Wife PA Asked to Leave First Job - Help!

[JeffreyEE]

Hi All,

 

My wife graduated from PA school last year, and started a job at a local hospital in the Trauma Surgery department. She rotated at this job during her last year of PA school, and they liked her enough to offer her a position.

 

7 months into this job they asked her to start looking for a new job. Apparently they were not happy with her performance, although they didn't say much to her about their perceived deficiencies in the months leading up to this. To put it lightly, this has absolutely devestated her. She is depressed, anxious, and scared to death to interview for any other jobs because she is afraid of this happening again. She has lost all confidence in herself, and is constantly talking about how she knows absolutely nothing, and how her short-lived career is over (which I know is a ridiculous statement, but when she says it she believes it).

 

I should add that this isn't her first battle with severe anxiety; she exhibited similar symptoms while in PA school after a particularly tough internal med rotation, talking about how she knows nothing, and how she was going to have to quit school. She was prescribed a benzo to help with the anxiety, and was on Cymbalta for a few months, which seemed to help. After she was feeling better, she eventually weened herself off of these medications, and went on to graduate PA school and pass the PANCE no problem. Everything was going great up until now, where these almost identical symptoms have re-surfaced.

 

I'm not necessarily looking for help from the psychological aspect of this, as I know this is not exactly the right place for that, however I was hoping to get any insight that any of her fellow PAs could offer for a PA in this awkward position so early in her career. She is scared to death that any place that hires her will expect her know more than she does, and that she will lose her job again.

 

Thanks so much for reading, and any words of wisdom are greatly appreciated.

[jmj11]

Catastrophizing . . . we all do it at times. She is just out of school and has a long and wonderful career ahead. You learn from your mistakes. She needs to humbly and honestly find out why they didn't like her. Then either focus on fixing this, or move into the specialty where she might have a better fit. Have her read about catastrophizing over and over and get her rational self back on track.

[bgdog]

The operating room has a certain culture to it and it helps to understand that culture in order to safely navigate those potentially treacherous waters. The personalities that are attracted to this specialty can be problematic to say the least.

 

If one does not have a lot of surgical experience and a knack of how to get a long with everybody, then it may not be the best specialty, especially for a novice.

 

There are more forgiving/less stressful area’s of medicine that may suit your wife better.

 

She just needs to find the right fit.

 

Good luck.

[Just Steve]

Thankfully they gave her advance notice. If anything, perhaps she can see that the Trauma Team sees she has potential to succeed in medicine and don't want to just cut her loose as a lost cause. They recognize it will not be a long term fit and are at least willing to give her a little time to find a better match. I understand her mind is probably not in the right space at the moment but is there any possibility she could approach the team and say "Thanks for the heads up, I am currently looking, do you have any suggestions of 1. what may be a good match? 2. know anyone looking? 3. areas for improvement?

[Derbingle]

The first few years are quite hard. And if you find yoruself in a specialty where they feel your personality isnt aggressive enough, as is required in trauma and espcially the OR culture they may just think its not a good fit. This is not uncommon so muster faith and look ahead. It doesnt mean she shouldnt be a PA. She must regroup, tend the wound inside, (it will go away eventually). There are many good jobs. I am out three years now. The first one was in neurosurgery, hard, self doubting daily, not much postivie feed back, it was i who realised it wasnt a good fit. OR is a lot like mean high school. Who needs that. Went to peds while I waited for hospital credentialing for my current job. Was pleasantly thrilled and entertained with peds. Fun job. A little boring but never hard or unhappy. Im back to EDnand its been five months of growing pains, i like to call them. Tough, tough work. But i know each month is better. And for you each month will be better. Confidence comes from knowing what to do and that takes times and experience. Try to encourage here to get over to

He ego hit, and be glad they are giving time. I would caution against learning why they have made the decision unless she is feeling up to handling what ever they may say. Might be as easy as personality differences and thats a big one whe working so close with docs under stress. In any case, she has a long career aheadnof her. Dont allow this first job to define here. She has madenitt his far. She will keep going. Take a breather! Good luck to her.

[zepoPA]

My first job after PA school was Trauma. I loved it, it was my passion. However, I had to leave trauma for reasons different than your wife's: I chose to be a Mom in the evenings and put my sons to bed every night. I thought it was going to be horrendous to switch specialties and "learn a new trade" outside of trauma! It was scary and caused a lot of anguish to say the least. In retrospect, it was the best decision I made because in no time I was very comfortable with Primary Care.

I am not suggesting that she should change specialties... I am merely relating my personal story in case, after a thorough self evaluation, she decides to leave trauma. Like someone else mentioned, there is a special type of character in Trauma and IMHO Trauma is truly a TEAM. I cannot imagine surviving the level of stress unless I AM an active part of the Team.

