The end

Graduation is in 5 days. I'm totally done with school and clinicals and am waiting to take the PANCE in less than 3 weeks (6/24). I start my new job 7/11 (that's a lucky day to start your career, right?!). It's an awesome, but weird feeling to be here. PA school has majorly changed my life, I think, and it's an interesting feeling to be on the other end of it. I know I've said it a lot lately, but I still can't believe how fast time has flown. I'm not sure that I'll have much to write about after I start working, so this blog has probably run it's course. I'm so thankful for the several of you that have actually taken the time to read my ramblings. :) When I started this blog, I just needed a place where I could talk about my excitement of starting school and talk about what I was going through (most everyone at home was tired of hearing me go on and on about PA school!). I have been pleasantly surprised that other students and pre-PA students have found my blog and have found it helpful. I suppose that was another mission of mine; when I was a pre-PA student I had so many questions. What would PA school be like? What is the interview going to be like? What kind of classes do PA students take? Would I have any life at all once I was in school? I am happy to be able to provide some answers (and hopefully reassurance) to now pre-PA students. I brag about our profession wherever I go to young students I meet... I feel passionate about spreading the word about how awesome PAs are. :)

On to the newest chapter in my life... life as a working professional. It is a very weird feeling to realize that I'm actually finally done with college/school. Other than one semester between undergrad and PA school, I've been going to school full time since kindergarten! I worked in high school and all the way through college (except most of PA school, but clinicals were like work that was unpaid!), so I'm ready to just work and get to have weekends and days off to relax, vacation, and spend time with my family without toting books and computers with me. :) I am also very excited to be one of the less than 3% of PAs in OB/GYN practice (according to the AAPA 2009 census), and hope to help promote our place in this specialty that is currently primarily held by FNPs (when it comes to mid-levels).

Thank you, everyone, for reading the story of my life as a PA-S and I wish you luck in your PA endeavors!

I got a job!

As of yesterday, I have officially lined up a job to start this summer after the PANCE. I will be working as a PA in an OB/GYN group. I'm so excited for the amazing opportunity I've been given and can't wait to start! I totally got my dream job. :)

PA school was a difficult, but amazing experience that most definitely has paid off. Hang in there, PA students! It's so worth it! :)

Time sure flies!

I haven't posted much in a while because I've been crazy busy pumping out the last of my ED and geriatric rotations, the rest of my family practice hours, and studying for my last exams. After 2 years of being seriously busy, I am happy to announce that I am virtually done! I completed my last exams this week (rocked them!), and have just 25 hours left of clinic.

I'm also happy to announce that my job search is going well. I have had a great response and actually have a decision to make between 2-3 job offers. I am currently doing some training/trial time with my first choice job, and loving it.

I can't believe PA school has gone so quickly. Time sure flies when you are busy. I've had an amazing time during school; I've met some amazing people who have become lifelong friends, learned an unbelievable amount of information, and grown a lot as a person. There is nothing like PA school to teach you what you really can accomplish and what you want from life. It feels like just yesterday I started this blog screaming, "I got in!!! I got in!!!" :)

I am so thankful to UC Davis for giving me the opportunity to have these experiences and become a physician assistant. It really is my dream job, and I love it. I think often, lately, of the saying, "If you love what you do, you'll never work a day in your life."

I hope that everyone gets the same opportunity that I did to do what they love. Hang in there, PA students! I know school is busier than you ever imagined and stressful, but it's worth it! And it'll be over before you know it. This is the first weekend in as long as I can remember that I have nothing in particular to do; no studying and no rotations. It's a beautiful thing!

Working on my last 2 rotations!

This week I started my geriatric rotation (in a skilled nursing facility) and my ED rotation. Neither are every day, so I'm filling in the holes of my ED shifts with SNF time. I've been to just one day of each so far, but I love them both. I was hesitant about the SNF rotation specifically, thinking it would be sad and depressing. However, I really like the SNF I'm at and I was pleasantly surprised to find out I am actually really enjoying myself there. There are, of course, some sad cases, but there were several others that were pleasant little old ladies that had so much to share about themselves and their families. And the slower pace was a nice change from surgery. It was nice to get to talk to the patients, and really it's a great medical practice because pretty much all of them are on dozens of medications and have several chronic diseases to think through. The staff has been really nice as well. :)

For ED, I also found that I really loved it! I never pictured myself working in an ED, but it was really exciting and I got to do and see so much for one day! In my first 10 hour shift I stapled a scalp laceration, sutured a leg lac, started an IV (first smooth one, yes!), watched an intubation and central line placement, and saw patients with everything from bumps and bruises to fractures to viral infections. It was fast paced and I loved it! I really love doing procedures, I've found. I also had my first experience with a complete EMR (electronic medical record) system, which was interesting to learn.

