Music and Medicine: journal of a PA student

The Death of M&M

2011-11-28T21:42:00.000-08:00

Hello gang!

Long time, no see. I've been wrapping up my ER rotation and working on my thesis, all while juggling several other projects. No worries; I head home in one week. No rotations, no studying...just me, my family, and some good home cooking!

Today marks an important day in the life of this blog. For almost 4 years it has served as my outlet. I have enjoyed very much the opportunity to use this platform to communicate the struggles and triumphs I have experienced as I abandoned my musical life and chose to take the leap that landed me into PA school. I couldn't be more happy.

I hereby announce the death of Music and Medicine. It will remain up and running so that others may benefit, and so I may visit frequently to remind myself of how far I have come. I am moving on to higher ground; I'm hoping to take some of you with me!

Introducing my newest venture: GetIntoPAPrograms.com

We've put a lot of blood, sweat and tears into this project to ensure that this site provides timely, relevant information in a refreshing manner. Check us out and spread the word!

Stacey

Rotation 6: week 1

2011-11-15T03:53:00.000-08:00

One word: Fantastic!

I'm enjoying the crazy world of Emergency Medicine so far. I've done and seen so much; I'll have to spend this weekend giving you all the details. Stay tuned!

The new website is almost up and running. Those of you who frequent this blog will be the first to see it. I hope it is helpful to those of you who are still chasing the PA school dream. It's been a blast putting it together.

Take care!

BIG ANNOUNCEMENT!

2011-11-01T18:28:00.000-07:00

Hello readers!

I am happy to announce that I am currently working on a new and improved website. My hope is that the new site will serve as a hub for prospective PA students who are looking to put together impressive applications in hopes of securing a seat in the program of their choice. I'll also continue blogging about my clinical year experiences. Only 4 more rotations to go!

I love teaching and sharing information, and that's what the new site is all about. You can expect the same quality material you've seen here, just more bells and whistles...and a few surprises that I'm really excited about.

Stay tuned!

Rotation 5: week 5

2011-11-01T18:12:00.000-07:00

Tomorrow I complete my Psychiatry rotation. It's been such a wonderful experience. The world of psychiatry can be a bit intimidating, but if you approach it with an open mind, it just might change your life.

I was given the opportunity to present Abraham Maslow's hierarchy of needs to didactic PA students one month ago as a guest speaker. I love to teach; in fact, I intend to teach as an adjunct professor in the future. Click here to read the blog entry I wrote about Maslow a few months ago.

I am reminded of Maslow and his hierarchy every time I interact with a patient in the Behavioral Health Unit. So many of them are homeless, penniless, and without family support. How, then, am I to expect a miraculous change in their behavior when their basic needs are not being met? How can I become upset with them when they tell me they haven't taken their medications, or haven't been to a PCP in decades? Maslow's work has really changed my life and the way I approach patients.

I'll be sad to leave this rotation, but I know that the field of psychiatry penetrates and permeates every single medical and surgical specialty. We will meet again soon.

ED...here I come!

2011-10-25T22:21:00.000-07:00

It's 1:22 AM. I'm gonna hate myself when my alarm clock goes off.

A fellow reader wants to know what's next on the clinical agenda. I'm hitting the road again. Next up is Emergency medicine in rural West Virginia. I am very excited. Psychiatry is all about the gift of gab, but I haven't given injections, read EKG's, or even done a physical exam. I look forward to using my clinical skills again.

Graduation is so close that I am considering options for employment. There are so many options to choose from, which is exciting. Because of the detective and our way of living, all options are pretty much wide open. I am in a wonderful place in my life right now! I'll be sure to keep you all posted.

Good night...er, good morning?

Rotation 5: weeks 1 - 4, and a much needed facelift!

2011-10-24T15:44:00.000-07:00

Hello Readers!

Today marks week number four in the world of inpatient Psychiatry. Yes, I entered the hospital for the first time with my eyes and ears wide open and my remaining senses heightened. It took no time at all for me to feel comfortable being on a lock-down unit with patients with diagnoses ranging from paranoid schizophrenia to suicide ideation.

Psychiatry is not for the faint of heart. Sure, there are no codes being called or MI's being diagnosed. The beauty of psychiatry is in the dialogue. It's amazing what people are willing to talk about with people they trust. Sometimes you win trust without even trying. Sometimes it takes days or weeks. My favorite patients have been the ones that scare the nursing staff the most: the antisocial personality disorder patient who is super aggressive, confrontational, and self-mutilates to escape his emotions, and the depressed/suicidal patient who feel larvae growing out of her hair, arms, and legs. These are precious, precious individuals, who are battling illnesses not much different than cancer or heart disease.

I love talking to patients. The gift of gab comes in handy in this specialty, and I think that's why I've enjoyed it so much. Does that mean I may have a future in psychiatry? Not likely. I like to talk, but love using my hands.

The joys of Psychiatry

2011-10-15T19:39:00.000-07:00

I am really enjoying my time on the Behavioral Health Unit. I wanted to really expose myself to the nitty gritty of psychiatric medicine. Boy, did I get it. I will share more detail soon.

Rotation 4: weeks 1-5

2011-09-29T04:26:00.000-07:00

Good morning readers.

Today is the last day at my Geriatrics rotation. I can't believe I've been away from the blog for so long. Moreover, I can't believe that this rotation is already coming to an end. I loved it! The office staff is great, my preceptor gives me a lot of independence and he loves to teach, and the patients have been lovely!

I've seen everything from general check ups, to tongue cancer, to MI's. I've always known I had an affinity for the elderly population, so much so that I could work with them as a PA. I'm not so sure now. Polypharmacy is no joke...managing 14 medications and the possible interactions is time consuming and tricky. Not to mention all the other players that are managing different areas of the patients' care. Still, I have enjoyed the challenge over the past 5 weeks.

Next I head south for my psychiatry rotation. It's an inpatient facility, and from what I hear I'll be spending the majority of my day talking to people who suffer from schizophrenia, suicide ideation, bipolar disorder, etc. I can't wait!

Rotation 3: week 2

2011-08-07T09:24:00.000-07:00

This week was more of the same with a few surprises thrown in. Lots of otitis media and swimmer's ear. Lots of URI's and strep throat. But I also got a chance to see my first case of herpangina. We also had a 16 year-old come in after sustaining a concussion, and a young girl came in and was diagnosed with an avulsion fracture of her right hip.

Unfortunately, it doesn't get much more exciting that that. The majority of my day is spent doing sports physicals. We are easily doing about 15 - 20 physicals a day, with sick visits and well check visits squeezed in between. Other than that, I try to stay on top of reading. As my former preceptor says, "Students can always read more." How right he is!

Student Case #1

2011-08-02T19:04:00.001-07:00

We'll do two cases in one just for fun!

Pediatrics: 3 year-old girl presents with her mother with a 3 day history of fever, stuffy nose and cough. Fever has peaked at 103.4 F. What other history do you want to know? What kind of physical exam will you do?

Ob/GYN: 30 year-old G2P2 patient presents with irregular bleeding. What history do you want? What physical exam findings, if any, do you do?

Let's try to stick with history and physical findings for now, then we will move on the labs/diagnostics. I will only give you what you ask for!

Ready...set...GO!

Rotation 3: week 1

2011-07-30T08:00:00.000-07:00

I've gone from measuring baby bumps, and C-sections to sore throats, AOM's, and sports physicals.

Despite the barrage of ear infections and common colds, I've seen some pretty interesting cases in Peds. A young girl, according to her growth chart, has developed microcephaly as a result of an accident sustained as an infant. An adolescent presented with a classic case of mononucleosis. And I've heard quite a few murmurs as well.

I enjoy doing sports physicals, partly because I enjoy adolescents and I like talking to them. Some feel comfortable having an objective ear listen to them gripe and complain about the woes of life. Others prefer talking to people their own age. Most times, I can at least make them laugh or loosen up before heading out of the office. Overall, the most upsetting thing I'm seeing in this population is obesity. I've never really liked that word. Fat works just fine, and to me it more clearly defines the problem. What's more upsetting is parents are in denial. Anyone who is fat knows they are fat. I don't have to tell them that! The challenge is doing something about it, and this is where physicians and PA's can really step in and offer guidance.

I always like to share my personal struggle with weight with patients. They look at me and think I've been a size 4/6 all my life. Wrong! I tell them how I lost 20 lbs and how I've been keeping it off. I tell them about the importance of weight training, especially for girls. More importantly, I share with them the importance of proper nutrition. You won't believe how many people eat at McDonald's for breakfast, lunch, and dinner, and think that because they ordered a diet coke they are eating "pretty healthy." I haven't eaten at McDonald's for over 15 years, and I think that has a lot to do with my success.

Lifestyle changes can be challenging to make, but it can be done...and fast! I've seen it work in my own life, and this is something I wish to impart to all of my pediatric patients, and all of my future patients. Change is the only constant. Why not make all change POSITIVE!

Week 2 in Peds is shaping up to be a good one. I do find myself eager to get back into the OR. I really miss it. My general surgery rotation is 6 months away, so I'll have to be patient. That's all for now!

Abraham Maslow

2011-07-19T18:04:00.000-07:00

Don't know him? If you are preparing for a career in medicine, you should!

This topic deserved a post all its own. One of the greatest gifts given to me on this rotation is the Maslow hierarchy of needs. Needs...we all have them, and when left unfulfilled, they can wreak havoc on us in many ways. One of those ways is via health status.

When a 19 year-old girl with a flat affect, poor social skills due to molestation and abandonment issues, and a history of miscarriages comes into the office, and after delivering her daughter 10 months ago finds out that she is pregnant once again, think of Maslow.

When a 42 year-old woman who's in an abusive marriage comes in for irregular bleeding, think of Maslow.

When a 20 year-old homeless girl with a history of drug abuse, depression, endometriosis, absent parents, and abusive relationships refuses to be discharged from the hospital because she has nowhere else to go and likes Dilaudid, think Maslow!!

Practicing good medicine is treating the acute condition. Practicing great medicine is understanding the psychology behind the diagnosis. Often times I find myself wondering why patients do the things they do. Why do they take chances with their bodies. How is it possible for a young person to have such a long list of complaints. Why is she having another baby. The answer is Maslow. Understand that, and the picture becomes more clear. Medicine, whether you practice Psychology or not, is all about psychology. Talk to your patients and give them more than pills. Give them your ear. Let them know you are aware of the conditions they are in. Offer them assistance if you can. Refer them to counselors and psychologists. Most of all, let them be heard. If possible, work with them to fulfill whatever need that should be met. Do that, and the behavior begins to change. Do THAT, and the body can begin to heal itself.

Maslow's hierarchy of needs...look it up!

Rotation #2: weeks 4 and 5

2011-07-19T17:41:00.000-07:00

My 125th post!!

Hello readers. I'm sad to report that my time in Ob/GYN is coming to an end. Never in my imagination could I have conceived a more articulate, compassionate, intelligent preceptor. Never in my wildest dreams did I ever think that I could fall in love with this specialty. I am sad to see the end of the week draw closer and closer. I know I have lots left to learn and that the rotations I have left will be phenomenal. I just love this hospital, these people, and most of all, my preceptor.

Still, as much as I love this work I still don't see myself working in this specialty. Not at all. I could do GYN all day long, but the Ob side is not the most exciting to me. I do, however, enjoy the OR, and I now know that whatever specialty I do chose to work in, there must be a surgical component to it. Surgery is like music in a lot of ways. You prepare in advance by learning your lines (the procedure), and before stepping foot onto the stage (the OR suite) you must put on your costume (gown, gloves, mask, etc.). The stage is set and once the curtains rise (drapes) it's showtime! And it really feels that way to me. I love it! There is a fanfare associated with the OR. You either love it or you hate it.

I've learned a great deal about myself on this rotation. I've learned that babies aren't so bad after all. I've learned that Ob/GYN is so much more than pap smears and Ob office visits. I've learned that being aggressive in this field is a good thing! I've learned that this really is something I can do for the rest of my life. I love being in the hospital, and I love working with people...the good, the bad, and the just plain ugly! I've seen enough 15 year -old mothers to last me a lifetime. I've diagnosed enough Chlamydia and Trichomoniasis to last my entire career. But the relationships that develop between me and my patients...that never gets old. It means a lot to have been given this much responsibility. It means a lot to touch someone and change their life. It means even more when, serendipitously, a patient touches you and changes your life.

Good-bye Ob/GYN, hello Peds!

Rotation 2: weeks 2 and 3

2011-07-06T18:55:00.000-07:00

Sorry for the delay. Time is flying!

