Starting my second week into this rotation I tried to get more involved. Every morning the residents round on their patients very briefly then write up their notes and orders. I tried to help and take a patient or two of my own to round on, but again, it was very brief. Around 9am the attending likes to have a teaching session where he finds some interesting topic or article. Since I felt as though I could not contribute very much I took it upon myself to look up an article of interest for the next day's talk. The topic he chose was very interesting, traumatic brain injuries and concussions. By no means did I have to work hard to be interested and engaged in these articles, if anything, I was trying to contain my excitement and interest. I try very hard to take on any task given to me such as H&P's or admission notes, but this is not exactly the amount of work that other rotations will have. I like to think that this rotation (at this point in time for me) will help ease me into the chaos that is the ER, my second rotation. I am very grateful for all the things I have learned on this rotation because the ER and primary care offices cannot take the time that the providers can, here, to discuss treatment plans with patients.
Unlike the rest of my classmates, I started my rotations after my vacation (since I went to the AAPA conference). I'm not gonna lie, on the first day I was nervous like most people, there was so much that could have been expected of me, so many things I should have been able to do at a drop of a hat... luckily the residents I am working with are very nice and willing to teach me so many things. The unit I am on is a PM&R section where patients are admitted to do some physical therapy and occupational therapy before they go home.
Physical therapy vs. Occupational therapy
For many of my readers it may not be clear that there is a difference between these areas of rehabilitation so I decided to throw in a little bit about each.
Physical therapy (PT) primarily focuses on improving strength and mobility after a chronic illness or life event. The unit I am on has a PT gym right on the floor where patients attend sessions throughout the day. Their sessions can focus on weighted or non weighted exercises, walking, as well as range of motion (ROM) activities.
Occupational therapy (OT) is primarily focusing on patient "activities of daily living" known as ADL's. These include dressing, bathing, eating, transferring, and toileting. This gym is pretty awesome because patients can feel accomplished when they start to cook and make yummy foods for themselves, their families and the staff.
There are many things within this week that I truly love doing. For example, most of these patients are in the last few days of their hospital stay which makes many interactions very positive. The resident I am working with is very friendly as well as knowledgeable. Her ability to explain conditions and procedures to patients is very clear and concise. At first I was noticing the generally positive interactions the resident was having with the patients but I could not put my finger on exactly what was so great about them. Finally, the resident said something that resonated with me, "its great seeing patients like you (referring to the patient in front of us) because we are catching you on the upswing of your journey here." With this in mind, I continue onto my second week at PM&R...
Once again our three current classes attended our picnic at John Boyd Thatcher State Park in Voorheesville, NY. Just like last year our director congratulated the soon to be PA-C's with a lovely cake and some photographs. The rest of the students brought all sorts of great food and desserts such as pasta salad, veggie trays, dips, subs and much more! Not only was there great food but we also had many different games going on from volleyball and baseball to Kubb (an alleged 100-year-old viking game).
It was also great to have our class get together after being apart for a month (which seems like an eternity after we have been so close since the start of PA school!). The 2018 class are seeing one another everyday but finally had the chance to take a study break and come out to the park for some fun. The class above us (2016 class year) gathered one more time before graduation on this coming Thursday! It was great to run into them and ask about certain rotation sites, what to expect and what to get excited for!
For more photo's, check out the PHOTO's tab above!
...from both points of view. Not only was I trying to make a good first impression with other PA's, students and recruiters for a potential job but what I was not prepared for was the first impression that this conference made on me. Stepping into the conference center that was 2+miles, 3 stories, full of 10k PA's/PA-S's I was instantly overwhelmed. I had never been to something as well organized, as large and as impressive as this conference. Thankfully, my classmate, Dave, was already there for a few days to show me around. With the maps, signs, handouts and information booths, I was able to ask anyone for help. But by the last day, I was able to navigate by myself and meander into some awesome talks!