 

I agree she should ask the team members (all of them) for suggestions for areas of improvement. This is vital if she choses to pursue the trauma field elsewhere. She can count her blessings for the heads up, take notes about her weak areas, improve such areas and MOVE ON... No need to waste a minute feeling devastated. In trauma there is no time to reflect back. In trauma you evaluate the situation (quickly), elaborate a plan of action for best outcome (quickly), ACT on that plan (quickly), then move on to the next case.

Maybe she simply did not fit in the current Team, if she truly loves trauma surgery and it remains her chosen specialty, It could be a blessing in disguise that she needs to find another hospital where she might perform better. It's ok. And if she choses to switch specialties, that's great too... Welcome to the PA profession. We can move around as much as we want until we find our niche.

 

 

Best luck to her.

PS... As a Primary Care PA I suggest she seeks help for the depression... (Quickly)

[UGoLong]

I agree with zeppoPA. I saw a warning sign reading the OP when you talked about her weaning herself off her meds at about the same time she took a challenging job. Ouch!

 

PA jobs are really in little microcultures that involve their own culture and a relatively small set of players. If one doesn't work out, it's time to try another. Games aren't over in the first inning and careers shouldn't end with the first job. That will take some confidence. She should learn what she can and then turn the page. That may take some career counseling to do, but there is a big world of possibilities out there. I wish you all the best.

[GREEN]

The operating room has a certain culture to it and it helps to understand that culture in order to safely navigate those potentially treacherous waters. The personalities that are attracted to this specialty can be problematic to say the least.

 

If one does not have a lot of surgical experience and a knack of how to get a long with everybody, then it may not be the best specialty, especially for a novice.

 

Yep, a lot of Type A personalities in one small room.

[SocialMedicine]

I think it would be important for her to very professionally in either verbal or written form get some feedback on what went wrong. She should take they advice to mentors, therapist, other support systems and use it as a stepping stone. Was a clinical issue vs. interaction w/ staff etc. She should come up with a way to paint this as not being a right fit and good learning experience for interviews. In a few months I am sure she will be in a new position, and probably one that is a better fit. Good luck.

[Hemegroup]

I find it odd she was given no counsel prior to this announcement. Trust me that something I learned REAL quick out of school is the large degree that politics play in employment situations. I agree with the other PA/PA-Ss' who stated to try and find out what, if it was the indeed real reason, went wrong. Again, this may be a situation of ... ok, for example, I was an EMT at a very large retirement community years back. Everything was great, I rocked the joint. I was terminated. It was so wrongful that I got a lawyer. You know what I finally found out? The CEO's daughter had recently become an EMT and wanted to become a PA. So, thankfully, the HR director there was kind enough to tell me I would always have a good reference from her. And that's what's going to be most important for your wife from here on, apart from any constructive criticism that would be warranted if any at all, is that she have someone in the department who will be willing to give her a decent reference. Then again, in the state of California all people are allowed to ask for is verification of employment, they're not even allowed to ask if it was termination or resignation. But somehow the Docs seem to dodge that bit when they call other Docs for references so have her to speak to one who has been kind to her so that she has that ball in her court. To date, I've gone through many jobs after graduation in 2010 until I finally found one where it is mutually a good fit. Tell her I said to hang in there and that the Universe(s) has/have something even better in store for her ... never give up, never surrender.

[emfdj]

My first job didn't work out either. They didn't have a PA before and didn't have a clue about what a PA could do and couldn't do (and the state's regs are very limiting). They thought I was just trying to get out of doing the work. I moved on to a new job in the same type practice and am loving it. I've been here for two and a half years and will probably stay for many more years. It was very difficult at first, realising that I didn't succeed at what I worked so hard to achieve. I wanted to just forget about being a PA and maybe become a truck driver, or something. My husband stood behind me and encouraged me to stick it out. I won't say it was easy to interview again but I managed to do it. Eventually, I realised the first place was just not a good fit for me. I looked harder at eventual positions to make sure they were places where I could practice the way I wanted to practice. Help your wife figure out what is not working for her at the current place. And let her know that other PAs have been in the same boat, have gotten through itand are better off then they were .

[whoRyou]

I would be careful JeffreyEE your wife might get upset that you are going behind her back and getting advice on HER (although it sounds you have good intentions). Remember HIPAA.

[Guest JMPA]

I think it would be important for her to very professionally in either verbal or written form get some feedback on what went wrong. She should take they advice to mentors, therapist, other support systems and use it as a stepping stone. Was a clinical issue vs. interaction w/ staff etc. She should come up with a way to paint this as not being a right fit and good learning experience for interviews. In a few months I am sure she will be in a new position, and probably one that is a better fit. Good luck.