Two days into week three and I'm still having a blast. What am I seeing/doing??

vaginal deliveries and C-sections (my subcuticular stitches are looking nice these days)
OB office visits and follow ups
invasive cervical CA
dyspareunia and palpable pelvic masses
incompetent cervix
annual exams and Pap smears
lots and lots of GC/Trich/Chlamydia
ovarian cysts
suction D and C
endometriosis
adenomyosis
leiomyomas
hysterectomies

The list goes on and on. I remember seeing a middle aged woman who had a seven month history of painful sex. Her past medical history was significant, but she had no pertinent family history. On physical exam her abdomen was quite tender. I felt what I thought were small masses in her lowe quadrants. Because she had a partial hysterectomy, I skipped the speculum exam and went straight to the bimanual, and again, another mass measuring about 2 cm was felt at 6 o'clock. I suggested a workup to my preceptor and he agreed! It will be interesting to see what the scans show.

I find myself getting upset when I think of this rotation coming to an end. I'm in love with my preceptor and I'm doing much more than I thought I would be. This rotation has shown me just how much I enjoy surgery...and just how much I enjoy the clinic! I don't think I would enjoy OR work exclusively. The clinic allows you to practice medicine; to get to know your patients and to really put your education to use. I enjoy the process of eliciting a history, performing an exam, and coming up with a diagnosis. I also love using my hands! That's where my fondness of the OR comes in. I enjoy procedure work, and certainly one can do lots of it in the clinic. However, the parade that is the OR is an experience like no other. I look forward to seeing what specialty I find myself in this time next year!

Rotation 2: week 1

2011-06-25T19:47:00.000-07:00

Here I am, one week into rotation number two: Ob/Gyn. I'm a little ashamed to say this, but I'm having a blast!

I've always known that I would never go into Ob/Gyn or Pediatrics. Neither one impresses me. However, I am extremely impressed with my preceptor. He is a true physician: smart, compassionate, available, and will say no if it's in the patients' best interest. I love working with him because I'm not only learning medicine, I'm learning the psychology behind the medicine and how important it truly is.

What have I seen this week. Everything! I've done annual visits and Pap and pelvic exams, and I've seen invasive cervical cancer, endometriosis, circumcisions and suction D & C's. I even saw my very first delivery, and was allowed to not only catch the baby (how awesome it is to be the very first person to physically touch/hold new life), but deliver the placenta and suture the mother's episiotomy! I get pimped constantly and I love it. I am realizing every day just how little I know about medicine. I have a long, long road to haul, but I will get there!

Once again, time seems to be flying by. I remember how eager I was to begin rotations. Then I remember how excited I was to go to Alaska. Now I'm in my second rotation with just 4 weeks left to go. I still pinch myself at times...I started out with a dream, and to watch it come to life in this way is fascinating and humbling all at once. I feel so honored to know what I know and to be doing what I am doing.

Week two promises to be jam-packed full of awesome opportunities and surprises. I can't wait!

Rotation 1: weeks 3 & 4

2011-06-13T17:50:00.001-07:00

I’m having the time of my life here in Alaska! The weather could not be better, the activities are endless, and now that the detective is here I have someone to share this all with.

The clinic is keeping me quite busy. I’m giving lots of vaccinations, I’m getting really good at female pelvic exams (they’re actually quite fun to do now), and today, I did cryotherapy all by myself! Amazing. We see a variety of illnesses and conditions. I truly feel like these are my patients, and I am honored to be taking care of them.

Demographically, this part of Alaska is not very diverse at all. The most diversity you will see is in the people who come off of the cruise ships and hang out downtown. Alaska has the third highest population of Tuberculosis in the nation. There is also a huge alcohol problem here. Needless to say, I saw my first positive PPD last week, and I’ve seen a few alcoholic pancreatitis patients, too. The majority of my time here has been spent seeing common things: viral illnesses, medication follow-ups, psychiatric disorders, minor injuries, annual well person exams, etc. Last week a young child stepped on a rusty nail and got a Td shot. I probably performed two to three Pap/pelvic exams each day. And I gave lots and lots of shots…for kids who step on nails, for young adults who are heading off to college, and for older adults who are traveling out of the country. While at the hospital last week, the radiologist and I came across a rare condition. Pulmonary intralobar sequestration. I had never heard of it. The radiologist had only seen one other case in his career. Fascinating stuff, and really interesting to see on CT.

Today marks the beginning of the end. I leave Friday evening. I hate thinking about it. I have grown to love this place. Has my time here been enough to convince me to pack up and relocate here? Maybe! I’m a pretty spontaneous person. I love the idea of living here, but I don’t know about working here full time. Perhaps once I become a hot shot PA I can do some locum work here. For now that is the goal. This time next week I will be on my way to Ohio to begin my Women’s Health rotation at one of the nation’s most respected hospitals. It will be a lot of early mornings and late nights, and a lot of OR time, or so I hear. I’m looking forward to a change of gears, and I’m really excited about spending the majority of my time in a hospital setting.

Rotation 1: week 2

2011-05-28T17:52:00.000-07:00

This week has proved to be the busiest so far. I've been challenged in lots of ways. More than anything, I realized just how much I have to learn.

This week I saw everything from hernias, irregular menstrual bleeding, and sore throats, to allergic drug reactions, abscesses, and alcohol-induced pancreatitis. I even got to do my very first Pap smear and male genital exam. Cool! The most challenging case of all was a follow up interview with a grieving mother who had recently lost a child. This job is A LOT more involved than I thought it would be, and I guess the lesson in this is that we as future PA's do a lot more than stitch people up and give meds.

Alaska is a beautiful place. Could I see myself living here? Maybe, but not year round. The patient population is exactly what I thought it would be, and I am so happy that I chose to come here. The detective will be here next week. I've been dying to get out and explore all that Alaska has offer. I can't wait to share this experience with him.

Stay tuned!

Rotation 1: week 1

2011-05-22T10:50:00.001-07:00

My first week here in Alaska has been absolutely amazing. Aside from the snow-capped mountains and gorgeous weather, I work with the most inspiring, intelligent people. I have a total of three preceptors, but I am learning so much from all the staff members. Each one is so eager to share whatever knowledge they have, and that certainly is enriching my experience here.

Juneau is a small, rural town with a population of about 30,000. There is one 55-bed hospital, and there are no cardiologists or Ob/GYN physicians. There are a total of two radiologists who read everything from mammograms to ultrasounds to nuclear medicine studies. The family practice providers deliver babies, do pap smears, suture minor lacerations, and everything in between. The family practice clinic is the one stop shop for all medical intervention not deemed an emergency. And I am so fortunate to be rotating in this kind of environment. To work here one needs to be a jack of all trades. There really is no such thing as specialization. Everyone trains to practice medicine outside of their expected scope of practice. The amazing thing is they all do a hell of a job. I’ve never seen such competency. I feel honored to be working with such intelligent, educated providers.

I spend four days of the week at a local family clinic and one day of the week at the local hospital. I didn’t expect to be thrown into the fire so quickly, but my preceptor seems to think I’m more than ready. So far, I’ve given vaccines, removed skin tags, heard murmurs, done breast exams, and seen patients all on my own. At the hospital I work with the radiologist and look at dozens of films, scans and nuclear medicine studies. What an opportunity! I’m having the time of my life!

It has been a challenge integrating all of the information I’ve learned in the classroom and applying it to a patient. For instance, a young girl came in complaining of a cough, SOB, fatigue, myalgias, and sputum production. On physical exam, her breath sounds were equal on both sides, however I heard abnormal sounds on the lower right section of her posterior chest wall, the same location that caused her pain when I palpated. In the very same spot I heard egophony, and this caused concern for pneumonia. She looked and sounded ill, but not toxic. In retrospect I should have taken more time to listen, but I knew the sounds were abnormal as soon as my stethoscope touched her back. I presented my case to my preceptor, and she immediately diagnosed her with bronchitis/walking pneumonia. Not bad for the first case of the day, but my differentials need a lot of work. I should have had at least five diagnoses on my list.

This weekend I intend to rest and study. My body still has not adapted to the 4 hour time difference. I really haven’t had time to adjust, but I’m so busy when I’m at the clinic that I don’t recognize just how tired I am. I love learning and I love using my hands. My preceptor said to me yesterday, “You’re going to love being a PA!” She’s absolutely right!

Sleepless in Seattle, headed for Alaska

2011-05-16T10:53:00.000-07:00

Jet lag can be a killer. Especially when you're running on two hours of sleep. To make matters worse, I don't sleep well on airplanes. I don't know many who do.

I am currently sitting in the Seattle airport. One more flight and I'll be at my final destination. I'm looking forward to settling into my apartment in Juneau and acquainting myself with the area. More than that, I'm looking forward to a good night's sleep. It's not that I'm nervous, or even excited. I think I'm too tired to be excited. This past week has been so very busy.

I have no doubt that Alaska will be a wonderful rotation. My preceptor seems excited to have me work with her, and I am looking forward to being exposed to a rural population unlike any other in the country. I am to arrive at the clinic every day at 7:30am, except for Thursdays. Every Thursday I am to report to the local hospital to work with the Radiologists there. I am really looking forward to this opportunity.

As I embark upon this portion of my training, it is my intention to relay my experiences to the readers of this blog as clearly and honestly as I can without compromising the privacy of my patients. I hope you will enjoy reading as much as I will enjoy sharing. I start Wednesday morning. Stay tuned!

One more notch in my belt

2011-04-17T18:18:00.000-07:00

Just completed ACLS training this afternoon, and now I am ACLS certified! And I feel like I know absolutely NOTHING.

Perfectly normal feeling, right? Many of you who are well into PA school can attest to this, I'm sure. The more you know and learn, the more you realize just how little you do know. Today as we ran mock codes, I found myself stopping and thinking about the algorhythms (which have recently changed a bit), second guessing my choice of drug and doubting that the intervention I suggested was correct, all while the "patient" lay there dying. Talk about pressure. It didn't help that the instructor at my station was sharp as a tack and tough as nails. I always manage to get the BEST instructors who give just a little bit more education that what is called for.

Again, it's all about integration. How can I take this piece of information that I learned months ago and apply it to this new information today. It's like building blocks, really. This is when medicine becomes fun! I have some fun moments. Moments when answers to questions just fly out of my mouth without a thought. And then I have not so fun moments when the only words that come to mind are, "I don't know."

I have many reasons for being so excited about clinical year. First, I'm tired of the classroom. There's no real fun in learning lots of medicine if one can't practically apply it. I'm a hands on type of person, and I learn by doing. Second, I miss the patients. I love the interaction with patients and I miss talking with them and hearing the stories they tell. Third, I love to travel. I love moving around. I look forward to being in a new environment with new people every 5 weeks! We will see if I eat those words 2 months from now.

Good night, folks!

3 months in, 1 month out

2011-04-16T13:09:00.000-07:00

Warning...this will be a long blog. Why? It's the least I can do for being away so long.

Hey gang! Wow...where do I begin? I can't believe I've let this much time pass since my last entry. I see I've gained a few more readers. Thanks to all of you who read the blog. I hope it is serving a purpose and answering questions. At the very least I hope it's allowing you to live vicariously through me while I journey through this thing called PA school. So, without further ado....

I'm three months in, and so far this semester has been another rollercoaster ride, albeit much easier than last semester in that I know what is expected of me, and I know what type of work ethic it will take to successfully complete it. The material is very interesting, and this semester we are really learning how to integrate. Early on the instructors stressed the importance of NOT integrating to avoid confusion. At this stage of the game, integration is key. Now I'm expected to take the anatomy I learned this time last year and apply it to the Neurology and Nephrology that I'm learning now. Not an easy task, but when it's done it makes learning a lot easier. Medicine becomes fun because you now are able to answer the most important question: why?

I'm enjoying the material for the most part. I would guess my weakest subjects this semester are endocrinology and neurology. My strongest subjects are nephrology, ortho, and EM. I've discovered that I'm really good with my hands and calm under pressure. I've also discovered that I need to work on developing a better differential list, and on my physical exam techniques. We all have strengths and weaknesses. It's important to acknowledge them, pat yourself on the back for the strengths, and work on the weaknesses.

Today we began our ACLS training. How exciting!! Recent changes have been made in BLS and ACLS, so we began learning the BLS changes (its CAB's now, and not ABC's), then we went on to learn how to intubate and place IO lines. Out of all the skills we learned today, I think intubation was my favorite. I got it in the very first time with no help, and the instructor praised me when I finished. Talk about an ego boost. Keep in mind, we practiced on dummies. Let's see how good I am when I intubate my first real patient...old school style, without a Glide-o-scope!

In the midst of studying for 3-5 exams per week, being in class from 4-8 hours a day, and having a social life, we've had to prepare for the clinical year, which officially begins one month from now. I'll be heading off to Juneau, Alaska to complete my primary care rotation. I can't express how excited I am about this opportunity. This is a wonderful site that will allow you to do what you want as long as you are competent and confident. I will be working both in the clinic and the hospital, and I'll even be working with the radiologist on occasion. I'll be sure to take lots of pictures, and if I remember to bring the appropriate equipment, I will post them here for those who are interested.

This blog will no doubt morph into something quite different as I embark on my clinical year. I plan on sharing as much information as I can with the readers here, being careful to maintain the anonymity of my patients. I'll let you know what I see regularly, and what I'm allowed to do. Something I would love to do is post student cases here. If time allows I will surely do that.