I'm about to start my last quarter of PA school and begin the search for a job as a PA. I'm a happy girl! :)

Surgery Rotation....check!

I just finished my surgery rotation and learned a lot during my 2 weeks there. I got to scrub in on a few surgeries, and even help a little with one. I learned a lot about trauma. I learned that I have forgotten a lot of details about anatomy/physiology in my path to squeeze more detailed information in (etiology, clinical manifestations, treatment, etc). It was a good reminder that I need to continue to study those when I study new stuff, because it's so important to understand well. I really thought I had a good handle on anatomy/physiology, etc. until I was constantly pimped on it and realized that I didn't know it well enough to repeat it. Surgery, as a specialty, is fast paced. At the hospital I rotated with, PAs don't get to go in the OR much; they are mainly in charge of the patients on the floor (pre- and post-op) and the clinics (to follow up after surgery, etc). As a PA-S, though, I got to scrub in on some surgeries. I worked with the trauma surgery team, which was extra fast-paced, and you really need to know a lot about trauma to be very good at examining these patients thoroughly, which I did not. I worked with several different preceptors (PAs, residents, and attendings) and most of them were great teachers. One, however, made my whole rotation difficult and it was a new experience for me in a rotation. What do you do if you are not being treated fairly/professionally by a preceptor? I went through my entire 2 weeks trying to wait it out and hoped it would get better, which it didn't. But the rotation is over, and I learned a lot about myself and about surgery. Here are a few tips I would give after this rotation:

1. Although PA school is super fast-paced, and there are plenty of times when you think there just isn't enough hours in the day to get everything done, try to review the anatomy/physiology of each system each time you go to study that system for other things. For example, when you go to learn about treatment, clinical manifestations, etc of the cardiovascular system, have your A&P book out and review CV anatomy/physiology first, then the patho, then the diseases you need to study. It will not only keep your A&P skills sharp, but that in turn will help you to understand disease. A lot of the things you study are not going to stick, unfortunately, if you just remember them well enough to do well on the exam. You have to understand the mechanism of what's going on, and honestly you have to see it in practice several times. I have not been doing this A&P review this way, and it really showed in my last rotation. I plan to take this very good advice I am passing on from one of my great preceptors during this rotation and study this way as I review for my last few exams and for the PANCE.

2. If you are in a rotation and are being treated poorly by a preceptor, don't be afraid to speak up to your advisor/program at the very least. As my advisor put it when I talked with her after this whole rotation was over with, just because you are a student doesn't mean you have to put up with abuse. It doesn't happen a lot, I hope, but it has happened with a few people in my class since we started.

3. In your rotations, try to get involved in seeing/participating in any procedure you can. You will not likely get the chance to be taught these things when you are a PA-C as patiently as when you are a PA-S, and you can get experience seeing things you may not get to see after you graduate (for example, the inside of an OR at this hospital).

4. In your hospital rotations, take advantage of the opportunity to practice your physical exam skills (especially the special tests) on patients with known pathology... it will not only give you a chance to practice, but a chance to see the abnormal results you are looking for but rarely see in your outpatient clinic. Practice listening to lung sounds on a patient with pneumonia or CHF (including those skills you probably rarely use in clinic... tactile fremitus, egophany, etc.), do an abdominal exam on patients with liver disease, cholecystitis, or appendicitis (including Murphy's, and all the special tests for appendicitis - psoas, obturator, Rovsing's), etc. It was really cool for me to see a true positive Murphy's sign, and a true appendicitis with positive Rovsing's and rebound tenderness, etc.

5. If you get a chance, help admit patients from the ER to your service (depending on which surgery service you are working with). Then follow them into the OR, and follow them on the floor. It was a really cool way to see the disease process all the way through.