She will not get an honest answer of why they canned her. what she needs to do is think why they canned her and consider getting counsel. If it was hostile co workers she could be medically blacklisted. Her carreer certainly is not over in either case. The fact that she has trauma surgery experience is only a plus and can be helpful in many other fields.

[Doc Savage]

I would tell her that EVERYONE's Internal Medicine / Hospital Medicine rotation was hard and made them feel like they knew nothing.

 

I rotated with a hospitalist group that I used to work for as a Critical Care Technician... I worked with them for over 5 years while I gained acceptance to PA school. I figured I would at least not struggle as much as some others. WRONG... It broke me off and I felt I was really prepared. I was top of my class for exams and graduated with a honors... so I would challenge anyone who said that their Internal Med Rotation was a "Peice of cake!"

[Hemegroup]

I would be careful JeffreyEE your wife might get upset that you are going behind her back and getting advice on HER (although it sounds you have good intentions). Remember HIPAA.

 

Yes and YOU need to remember that no names or specifics were mentioned. Research HIPAA. And please, make sure you know your facts before you counsel.

 

http://www.hhs.gov/ocr/privacy/hipaa/understanding/summary/index.html

 

Just skip to the 'What Information Is Protected' part ...

 

and that identifies the individual or for which there is a reasonable basis to believe it can be used to identify the individual.¹³ Individually identifiable health information includes many common identifiers (e.g., name, address, birth date, Social Security Number).

[JFarnsworth]

Every PA feels that "I don't know anything" panic, especially in the first 5-10 years of being a PA, regardless of the specialty. It takes a while to understand that some employers don't know how to effectively utilize a PA, and may blame the PA for this. There are places that know what a PA does and how to utilize them appropriately. It's tricky. Be patient with your wife, realize that the feeling of not knowing enough will persist throughout her career, and perhaps suggest counseling and/or medication.

She may not get an honest answer as to why they let her go. From my experience, it could be a myriad of reasons, and may have nothing to do with her abilities as a PA. Remember the limbic system and people's gut feelings... unfortunately they can make or break you. It all depends on the culture of the place. One way to look at it: it's not a good fit, for whatever reason.

Your wife is still young in her career. It took me 12+ years to find a place that complemented who I am as a PA, worked with my family situation, and made me happy. Up until then I endured many disappointments and hardships. Be supportive, and maybe let your wife know that many PAs go through the same thing. She can contact me if she needs to talk and/or vent.

[JeffreyEE]

Wow, thank you so much to everyone for all of the responses, I can tell this is a good group of supportive people on here. I'm going to re-read all of the suggestions and try to relay some of these to her, though I feel like it's difficult for her to take my words of advice seriously since I'm not in the medical field, and I have a relatively low stress desk job that I am well established at.

 

As far as "going behind her back", well, I'm not sure how she would react to me posting this, but you can bet that I wouldn't have even thought to do this if I didn't feel desperate to get my wife back on track. It's been a very difficult month to say the least, and I know that things will get better, but right now I just feel that I need to do all that I can to help.

 

Right now she feels stuck; she doesn't feel good enough about herself to even interview, and is worried that her lack of confidence will show through in these interviews. However, to get confidence, she feels that she needs a job and needs to be learning! Kind of a catch 22. The job offers she has gotten aren't exactly ideal, but she feels pressure to take them because of concerns that the offers will be few and far between. For example, one offer is for an ER job, and it sounds like it would be a great learning opportunity, however it's a one hour commute each way. I'm wondering if it would be worth the commute for her to gain some experience in the ER. Two hours a day in the car is a lot!

 

Thank you again to everyone for the words of encouragement and advice. I'll be checking back, and I'll post an update when we hopefully have some good news.

[jmj11]

Just as another word of encouragement. When I graduated from PA school in Kentucky the job market was horrible in that state. There was a law trying to get passed, being pushed by the Kentucky Nursing Association that would have made it impossible for a PA to work (The MD would have to have visual contact we the PA at all times or something like that). I made 120 cold calls to physicians (as there wasn't a single job opening in the state). I was treated horribly by them. I was told to go blank myself and things like that. I ended up working at Sears part time because I was literally malnourished (eating one packet of Ramen noodles per day). I was damned depressed and felt hopeless. My whole class, save two who had jobs lined up prior to PA school, were in the same boat. One of my classmates shot and killed himself during this time. It took 8 months to land my first job and to do so, I had to go out of state and take a terrible prison job for $14,900/ year. I think half my class never worked as PAs because they got so discouraged they just gave up. I know one went back into nursing and others did Real estate or things like that. But speaking of feeling bad about yourself, I don't know how anyone could have felt worse about our careers than we did. However, things did turn around. Six months into the prison job I was offered a fantastic job and I've never looked back. Things do get better . . . unless you give up on yourself.