My goal while at the conference was to learn as much as I could from not just the lectures but also from other PA's, exhibitors and PA organizations. While attending my first workshop, suturing superficial wounds, I met some other PA students from all over the US. The student next to me at the workshop was from Oklahoma and had never practiced suturing before. Even though I have never sutured a patient, I was able to help him with some basics questions about how to hold the forceps and needle driver, how to execute vertical, horizontal mattresses and other sutures. We started to chat a little about our programs and how they differed in so many ways, more than I imagined.
My program director, clinical coordinators, and two other students from my program attended the conference with me and invited us all to dinner at a local restaurant on the Riverwalk. I could not be more thankful for what they provided us while at the conference; whether it be dinner, words of wisdom, or even just gratitude for us taking the time to join them. Aside from the great food and atmosphere, I was able to learn from many other new faces at the conference. I learned so many things starting with some basics about being a hospitalist PA, surgical PA, transplant crisis, job searching, new technology and much more.
Some interesting take home notes:
1. The new criteria for kidney transplants has helped increase the number of kidneys to the middle aged population but decreased the number to pediatrics.
2. The population 60-65+ can opt to get a "hep C- infected" organ and take prophylaxis/meds to prevent the transmission of the hep C so that theoretically they won't get the Hep C. This was developed in one of the major medical facilities but is not extremely popular.
3. Hospitalist PA's see all sorts of interesting cases and get to follow their patients during their hospital stay. One PA said that when he worked in Scotland, if a patient presented with a hip fracture, he/she was given a nerve block to reduce pain. This pain management method was implemented to reduce the number of pain meds and opioid addictions for such a painful injury. I personally think this is a great idea in theory since pain medications do not always "relieve" the pain as much as they make the patient "not care" about the pain. A nerve block can help the patient legitimately "relieve" and "not feel" the pain during their stay or even until they are partially healed. The only downside to this could be more risks of execution, and longer hospital stays, which the US seems to avoid due to over night hospital costs.
4. Unfortunately, I did not arrive until the afternoon on Sunday so I missed out on the Saturday activities; however, my classmate informed me that our SAAAPA leadership group, that I volunteered on, presented our work and seemed very impressive. He said that he thought we "did a lot of work." This makes me proud, even though I only helped in small ways for this group, its great to see that all of us were able to help make something great like clarifying the AOR position and creating ways for other students to get involved in leadership within the AAPA.
5. There are tons of jobs for PA's. Sometimes I get nervous about finding the right job or not being competitive enough for the specialty that I want, but after speaking with different companies, hospitals, recruiters, special interest societies, and other PA's, I started to realize that the world is at our fingertips. Salaries, benefits and opportunities are competitive for facilities to gain more PA's.
6. There are so many different inventions and procedures for learning purposes, efficiency and better patient care. It was awesome to be able to see the demonstrations for some of this stuff. For example, there was a one size fits all finger and toe tourniquet that can reduce blood flow injury. There was also an ultrasound teaching software that allowed students to use a simulated US machine to read, dx and tx. Finally, there was a life size, virtual dissection table (cost ~$70k) that could be used for teaching with a clearer picture of the body. They were trying to sell it as a supplement to a cadaver lab but I see its practical use more in facilities that can not have a real cadaver lab, since even though there is not a tangible component to the VR table, it can at least provide a life size portrayal of dissection.
Would I do it all again?
ABSOLUTELY! Not only was this my first time traveling on a plane alone, navigating the airports during layovers, checking into a hotel and arriving in a city hundreds of miles away from home all by myself, but it was also the first time I was ever more south, in the US, than northern Pennsylvania. I never had the opportunity to travel that much when I was younger, as my family did not have the funds to take big elaborate vacations to Disney World or California, so I truly treasured the opportunity that my program gave me to travel, especially to a professional conference.
When the sun went down and lectures ceased for the day, we took it upon ourselves to meander the land of San Antonio and get some great local Texas cuisine. I never thought that I would be able to set foot on the Alamo or even see the Riverwalk. Something about San Antonio is pretty awesome by day and very charming and welcoming by night. Since all the hotels were very close to the convention center, it was great to be able to walk to my hotel and know I was surrounded by PA's.
So again, would I do it all again? I would say yes, because the things I learned from the conference could not be replaced.