6. Ask lots of questions; the preceptors you are working with have a lot of experience and are often great at explaining things.

All in all, I was thankful for the experience I had at this rotation. I am looking forward to my next (last!) 2 rotations, and getting back into my main clinic... and then graduation! I have only 3 more trips up to Sacramento for exams and then graduation (3 months and 29 days!). I can't believe how fast it has gone. I can't believe how much I have learned (and how much I have yet to learn!). I can't believe what an amazing experience this has been. I am really thankful that I was given to opportunity to come to PA school, and to soon become a PA-C! :)

Rotations Update

I finished my family medicine inpatient rotation a couple of weeks ago, and I was really glad that I did it. I learned so much and I really enjoyed myself. Inpatient medicine is just so much more intense and complicated than outpatient medicine (which I've been used to), so it has kept my brain on its toes, so to speak. It's been wonderful to be learning at a teaching hospital as well, because there are so many wonderful clinicians willing and excited to teach and help you learn.

I am currently in the middle of my surgery rotation (trauma/general). Overall it has been going really well. Again, there is so much to learn! Trauma care is something totally new to me, let alone surgery. I feel like I know practically nothing after having learned so much at the same time. The constant quizzing from the PA I am working under is reminding me not to let my brian get lazy and to always keep going back to the basics (how long ago was SBD????). In PA school, at least in my experience, it goes so quickly that you only have time to learn a little about a lot of things. When it comes to hospital medicine, I'm realizing, you have to know a lot about a lot of things. It's been back to the books for me! An amazingly interesting adventure, though. I have just one more week to go in this rotation. I hope I get to scrub in on some cool surgeries! I got to scrub in on a cholecystectomy last week. Pretty basic as far as surgery goes, but awesome to see nonetheless. :)

I can't believe it's February already! 4 months and 6 days until graduation! I can't believe it!

Happy New Year!

Happy New Year! I'm excited that 2011 is finally here. 2010 was a great year, but I'm looking forward to a lot of good things in 2011. First of all, 2011 is the year I graduate from PA school, take the PANCE, and start work as a full-blown PA-C! I'm excited about the prospect of both my husband and I working and not going to school at the same time (that's never happened before for both of us at once!). Although I plan to eventually pursue a Master's degree in PA studies, I don't plan to do it right away. In 2011, now that school will be done, we are hoping to start expanding our family. :) What a great year this could turn out to be. :)

For now, I'm trying to find ways to earn a little extra money... I've found it difficult if not impossible to work much during PA school and finish on time. Anyone need a photographer? ;) I really enjoy photographing families, but just haven't had the time to advertise much during school. Here's my website, if anyone is interested or wants to see. :) I'm also going to play around with affiliates... for example Amazon has a program where I will get a small percentage of the purchase if someone makes one from a link here on the blog. Not much, but I occasionally do mention PA related books, so I figured it couldn't hurt. For example, I found this little pocket reference book (Medical Notes by Bruce Lee, MD - see link at bottom of post), and have found it very useful in my rotations, especially my inpatient hospital rotation, although I use it occasionally in my outpatient clinic as well. It has laminated-type pages so you can write on it with a ballpoint pen and "erase" it with an alcohol swab. I love it because it has a place to put sticky notes at the front, and has a quick reference to everything from some physical exam reminders to algorithms to procedures to some diagnosis tables. It is a little fat, but lightweight and fits great in a lab coat pocket. So if you happen to buy this little book, click on the link at the bottom of this post, please. :)