[JeffreyEE]

Just as another word of encouragement. When I graduated from PA school in Kentucky the job market was horrible in that state. There was a law trying to get passed, being pushed by the Kentucky Nursing Association that would have made it impossible for a PA to work (The MD would have to have visual contact we the PA at all times or something like that). I made 120 cold calls to physicians (as there wasn't a single job opening in the state). I was treated horribly by them. I was told to go blank myself and things like that. I ended up working at Sears part time because I was literally malnourished (eating one packet of Ramen noodles per day). I was damned depressed and felt hopeless. My whole class, save two who had jobs lined up prior to PA school, were in the same boat. One of my classmates shot and killed himself during this time. It took 8 months to land my first job and to do so, I had to go out of state and take a terrible prison job for $14,900/ year. I think half my class never worked as PAs because they got so discouraged they just gave up. I know one went back into nursing and others did Real estate or things like that. But speaking of feeling bad about yourself, I don't know how anyone could have felt worse about our careers than we did. However, things did turn around. Six months into the prison job I was offered a fantastic job and I've never looked back. Things do get better . . . unless you give up on yourself.

 

Thanks for the words of encouragement JMJ. It's hard to believe things were that bad in Kentucky for new PAs!

[True Anomaly]

Just as another word of encouragement. When I graduated from PA school in Kentucky the job market was horrible in that state. There was a law trying to get passed, being pushed by the Kentucky Nursing Association that would have made it impossible for a PA to work (The MD would have to have visual contact we the PA at all times or something like that). I made 120 cold calls to physicians (as there wasn't a single job opening in the state). I was treated horribly by them. I was told to go blank myself and things like that. I ended up working at Sears part time because I was literally malnourished (eating one packet of Ramen noodles per day). I was damned depressed and felt hopeless. My whole class, save two who had jobs lined up prior to PA school, were in the same boat. One of my classmates shot and killed himself during this time. It took 8 months to land my first job and to do so, I had to go out of state and take a terrible prison job for $14,900/ year. I think half my class never worked as PAs because they got so discouraged they just gave up. I know one went back into nursing and others did Real estate or things like that. But speaking of feeling bad about yourself, I don't know how anyone could have felt worse about our careers than we did. However, things did turn around. Six months into the prison job I was offered a fantastic job and I've never looked back. Things do get better . . . unless you give up on yourself.

 

Wow.....if any of us "youngin'" PA's need a reminder what it was like back in the day, that's a pretty stark example of it.

[whoRyou]

Just as another word of encouragement. When I graduated from PA school in Kentucky the job market was horrible in that state. There was a law trying to get passed, being pushed by the Kentucky Nursing Association that would have made it impossible for a PA to work (The MD would have to have visual contact we the PA at all times or something like that). I made 120 cold calls to physicians (as there wasn't a single job opening in the state). I was treated horribly by them. I was told to go blank myself and things like that. I ended up working at Sears part time because I was literally malnourished (eating one packet of Ramen noodles per day). I was damned depressed and felt hopeless. My whole class, save two who had jobs lined up prior to PA school, were in the same boat. One of my classmates shot and killed himself during this time. It took 8 months to land my first job and to do so, I had to go out of state and take a terrible prison job for $14,900/ year. I think half my class never worked as PAs because they got so discouraged they just gave up. I know one went back into nursing and others did Real estate or things like that. But speaking of feeling bad about yourself, I don't know how anyone could have felt worse about our careers than we did. However, things did turn around. Six months into the prison job I was offered a fantastic job and I've never looked back. Things do get better . . . unless you give up on yourself.

Jim, just out of curiosity when was this? How we all take things for granted ...

[jmj11]

It was way back in 2008 . . . no, 1982. Starting salary with BOP for PAs (new grads) was 14,900/year. That would be $33,000/year in today's money. PA salaries didn't mushroom until the late 80s early 90s.

[Houstonian]

I would encourage your wife to consider a PA residency. It would give her additional training and a stipend. Then she would be more marketable and likely have more confidence.

 

In a well-managed practice she would have been given feedback about her performance before being let go. But we seldom live in an ideal world, and most physicians tend to be non-confrontational. They don't want to deal with management issues; they just want employees who can already do the work.

[whoRyou]

I would encourage your wife to consider a PA residency. It would give her additional training and a stipend. Then she would be more marketable and likely have more confidence.

 

In a well-managed practice she would have been given feedback about her performance before being let go. But we seldom live in an ideal world, and most physicians tend to be non-confrontational. They don't want to deal with management issues; they just want employees who can already do the work.

I do believe this is true, BUT we ALSO live in a world that everything is so P.C. these days. We can't be truthful with one another and if we are honest with one another there may be consequences that might not be so pleasant in the end. :sad: