Medical multitasking and my future career (help!)

[Lemon Bars]

I am a pre-PA student, and I will be finished with all of my pre-requisites in a few weeks. But I'm having a bit of a crisis right now and I could use some information. The situation is this: I recently got an emergency room scribe job that I was very happy and excited about. At first I was thrilled to be with the doctors in the exam rooms, seeing how the doctors interact with patients and learning all kinds of new medical terms and how the electronic medical records system works. But after a few days of scribe training I realize that I hate my job. I cannot stand being interrupted when I'm working on a patient's chart and the doctor gives me an EKG reading or some other result, and then asks me to do something else in another patient's chart. Now I've got three things to think about at once; the chart I was working on, inputting the new EKG reading into a second chart, and adding some other thing to a third chart. I'm honestly terrible at multi-tasking and it's very likely that I'll be fired for being terrible at my job (I've already received warnings).

 

Worse than losing the scribe job, this experience has made me question my ability to work as a physician assistant. I watch the ER doc handle so many things at once while being constantly interrupted by nurses asking questions, other doctors calling regarding consults, Xray reports coming in, me asking for physical exam findings, etc. I'm not sure I could ever function at that level.

 

Now, I never wanted to work in emergency medicine. It was never in my thoughts to deal with drunk patients, suicidal patients, stroke victims who can't speak, confused elderly patients with take 20 different medications for 10 different illnesses, and so on. I always imagined myself working at a small clinic taking care of everyday problems like colds and the flu, asthma exacerbations, casting a broken arm, cleaning a laceration and giving a couple of stitches, things like that. My PCP is a nurse practitioner and there are only two exam rooms in her tiny office.

 

I'm sorry for being long-winded. My question is this: Is working in a community clinic a slower-paced, less chaotic environment such as I had originally imagined, or am I deluding myself? Is there a place for me in medicine if I don't want to be fighting through chaos every day? My grades are pretty good I really think I want to do physician assisting but like I said I'm now having doubts. Thank so much for any insight!

[Lemon Bars]

I am a pre-PA student, and I will be finished with all of my pre-requisites in a few weeks. But I'm having a bit of a crisis right now and I could use some information. The situation is this: I recently got an emergency room scribe job that I was very happy and excited about. At first I was thrilled to be with the doctors in the exam rooms, seeing how the doctors interact with patients and learning all kinds of new medical terms and how the electronic medical records system works. But after a few days of scribe training I realize that I hate my job. I cannot stand being interrupted when I'm working on a patient's chart and the doctor gives me an EKG reading or some other result, and then asks me to do something else in another patient's chart. Now I've got three things to think about at once; the chart I was working on, inputting the new EKG reading into a second chart, and adding some other thing to a third chart. I'm honestly terrible at multi-tasking and it's very likely that I'll be fired for being terrible at my job (I've already received warnings).

 

Worse than losing the scribe job, this experience has made me question my ability to work as a physician assistant. I watch the ER doc handle so many things at once while being constantly interrupted by nurses asking questions, other doctors calling regarding consults, Xray reports coming in, me asking for physical exam findings, etc. I'm not sure I could ever function at that level.

 

Now, I never wanted to work in emergency medicine. It was never in my thoughts to deal with drunk patients, suicidal patients, stroke victims who can't speak, confused elderly patients with take 20 different medications for 10 different illnesses, and so on. I always imagined myself working at a small clinic taking care of everyday problems like colds and the flu, asthma exacerbations, casting a broken arm, cleaning a laceration and giving a couple of stitches, things like that. My PCP is a nurse practitioner and there are only two exam rooms in her tiny office.

 

I'm sorry for being long-winded. My question is this: Is working in a community clinic a slower-paced, less chaotic environment such as I had originally imagined, or am I deluding myself? Is there a place for me in medicine if I don't want to be fighting through chaos every day? My grades are pretty good I really think I want to do physician assisting but like I said I'm now having doubts. Thank so much for any insight!

[Guest Paula]

First as a PA you will not be physician assisting. You will be a PA: Physician Assistant/Associate. Big difference. I work in a small clinic, rural, with two other providers. We all multitask as does our staff. Some days I have gaps in time to do paperwork, and other days leave it to the end. I can wait to do some tasks the following morning. Depending on where you work and how busy they are will dictate how much multitasking you need to do. Plus, you may be the one asking a nurse or MA to do some of the multi-tasking for you. You may have some control over that. In the mean-time, think of ways to learn organization, prioritizing tasks, figure out how you can delegate things to others (not now in your current job, tho).

[Guest Paula]

First as a PA you will not be physician assisting. You will be a PA: Physician Assistant/Associate. Big difference. I work in a small clinic, rural, with two other providers. We all multitask as does our staff. Some days I have gaps in time to do paperwork, and other days leave it to the end. I can wait to do some tasks the following morning. Depending on where you work and how busy they are will dictate how much multitasking you need to do. Plus, you may be the one asking a nurse or MA to do some of the multi-tasking for you. You may have some control over that. In the mean-time, think of ways to learn organization, prioritizing tasks, figure out how you can delegate things to others (not now in your current job, tho).

[KCMA79]

If you want to survive as a PA you must learn to multi task. Between seeing patients, reviewing lab/test results, reviewing charts, answering questions from staff, filling out paperwork, returning phone calls, doing research on patient probs and trying to go home at a resonable time after missing lunch you must prioritize and multi task. Being a PA is not a kick back job for most of us.

[KCMA79]

If you want to survive as a PA you must learn to multi task. Between seeing patients, reviewing lab/test results, reviewing charts, answering questions from staff, filling out paperwork, returning phone calls, doing research on patient probs and trying to go home at a resonable time after missing lunch you must prioritize and multi task. Being a PA is not a kick back job for most of us.

[SocialMedicine]

in my opinion medicine is typically a controlled chaos. even in the private practice internal medicine setting. in room one someone is newly diagnosed with HIV and needs 30-45 minutes of support, in room 2 someone has been waiting 20 minutes beyond the appointment time and is asking the nurse to page you in order to complain, the front desk needs to ask you to triage a patient on the phone with SOB for 1 week, all the while the list of phone and email messages pile up on your electronic chart. There is a lot going on and you need to be extraordinarily organized. If you miss a keyword in the history or lab value, or do a cursory review of an ECG someone gets hurt and you get sued and lose money, time, and your job. I laugh\love when friends talk about how stressful selling clothes or cars can be (and I get it , that stuff can be VERY demanding and challenging) but it is not like medicine. People who cannot handle the rigor quickly find themselves in non challenging jobs or become very unsuccessful at what they do. Some jobs which are very challenging and rewarding in medicine do not carry this pace and stress .... I feel they are few and far between. The way reimbursement and cost of practice stands these issues will be here for awhile. Let me say I am by no means the coolest cat on the block .... I can get stressed like most people .... but my hobbies include volunteer firefighting and medic so I am not someone who typically exaggerates the level of stress and interruption (unless of course I am describing a fire I fought recently hah).

[SocialMedicine]

in my opinion medicine is typically a controlled chaos. even in the private practice internal medicine setting. in room one someone is newly diagnosed with HIV and needs 30-45 minutes of support, in room 2 someone has been waiting 20 minutes beyond the appointment time and is asking the nurse to page you in order to complain, the front desk needs to ask you to triage a patient on the phone with SOB for 1 week, all the while the list of phone and email messages pile up on your electronic chart. There is a lot going on and you need to be extraordinarily organized. If you miss a keyword in the history or lab value, or do a cursory review of an ECG someone gets hurt and you get sued and lose money, time, and your job. I laugh\love when friends talk about how stressful selling clothes or cars can be (and I get it , that stuff can be VERY demanding and challenging) but it is not like medicine. People who cannot handle the rigor quickly find themselves in non challenging jobs or become very unsuccessful at what they do. Some jobs which are very challenging and rewarding in medicine do not carry this pace and stress .... I feel they are few and far between. The way reimbursement and cost of practice stands these issues will be here for awhile. Let me say I am by no means the coolest cat on the block .... I can get stressed like most people .... but my hobbies include volunteer firefighting and medic so I am not someone who typically exaggerates the level of stress and interruption (unless of course I am describing a fire I fought recently hah).

[rev ronin]

Yes, rural family medicine runs at a MUCH slower pace most of the time. Less multitasking, but less support from other clinicians, either. I rotated at a clinic where as a PA student, I was the fourth person in the clinic--normal staffing was one receptionist (who was also a volunteer EMT), an LPN, and the PA I was studying under.

[rev ronin]

Yes, rural family medicine runs at a MUCH slower pace most of the time. Less multitasking, but less support from other clinicians, either. I rotated at a clinic where as a PA student, I was the fourth person in the clinic--normal staffing was one receptionist (who was also a volunteer EMT), an LPN, and the PA I was studying under.

[Lemon Bars]

Thanks so much you all! rev ronin this gives me hope. Do you think it would be wise to get a job as a medical assistant in a clinic so that I can see how things fun firsthand?

[Lemon Bars]

Thanks so much you all! rev ronin this gives me hope. Do you think it would be wise to get a job as a medical assistant in a clinic so that I can see how things fun firsthand?

[bradtPA]

Keep in mind, in rural medicine, in between the simple things, you will still see drunk patients, patients with twenty meds for ten diseases, cardiac infarctions, and suicidal patients. Furthermore, unlike the ED, you will likely have to decide the care of these patients without help from others.

[bradtPA]

Keep in mind, in rural medicine, in between the simple things, you will still see drunk patients, patients with twenty meds for ten diseases, cardiac infarctions, and suicidal patients. Furthermore, unlike the ED, you will likely have to decide the care of these patients without help from others.

[Guest Paula]

Keep in mind, in rural medicine, in between the simple things, you will still see drunk patients, patients with twenty meds for ten diseases, cardiac infarctions, and suicidal patients. Furthermore, unlike the ED, you will likely have to decide the care of these patients without help from others.

 

So true. At my clinic the physician is not always available and not always on site. I believe yesterday we saw all of the above. I found when I worked as a PA in an ER it greatly increased my skills to handle such emergencies in a rural clinic. Get yourself organized as a scribe, ask for help with it, and learn as much as you can in your current job.

[Guest Paula]

Keep in mind, in rural medicine, in between the simple things, you will still see drunk patients, patients with twenty meds for ten diseases, cardiac infarctions, and suicidal patients. Furthermore, unlike the ED, you will likely have to decide the care of these patients without help from others.

 

So true. At my clinic the physician is not always available and not always on site. I believe yesterday we saw all of the above. I found when I worked as a PA in an ER it greatly increased my skills to handle such emergencies in a rural clinic. Get yourself organized as a scribe, ask for help with it, and learn as much as you can in your current job.

[winterallsummer]

Don't give up! Being overwhelmed is part of the learning curve. I remember working as a tech in the ICU and undergoing the same experience. Being asked to go get xyz from the supply closet, and on my way there asked to go help move this patient, and before even getting to that patient's room being told to get a room ready ASAP, and then standing there trying to remember all these and getting yelled at "WHERE IS THAT XYZ FROM THE SUPPLY CLOSET I ASKED FOR 10 MINTUES AGO?!".

 

It is just part of the game. But don't get discouraged. You will get better with practice. And other specialties allow you to spend more time with patients and less doing a million things at once. Keep your head up, it will get better!

[winterallsummer]

Don't give up! Being overwhelmed is part of the learning curve. I remember working as a tech in the ICU and undergoing the same experience. Being asked to go get xyz from the supply closet, and on my way there asked to go help move this patient, and before even getting to that patient's room being told to get a room ready ASAP, and then standing there trying to remember all these and getting yelled at "WHERE IS THAT XYZ FROM THE SUPPLY CLOSET I ASKED FOR 10 MINTUES AGO?!".

 

It is just part of the game. But don't get discouraged. You will get better with practice. And other specialties allow you to spend more time with patients and less doing a million things at once. Keep your head up, it will get better!

[rcdavis]

Are you kidding me? Overwhelmed by multitasking?..

I am assuming that you are somewhere south of 25 years old.. And have grown up watching tv while cruising the web while listening to an IPOD while searching thru YouTube on an iPad, while texting on a phone while driving and doing your homework... And so on...

You KNOW how to multitask.. You've been doing it since learning to walk.

 

What you need to do is learn the language of the field you're trying to multitask in..

Once the lingo is learned, everything else falls into place...

 

Hang in there.. It will make sense soon.. Do not give up.

 

Think of it this way.. If a dinosaur like me can learn these things, you can too!

[rcdavis]

Are you kidding me? Overwhelmed by multitasking?..

I am assuming that you are somewhere south of 25 years old.. And have grown up watching tv while cruising the web while listening to an IPOD while searching thru YouTube on an iPad, while texting on a phone while driving and doing your homework... And so on...

