comfort/confidence curve. Having faith in your potential down the road and gracefully enduring the discomfort until you get there will help you get there sooner and more smoothly.

[Friction]

Before being an ER Tech all I had was my EMT-B (NJ). They trained me in phlebotomy, EKG's, etc.

 

When I first started as an ER tech I was intimidated by everything/everyone, i.e., the doctors, the PA's/NP's, the nurses, the pts, the pt's family, the wires, the tubes, everything. Now I go in and most things I do are second nature and I walk around with confidence.

 

Many things in life have a comfort/confidence curve. Having faith in your potential down the road and gracefully enduring the discomfort until you get there will help you get there sooner and more smoothly.

 

I agree with this 100% Learning to interact with patients and their families, nurses, MDs/DOs/PAs is definitely not something you learn to do in a day. Every time I go to work I get paid to learn, not much but I still get paid. Helping the providers with procedures, as well as working on my own, has given me great confidence that I can succeed as a PA. If I hadn't spent the last year in the ED, I wouldn't have known how a provider does a lumbar puncture, a chest tube, suturing, an intubation, a closed reduction, or any number of things. I kind of look at it like being expose to my future job. At least when we cover it in PA school I have some idea of what is being talked about.

[Lemon Bars]

I'll definitely try to get on as an ER tech. It would be a lot more valuable than the nurse aide work. I'll get whatever experience I can. I applied for an ER scribe job but I didn't get it.

[WanderlustPA]

Thanks for your repy, huntstyle! My pre-req GPA is high, about 3.87 at the moment. Maybe I will get in somewhere!

 

You're welcome! I'd say you have a good shot, just look for the schools that don't require HCE. I contacted a lot of schools as well to find out what they were looking for, because while some don't actually have a minimum number of hours, they still basically require some. BTW, I talked to one program director who compiled years of stats, and found no correlation between HCE and performance in PA school! That school used to require HCE, but after these findings, they dropped that requirement.

[Friction]

You're welcome! I'd say you have a good shot, just look for the schools that don't require HCE. I contacted a lot of schools as well to find out what they were looking for, because while some don't actually have a minimum number of hours, they still basically require some. BTW, I talked to one program director who compiled years of stats, and found no correlation between HCE and performance in PA school! That school used to require HCE, but after these findings, they dropped that requirement.

 

How do you qualitatively measure a PA's long term performance based upon one year of clinical experience? I guarantee you there are a majority of people here who would disagree with this "program director." I'm not saying there aren't people who can do it, but developing a bedside manner and learning invaluable skills doesn't come from a book in one year. It takes time, experience, and learning the hard way. I guess if you want to experience that steep learning curve, then go right ahead. I'd rather push of PA school until I know I'm able to handle the extraneous things associated with medicine before I jump in the deep end. Only my 2 cents.

[Lemon Bars]

How do you qualitatively measure a PA's long term performance based upon one year of clinical experience? I guarantee you there are a majority of people here who would disagree with this "program director." I'm not saying there aren't people who can do it, but developing a bedside manner and learning invaluable skills doesn't come from a book in one year. It takes time, experience, and learning the hard way. I guess if you want to experience that steep learning curve, then go right ahead. I'd rather push of PA school until I know I'm able to handle the extraneous things associated with medicine before I jump in the deep end. Only my 2 cents.

 

Theoretically, I agree with you Friction. But the skills I'm learning are extremely basic. A couple more months of being a nurse aide and I'll be bored out of my mind. Also, how much bedside manner can I learn when my patients are elderly and confused, or can't talk because they're on a bipap machine, or they're doped up and can barely roll over so that I can wipe their bottoms?

 

Mostly I'm just learning how to hustle. I'm like a busy waiter except that instead of bringing you food, I remove the digested leftovers...

[Alliecat419]

Theoretically, I agree with you Friction. But the skills I'm learning are extremely basic. A couple more months of being a nurse aide and I'll be bored out of my mind. Also, how much bedside manner can I learn when my patients are elderly and confused, or can't talk because they're on a bipap machine, or they're doped up and can barely roll over so that I can wipe their bottoms?

 

Mostly I'm just learning how to hustle. I'm like a busy waiter except that instead of bringing you food, I remove the digested leftovers...

 

 

I do agree that skill-wise, CNA's are on the low end of HCE but I just want to point out that some of the things you are learning may be invaluable experience even if you don't realize it until down the road. I worked full-time as a CNA for a year and only after I left did i realize how much I actually did learn, skills aside. The biggest factor probably being TIME MANAGEMENT. As an aide, you pretty much have no choice but to master this, and that's something you will need regardless of your position or scope of practice in healthcare. And it DOES get easier with time! I thought there had to be something seriously wrong with me for not being able 'pick up' on something as simple as aide work right away- it's normal to feel slow. Learning how to deal with confused/Alzheimer's patients can only help as the incidence is predicted to skyrocket in the next few decades. Ditto for dealing with difficult families, learning how to accept death, communicate with nurses, doctors, rehab, etc.

