With the majority of my clinical hours from emergency medicine, I felt relatively prepared for this rotation. After speaking with the PA student coordinator for the hospital they provided me with a schedule and some basics about getting set up at the hospital. After getting my badge and driving almost an hour down to the hospital, I met the first PA I would be working with for twelve hours. She was very nice and willing to teach which made the day go by very quickly. The second and third days of ER I was observing with some doctors who were great teachers, they took the time to "pimp" me on as much as they could. At first I thought the questions (pimping) were going to be really detailed and impossible questions; but after being there for a few shifts now, I realize that most of the questions that are typical "pimping" style questions are really common or really important topics. For example, one of the questions asked as a PA was suturing a kids forehead was "for which can you wait longer before suturing, face or hand?, why?" Which would be face because it has a lesser chance of getting an infection from surface bacteria unlike the hands. When suturing a wound, obviously it needs to be cleaned and irrigated first, however there is still a chance of bacteria remaining or getting into the wound to cause an infection and prevent healing.
Another question they asked was.... "what would be some things to worry about with chest pain?" in this case emergent things should be the first answers like MI and PE. ROS questions can sometimes help get a better picture of what is going on to add to those DDx. For example if the patient says their pain is after they eat then it is likely related to reflux but if it is after a long plane ride while on birth control pills, the risk for PE is much greater and needs to be ruled out. As you can see, I have been having a good first few days in the ER. I have not been able to do many procedures yet, only an IV and some sutures but not much more has come through the door to the physicians I have been working with that required many procedures. I am sure that the days I am working with some of the PA's who tend to do more procedural cases that I will get my fair share of it all.
The days as a student are a lot more fun and less work than being a tech. The entire time I worked for my clinical hours I was running around with what felt like a billion things to do. As a student the most of the "work" I was doing was more brain power than leg power. When I worked in the ICU and ER I worked 12 hour shifts often and never seemed to have an issue with fatigue, however with the driving almost an hour to the rotation site every time, I am getting tired on the drive home. I am very grateful for the 12 hour shifts though, I get more days off and I get more out of the drive all the way down to the hospital. All in all, this rotation is going relatively well so far.
Another question they asked was.... "what would be some things to worry about with chest pain?" in this case emergent things should be the first answers like MI and PE. ROS questions can sometimes help get a better picture of what is going on to add to those DDx. For example if the patient says their pain is after they eat then it is likely related to reflux but if it is after a long plane ride while on birth control pills, the risk for PE is much greater and needs to be ruled out. As you can see, I have been having a good first few days in the ER. I have not been able to do many procedures yet, only an IV and some sutures but not much more has come through the door to the physicians I have been working with that required many procedures. I am sure that the days I am working with some of the PA's who tend to do more procedural cases that I will get my fair share of it all.
The days as a student are a lot more fun and less work than being a tech. The entire time I worked for my clinical hours I was running around with what felt like a billion things to do. As a student the most of the "work" I was doing was more brain power than leg power. When I worked in the ICU and ER I worked 12 hour shifts often and never seemed to have an issue with fatigue, however with the driving almost an hour to the rotation site every time, I am getting tired on the drive home. I am very grateful for the 12 hour shifts though, I get more days off and I get more out of the drive all the way down to the hospital. All in all, this rotation is going relatively well so far.