Ok...not much else to say other than have a good weekend, and if you're in the NW part of the country, try to stay dry!!

Let's get back to work

2011-01-19T08:10:00.000-08:00

I've three more days before I board the plane that will take me back to PA school. These six weeks have come and gone so quickly. By far this has been the best school break ever. I think my mind and body were so exhausted; I definitely needed every hour, every minute of this break. Now it's back to work!

I've already outlined what lies ahead of us this semester. Looking at the spring calendar is like looking at the calendar for last semester. We'll be as busy as ever, but this time we know what to expect. I say bring it on!

Happy New Year!

2011-01-06T04:08:00.000-08:00

Hey gang. I hope all is well, and I trust you all had a Merry Christmas and a wonderful New Year's Eve/Day. Time is just flying by.

I am officially a second-year PA student. In retrospect, I'm amazed that I have three semesters behind me. I've learned a lot, but there's so much more to learn, and now that clinical year is 5 months away I've got to kick it into high gear. What I love about my program is we have some say in where we want to go, and we are allowed to pursue preceptorship in any area of the country. The bad news is each and every one of my prospective rotation sites here at home have fallen through. But who cares! The great news is...

I'm going to Alaska!!

Our program is affiliated with a private Primary Care office in Juneau that has state of the art facilities: labs, micro, xray are all on site! They also have hospital privileges so I will have a chance to participate in that as well. Needless to say I am excited and appreciative. What a great opportunity this is for me. I will be the second student from my program to attend this site. The first student to go gave this site rave reviews, so I'm expecting to learn a lot. No word yet on any other rotation sites, but I feel like I will end up exactly where I need to be.

Now, the following is for any pre-PA students out there. Repeat after me: there are no shortcuts. There are no shortcuts. One more time...There are no shortcuts. Good!

I recall mentioning this before, but it bears repeating. PA school is a well demarcated path etched in the road. There are many side paths that feed into it, but there is no one way that will get you to your destination (a seat in PA school) the fastest. There are no shortcuts. Yes, PAs make a comfortable living and they are an integral part of the healthcare system, and they get to wear the cool white coat. Before you can begin to enjoy these perks, you've got to get your "C," and before you get your "C" you've got to graduate and pass the PANCE, and before that you must do well in your respective program. And in order to do well in your program you must lay the ground work.

There are many common threads floating around on the forum as of late, the most common being "What are my chances," and "Am I competitive." The most recent one to irritate the heck out of me is "Which schools don't require HCE." My response is if you don't have the time to acquire direct HCE you may want to reassess your goals. I have personally journaled my experiences in the unit where I racked up my hours, and you can refer to the 2009 entries to learn more about it. It sealed the deal for me in more ways than one. Not only was I touching patients, sticking them, drawing blood, run EKG's and do preliminary interpretation, doing wound dressings, talking one on one with patients' families, doing post mortem care, and drawing flushes for codes, I got a chance to stand bedside as I watched lines being put in and ventriculostomies being performed, and in my down time I read SOAP notes, learned how to read a basic chest xray, read lab values, etc. You can't begin to understand how this has helped me during didactic year. And I bet I won't truly appreciate my time on the unit until I reach clinical year.

The question is do you want to hit the ground running or do you want to play catch up? When questions like this come up, it screams that many of us coming into this profession don't know its history. No one expects you to know it all. No one expects you to be a PA on the first day of PA school. Knowing the basics, however, goes a long way in prepping you for success during didactic year and clinical year, and it just might help you land the job you want once you graduate. It's a snowball effect. Ok, I'm done.

I have two weeks left until we start up again. I am renewed and refreshed, in part because I know this is my last semester in the classroom. I couldn't be any happier about that! I miss the patients.

There's No Place Like Home

2010-12-15T05:03:00.001-08:00

I've been home for exactly 5 days now and I'm already getting antsy. It doesn't take long for me. Don't get me wrong...I love being home with my family, not having to study for 10 exams at once, not dealing with the nasty winter weather up north, but I do miss the hustle and bustle of school. I miss learning. I am the ultimate nerd! I better enjoy this break while it lasts. Rest now, work later! I did bring a few books with me to read: my lab medicine text, Cecil's (not the easiest read, but a fascinating read nonetheless), and my radiology text. I'll start cracking those sometime next week.

Here's a line up for the classes that await me next semester:

General Surgery

General Surgery lab

Clinical Medicine

Pharmacology

Primary Care Modules

Geriatrics

Research class

Clinical Decision Making

Just a continuation of what we've been doing, minus the Pathophysiology. Man, I'm going to miss Patho!

A word to the wise: PA school is much more than going to class and getting good grades. I'ts much more than showing up and performing well. It's much more than memorization and regurgitation. There is a lot expected of you outside the classroom. Criminal background checks, liability insurance payments, AAPA/local chapter professional organization fees, additional training (BLS, ACLS, etc.), traveling off-site for lectures and seminars, fingerprinting, the list goes on and on and on. Be prepared! BE PREPARED! Paying for PA school can be challenging all by itself. Be sure that you have residual funds for these kinds of expenses because they will come up, often at the most inconvenient of times.

I think I've rested up enough to go out tonight! It's time to show these Southern salsa folks what I've been up to while I've been away. I had to cut down a bit on the salsa dancing as of late due to the heavy workload. It's been two weeks since I've danced. Insane! That's unacceptable. Yep...tonight's the night! I plan on writing again soon, hopefully after I've visited my old coworkers in the unit! I can't wait to see them.

First year of PA school...DONE

2010-12-10T17:47:00.000-08:00

Wow, I've been so busy I almost forgot I had a blog.

Sorry for the wait, dear readers. I can't put into words how busy the last three weeks have been for me. But this is a blog, and words are all I have, so I will do my best!

It's quite simple really...14 exams total over the last two weeks, seven per week including practical exams. I was warned long ago about the rigors of PA school. I began school 12 months ago with my eyes wide open. I knew what I was getting into. I knew about the hard work and the late nights of study, and the unforgiving amount of information that was expected to be learned. There is NOTHING that could have prepared me for what I've been through this semester. When they tell you PA school is tough they are not lying. I didn't expect it to be this tough, though. I feel like I've been run over by an 18-wheeler.

The topics covered this semester were vast: hematology/oncology, EKG interpretation, lab medicine, Cardiology, Pulmonology, Psychiatry, GI, more history taking and soap note writing, etc. We learned a lot, and I enjoyed it. I'm starting to feel myself transforming into a clinician.

When I return to PA school next month, I begin my second year. My second year! Where has the time gone? I remember the days when I was still taking prerequisite courses. I remember deciding what school I would apply to. I remember going shopping for my interview outfit (man, I looked good that day!). And here I am, one year into my professional training as a PA. Absolutely amazing. This semester has been a whirlwind for me and many of my classmates. I've never performed so poorly academically in my entire life. I've never been a "C" student. I've never been accustomed to failing test after test...until now. It hurts the ego for sure, but you get up, dust yourself off, and get back on the horse. I must say, though, I ended strong, my final exam scores look amazing, and I am really proud of myself and my accomplishments.

One more didactic semester left before I am let loose to begin treating real live patients. Scary, yes! But I'm ready to get out of the classroom. I learn with my brain and with my hands. I am a doer, and I know I will thrive during clinical year.

Well, not much else to say for now. I have the next 6 weeks to do absolutely nothing, and nothing is precisely what I'm going to do. Currently I sit in the Charlotte, NC airport heading for home. I haven't seen the detective in almost four months. I can't wait to talk to him and spend time with him.

Updates

2010-11-03T07:52:00.001-07:00

Hello November...so nice to see you!

I'm counting down the days to the end of the semester. I'm amazed at how quickly time has passed. We have been extremely busy lately, as usual. And grades are on the rise! Woo-hoo!

So, what's been going on? Well, lots! We began our POME module two weeks ago. This is our version of problem-based learning, where we are given a chief complaint and must come up with a differential diagnosis and primary diagnosis with only the use of a history and physical exam findings. I love learning this way! It forces you to commit to a disease process, even when you don't have all the answers. It forces you to think. It forces you to ask yourself some serious questions. The bottom line is you must know your diseases. If you don't know a disease exists, you won't consider it. You must know how to perform a thorough physical exam. If you don't you will miss important findings that may steer you in the wrong direction. And finally, you must know how to take a good history. It's true when they say that most diagnoses can be figured out based on the history alone!

This weeks' CC was abdominal pain. As a class we rattled our brains to come up with diseases that would manifest in abdominal pain: neoplasm, GI bleed, acute pancreatitis, Ulcerative Colitis, Crohn's, AAA, pyelonephritis, peritonitis, appendicitis, ishcemic bowel, biliary ostruction, cholecystitis. We ended up with 99 potential diagnoses! We were split up into three groups and were given a history based on the questions we asked. If we didn't ask the question, we didn't get that part of the history. The next day in lab, we asked for physical exam findings. I'm happy to say that our group got the diagnosis correct. I'm even happier to say that the correct diagnosis, acute pancreatitis, was my primary diagnosis even before getting physical exam findings. The history was textbook acute pancreatitis! I love this stuff!

I think what I love most about PBL is the feeling of really becoming a clinician! PAs are sleuths, detectives, investigators. They ask questions, and use their senses (ears, eyes, nose, etc.) to detect disease. It's amazing what we are able to do without the help of sophisticated diagnostic equipment. Thank goodness we have it to confirm our suspicions, but we do quite well without it most times.

We had no class last Friday, so salsa was definitely on the list of things to do last weekend. And Salsa y Control, Boston's top salsa crew, came through to give workshops and to perform. I had a ball, and I shared a dance with both brothers! AMAZING! A few dancers from neighboring states came by also, and I got a chance to dance with brand new dancers...and they were fabulous!!! It's always fun meeting and dancing with new people.

Two exams down this week, and one more left to go tomorrow. The next few weeks should be smooth sailing, but the weeks leading towards finals week will be hellish for sure. I look at it as my rite of passage. If/when I emerge victoriously, I will have 6 whole weeks of bliss to look forward to. I can't wait!

RIP Dame Joan Sutherland

2010-10-12T14:04:00.000-07:00

One of the most beautiful voices of our time. It's amazing...I told a friend the other day that the legends are leaving us. It's bizarre because although I never saw Sutherland live, I always considered her a great talent. She will be sorely missed.

Ace in the Hole

2010-09-30T09:02:00.000-07:00

Just completed my first clinical medicine cardiology exam, and I must say I killed it! Feels good...especially when I've been bombarded with one to many C's lately. I don't like C's.

I am in need of a serious break. I'm looking forward to tomorrow night. One of the local salseros is moving up and out to pursue his dancing career. He is a fantastic lead and I've been privileged to dance with him many times in social settings. It's always a great dance. I hate to see him go. He's one of the few On2 dancers we have here, and it sucks because the On2 scene can't grow without On2 dancers. Oh well, I won't be here forever. I'll finish PA school, head back to the South, and I'll have my fill of On2 dancers!!!! Speaking of which, the Atlanta Salsa Congress kicks off tomorrow. Damn it...I wish I could go! It's sad, really...after a year and 1/2 of dancing, I've never been to a Congress. I'm hoping to make my way to one very soon. Maybe I can schedule on of the clinical rotations based on the congresses going on around the country. I better get on that soon!

Well, back to the books. Another test awaits me tomorrow, and then 5 exams next week. Looks like it's gonna be a long weekend.

Staying Alive...

2010-09-28T08:24:00.000-07:00

...and doin' a pretty good job of it, too!

It's another gloomy day here in the Northeast. Lots of rain, very little sun, but lots of things to do to keep me busy. Honestly, this semester is flying by. October is soon to arrive, and before we know it, December will be here. I'm looking forward to a break already!

The weeks thus far have been insanely busy. We were warned in advance that Fall semester would indeed be the busiest. They weren't lying. This week, for instance, started with a Pulmonary exam, class from 8am to 9pm, practical exams today and tomorrow, a cardio exam on Thursday, and a Hem/Onc exam on Friday. Next week we have 6 exams and 1 practical exam.

For the readers out there who are beginning the application process, or for those who have been accepted and are awaiting the start of their program, be mindful of the commitment you are making. PA school, though not the be all-end all of life, will be your top priority...but only for a while. There are some semesters that are easier to manage, and others where you feel you are drowning in information. I'll be the first to admit that my grades this semester are nowhere near where they have been in the past. I've come to love B's, and I don't stress out about the ten-point quiz that I fail. Of course, those A's do wonders for one's ego! I'm being honest....you learn to pick and choose your battles. For me, I choose to spend my time on pathobiology, anatomy, pharmacology, clinical medicine, and procedures. If I know these things pretty well, I should be able to work through most problems I encounter in a hospital setting. PA school is not about being the perfect A student. It's about making it through, learning as much as you can, and knowing how to APPLY what you learn to a real patient. I'm truly looking forward to clinical year.

Another thing: If you find yourself unhappy with your program, the instruction, the professors....by all means LEAVE! Don't ever forget the following words...

You applied, you accepted the invitation, you decided to attend. And only you can decide to stay. You will be among the same people and work with the same instructors for the next 2 and 1/2 years. Why be miserable? Do yourself, and those around you, a favor and just leave. Why be unhappy? Why complain? Complain after you leave. I know...you're thinking, "But I want to be a PA and this is my only shot." Wrong. Just apply to a different school and maybe things will be different there! (yeah, right!)

I'm sure some of you current PA-S can relate.

Ok, folks. I aced my practical today ( btw, it was genital/rectal exams and Pap smear). Time for some much deserved rest and relaxation.

The Future of Opera

2010-09-14T20:41:00.001-07:00

Hey gang! I’m exhausted. I’ve spent the last 12 hours on campus studying for a boat load of tests and practical exams. But before I retire, I thought I’d stop by for a quick rant that has absolutely nothing to do with medicine.

I love opera. I love classical music. It has been a love of mine for many years. I’ve spent more than a decade devoting my time and energy to perfecting and cementing techniques that take years to comprehend, let alone practically apply. I no longer sing for a living, but I am a singer. I no longer create music for others to enjoy, but I am a musician. My body was my instrument, and I took great pride in producing the type of sound that did not depend on a microphone for amplification. I did my best to become the character I was portraying. I knew every word of every language I sang in. The emotion I conveyed stayed true to the lyrics and the music. More importantly, I listened and studied the great artists. I watched them and emulated them (sometimes to the detriment of my own technique). More importantly still, I had a one of a kind vocal coach/teacher (the combination is quite rare) who was master and teaching the Swedish/Italian school of classical singing. Moreover, she was a master at teaching me. She gave me what I could handle at the time. She never pushed my voice. She always encouraged me to ease into heavier repertoire. She never hesitated to steer me clear from things that would hinder my progress. She believed in me and my talent.

The title opera singer is being tossed around a lot these days. Let’s be clear: dressing up in fancy costumes and expensive clothing and singing song from operatic works does not make you an opera singer; being young and cute and charming does not make you an opera singer; sounding like an adult singer (even though the sound is being manufactured) when you are only ten years old does not make you an opera singer. It boggles my mind that people who have never stepped foot inside an opera theater, or couldn’t name one member of the Bel Canto Trio, or name the principal characters in Die Zauberflote (or the composer for that matter…and this is one of the easy ones) are judging the talent, or lack thereof, of these “opera singers.” Are these performers singers? Absolutely! Are they opera singers? Not in the least.

History lesson, folks! The great opera singers-Caballe, Callas, Di Stefano, Nilsson, Gigli, Bjorling, Ludwig, Fischer-Dieskau, de los Angeles, Verrett, Sutherland, Carerras, Flagstad, Milanov, Gedda, Ghiaurov, Caruso, Galli-Curci, Pons, Grist, Horne, Sills, Corelli, et al (notice I did not mention Pavarotti’s name…he’s great, but there are so many others that are overlooked)- these are opera singers. Study them. Listen to them. Watch them. This is what the classically trained voice sounds like. Now, compare and contrast. Put any of the above in a concert hall, and they would rip the paint off of the walls with no microphone. Put today’s “opera singers” next to any one of the above, and you wouldn’t even know they were singing. Theatrics are great. A cute face and a smile is great, but it does little to mask the fact that you’re simply going through the motions, and playing on the emotions of an ignorant audience.

Now, I’m not referring to the vocal talent of these “opera singers.” In fact, I think they are talented. They would do well in amateur competitions, karaoke nights at the local bar, and Christmas sing-a-longs. There are many people who have good voices. There are very few who have operatic voices. This takes training…and from what I hear, every single “opera singer” today lacks the training. If your ear is trained to hear it, you will pick up on a myriad of things: chest breathing with a closed pharynx, pulled down pharyngeal posture which creates a low soft palate, flat/retracted tongue posture, and poor breath management. Simply put, you have bad crooning! What’s worse is many of these things can shorten the life of the singing voice. This is horrible to think of when you consider some of these “opera singers” have barely begun to live life.

The future of opera is bleak. It’s full of watered down singers who shove mics down their throats. It lacks the grandeur of the old days when you could walk into the theater one way, and walk out of the theater a changed human being. Life changing performances are still occurring. I recall my account of a concertized version of Dr. Atomic that I entered here a few years ago…changed my life! It’s these emotional journeys that make music so precious. Taking a score written 2 centuries ago, performed a million times, and transforming it into something brand new! I get chills just thinking about it. I fear these kinds of performances are becoming more extinct as time goes on. It’s ok! Go ahead and cheer on these “opera singers.” I’ll keep listening to the legends!

Sunday Morning

2010-09-12T05:59:00.000-07:00

Good morning, readers!

I love Sundays. I usually sleep in late, wake up and prepare a delicious breakfast, and lounge around until late afternoon. Not so today. There's just too much work to be done. And I'm loving every minute of it. And I'm happy to be enjoying it as much as I am, because if I weren't, I'd have some serious thinking to do. Yes, PAs make great money. Yes, PAs get to "help people." And they get to do things to other human beings that most will never do. But there isn't enough money in the world that could keep me here if I were miserable!

It just hit me last week that in less than 9 months, I will inside an office or hospital somewhere dealing with real patients. They will be sharing intimate information with me, and they will instill a great deal of trust in me. They will disrobe and allow me to see them and touch them. They will listen to what I say as if it is law, and they will follow whatever regimen I prescribe, many without hesitation. What an honor, what a gift! I believe it was the cardio lecture last week that really got me thinking. Our adjunct instructor, who is an internist, impressed on us the importance of reading, researching literature, and learning as much as we can NOW. He stressed the importance of touch, and explained how therapeutic it is for patients. He stressed the importance of listening (the overwhelming majority of patients can be diagnosed simply from taking a great history and performing an excellent physical exam). He stressed the importance of good physical exam techniques. This is the time to absorb as much as possible, because once out in the field, there is no going back. It's important to learn now, to set a strong foundation now.

I didn't come to PA school to become an average practitioner. I came here to be the best!

One Week In...

2010-08-28T21:08:00.000-07:00

...and we've hit the ground running...sprinting!

18 credits, 8 classes, early mornings and late nights. I practically live in the library. But I feel like this is the semester when things will start to come together. I'm already beginning to connect the dots between my current classes and classes I took two semesters ago. It's amazing the volume of information you go through month after month, but as I go along, I realize just how important it is to revisit the old handouts, powerpoints, and note cards to keep the information fresh in my mind.

This semester I plan to begin studying specifically for the PANCE. I've begun looking at a few test questions online, but have yet to purchase a review book. With so many choices out there, I'm reluctant to make a quick purchase. Any suggestions??

Summer Semester...DONE

2010-07-31T06:03:00.000-07:00

Good morning, and greetings from SE USA!! I just arrived home late last night. It feels good to be done...

Finals week was tiring, of course, but I had lots of fun with the exams. The material this semester was enjoyable for the most part, and I feel like I really earned some stripes. I have a few simple procedures under my belt, I know how to write prescriptions, and I'm really starting to feel like I'm gaining some workable knowledge. Here is what lies in store for us next semester:

EKG/Lab Medicine/Radiology
Patho III
Clinical Medicine III
Pharmacology II
Women's Health
History taking and Physical Exams II
History and Physical Lab
Procedures and Diagnostics II

Yep...8 classes and a total of 18 credits. Instructors have warned us that this is the most difficult semester of them all. This is when most students are lost to bad grades and poor time management. To make it through two semesters just to be kicked out seems cruel. I don't intend to be in that number. I'm not going out like that!

The detective and Linc are sleeping right now. I feel like I need something to do. It's difficult trying to relax when you've spent months in high gear, but I'm going to force myself to do it. I deserve it!

2 Weeks

2010-07-19T18:56:00.000-07:00

Can you believe it!?! In two weeks I'll be home with the detective and Linc. What a roller coaster this semester has been.

In 8 weeks we've plowed through medical ethical issues, learned cardio and respiratory pathophysiology, drawn each others' blood, learned ABG technique and interpretation, learned all about MS issues and how to recognize them, AND learned prescription writing for a boat load of drugs. Can life get any better? I must admit, I had a rocky start this semester due to family concerns. It's not easy being in PA school and being miles away from your family. But I chose this lot, and I wouldn't change a thing about it if given the chance to. My grades are stellar right now. Sweet!!

This week marks the last of the semester, and next week is finals week. Then, we're outta here!!! Wooooo-hooooo. Three whole weeks of bliss, peace, quiet, fun, salsa, and NO BOOKS. Well, not really. I plan on going through every single notecard that I have ever made, and brushing up on my EKG skills. It's amazing how much information you forget when you don't use it.

Talk to you all soon!

Go SLP, it's your birthday...Go SLP, it's your birthday...

2010-07-10T17:30:00.000-07:00

Yep! The big day is right around the corner. This birthday marks a time in my life where are components have come together! It feels good to know that I'm on the right track in life, doing the things that I love doing, meeting wonderful people, and doing amazing things! I can honestly look back over my life and say I have no regrets. The good, the bad, and the downright horrendous events of my life have all made me who I am and what I am. And I love who I am and what I stand for. And most importantly, I love where I am headed!

The better it gets, the better it gets!

Hellooooo..... anybody home?

2010-07-10T17:19:00.000-07:00

Yes, I'm still here, and no, I'm not ignoring you. Do I really need to explain? Probably not. You all understand, I'm sure!

So, we just wrapped up a hellish week of tests and practical exams. Funny thing is, during my ABG practical, while trying to take the cap off of the needle, the entire needle came flying out. My hands were shaking so badly, I could barely put the needle back onto the syringe. I couldn't help but laugh to myself...and laugh out loud as I walked out of the testing site. You would think that with all my years of performing I wouldn't have a nervous bone left in my body. Yeah right!

Last week, in comparison to the week before, was a great success. There wasn't one exam I walked out of where I felt that nasty, hollow pit in my stomach. The exams were challenging, but I prepared well, and I trust I did well. There's nothing like a difficult Patho exam to cheer me up and make me feel smart! I must admit, I'm growing weary. The summer semesters go very quickly and material is thrown at you at lightning speed. It's ok! In three short weeks, I'll be home on summer break!

It looks like my break is already booked up! I'm traveling to Mississippi for a few days with the family, and then Linc, the detective and I are planning a mountain retreat for a week or so. I can't think of anything better than waking up early just to catch the sunrise; having breakfast on the patio; breathing in that crisp, clean mountain air, and hiking with my two favorite people (yes, my dog is a person, too) in the world.

Until then, it's back to the books.

Approach PA school with positivity

2010-06-14T14:54:00.001-07:00

Hey gang!

Not much time to blog today (I'm taking it easy this evening, and I want to make it last!), but I just stopped by to say that PA school can be tough. Lots of reading, lots of assignments, and lots to learn. PA school can be stressful. PA school can wear you down. But here's the good news...it's all relative.

Isn't everything in life. Throw two people into a bad situation...I mean a situation that is so bad, so challenging, it makes your head spin. One person could view the glass and half full, while the other sees it as half empty. The point is, both parties have a choice! How would you choose to see the situation?

The same goes for PA school. Yep, there will be days when a professor switches test days and screws up your plans to go out on that hot date. Yep, there will be days that that student continues to ask the most irrelevant questions. Yep, there will be days when everything that everyone does just gets on your nerves. There will be times when you wonder why you continue to come to class. Attitude is EVERYTHING! For me, this is becoming more evident and school progresses. A positive attitude can make the worst of times the absolute best of times. A positive attitude is contagious. A positive attitude demands attention. A positive attitude is a winning attitude!

Sure, I have my moments when I grow tired of the mundane, day in, day out PA school routine. But two thoughts run through my mind: there are lots of students that would give ANYTHING to be sitting where I am, and...I signed up for this, not because I was forced to, but because this is what I love doing! I suck it up, put on a happy face, and keep plugging along. I love being here. I love doing what I am doing. I am blessed to be here. I want to see only the good in all things. I trust this attitude will serve me very well.

O Happy Day!

2010-06-07T09:47:00.000-07:00

Today I feel good. No, I feel GREAT! Why???

No particular reason. Doesn't it feel good to feel good, for no real, tangible reason? That's the best feeling in the world. Truth be told, I can look around and find lots of things to be happy about. Let's name a few:

I had a virus on my computer last night, and this morning I figured out a way to get rid of it.

I'm having a good hair day.

Today is "Dress Up Monday" and I am dressed well.

I had a few minutes to listen to Hab mir's gelobt this morning and it brought a smile to my face.

I spoke with my husband and my mother this afternoon.

I'm having a good hair day.

I'm all caught up with my notecards for Patho and Clin Med.

I self installed an Air Conditioning Unit in my bedroom. No more night sweats!

My car is in great working order, and looks great! (I need to wash it, badly.)

I just had a great bowl of oatmeal, and a sweet navel orange.

I could keep going....but you get the point.

There is much to appreciate, so many free gifts in this world. Never will I let another day go by without taking some time to focus on the many things that are going right in my life.

We just concluded a 4 hour class. Only one more to go. Then I have the rest of the afternoon and evening to myself. Yipee!!

Great First Day

2010-06-03T13:55:00.000-07:00

Just returned from the first day back at school. Today was an easy, laid back day. It felt good to be back in the swing of things. Four hours of lecture before lunch, and two hours after...plenty of powerpoints, but the material is very interesting. Tomorrow we begin Procedures and Diagnostics, and by next week I will be sticking someone! Sweet!

I'm glad that the weekend is just a day away. This will give me ample time to get all this new information down in a study guide format, and rest up before we begin our first full week of class. I'm still feeling quite sluggish after such a restful 2 week break. I haven't slept well since I returned, which explains why I yawned my way through class today.

Well, our class tomorrow has been moved from 8am to 10am, so you know what that means. Salsa time! I promise, I won't be out too late!

Summer Break: Done...

2010-06-02T11:25:00.001-07:00

...but that doesn't mean my brain isn't still on break.

Hey folks! Words cannot express just how PHENOMENAL my break was. I feel so rejuvenated, rested, calm, and ready to embark on the next step in the PA school process. I got chance to see lots of family members, salsa friends, and I spent lots and lots of time with the detective and Linc. It was exactly what I needed. About half way through the break I felt my brain turning to mush, but I forced myself not to read any textbooks or medical-related literature. Difficult, but doable.

I'm eager to return to school and get back into the books. I've spent most of the day restocking the kitchen, cleaning, throwing old papers out, and reorganizing my binder to make room for the new stuff. I'll be in class tomorrow morning at 8am...sharp! And the countdown begins again; only two months until we get another HUGE break.

Finals week: DONE!!

2010-05-14T16:39:00.001-07:00

I’m happy to report that I have successfully completed my first semester of PA school!!! *happy dance*

This past week has been a whirlwind. The script went something like this: stay up late, study, get 5 hours of sleep, wake up, study, take test, repeat. Needless to say, I’m exhausted for the first time in a long time, simply because I can be! I’m really proud of my academic performance this semester. No C’s, no academic probation, and I get to come back to do this all over again in the summer. Some of my colleagues will not be able to say the same. However, there is great room for improvement. I started off quite strong in the beginning, but slowly, as the workload got heavier and heavier, I began to procrastinate. And that, folks, spells disaster. I can’t let that happen in the summer, and it surely can’t happen in the fall semester. So today, I am rewarding myself with…yep you guessed it…SALSA! Party starts at 10:30pm, and I intend to stay until they throw me out.

I head home tomorrow to spend the next two weeks with the cop (oops, sorry…Detective) and Linc. I can’t wait to see them and my entire family. And now that I’m dancing mostly on2, I’m looking forward to seeing my salsa folks back home and showing them all the stuff I’ve learned while I’ve been away. It’s gearing up to be a busy, fun-filled summer break. Much needed, and much deserved.

I’ve already written about what classes await us this summer. I’m really looking forward to getting my hands dirty. The summer semester is only 1 1/2 months long, so there will be no time to play around. Right now, the summer semester is the last thing on my mind, but I know myself. Give me one week of no studying, no reading, no medicine, and I’ll be wishing I were back up here with a million and one things to do.

I plan to check back in with you guys once I return. Until then, happy summer break!

Wrappin Things Up

2010-04-18T10:30:00.000-07:00

Hey folks. It's been a while.

The semester is quickly coming to an end, and as a result, the workload is piling up. I've got so much on plate right now, it's ridiculous. We continue to learn so much everyday, and I'm still enjoying every bit of it.

Last week we were allowed to register for the upcoming semester. Here's what lies in store for us this summer:

Procedures and Diagnostics
Medical Ethics
Clinical Medicine II
Pathophysiology II
Pharmacology I
Primary Care Modules

And all this for a measley 10 credits. Yes, you read that right!

The summer is shaping up to be an exciting semester. I think I'm looking forward to the Procedures and Diagnostics class the most. I love being in lab and using my hands! But before I can embark on that journey, I've got to wrap up this spring semester...successfully. I'm really pleased with my grades this semester. I've worked hard, but I've found a healthy balance with work and play. I have time to go out when I want, and I've learned how to divide my study time among every course I'm taking. It's impossible to do well in PA school if you devote your time to one subject and neglect the others. Each subject must be looked at daily, and I've been slacking in this area. Oh well, summer semester is the perfect time to re-implement this study habit!

On a personal note, the cop will now be referred to as the detective! Yes, hubby is now a detective with the Traffic Specialist Unit back home. I can't be more proud of him. For some reason, the closer we get to summer break the more I miss him. I just have to hold on a little longer, then I can spend two straight weeks with him and Linc. I can't wait!!!

Well, back to Anatomy...and Clin Med...and all the others!!!

Currently on Easter Break...

2010-04-02T14:33:00.000-07:00

...yep, and lovin' every minute of it!

What a week this has been! It all started with a HEENT quiz on Monday, a physical exam practical on Tuesday, and ended with a big, fat anatomy test on Wednesday. I literally skipped out of class on Wednesday. My break began as soon as the proctor had my test in his hands!

School resumes on Tuesday. I have made a pact with myself to relax and enjoy this beautiful weather for two days. I'll be back in the books tomorrow afternoon. Honestly, I've found it pretty difficult to stay still. PA school has required me to stay "up" for so long, and now it seems so difficult to come down and chill out for a spell. I better take advantage of this time while I can. A mountain of work awaits me tomorrow! So far the break has been wonderful. I went salsa dancing Wednesday night (I didn't waste any time, did I?), caught up on a few Twilight Zone episodes, and I'm going salsa dancing tonight! Life is so sweet.

Not much else to report right now. We begin summer registration in the next week or two. I'll let you know what classes lie in store for me.

Catching my breath

2010-03-19T07:28:00.001-07:00

It’s been a while, again. I know…i know.

Lots to talk about today. First, spring break was wonderful! I had a blast seeing the cop and Linc, and catching up with family and salsa friends. There were so many folks I wanted to see, but even six days wasn’t enough to get to all of them. I’ll have two weeks off before the summer semester starts, and I’ll be sure to see everyone then!

Secondly, school has kicked up a notch. They’re throwing new material at us left and right, and I must admit two things: I lost my drive due to spring break, and I got behind on my readings and studying. Big no-no!!!! So, I’ve had to kick it into high gear, find my motivation, and catch up. And finally, I get to sit down and catch my breath. The good news is my grades did not suffer at all! I am so proud of my performance here this semester. We still have lots of work to complete before the summer session, but if things continue the way they have been, I will be going into it with a strong GPA, and a strong understanding of the material. On a not so good note, we have lost a total of 3 students to date, all for various reasons. I don’t know the details, and to be honest, I really don’t want to know. It’s none of my business. I do, however, wish them well in their endeavors.

Now for the great news! It’s PARTY TIME TONIGHT! Mr. Eddie Palmieri and his world famous Salsa/Latin jazz orchestra is coming to town, for one night only, and I will be there with my dance bag in hand and a smile! After the concert I’m heading downtown to dance the night away, and this time, I will have my ballroom shoes. Yes!!! Time to decompress, relax, and have some fun.

It’s been a while

2010-03-02T12:43:00.001-08:00

I know, I know. I’ve been incognito for a little while, but I have my reasons. First, my computer crashed and burned! Second, the past few weeks at school have been quite busy. The workload never lessens, and we are getting into the meat and potatoes of history taking and physical exam techniques, all which require loads of practice time.

Nevertheless, I’m really enjoying my time here. As the days go by, I find myself becoming more and more comfortable with my classmates, and my time management skills are being put to the test. That feeling of excitement is still present, and I’m hoping to hold onto it for as long as possible.

Spring break begins this Thursday, and in approximately 48 hours I will be in the arms of the cop…and Linc will be in my arms! I can’t wait to see them, and my mother, sister and stepfather. I’ll be there for about 6 days, which isn’t nearly enough time to see all the people I want to see. However, I’ve already got plans to meet up with the salsa family on Friday night, and my old coworkers want to get together this weekend. Of course, the cop has top priority. We have a lot of catching up to do, and finally, after a year of pining and dreaming, the cop and I are going out to buy his very first mountain bike! I’m so excited for him! Quite a bit of money for a toy, but for my sweetheart, it’s money well spent!

We have lots of projects due once the break is over. I intend to milk the break for all it’s worth and put my family members to good use. They’ll get the full workup: eye exam, percussions, palpations, auscultations, ear exam, and a full medical history. At this point, I need all the practice I can get.

Time To Step it Up/Good News

2010-02-15T18:57:00.000-08:00

I've been studying for 6 hours; I need a break.

I got the fear of God put into me today. It seems that our class is not performing as well as we should at this point. One could say that enough time has not passed for us to hone in our study strategies, ingest the material, and feel settled in this new learning environment. Those would all be valid arguments. But when you're receiving over one hundred powerpoint slides per class, one month's worth of PA school equates to about three. And in three months, if you're not a master of the learning material then something is wrong; if you're not yet comfortable in the new environment, you never will be.

We got not one, but two, lectures on grades and our performances on tests so far. I don't think we would have gotten these pep talks if the overwhelming majority of the class was doing well. That worries me. It worries me because I know that I could have easily been on of the students with the pink slip attached to their scantron, and I don't want to experience that. I've done quite well so far, nevertheless, I aim to do better, and the pep talks we got today were precisely what I needed to redirect and study with a much sharper focus. I realize I can't know everything, but my attention to the details could definitely improve.

Next week is a whopper: 3 big exams, in addition to the start of projects and presentations. Talk about time management. I don't even think I should try to go salsa dancing this week, although it would serve as a great stress reliever. I certainly could use that time to study.

As far as the good news goes, I may have secured a pediatrics rotation in my hometown. One of my PA mentors has offered me a spot in her peds office and I have gladly accepted it! I can't imagine being able to go home for 5 weeks! I'm really excited about this prospect, and I will talk more about it as the details and dates become more solid.

Some kind of break this has been...there is no escaping school, ever! Back to the books!

Another week complete

2010-02-14T15:53:00.000-08:00

I'm really amazed at how fast time is going by. We are already entering our 4th week, and there hasn't been a dull moment yet.

The week started off with tragedy. I...skipped...class. Not because I wanted to, but because I was forced to. I will spare you, my invisible, perhaps nonexistent audience, all the gory details. Suffice it to say I cried, screamed and cursed my way into alignment with who I really am. It took a few days, but I'm good now!

Due to the inclement weather here in the north, classes were cancelled -to my dismay- on the busiest day during our school week. We missed two three-hour classes, one of which had to be made up early Saturday morning. The good news is the lecture yesterday was wonderful! I love anatomy, always have, but the lecturer was a older, nerd-like PhD with an unwaivering charm and a knack for dispelling the mystery of anatomy. In short, he made our three hour class fun and informative. I don't mind getting up early on the weekends to attend classes like that! And...I have a thing for nerds! Our first anatomy exam is scheduled for this week. I'll be happy to have it behind me.

The daily addition of learning material in PA school is unforgiving; one must stay on top of things constantly to keep from falling behind. There are tough lessons to learn as you go along. Last week I learned something very valuable: no matter how team oriented you may be, at the end of the day you are simply a PA student, alone, with the sole responsibility to keep your head above water, master the material, pass the PANCE, and begin saving lives. No, there is no "I" in team, and rightfully so. If you fail, there is no one to blame but you. If all hell breaks loose, YOU pick up the pieces alone. It's great if someone lends a hand to help you, but don't depend on it, because most people will let you down. The only person you can ALWAYS depend on is you! And really, should it be any other way? Self dependence is self empowerment, and that is never a bad thing. I can think of lots of instances where dependence on others may yield less than desired results.

Ok, enough philosophy for one night. One more round of studying and I'm off to bed. Three more weeks, and I get to see Linc and the cop. I can't wait!

Second Week

2010-02-05T08:28:00.000-08:00

Hey, I'm still alive. Is that a good sign?

Classes are going very well. We received our test grades and I did quite well, but I felt these preliminary exams were far too easy and I expect things to become more difficult in the near future...like next week.

We have three exams scheduled for next week, and next Saturday we begin working with our cadavers. I'm really looking forward to holding a part of the human body in my hands, and assaying the insides of something that most never get to see. Pretty exciting stuff!

Finally...finally...after a bust two weekends ago, I finally found a salsa spot nearby. I didn't know what to expect, but when I walked through the front door I knew I was home! Lots of people and lots of great dancers. I had a great time, danced some stress away, and even made a few new friends. I love salsa. I know I won't be able to go all the time, but at least I know of one place I can go where the dancing is awesome!

A Week in Review

2010-01-31T08:35:00.000-08:00

What they say is definitely true. PA school is like drinking from a fire hydrant!

