i have already become pro at coming home and ignoring my husband and falling asleep w/ my clothes on, so i'll make this quick since i'm still awake and he might want to see me conscious for a change. 10-12 hours on my feet and getting up at 5am....not my bag, baby.
anywho--things are going well. i'm terrified most of the time but have started to get over the EVERYTHINGHASTOBECORRECTANDPERFECTEVERYSINGLETIME thing and am relaxing and sponging up info. i HATE to be wrong, but such is life as a student. so even stupid simple questions that make me paralyzed in the OR when drilled by a surgeon and that i get wrong by stammering something like...."ummm.....blue?" don't freak me out as much now. i've had some great preceptors and they're letting me do SO much. i'm already first assisting and suturing closures and stuff (badly, still, but getting better) and have seen and participated in some really neat surgeries. i'm getting comfortable w/ the names of the instruments and procedure methods and know how to make myself useful in the room pre and post-op. i'm also starting to get the layout of the building so i don't keep having to ask janitors to point me to surgical suite #4.
more soon....
Thursday, August 30, 2007
Monday, August 27, 2007
OH-HOLY-HELL-I-WAS-IN-SOMEONE'S-BELLY!!!
so first day of surgery today and everyone was splendid. very sweet, understanding, generous. the place isn't as far from my house as i thought and the hours are MUCH better than i originally feared. i'll be working mon-fri w/ one night of call (from home) each week and (tra-la-la) NO WEEKENDS! i'm actually on-call tonight....so might need to cut this short to go, you know, save lives and suture stuff back together....or something.
there is a huge surgical PA dept and they're all sweet, young, and seem to really enjoy what they do. many went to my school and know my professors, so we were able to share in that.
so that is how everyone around me was today. but you might ask, " my dear stressed-out-manic PA student, how were YOU today?" i was fair. i was friendly and out-going and not afraid to ask (unbelievably dumb) questions. but i yes very much indeed did almost pass out on my first case. like everyone warned us we would. i complied beautifully.
i got there before 7 and by 8:30 or so, i was in surgical scrubs w/ my dead sexy hair net and shoe covers, scrubbed in and working on a belly case. the incision under the belly button did me in. i felt sweaty and couldn't catch my breath, so i sat down and the nurses rushed over and fussed over me. as soon as i was sitting and my gown was off, i felt better. so i scrubbed back in and joined the team. then the little black confetti started showing back up in to my peripheral vision and eventually took over the whole visual field. so i sat down again. all in the room were trying hard to be sympathetic and not laugh at me, and were mostly successful. they were reassuring and not judgmental, but i was still pretty mad at myself.
we did a few more belly procedures and after the first case, i no longer felt dizzy and really enjoyed myself. i got to hold a camera (on a long tube, inserted deep into the abdomen and the image displayed on screens above our heads) and i also got to do some sutures. which were less-than. i will continue to practice on chicken breast, towels, my sleeping husband, etc until i get it right.
more later.....so sleepy.....
there is a huge surgical PA dept and they're all sweet, young, and seem to really enjoy what they do. many went to my school and know my professors, so we were able to share in that.
so that is how everyone around me was today. but you might ask, " my dear stressed-out-manic PA student, how were YOU today?" i was fair. i was friendly and out-going and not afraid to ask (unbelievably dumb) questions. but i yes very much indeed did almost pass out on my first case. like everyone warned us we would. i complied beautifully.
i got there before 7 and by 8:30 or so, i was in surgical scrubs w/ my dead sexy hair net and shoe covers, scrubbed in and working on a belly case. the incision under the belly button did me in. i felt sweaty and couldn't catch my breath, so i sat down and the nurses rushed over and fussed over me. as soon as i was sitting and my gown was off, i felt better. so i scrubbed back in and joined the team. then the little black confetti started showing back up in to my peripheral vision and eventually took over the whole visual field. so i sat down again. all in the room were trying hard to be sympathetic and not laugh at me, and were mostly successful. they were reassuring and not judgmental, but i was still pretty mad at myself.
we did a few more belly procedures and after the first case, i no longer felt dizzy and really enjoyed myself. i got to hold a camera (on a long tube, inserted deep into the abdomen and the image displayed on screens above our heads) and i also got to do some sutures. which were less-than. i will continue to practice on chicken breast, towels, my sleeping husband, etc until i get it right.
more later.....so sleepy.....
Sunday, August 26, 2007
Last Day of Freedom.....(gulp).....
i am on my last day of vacation (which started last thursday) and i start my rotations tomorrow morning at 6:45am in a hospital 45 minutes from here. it's surgery, and it's supposed to be a really good rotation. but seeing as i have nothing to compare it to, a "really good rotation" may only mean they don't beat us w/ medical instruments and let us sleep on an actual cot when we're on-call instead of down in the morgue w/ the lawsuits.
i think it actually means we get to be involved in a lot of cases since there are no medical students at this particular hospital, so we're kind of the top of the heap of the student order. in many hospitals we're competing w/ the medical interns and residents for time w/ the attendings and opportunities to do procedures.
i've gone from feeling terrified to feeling inevitable about the whole thing. i only know what i know and can only be as charming and out-of-the-way as i can be, so that's what i'm prepared w/. i had every intention of re-reading much of my surgery text book this week and re-learning all of human anatomy, but this is not going to happen. it's been a very relaxing, enjoyable week. today is my day to get all my last minute stuff together (and to be totally honest, to pace the house in terror).
all of my classmates are feeling jittery and uncertain, also. the few of us who have surgery first have a lot of anxiety, since this will be the most new, most different from what we learned. and some of us have a bit of a woozy issue with body gore....so we'll see how that goes. working in a hospital i've had my fair exposure to colostomy bags and bloody emesis (puke) and feel ok about all of the smells and sights i'll experience, but i remember making abdominal incisions into the cadaver and 'feeling his pain' and so anticipate the actual scalpel to living flesh experience will be a bit nerve-racking. also, our professors have instructed us repeatedly on backing out of the sterile field and sitting down if we feel light-headed. apparently students drop head-first into sterile patients all the time. something about no sleep, no food, and a stretch of 8 hours on your feet in hot surgical scrubs and gown. go figure. i'll keep you posted. if anyone wants to start a bit of a wager on how soon/how often i'll bite it, i would not be the least offended (and only expect 20% of the winnings....i'm not to proud to go down for the right price).
anyway.....off i go. i feel like i'm jumping either onto a roller coaster or into a black hole. also, i am seeing that w/ only a week off, i head into a WHOLE NOTHER YEAR OF THIS. i am so aware what the last 12 months did to me...how long it was, how much work and angst and stress it was. i feel like i've been through the battle and should be able to sit it out for a while...but instead i have to be even more alert and vigilant as now there will be vulnerable patients relying on me. i have to keep my head in it and as one of my classmates rips off from "Finding Nemo," i have to "just keep swimming, just keep swimming...."
more soon.....wish me luck!
i think it actually means we get to be involved in a lot of cases since there are no medical students at this particular hospital, so we're kind of the top of the heap of the student order. in many hospitals we're competing w/ the medical interns and residents for time w/ the attendings and opportunities to do procedures.
i've gone from feeling terrified to feeling inevitable about the whole thing. i only know what i know and can only be as charming and out-of-the-way as i can be, so that's what i'm prepared w/. i had every intention of re-reading much of my surgery text book this week and re-learning all of human anatomy, but this is not going to happen. it's been a very relaxing, enjoyable week. today is my day to get all my last minute stuff together (and to be totally honest, to pace the house in terror).
all of my classmates are feeling jittery and uncertain, also. the few of us who have surgery first have a lot of anxiety, since this will be the most new, most different from what we learned. and some of us have a bit of a woozy issue with body gore....so we'll see how that goes. working in a hospital i've had my fair exposure to colostomy bags and bloody emesis (puke) and feel ok about all of the smells and sights i'll experience, but i remember making abdominal incisions into the cadaver and 'feeling his pain' and so anticipate the actual scalpel to living flesh experience will be a bit nerve-racking. also, our professors have instructed us repeatedly on backing out of the sterile field and sitting down if we feel light-headed. apparently students drop head-first into sterile patients all the time. something about no sleep, no food, and a stretch of 8 hours on your feet in hot surgical scrubs and gown. go figure. i'll keep you posted. if anyone wants to start a bit of a wager on how soon/how often i'll bite it, i would not be the least offended (and only expect 20% of the winnings....i'm not to proud to go down for the right price).
anyway.....off i go. i feel like i'm jumping either onto a roller coaster or into a black hole. also, i am seeing that w/ only a week off, i head into a WHOLE NOTHER YEAR OF THIS. i am so aware what the last 12 months did to me...how long it was, how much work and angst and stress it was. i feel like i've been through the battle and should be able to sit it out for a while...but instead i have to be even more alert and vigilant as now there will be vulnerable patients relying on me. i have to keep my head in it and as one of my classmates rips off from "Finding Nemo," i have to "just keep swimming, just keep swimming...."
more soon.....wish me luck!
Monday, August 20, 2007
My Week Off
(in satisfied yawn voice) aaaaaaahhhh. sigh. this has been the best vacation ever. went to my parents' cabin with my lovely husband and parents and sister this weekend. we pretty much just slept and ate the whole time. that's what the fresh air is good for- puts you into a nice semi-conscious state of gluttony. yum.
it was good to get re-acquainted w/ my husband. i think last time i saw him he may have had a beard. and he seems taller now. huh. the poor guy. this year has been madness for our marriage. we've faired pretty well, but it's stressful for one partner to be so focused on something so all-encompassing as PA school. he's become the maid, gardener, chauffeur, cook, and ambassador (standing in as my representative for important family functions such as MY OWN FATHER's 50th bday party). he's a trouper, though, and is right there with me celebrating the success of finishing this school year. i think he's glad i have real patients to practice on now and won't come home to poke/prod/light up any parts of him any more. i'll never forget the first fundoscopic (eye) exam i attempted on him. in the pitch dark. without any warning. blinded him for an hour. he was so innocent and unsuspecting. not so much after that, though.
maybe eventually he'll stop adamantly denying that he has any hernias for me to palpate when i try to get fresh with him. :)
so this week off for me is all about relaxing and reading real books that can't be classified as text books, catching up on movies i've missed (see side panel of my reviews of the movies i watch) and getting ready for rotations. i'm cleaning my house top to bottom (while my husband may have been the official "help" over the past year, he's like the maid who shtups the boss and so the level of cleanliness ends up rather sub-par). and i'm practicing suturing skills on chicken breasts, since my first rotation is in surgery, and my dog won't hold still long enough for me to try my stitches on her. i'm pretty sure i won't know where the olecranon process is (it's part of the elbow, i just looked it up) so i better be really good at knot-tying and stitch-making to make up for my wholly pitiful lack of anatomy recall. i find that i have words like "olecranon process" floating around my head, but i can't always associate them with anything meaningful. perhaps in time.
it was good to get re-acquainted w/ my husband. i think last time i saw him he may have had a beard. and he seems taller now. huh. the poor guy. this year has been madness for our marriage. we've faired pretty well, but it's stressful for one partner to be so focused on something so all-encompassing as PA school. he's become the maid, gardener, chauffeur, cook, and ambassador (standing in as my representative for important family functions such as MY OWN FATHER's 50th bday party). he's a trouper, though, and is right there with me celebrating the success of finishing this school year. i think he's glad i have real patients to practice on now and won't come home to poke/prod/light up any parts of him any more. i'll never forget the first fundoscopic (eye) exam i attempted on him. in the pitch dark. without any warning. blinded him for an hour. he was so innocent and unsuspecting. not so much after that, though.
maybe eventually he'll stop adamantly denying that he has any hernias for me to palpate when i try to get fresh with him. :)
so this week off for me is all about relaxing and reading real books that can't be classified as text books, catching up on movies i've missed (see side panel of my reviews of the movies i watch) and getting ready for rotations. i'm cleaning my house top to bottom (while my husband may have been the official "help" over the past year, he's like the maid who shtups the boss and so the level of cleanliness ends up rather sub-par). and i'm practicing suturing skills on chicken breasts, since my first rotation is in surgery, and my dog won't hold still long enough for me to try my stitches on her. i'm pretty sure i won't know where the olecranon process is (it's part of the elbow, i just looked it up) so i better be really good at knot-tying and stitch-making to make up for my wholly pitiful lack of anatomy recall. i find that i have words like "olecranon process" floating around my head, but i can't always associate them with anything meaningful. perhaps in time.
Friday, August 17, 2007
Intro
hello, there. i am a physician assistant student and i finished my final exams of my academic year YESTERDAY so i am writing this in bed with a bit of a hangover. this is literally the first day i've been able to sleep in in several months....and i'm up and its not even 8:00am. awesome. i think PA school may have broken my head. :)
the last year was very intense. i had 5-6 classes/semester, which is madness in graduate school. the classes ranged from human anatomy with a cadaver lab (fascinating and so important for our understanding of the workings of the body...but every bit as unsettling as you're imagining right now), pathophysiology, research, pharmacology, howtobeanicepersonandnotkillpatientsonpurpose ethics and policy classes and then the nuts and bolts classes of clinical medicine, physical exam, and diagnostics. i'm in a great program w/ wonderful professors and i have amazing friends/peers alongside me. it's been good, but exhausting.
