Thursday, February 24, 2011

New Kid on the Block

After 3 months on the job, I'm no longer the new kid!  Well, that's not totally true because I still consider myself new, but we have a newer team member now.  I worked with her for the first time a couple days ago and it was a strange feeling giving her advice and answering her questions.  While I am by no means an expert (let alone feel comfortable in my every day practice) it showed me that I have learned so much in my first 3 months as a PA-C. 

So far a lot of what I've learned deals with institutional things.  By that I mean, the way things are done in my specific hospital.  As any of you who have ever worked in medicine, things are done differently based on region, city and indiviual hospital.  And it includes anything from how you admit patients to the hospital from the ED to what first line antibiotics are for pneumonia or cellulitis.  It also includes what numbing medicine is used for different procedures and what the phone numbers are for lab, radiology, the radiology reading room and the pharmacist (definitely my top 4 people I call!)

While I've managed to get a pretty good grasp on the way things are done at my facility, I've also learned alot of medicine.  When I first started I felt like I knew absolutely nothing about anything.  My PA program (as I'm sure every other one the country) focused on adult medicine.  I only had a 4 week pediatrics rotation and one pediatric course.  I could tell you everything you wanted to know about diabetes or high blood pressure.  I could give you a long list of differential diagnoses for chest pain, shortness of breath or abdominal pain.  And I knew about flu, strep, ear infections and well-child visits, but that's not the kind of patient I see in my emergency department.  We see the kids with chronic medical conditions like type I diabetes, kidney disease, cancer, or those that have had organ transplants.  I've seen some medical and genetic conditions that affect only 1 in 10,000 live births and some even more rare than that.  I'm not saying I haven't treated many kids with common things like flu, asthma, RSV and stomach bugs (see previous post about that, ugh) because I definitely have.  I just get to see some really interesting things interspersed. 

Along with all the medical knowledge and what I consider system "know-how", I've also learned personalities.  From fellow mid-level practioners to residents, attendings and nursing staff there are alot personalities to work with.  And luckily, most are fantastic people and super easy to work with.  Others are a little harder to work with, but that comes with any workplace. 

My confidence is slowly on the rise.  No to toot my own horn, but I've gotten several compliments from a few different attendings over the previous week or two and it feels great.  These past 3 months I've been trying so hard not to make a fool out of myself.  So it feels great when my attending compliments me in front of the residents.  Last night an attending mentioned "we need more people like you in the department."  Talk about making me feel great!

The best part about feeling more comfortable in my role and with my abilities?  Walking to my car at night and not feeling like I may have screwed something up.  Sure, I still worry about my patients when I go home at night, but more because of their disease process, not what I did to mess things up.  I still have good and bad days, but the good days are starting to outnumber the bad.  It's a process and I'm taking baby steps (haha get it?) but I'm getting there!

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