Honestly, this past week feels like 5 weeks rolled into one. The amount of information and the pace at which classes are conducted are astounding. Prior to the start of school, I was constantly trying to figure out a way to better prepare myself. The truth is, there is no way to prepare for this kind of experience. You have to jump in feet first!

I am by no means overwhelmed at this point. On the contrary, I am inspired to spend a great deal of time reading and absorbing as much as I can. Every book on the book list is important, and every class counts. There are no fillers in PA school. Everything matters, and everything is done for a purpose.

Here are a few things I've picked up during the first week that I feel will be paramount to my success:

1. Study daily: Due to the amount of information thrown at you from day one, there is no possible way to learn what needs to be learned unless you give each class a bit of attention everyday. The key to daily study is to add to your notes, even if it is two or three sentences. This is the meaning of integration. What are you learning in your other classes that you can relate to the class you are studying for.

2. Study in groups: I'm not really a group person, but already I can see how valuable they are. The key for me is to study the lectures and read the book on my own first, then get together with the group to hammer it all out and make sure we all are on the same page. Study partners make you think about topics in different ways, and some of the mnemonics they come up with are really helpful.

3. Read: Sounds simple enough, but I think lots of people just focus on the notes and neglect the text altogether. This doesn't work for me. I love to read, and I learn well just by reading the text. If a topic in the notes just doesn't make sense, go the text and get clarification. Typically the text will give you detailed information about a certain topic. And in medicine, it's all about the details.

4. Attend lecture, always: Avoid missing class if at all possible. Attending lecture keeps you on top of your studies. Missing lecture guarantees that you'll get behind. There is no substitute for being in class and taking your own notes.

I'm really enjoying this process so far. I'm expecting the workload to increase as we move along, but I am pleased with the results of my study techniques. Two tests tomorrow...already! I'll let you know how it goes.

Study Methods

2010-01-21T15:52:00.000-08:00

As we draw closer and closer to the beginning of the didactic portion of my program, I find myself going back and forth between strategies I've come up with to tackle the massive amounts of learning material that's headed my way. I'm not quite sure how to format my studies and organize my binders. I'm not even sure if I should get binders for each class.

I've never really been an in-class notetaker. I've always thought that class time should be spent listening and absorbing as much information as possible. I usually reserve notetaking for private study sessions at home, and in turn, my notetaking becomes a form of study. I don't know how that strategy will work here, but I'm willing to give it a try. I only know that time is of the essence, and I can't waste it sifting through multiple study strategies. I need to do what works NOW!

Today was a busy day, but it was enjoyable. We got a bit of insight on the classes we will be taking this semester. It seems like gross anatomy will be the toughest of all. I was happy to hear that we are taking the same anatomy class (with the same instructors) that the medical students up the road take. I want to be challenged, and I know this class will push me to my limits. Perhaps this class will push me past my limits! Even better.

The most resounding piece of advice our academic coordinator has given us so far is to never fall behind. I think the best way to avoid this is to visit and revist the material as often as possible. If I can read and review the material daily then I should be able to retain it easily.

We conclude orientation tomorrow and then its time to hit the books. But before Monday, I plan to party like a rockstar one last time!!!

Orientation

2010-01-20T13:48:00.000-08:00

So far, so good!

There are 40+ students in my class, many of whom look like they just graduated from high school! At this point, I am the oldest person in the class, although there are a few that I have yet to talk with that look around my age. I managed to have some meaningful conversations with a few people, and even found a group of older classmates who seemed to have some life experience! How refreshing!

The day ended rather early. We started by filling out lots and lots of paperwork, meeting the faculty and staff, and going over our admission packets with our advisors. I love my advisor! She seems to be a no nonsense type of person, and I like that! We have two more days of orientation, and we begin classes on Monday morning. It's interesting...I'm finally here, settling into graduate studies, living on my own, pursuing the thing I've dreamt of for 2 years. Officially a PA-S!! I must say, it's gratifying to see the fruits of my labor.

I'm so happy to be here, and I'm looking forward to developing as a person and a professional. I'm looking forward to being the best PA I can be.

My Circadian Rhythm

2010-01-10T04:17:00.000-08:00

It's pretty much shot to hell. One day I'm up bright-eyed and bushy-tailed at 7am, and the next day I'm dragging myself out of bed at 12 noon. It hasn't been easy transitioning from the night shift schedule to a "normal" day schedule, but it must be done. In two weeks I'll have to be up by 7am every morning in order to be in class on time.

I'm still tying up loose strings here in preparation for relocating. Salsa dancing has been priority, of course, and as I see friends and favorite dance partners, I am bidding them farewell. A lot of them had no clue I was going anywhere. I will miss them all dearly! I'm hoping to come back a better, stronger follow, and I hope to master the on2 style while I'm away. My winter wardrobe is complete, and I'm almost done packing. All that's left to do is drive off into the sunset!

For over a year I've been waiting for this blog to trasition to one of a pre-PA to that of a PA-S. I won't claim PA-S yet until my fanny hits the seat on the 20th, but I'm excited to have the opportunity to give future readers an idea of what PA school is like from my perspective. So, my school has been in contact with us regularly since last October. The orientation packets we received gave us a glimpse of what's in store for the next 2 years. We hit the ground running on the 20th with an orientation that lasts 3 days. On the first day we will meet with our advisors to go over any provisions that exist, and we will meet and greet, have lunch with faculty and students, tour our learning facilities, set up our student email accounts, complete a PACKRAT computer lab assignment, get parking decals, complete an overview of clinical rotations, and purchase books. The second day consists of a diversity exercise and study strategy workshops. And the final day will consist of a didactic year overview, a simple group project, and the PACKRAT entrance exam. We officially begin classes on the 25th.

I hope to write one more entry before moving next Friday, and my goal is to update this blog often once I begin school.

So Much To Do

2010-01-04T06:20:00.000-08:00

My list of things to do just keeps growing and growing. I'm not complaining, though; I've always enjoyed having lots and lots to do. However, as I mentioned before in a previous post, I had no idea the amount of "housekeeping" that needed to be done prior to the first day of class. I imagine it's a lot of work for students who live close to their respective programs. But for those of us traveling cross country, there are added stressors that make the process much more time consuming.

I've finally finished packing my clothes and shoes. That alone took two hours. I didn't realize how clutered my closet was! I can't let that happen in the new apartment. And the shopping lists...it's funny when you're looking it over and you've got the common sense items on there like soap, shower curtain, and towels, but then you later realize you forgot to put an iron on there! What I don't want is to get snowed in without all of my necessary items. Let's just say I'm glad soap is on the list. I can't go to class funky, but I have no problem wearing wrinkled clothing for a day or two!

The cop has another long stretch of off days. That makes for lots of "us" time, and I'm looking forward to it! He's been so supportive of me, and I appreciate him for that.

Well, my goal this week is to get back on a normal sleeping schedule, so I guess I should retire for the night. Till next time...

Here's to you, 2009!

2009-12-31T06:18:00.001-08:00

What a year this has been! When I look back over the past 12 months, many things come to mind. Firstly, where did the time go? At first glance it feels like I've been sleepwalking, or like I didn't savor enough, didn't stop to smell the roses, didn't take time to slow down.

Secondly, did I accomplish much this year? At first glance it sure doesn't seem like it, but as I think back I realize just how many wonderful things have manifested into my life. It helps to make lists of life experiences. It helps to recap so we never forget how blessed we are. So, here's to you, 2009. Thank you for testing and strengthening my marriage. Thank you for the ICU job and all the wonderful folks it has brought into my life. Thank you for the trips to the mountains and to Costa Rica, and for the drive up to Pennsylvania. Thank you for the classes and the exams and the transcripts, and the undergraduate degree. Thank you for Abraham, and for Linc. Thank you for making me smarter, stronger, and wiser. Thank you for SALSA. Thank you for new and renewed friendships. Thank you for family. Thank you for my father and my mother. Thank you for guiding my sister. Thank you for music. Thank you!

Tomorrow I work my last 12 hour shift as an ICU tech. It will be bittersweet. I love those people. I never expected that...what a pleasant surprise they have been. I have seen and done more than I could have ever imagined, and I have made lasting friendships that have truly changed my life forever! For this I am extremely appreciative. Next week, I start packing this place up, and the week after that I'm outta here. I am in awe of my life right now. I feel I am exactly where I need to be. All creative components have come together for me, and all that is left to do is be! Be me...be true to myself!

Goodbye, 2009. Hello, and welcome, 2010! It's gonna be fast, fun ride. Bring it on!!

Success!

2009-12-13T02:54:00.000-08:00

After ten long years, I am finally a college graduate!!!! *HAPPY DANCE!!!!

I just got word from the dean of my department that I have satisfied the requirements for the B. Mus. degree I have been seeking for the last ten years of my life. It feels so, so good, and I'm proud that I went back and earned what was rightfully mine!

I am living proof that you can have/be/do/become whatever you want. Nothing is impossible!

My life just keeps getting better and better and better. I'm heading to the mall tomorrow for some much needed winter clothing. By this time next week I will be done with organic chemistry. I leave my job in two weeks (YEEEEEEEEEESSSSSSSS!!!). AND...I relocate to the snow covered hills in a month! Sweet! I'm sure gonna miss my family, especially my hubby and puppy. I wish I could take them with me, but I know they must stay behind. I really do want the cop to further his career and focus on his own goals. He's so smart and so loving. It's time he does some soul searching and figure out how to go about advancing to where he needs to be, and I am in total support of him and of his goals.

Well, one more night off then it's back to work. I love Sundays...I usually cook a nice meal, spend two hours or so doing my hair, go visit family, and lounge around the house. Maybe I'll finish off that bottle of Riesling!

Too Damn Cold

2009-12-08T14:47:00.000-08:00

The cop and I just returned from apartment shopping up north. It snowed the entire time. All I have to say is I hope I can acclimate quickly to a much colder climate.

Anyone who knows me knows I can't stand being cold. I guess I should have taken that into consideration before I applied to this one PA program. Common sense should have told me that if I plan to move north, I'm gonna be cold most of the time. Damn it. Oh well! I'm hoping I'll be on the move so much, I won't even notice how cold it is. I may even come to like it...maybe.

We had a great time up there. This was the cop's first time setting foot on my campus, and I hadn't been there since my interview over a year ago. And yes, we secured an apartment! It's absolutely perfect for me: spacious, clean, secure, affordable, and only 2 minutes away from campus. I'm looking forward to moving in.

My main focus now is making sure the cop is well taken care of while I'm away. He's a good cook, and a great housekeeper. I just hope he actually does these things while I'm gone. I don't think he'll have a choice! I sure will miss him and Linc, and my family. All of them have been so supportive. Well, it's getting down to the wire. Christmas is almost here. O-Chem is almost done. I'll begin my journey to competent medical practice sooner than I realize.

A Year in Review

2009-11-29T04:46:00.000-08:00

So, I've been blogging a little over a year now! How cool is that?

I love lists! I'm always writing them, revising them, and re-writing them to make them better than the last. Lists help you to stay organized, and they keep you on track. It's an easy way to outline your goals, and to be sure you are meeting them. I recall this time last year that I blogged about my goals for this year. Here is a list of those goals:

1. Finish my degree: I can do this one of two ways. Either transfer the credits or go back to my alma mater and spend a sememster there. I would prefer the former, but at this point, NOTHING is gonna stop me from getting that worthless, useless piece of paper.

2. Finish my last two prerequisite courses: both are chemistry courses. I think I will do just fine with this.

3. Gain meaningful healthcare experience: I have 500+ hours under my belt so far, but as you all know, my goal is to work in a hospital setting where I can utilize my critical thinking skills and learn simple procedures.

4. Learn as many simple procedures on my own in the meantime: Any courses I can take to learn skills will be a huge benefit to me (ie. phlebotomy next Friday!!!!!)

5. Learn to read simple Chest radiographs: I LOVE reading xrays. To me, this is a really important goal. I want to be able to look at a shadow and tell if it's abnormal or not...then go from there.

6. Learn how to read EKG's: Yes...this was something that was suggested to me. Once you have a really solid reference, EKG's make a whole lot of sense. Not too difficult. Once you know the basics, it's all about reading often so you don't loose the skill.

In retrospect, I can honestly say I have done all of the above! My undergraduate degree has been completed (thank you God), in two weeks I will complete my last prerequisite course, I have secured a great hospital-based job, and this job has exposed me to many procedures (central lines, A lines, ventriculostomies, phlebotomy, IV insertion, foley insertion), I know how to read and interpret simple chest radiographs, AND I'm pretty darn good at reading EKG's.

I'm impressed, if I do say so myself!

Happy Thanksgiving!

2009-11-29T04:17:00.001-08:00

I hope everyone had a wonderful Thanksgiving!

Not much out of the ordinary happened around here. The cop and I both worked Thanksgiving night, but were rewarded with a three day weekend! I went salsa dancing last night (yes!!!), and we both head back to work tomorrow night. There's still plenty of food around here, but I'm starting to get tired of turkey and dressing. There's only so much I can eat...