You KNOW how to multitask.. You've been doing it since learning to walk.

 

What you need to do is learn the language of the field you're trying to multitask in..

Once the lingo is learned, everything else falls into place...

 

Hang in there.. It will make sense soon.. Do not give up.

 

Think of it this way.. If a dinosaur like me can learn these things, you can too!

[Storm-Lynn]

I currently work as an ER Scribe and have been for over 2 years. I am starting PA school in the fall. I just want the OP to understand that i have been exactly where you are right now. I was initially overwhelmed by the ED environment. It cant be completely chaotic at times. Everyone has different learning curves. BUT what makes a difference is tenacity ,determination, and understanding that there is so much to learn from this opportunity. Once you begin to understand the ED flow, which you WILL with observation and patience, this job honestly becomes second nature. I am saying this as i reflect on my shift which included an ICH, STEMI, and Cardiac Arrest within a 1.5 hour period and only one physician. Talk about documentation hell...trust me, it is doable. Gives yourself sometime. You can learn so much with this opportunity so take advantage of that while you can.

[Storm-Lynn]

I currently work as an ER Scribe and have been for over 2 years. I am starting PA school in the fall. I just want the OP to understand that i have been exactly where you are right now. I was initially overwhelmed by the ED environment. It cant be completely chaotic at times. Everyone has different learning curves. BUT what makes a difference is tenacity ,determination, and understanding that there is so much to learn from this opportunity. Once you begin to understand the ED flow, which you WILL with observation and patience, this job honestly becomes second nature. I am saying this as i reflect on my shift which included an ICH, STEMI, and Cardiac Arrest within a 1.5 hour period and only one physician. Talk about documentation hell...trust me, it is doable. Gives yourself sometime. You can learn so much with this opportunity so take advantage of that while you can.

[Just Steve]

There is the culture of medicine. It has it's own gestalt, it's own language, it's own flow. It is no different than being in a foreign country, trying to blend in with the natives. It takes time. Even in the ER, there is a predictable rhythm. Acute MI? 95% get treated the same way. Stroke? Once you find out how long the symptoms have been present and certain key co-morbidities, you have a rough outline that you are going to work in. Acute on chronic respiratory failure secondary to COPD exacerbation and SIRS/pneumonia? Treatment plan is already flowing in my brain before I can finish writing out the diagnosis. Trauma? 85% of trauma runs on autopilot via algorithms that are set by best practices and evidence based medicine.

 

Don't get confused, I take nothing for granted and try really hard to expect the unexpected. Getting complacent is manslaughter...but there is order in chaos.

 

But my point is, once you learn the basics, you get more and more comfortable. Jumping in the deep end without knowing how to swim means 1 of a few things...you drown immediately (get fired while on probation), you struggle like hell, get exhausted then drown (fired after having training phase extended), or somehow you figure a way to stay afloat and survive. This is in contrast to wading in the shallow end and learning how to swim while you can still touch the bottom.

 

The ER is a pretty damn deep portion of the pool. A multi provider family practice clinic associated with a university hospital? Water wings and sunscreen..the choice is yours.

[Just Steve]

There is the culture of medicine. It has it's own gestalt, it's own language, it's own flow. It is no different than being in a foreign country, trying to blend in with the natives. It takes time. Even in the ER, there is a predictable rhythm. Acute MI? 95% get treated the same way. Stroke? Once you find out how long the symptoms have been present and certain key co-morbidities, you have a rough outline that you are going to work in. Acute on chronic respiratory failure secondary to COPD exacerbation and SIRS/pneumonia? Treatment plan is already flowing in my brain before I can finish writing out the diagnosis. Trauma? 85% of trauma runs on autopilot via algorithms that are set by best practices and evidence based medicine.

 

Don't get confused, I take nothing for granted and try really hard to expect the unexpected. Getting complacent is manslaughter...but there is order in chaos.

 

But my point is, once you learn the basics, you get more and more comfortable. Jumping in the deep end without knowing how to swim means 1 of a few things...you drown immediately (get fired while on probation), you struggle like hell, get exhausted then drown (fired after having training phase extended), or somehow you figure a way to stay afloat and survive. This is in contrast to wading in the shallow end and learning how to swim while you can still touch the bottom.

 

The ER is a pretty damn deep portion of the pool. A multi provider family practice clinic associated with a university hospital? Water wings and sunscreen..the choice is yours.