 

I definitely think it would be great if you can get higher level HCE as well but just wanted to say that you can put a positive spin on the aide work (easier said than done while you're in the trenches, I know) and that you havn't wasted your time!

[WanderlustPA]

How do you qualitatively measure a PA's long term performance based upon one year of clinical experience? I guarantee you there are a majority of people here who would disagree with this "program director." I'm not saying there aren't people who can do it, but developing a bedside manner and learning invaluable skills doesn't come from a book in one year. It takes time, experience, and learning the hard way. I guess if you want to experience that steep learning curve, then go right ahead. I'd rather push of PA school until I know I'm able to handle the extraneous things associated with medicine before I jump in the deep end. Only my 2 cents.

 

He didn't. He measured performance in PA school. Someone said earlier (might have been you, not sure) that it was not recommended to go to PA school without HCE. I'd love to see some kind of evaluation of recent grads, and then see which ones had HCE and which ones didn't. I bet there'd be no correlation.

 

When you look at some of the issues with healthcare in this country, and the provider shortage, it really doesn't make sense to have a large number of intelligent, talented, and driven individuals working entry-level healthcare jobs when they could instead go through 27 months of training and be a mid-level provider. It's a waste of time, a waste of money, and a waste of resources. But then again, we waste a lot of all of those in this country! :wink:

 

The only limits you really have are those you put on yourself. If you feel like you need that experience, then by all means get it. Just keep in mind, if you delay PA school for 2 years, then by the time you do graduate, you could already have 2 years of experience AS A PA! Between those 2 PA's, if I were a patient, I'd rather see the one with 2 years of PA experience.

[Friction]

According to some of the PA's on here who have 20+ years of experience there is a difference, I couldn't tell one way or the other. Personally, and this is only me, if I didn't have my Navy Corpsman training and my time as an ED tech I would not feel nearly as ready or capable as I do now. Others may be different.

[Moiraine57]

I think this is a fascinating debate.

 

I just don't get the focus on low level healthcare I see in some threads around here. Either PA school can teach you what you need to know from scratch, or you need a solid healthcare background.

 

Either way, CNA seems immaterial. If a solid healthcare background is needed, CNA (or physical therapy aide, or pharmacy tech) doesn't check that box. If it isn't needed, then why the focus?

 

I think the process as its currently instituted makes no sense. If a PA is truly a mid level provider whose expertise is based upon years of high quality HCE PRIOR to PA school, then we shouldn't dilute those standards for someone who works 1000 hours as a CNA to check some box.

 

If the PA school thinks it can form a mid level provider out of essentially whole cloth, then stop the "need HCE" nonsense and make it more like med school-a few hours of shadowing and maybe some volunteer experience, just to know the environment you're getting in to.

[WanderlustPA]

I think this is a fascinating debate.

 

I just don't get the focus on low level healthcare I see in some threads around here. Either PA school can teach you what you need to know from scratch, or you need a solid healthcare background.

 

Either way, CNA seems immaterial. If a solid healthcare background is needed, CNA (or physical therapy aide, or pharmacy tech) doesn't check that box. If it isn't needed, then why the focus?

 

I think the process as its currently instituted makes no sense. If a PA is truly a mid level provider whose expertise is based upon years of high quality HCE PRIOR to PA school, then we shouldn't dilute those standards for someone who works 1000 hours as a CNA to check some box.

 

If the PA school thinks it can form a mid level provider out of essentially whole cloth, then stop the "need HCE" nonsense and make it more like med school-a few hours of shadowing and maybe some volunteer experience, just to know the environment you're getting in to.

 

Very well said. I actually read on one program's website under the admissions criteria that the reason for requiring HCE was that it "showed a commitment to the application process." That's it! Don't my 2 years of pre-req classes accomplish that?!

[Timon]

I'm interested to know if there is a correlation. Speaking from personal experience it's one thing to be taught something in a class and its another when you see it done in person. I say this because as a CPR instructor we practice CPR all the time as we demonstrate how to perform this BLS skill on manicans. When I saw CPR performed during a real code I was conflicted and actually doing chest compressions on a real patient is so much different then just practicing it. Especially working as a team with various departments all at the same time.

 

Working as an ER Tech I feel I'll be going into my program with confidence and that little seed of knowledge that'll later sprout and mature into a strong plant with strong roots / foundation. I can't speak about experience as a CNA and working at a hostile or at a SNF. But everyday I work I honestly feel like I'm being paid to learn. I mean I can probably write about 100+ pages of stuff I learned in the 8 months I've been working as a Tech from setting up and step by step what to do and why from suturing to pericentesis to splinting to correlating lab values to C/O to splinting to reading diagnostic images to just learning how the system works.

 

Prior to gaining HCE I myself didn't see the point and viewed it as a formality. After working in the ED I can tell you I understand now how invaluable this experience has been for me and feel blessed to have had the opportunity. In my opinion, as remedial as it seems, I recommend if you haven't had direct patient contact HCE to go do it regardless if you're a shoe in because your GPA is flawless. You will not regret it.