The start of PA school is looming. On Friday we travel north to go apartment shopping! I'm hoping to secure something while I'm there. That would be one less thing to worry about. So far, all is going according to plan. O-Chem is going extremely well, and I'm slowly crossing some bare necessities off of the shopping list. Next week, I submit my resignation at work. Only one more month to go and I'm outta here.

I can honestly say this is the best time of my life right now. I'm realizing dreams I've had for years. Everything is falling into place just as I intended. I couldn't be happier!

Orientation Packets are in!

2009-11-14T17:23:00.001-08:00

I need a break from O-Chem...

So, the long awaited orientation packets are in. All I have to say is wow! I've been so focused on the studying, the classes, and volume of material I'll be learning that I forgot all the preliminary stuff that must be done before I can even set foot into my first class. Name tags, medical history forms, physical examinations, parking permits, medical equipment, background checks...I still have LOTS to do before I leave for PA school.

Not to mention I still have to secure an apartment. I think that is the least of my worries for right now. My main concerns are completing this chemistry course, getting all my undergrad stuff done, and packing. I have decided to submit my resignation at work on the first of December. That should give them plenty of time to find a replacement. I've also decided my departure date: January 14! I'm so ready to get this party started!!!

My goal for this blog once school begins is to take the readers along with me as I go through this process. Most pre-PA students live vicariously through those that are actually experiencing PA school. I know that's what I did. My favorite blogs were always the ones that made me feel like I was experiencing what the author was experiencing. I want this blog to serve the same purpose for my readers. I plan on debuting this blog in January once school starts.

Where has the time gone?

2009-11-08T21:26:00.000-08:00

It's been a month since my last post! Goodness...where does the time go? Life has been busy, but not that busy. I've been having the time of my life, though!

Finally...FINALLY... we are working three twelve hour shifts at work. No more driving to work five days a week. No more 8-hour shifts. I finally have a life outside of work. The cop and I finally have time to go out and enjoy one another. And...I can go salsa dancing more often. Yesssss!! Most importantly, I have time to complete my Organic chemistry assignments. Speaking of which, I should be doing homework right now. Three weeks in, and I'm already on chapters 8 and 9. This Thursday I begin chapters 10 and 11, and I take my midterm this weekend! Talk about determination!

It seems everyday I'm receiving some sort of correspondence from PA school. I am looking to receive my orientation packet this week, and I have already registered for the first round of classes. 7 classes totaling 16 credits! Bring...it...on! Because of O-Chem, I've had to take a break from brushing up on Anatomy and Physiology, but I think I got a lot out of the little I did review. I mainly focused on Neuroanatomy and Physiology, which has always been a weak point for me. I feel like I have a better mental picture (no pun intended) of the brain, spinal cord, and PNS. I never thought I'd be interested in it, but I guess that was only because I didn't understand it. At this point, I don't see myself specializing in Neurology. It's interesting, no doubt, but not that interesting.

I am approximately 8-9 weeks away from leaving my entire family behind and moving to a strange, new section of the country. It's finally starting to sink in. I won't lie; the thought of PA school is starting to scare me, and I often ask myself what I've gotten into here. But I know that nothing worth having is easy, and I've worked so hard to get to where I am. I truly love medicine, I love people, and I love challenges. This career path has my name written all over it.

Well, time to hit the books again. I hope to write again very soon.

We're Back!

2009-10-04T08:03:00.000-07:00

Hey folks! The cop and I made it back from Costa Rica in one piece. What an experience: two whole weeks of roosters crowing at 5 in the morning, having howler monkeys as your alarm clock, being surrounded by beautiful flora and unfamiliar, majestic fauna, having fresh gallo pinto and mango juice for breakfast every morning, zip lining through the treetops..not to mention the friendly people, the language, the music, the culture! Needless to say we had a great time. I am officially ready for PA school!

While we were away, I received an email from my program director informing me that orientation packets would be mailed out soon. How exciting. I still have a few things to accomplish before I can matriculate: I have to submit my final transcripts for the two music courses I've completed (I got an A in both classes...awesome!!!), and apply for my undergraduate degree; I have to complete Organic Chemistry; I have to submit all final transcripts to complete my PA admissions file.

Am I getting excited about starting PA school? Yes, of course. I just don't like being this close to the deadline with all these outstanding requirements. I wish I would have taken O-chem sooner, but I couldn't. I know things will be complete by the end of the year, but it's a bit too close for comfort for me. As long as it all gets done, that's all that matters. My main focus for the remainder of the year is successfully completing the O-chem course, and applying for my undergraduate degree.

Work continues to be a challenge. We have lots of interesting cases coming in, and I'm still learning a lot. It gets frustrating, though, when you can't participate in the conversations about patients and their condition, even if you are familiar with the disease process and prognosis. It's frustrating when a nurse refers to a patient that we both have as "her patient"......"SLP, did you get my patient's blood glucose reading? Can you get my patient a pillow and an apple juice?" I don't mind the work, but I can't stand this attitude of ownership. The nurses don't look at me as a part of the team. They look at me as an extra set of hands, and I guess that's what my job description is. It's hard focusing on the job I have now when I know that in less than 3 months the level of responsibility will increase tremendously. It's scary and exciting all at once. One PA-C gave me some great advice when I first started in the ICU. He told me to remember that I'm not a PA yet; I am an ICU tech and I must work in that capacity only. He told me to use my time wisely by reading charts and keeping notes of diseases I see, their clinical manifestations, treatment options, and drugs used for that disease. I try to do this daily.

Well, not much else to report. I realize this blog gets no visitors because I haven't told anyone about it. I'm looking to debut this blog on the PA forum in January when school starts.

The Countdown Ends

2009-09-11T13:28:00.000-07:00

Yay...it's here! Tomorrow we board our flight to Costa Rica! I'm really starting to get excited! The packing is done, accomodations have been made for the dog, the house is clean, and we are packed. Now, all I have to do is get through one more 12 hour shift.

I don't know why I didn't take the night off. I don't know why I volunteered to work extra tonight. That's me, though. I never take the easy way out...ever! I'm really looking forward to this trip. I look forward to rest and relaxation; to eating some delicious Costa Rican cuisine; to swimming in the bluest of waters; to falling in love with my husband all over again.

I hope the next two weeks don't fly by.

On another note, there seems to be an epidemic going around. No, not H1N1...it's called "stupid girl syndrome." It explains why in the last 24 hours we have admitted two 21 year-old girls who threw themselves out of moving vehicles because they had fights with their boyfriends. Yeah..."stupid girl syndrome." I hope both of them have been discharged. I can't stomach another night of valley girl talk, not to mention walking by their rooms and seeing the boyfriends give feet massages. Lord, where are the parents...and what the hell are they doing??

Bye!!!

The Countdown Begins...

2009-09-08T06:13:00.000-07:00

4 days from now, the cop and I will be sitting in our bungalow eating gallo pinto, and kicking back a few drinks! Man, I can't wait to get outta here! Paradise awaits!!!

Planning this trip has been both exhausting and exciting! It kind of reminds me of the trip I planned this past May for the cop's 30th birthday! I had all the ducks in a row, and we had no mishaps during the trip, but the smooth sail didn't come easily. A lot of time and planning went into it. This trip is no different. In fact, more attention needs to be paid to the minor details if it is to be a success. Costa Rica is unfamiliar territory for the both of us. Going to a foreign country is never easy, but staying in the middle of the jungle with no phone, television, and very little civilization makes things a bit more interesting. This is just the kind of honeymoon we wanted, but we've had to do lots of homework to make it happen.

As usual, it's been up to me to see to it that all the wrinkles are ironed out. Passports copies, currency exchange rates, itinerary print outs, contact information lists, making arrangements for the dog....it goes on and on. After this week is over, we will really be in need of a vacation!

Work is...work. I love it and I hate it. I still find the work mundane and boring. The cases, however, are anything but boring. I learn something new everyday, and that's just the way it should be. I've been giving some thought to completing a residency after I complete school and pass the PANCE. Depending on the specialty I choose, this could really give me an edge. It's not the salary that I'm worried about. Work hard and the money will come...that's always been my motto. What I'm concerned most about is the huge learning curve. If there is anything I can do to ensure that I'm a productive member of the healthcare team from day ONE, I want to do it. And I think a residency would be perfect for that. Three more months to go, and I will no longer be an ICU tech. I'll be a PA-S.

"Hello Friends..."

2009-08-24T07:19:00.000-07:00

"...I'm your Vitamitavegemin girl! Are you tired, run down, listless? Do you poop out at parties?"

Yes, yes, yes...and yes! I don't know why, but last week's workload wore me out. No gym, no household chores, and very little cooking....just work and sleep. And salsa this past Saturday? I didn't poop out at the party. I didn't show up.

My mother has been telling me for weeks that I need to settle down and rest. That all this running would catch up with me. That I'm gonna crash and burn. I hate that she's always right. I'm just grateful that I didn't run myself into a cold, or even worse, the flu, which has been going around at work lately. So the cop and I stayed home all weekend. We did some shopping for the honeymoon, and I prepared a lovely Sunday dinner, but for the most part we parked it on the couch, kicked back a few drinks, and caught up on some of our favorite television shows. It was precisely what we needed.

So, it's back to work tonight. I'm looking forward to it. As I've said before, Monday's aren't all that bad for me. I enjoy not knowing what awaits me. I enjoy the mystery of the unit, and the waxing and waning of excitement. There are times where I sit on my butt for 8-12 hours, and then there are nights when I don't eat for 8-12 hours (like last Friday). I hate it...and I love it!

Lately I've been thinking a lot about specialties. What specialty am I most suited for, and which will provide me the excitement and the challenge that I desire. ED? Sounds fun but I would hate to be stuck in the fast track treating the common cold and repairing superficial lacerations. Ortho? I love bones and muscles, but will I enjoy being the minority in a male dominated field, and will I be treated like an associate rather than an "assistant?" As of now, I have narrowed it down to Critical care (not sure which subspecialty), Cardiology, ED, and perhaps GI. I'm sure this all will change once I reach clinical year.

Time is flying!

2009-08-21T12:53:00.001-07:00

Goodness, gracious. Where has the time gone. I didn't realize it had been this long since my last visit here. Ok, time for a major update...

1. I am now a college graduate, sort of. I completed my last music course with flying colors. Now all that's left to do is submit my final transcripts, pay my money, and receive my degree. God has been so good to me!!

2. I just returned from a trip to Ohio. After 8 long years, I reunited with two of my best friends, one of which got married last weekend. She was beautiful, and she and her new hubby look so happy. I wish them all the best.

3. My hubby and I are vacationing in Costa Rica in three weeks!!! Yes! This will serve as the honeymoon we never had. We will be spending two weeks in a bungalow in the middle of the rainforest, 4 minutes away from the beach! How cool is that? Again, God is so good to us!

I have postponed my final chemistry course until we return from our vacation. It makes no sense to be enrolled in a course as serious as that in the midst of a two week vacation. I still have time, and my goal is to finish a few weeks early, like I did with the music course I just completed. Work is still work. I'm loving it, but it becomes more and more mundane every day. I try to remain grateful, because I know things could be worse. I could be jobless, or even worse, working at that dreadful LTC facility. I'm milking this gig for all it's worth, because there is always something to learn. Lately, some of the nurses have been kind enough to let me do some cool stuff. So now I can add foley catheter insertion and removal, dressing changing, and endotracheal suctioning to my list of skills. This is precisely why I wanted to work in the ICU. LTC could never afford me these opportunities.

It seems the patients these days are getting sicker and sicker. Sometimes we experience overflow, but lately we've had true ICU patients: Fournier's gangrene with multiple debridement, several anoxic brain injuries, and fatal MVA's. Sometimes the family dynamics that come with some of these patients are more interesting than their diagnosis and prognosis. We've had several instances where security has been called to extinguish heated arguments and violent situations. It's all a part of healthcare, unfortunately.

I am really getting excited about PA school now! I only have a short time before I pack my things and head off to tackle what I'm sure will be one of the biggest challenges of my adult life. I'm amazed at how fast this year has flown by, and as upset as I was about not starting this year, I see now that I needed this time to better prepare myself for the rigors to come. I'm sure this will become even more evident once I'm in PA school. So, 8 months down, 4 more to go.

Another Great Salsa Weekend

2009-06-21T02:16:00.000-07:00

Man, my feet are killing me. I have danced a total of 7 hours this weekend....nonstop! Viva la Salsa!!!

My hometown is becoming quite the venue for salsa events and socials. In addition to the annual "invasion" that takes place, we have a social 6 out of 7 days of the week! Pretty impressive. Salsa is an interesting hobby in that it immediately grants you access to dozens of people who could be potential friends. I can't tell you how many friends I have made in the past four months from salsa alone.