so a week from now i go into my rotations. they will last 12 months and will include all the major disciplines (surgery, ER, family practice, peds, OBGYN, internal medicine, psych and a few electives) all in 4-6 week stretches. this is like the internship year for medical students, except that since we will graduate at the end of our rotations year and get jobs and be responsible for human lives, instead of continue on for a few more years of residency, our preceptors treat us like 3rd/4th yr medical students. another difference betwixt us and the medical students is that we have no legal restrictions on our hours. you may recall legislation changes that determined that medical students are not allowed to work more than (something like) 80 hrs in a week and 30 hours in a stretch...with the hope that fewer students falling asleep while operating on their patients will result in few casualties and law suites. well, we PA students haven't quite gotten our lobbyists to pull that sweet deal for us...so we stay on after all the med students leave at night.
all i have going into this year is hearsay on what to expect. before starting the program last year i also read the books "The Intern Blues" by Robert Marion and "The House of God" by Samuel Shem, which i really enjoyed but also which gave me a sense of terror throughout this last year as i looked forward into my clinical year. most of my fellow students happily plodded along, just aching for the hard tests to be over, but i always kind of savored the classroom setting since the worst that can happen is you pick the wrong multiple choice answer or confidently announce to your professor and entire class that the 12 y/o kid w/ diarrhea most likely has colon cancer. in the safety of academia your misinterpreting lab values or inability to read an EKG only hurts your GPA, doesn't risk a life or cause a misdiagnosis or get you sued. that is my fear.
and yet i receive reassurances all around that we will have our hands held at first and will "remember more than you think you will" so i go forth with enthusiasm. i just really am hoping i won't be escorted out of my first rotation on the first day, tossed into the parking lot by angry red-coat wearing volunteer help desk old people saying, "you're the worst student we've ever had! did you sleep through the entire 12 months of classes? you are no longer invited into medicine." if that doesn't happen on my first day, i'll feel pretty good. :)
again, my purpose in this blog is to share my experiences and perceptions on my clinicals with my family and friends (who i won't see for long stretches of time, see above under Medical Students Have All the Luck) and for anyone else in PA school, considering PA school, or for those who are sadists and enjoy other people's woes.
hope you're having a pleasant friday....more soon.....
the last year was very intense. i had 5-6 classes/semester, which is madness in graduate school. the classes ranged from human anatomy with a cadaver lab (fascinating and so important for our understanding of the workings of the body...but every bit as unsettling as you're imagining right now), pathophysiology, research, pharmacology, howtobeanicepersonandnotkillpatientsonpurpose ethics and policy classes and then the nuts and bolts classes of clinical medicine, physical exam, and diagnostics. i'm in a great program w/ wonderful professors and i have amazing friends/peers alongside me. it's been good, but exhausting.
so a week from now i go into my rotations. they will last 12 months and will include all the major disciplines (surgery, ER, family practice, peds, OBGYN, internal medicine, psych and a few electives) all in 4-6 week stretches. this is like the internship year for medical students, except that since we will graduate at the end of our rotations year and get jobs and be responsible for human lives, instead of continue on for a few more years of residency, our preceptors treat us like 3rd/4th yr medical students. another difference betwixt us and the medical students is that we have no legal restrictions on our hours. you may recall legislation changes that determined that medical students are not allowed to work more than (something like) 80 hrs in a week and 30 hours in a stretch...with the hope that fewer students falling asleep while operating on their patients will result in few casualties and law suites. well, we PA students haven't quite gotten our lobbyists to pull that sweet deal for us...so we stay on after all the med students leave at night.
all i have going into this year is hearsay on what to expect. before starting the program last year i also read the books "The Intern Blues" by Robert Marion and "The House of God" by Samuel Shem, which i really enjoyed but also which gave me a sense of terror throughout this last year as i looked forward into my clinical year. most of my fellow students happily plodded along, just aching for the hard tests to be over, but i always kind of savored the classroom setting since the worst that can happen is you pick the wrong multiple choice answer or confidently announce to your professor and entire class that the 12 y/o kid w/ diarrhea most likely has colon cancer. in the safety of academia your misinterpreting lab values or inability to read an EKG only hurts your GPA, doesn't risk a life or cause a misdiagnosis or get you sued. that is my fear.
and yet i receive reassurances all around that we will have our hands held at first and will "remember more than you think you will" so i go forth with enthusiasm. i just really am hoping i won't be escorted out of my first rotation on the first day, tossed into the parking lot by angry red-coat wearing volunteer help desk old people saying, "you're the worst student we've ever had! did you sleep through the entire 12 months of classes? you are no longer invited into medicine." if that doesn't happen on my first day, i'll feel pretty good. :)
again, my purpose in this blog is to share my experiences and perceptions on my clinicals with my family and friends (who i won't see for long stretches of time, see above under Medical Students Have All the Luck) and for anyone else in PA school, considering PA school, or for those who are sadists and enjoy other people's woes.
hope you're having a pleasant friday....more soon.....
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