I promised an update on my inpatient rotation. So far week 1 was awesome. I've really enjoyed the residents, medical student, and attendings I have worked with. I am learning a lot already. I like being able to take one or two patients and follow their care daily from admission to discharge. In the mornings, I arrive at the hospital between 6:30 and 7:00 AM, I review my patient's chart for vital signs over the last 24 hours and talk to the nurse to see if there were any events overnight. I then do a quick visit with my patient; a quick physical exam for signs of improvement or worsening of their condition and watching out for other things that can happen from being in the hospital and in bed all day. I ask him/her about how they did overnight. I then write up a progress note, look up their labs from that morning, grab a quick coffee and breakfast (at my hospital it's free in the medical staff lounge - sweet!), and head to meet up with the residents for "Morning Report." Morning Report is basically a half an hour where one resident either presents a patient case scenario or a quick presentation on some other medical topic for us to learn from. I then head over to meet the team for morning rounds. I then present my patient and any changes from yesterday to the attending, as does everyone else on the team with their respective patients. We then go around to each room as a team (for me it's myself, a medical student, an intern, a senior resident, and the attending) and the attending quickly sees the patient. Then I put in orders for any new labs or medication changes, if necessary and have the rest of the day to do research on my patient's disease, study some, and wait for people to get admitted or discharged, which I help do when they occur. It makes for a fun, albeit early, day. And I've really been loving it. I have 2 weeks left, and I'm excited to go back tomorrow. It was nice to have a long weekend, though (my resident gave us Friday and today off - this team doesn't work Saturdays).

Happy New Year! I hope everyone had a great time and are looking forward to 2011 as much as I am! :)

To Hospital I Go

I hope everyone had a wonderful Christmas; I know I did. I took the last week off of studying (I'll probably pay for that later, but I needed it) and it was nice, although I was sick for most of it. :( I'm feeling better now, and Christmas is already over. Time to get back to work.

This afternoon I got a quick tour of the part of the hospital I am going to be in for the next 2 1/2 weeks doing my inpatient rotation. I'm getting things prepared tonight and catching up on tracking my patients from my outpatient clinic. I will try to post next weekend, at the end of the first week, an update on how the rotation is going.

Happy New Year! (almost!) I cannot believe it is about to be 2011. I was looking at my calendar today, at the days I have to be in class and the tests I have to study for, and it is starting to sink in that I'm almost done! 5 1/2 months left! Time to hit the clinic/hospital with roller skates on to get all of these hours and MCRs done so I can be done by graduation! PA-C here I come! ;-)

Vacation

Vacation does happen in PA school, at least in my program. Not much, but I have been usually able to manage a week between quarters. This "break" I was planning to go to clinic but my preceptor is taking the week off for Christmas so I took the opportunity to take a week break myself. This weekend my husband and I are hanging out and relaxing at a cabin my parents own. It has been raining nonstop since yesterday morning! Very relaxing and I'm thankful to have such a warm, dry place to be. 

This coming week I plan to use to do some serious house cleaning and baking for Christmas. With a program that goes straight through for 2 years, these little breaks are important for your sanity and stamina. I think they help me gear back up to hit the next quarter at full steam and be able to continue to be able to give PA school 110%. It's easy to feel guilty and just push through to study the next quarters' material, thinking that it will keep you from getting behind. Or that you can get that many more hours in clinic done. But I think it's important to remember to squeeze in some "me time" here and there; you have to take care of yourself if you expect to be able to take good care of others. 

Just after Christmas I start my inpatient hospital rotation, which I'm excited about. I'm looking forward to the opportunity for new, exciting learning experiences. Merry Christmas, everyone!!!

Happy Thanksgiving!

I have had a wonderful Thanksgiving weekend so far. We spent one day with my family, one day mostly just my husband and I, and this weekend with his family. It has been so nice! I'm really excited to start decorating for Christmas this week, too.

What are holidays like for a PA student? Well, that depends on your program, but in my experience, there really aren't any substantial "breaks" and no holiday has been completely spared from the need to study. I took the last 2 days off but brought my books and laptop with me so I can study in the car to/from my husband's family get together. Thankfully, I have quite a bit less studying to do this year as a Year 2 student than last Thanksgiving/Christmas as a Year 1.

I hope everyone has had a wonderful Thanksgiving and were able to take a quick break from studying to enjoy spending time with family. Remember them? Those people you used to see a lot before PA school started? ;) Nah, in all seriousness it hasn't been that bad this year. 2nd year has definitely been much better for family and spouse time.

This year I'm thankful for my wonderful, supportive husband and family who have put up with me during this crazy busy journey that is PA school. I am thankful for finding a career where I love being at work and doing what I do, and one that will also allow me to be constantly challenged yet have time to be with my family as well. I am thankful for my second family; my amazing friends I have made in PA school. Even though we don't live close to each other, we've become very close and formed lifelong friendships. I am looking forward to hanging out with them in 2 weeks when I go back to Sacramento for finals.

Happy holidays!!!