The Professor is perhaps one dance partner I have that I could become quite close to. Unlike most of my dance partners, we have spent a considerable amount of time together off of the dance floor. It's interesting getting to know dance partners outside the context of salsa. They become real people. TP is a great dancer, and a wonderful conversationalist. He has a way of keeping my attention. He intrigues me, and he impresses me. When I dance with him and talk with him, I am myself...no pretense, no walls, no formalities. Just laughter, smiles, fun...peace and contentment. I'm not quite sure how old he is, but I'm certain he's a bit older than I am. Honestly, I couldn't care less; we have so much fun together! It's scary how well we get along...and how well we connect! He's an adorable man with a great sense of humor, and a great pair of dancing feet!!! One of the best dance partners I have, no doubt, and surely someone I hope to keep in my life for years to come!

Well, this week brings a few changes. I begin my final music course on Monday. I will be a college graduate at the end of August!!! The cop's work schedule has changed again, so now we will both have Sundays off! I'm so excited. Now we have at least one day of the week when we can spend some quality time together. I have Wednesday night off this week. Guess what I'll be doing? That's right. I'll need the next three days to rest my feet, recuperate, and learn some new styling moves!

Coming soon to M&M

2009-06-16T16:18:00.001-07:00

So, I'm an official Salsera, yes?? Ok!

I've been getting a few requests for salsa videos from partners that want to videotape themselves dancing with me! Me, of all dancers in my circle...and there are hundreds of us!

It's just what we do. We also take lots and lots of pictures, and lots of videos. So, since salsa has become a permanent part of my life, I figure I need to create a chronicle of this experience by taking pictures as well. I will post a few of them here. I will be traveling quite a bit very soon, and I'll be going to some of the hottest salsa spots in the country. So, be on the lookout for pictures of me and dance partners from all over the place. This should be fun!!!!

Oh, and for the record...

2009-06-16T16:12:00.000-07:00

Music History class is OVER!!!!!!! *Happy Dance*

Yes, I made it, with the grace and favor of God and all the energy and power of the universe. Sounds dramatic, but for real....seriously...

Aced the class, and now I am already in week two of Chemistry. I start my last music course in two weeks, and begin Organic Chemistry at the end of July.

Then, I can take a much needed break from all things school related until the end of January.

Ahhhhhh, life is good!

Rollercoaster

2009-06-16T15:58:00.000-07:00

Yep, I've been riding one since last week.

It all started when I got sick. I came down with a nasty, nasty cold early last week that knocked me off my feet. I only missed one day of work, but I slept so much it felt like I had missed a whole week. Ironically enough, I hate taking medications, so I took only what I needed to get through the week, and it helped tremendously. I still managed to go dancing Saturday night.

Well, I'm getting dressed to go to work yesterday, and the cop wakes up out of his sleep moaning and groaning. I walk in to check on him, and he begins to complain of dizziness. I initially thought he may be overheated; our apartment gets very hot in the summertime. When the dizziness returns, and is accompanied with profuse sweating and nystagmus (which I had never seen up close before), I know something more serious is wrong. Thank God we live literally two minutes away from the hospital.

So, the cop has vertigo. Scared the living daylights out of me. We had an excellent doctor working with us. I took mental notes as he performed the cop's physical examination. The medical interview was beautiful! Great open-ended answers, and great rapport with the patient. Within 5 minutes he had his diagnosis, and within 20 minutes we were headed to the pharmacy to fill prescriptions.

Needless to say, I didn't go to work last night. I'll be returning tonight. Word has it that census is low. I'm hoping this pick up. I need all the diseases, drugs, lab values and patient interaction that I can get. That sounds really selfish, doesn't it...

Work is still exciting, however, it becomes more and more mundane every day. I feel like I have all of this new knowledge and no license to use it. Very, very frustrating. My saving grace is knowing that at the end of this year, in 7 months, I will be in PA school studying all the diseases I see everyday, and learing how to treat them! How cool is that? I've been in contact with my school, and everything is set to go. I paid my deposit last Monday (YAY!!!!), so my seat has officially been set aside for me. What a relief!

In the meantime, it's work, eat, sleep (very little), and SALSA!!!! And not necessarily in that order!!

Hello? Anybody Home?

2009-05-25T14:22:00.000-07:00

Is anyone reading this blog? I don't think so, but I sure have enjoyed writing. I don't write as much as I used to; school, work, and salsa are taking their toll on me, but I can't seem to sacrifice any one of them. I had a fabulous time this past weekend! I basically spent the majority of it in the ballroom dancing my butt off. It was great. Can't wait to do it all over again this weekend!

It's back to work tonight. They say Mondays are the hardest days. We return to work and have to get back into the groove. I enjoy Monday nights. I look forward to what awaits me there. Patient turnover in the ICU is a bit high. Some patients stay longer than others, of course, but for the most part we get 'em in and out ASAP. I always look forward to seeing what Mondays have in store for me. Things have been pretty mellow at work. No codes, no deaths, and no violent situations in about a week or two. For a while, that was all we were getting.

We got a middle aged man some weeks ago who put a gun to his head and pulled the trigger. Motive? He had been diagnosed with metastatic pancreatic cancer, and didn't wish to contine with therapy. His wife heard the gunshot and ran into the room to find him on the floor in a pool of blood...alive. By the time he got to us he was a mess, obviously. I have never seen anything like this before: the entrance and exit wounds were clearly visible, and his eyes and face were severely swollen and blue. Needless to say, he didn't make it through the night. The very next night we had another patient who had come to us for respiratory failure secondary to a brain tumor. She suffered from mental retardation due to child abuse. To look at the young girl was to look at an angel. She was in her late twenties, but looked half that. She had become a ward of the state and was living in a nursing home when she fell ill. With no family and no friends at her bedside, she quietly passed away, clutching to a stuffed teddy bear. There wasn't a dry eye in the house.

I'll tell anyone...working where I work -even as a low on the totem pole, know-nothing tech -is not easy. But so far, it has been one of the best things I've ever done. Yes, I have to commute almost an hour five days a week and lose sleep, but I believe once PA school starts, I will realize just how fundamental this position has been for me.

This week is all that stands between me and a final exam for my music history class. Then I start chemistry next week. The fun never ends! 7 months to go before PA school. I can't wait!

Update 2

2009-05-09T05:52:00.000-07:00

Wow, time is surely flying by. I haven't done a great job with keeping up with this blog. My life has been so busy lately.

For starters, work continues to be a challenge. I'm still enjoying the job and the night schedule, but all I do is sleep all day long when I get home. It doesn't leave much time for cooking, cleaning, and spending time with my husband. Good thing the cop works at night, too. At least we can go to sleep together! I continue to learn more and more everyday at work. The nurses have come to know my work ethic, and they are learning to trust me. I remove lines, catheters, draw flushes, and participate in codes on a regular basis now. I've come a long way in 5 months. I was voted employee of the month this month...can you believe that? 5 months in, and I'm employee of the month. It is quite an honor! I hope I can live up to it. Most people at work now know that I will begin PA school in the spring. They are genuinely happy for me, I think. The hardest part for me is being 'just a tech.' As smart as the nurses think I am, I am nothing more than the tech that assists them. Sure, I can carry conversations with them, and they come to me and ask me questions, but I'm still just the tech. It's hard playing this role, especially when I am in such a great learning environment.

I'm blessed to be in a job that allows me to read the history, physical, labs and progress notes on every patient in the unit. Everyday I see something new, learn a new drug or disease. I am constantly writing in my notebook. The nurses let me ask them questions, and I peer over their shoulders as they start IV's and change dressings. As a tech, I don't think it gets any better than this. This is precisely what I need before going off to school.

Working in the ICU forces one to become intimately acquainted with death, also. From time to time I flip through the discharge notebook, and it amazes me how many patients we lose each week. I try to put myself in the mix of every code; I think it is important that I deal with death now rather than later. When I become the decision maker, I can't crack under the pressure just because I see someone dying before my eyes. On the other hand, I can't allow myself to become too cold, too rigid, that I lose my sense of empathy and compassion. It is a thin line to walk.

I've been working lots of hours lately for two reasons: to save money for school, and to surprise my husband with a weekend getaway for his 30th birthday. We depart today for 4 days in the mountains. The cop works way too hard. I really want to wow him and show him just how much he is appreciated and loved. If a cabin in the mountains, a personal chef and a day at the spa doesn't convince him, I don't know what will. We both need the rest, really. I can't wait to climb into that hot tub, sip Greek wine, read a book, watch the sunset, and stuff myself with as much birthday cake as I can. Might as well enjoy it...it will be over before we know it.

I have so many stories to share relating to work and the patients and medical staff I work with on a daily basis. Perhaps after this trip, my mind will be clear enough to begin blogging these stories. As of now, the mountains await us!

Update 1

2009-04-13T04:08:00.000-07:00

Hey, folks!

I can't believe it's been a month since I last wrote. I've been terribly busy with life lately. Lots of exciting this have been happening. To make better sense of it all, I think I will submit a few entries instead of cramming it all into one.

I am officially a salsera! Yeah, I know this blog is supposed to be about PA school, but even that has taken a temporary backseat to dancing! It's been almost two months since my first salsa bootcamp, and I've been consistently dancing ever since! I LOVE SALSA DANCING! I don't know why it took me so long to jump on this bandwagon.

I pretty much go every weekend to one social or another. In my area, there is a solid community of dancers who are faithful dancers. You see the same folks, dance with the same folks, and become friends with lots of people. What I like most about it is that, for the most part, no one is looking to hook up. These are die hard dancers who simply enjoy the dance, the music, and the social setting. It's been a great outlet for me. I work hard all week knowing that on Saturday I get to dance the night away, and Sunday I get to go to my salsa lessons. I've even located the salsa spots in the town where I'll be going to school. I just hope I'll have the time to continue dancing while I'm away. It sure would make a great outlet! Okay enough rambling abot this stuff. There's lots more to write about.

Time Flies

2009-03-10T05:41:00.000-07:00

We are approaching the middle of March already. Where is the time going to?

I'm pretty exhausted this week. I picked up an extra 12 hour shift for a coworker this weekend, and have another scheduled this Thursday in addition to my regular work schedule! Hey, I'm gonna need the money, and I might as well start saving now! Nothing too interesting going on lately, but we did end up losing a patient that I grew attached to. Sweet guy...just too much drinking and smoking.

In other news, I seem to have found something else to occupy what little time I have. Salsa dancing! I've been going every weekend for the past month, and I love it! The music, the culture, the dance...it's all me! Too bad the cop isn't interested in practicing as much as I am. Oh well...finding a dance partner is the least of my worries. We have a pretty big salsa scene in my town, and lots of socials every week. You tend to see the same faces and dance with the same people. I can't wait to go this Saturday. I'm taking a class on spins and turns, then going to a social that night!

A First

2009-03-04T06:50:00.000-08:00

I'm moving up the food chain, folks. Today, I got to remove a Port a Cath from a patient!!!

The patient expired shortly after I arrived to work. She was very, very ill, with a laundry list of illnesses and conditions. Thankfully, the family decided to take her off of life support and let her go.

She had two indwelling lines; one for dialysis and the other for the numerous blood gases, draws, and medications. The nurse offered to have me d/c the lines, and I jumped at the opportunity. I got to cut the sutures and yank the line right out without much blood. The second line was not so kind to me.

This catheter had been in so long that the skin surrounding it had adhered to it. No matter how hard I pulled, it wouldn't budge. Needless to say, I had to cut into her skin to loosen the catheter, and it was only when the nurse used a scaffold that it came gliding out. No blood!

Now, I've always said I would never be interested in surgery. I think last night may have sparked an interest! We will see!

Two Words

2009-02-25T06:46:00.000-08:00

Fournier's Gangrene!

I remember hearing about a case of this on the unit, but I didn't get to see it. Well, last night I got well acquainted with it. I think it is, to date, the most fascinating, gruesome, eye popping, awesome disease process I have seen. I got lucky, really! I just happened to walk to another unit to see if I could be of any assistance. One nurse, Chad, was preparing to give a bath, but needed to do a dressing change first. When I saw the site of the dressing change, I knew I had struck gold! What lay behind the mass of ABD pads and saline-soaked gauze was a bout of gangrene that left the poor patients left testicle totally exposed.

The doctors had debrided the wound yesterday, and removed so much necrotizing flesh that today I was able to observe the left spermatic cords' descent through the internal oblique! I was so shocked to see real live anatomy that I began to call everything out by name as I saw it. It was a remarkable specimen to see, but unfortunately this poor patient is not doing well, and will probably have to go back in for more debridement.

That pretty much sums up my night! We did loose a patient sometime after I got off work last night, and we are sure to lose a few more when their families come to grips with their loved ones' demise. It's a sad, sad thing...death. C'est la vie.

Goodbye, February!

2009-02-24T13:47:00.001-08:00

Wow...is it me, or does it seem like the months are flying by. March is just a few days away!

Great night last night on the unit. Lots of interesting cases: 18 y0 overdose, acute MI, syncope with PVC's, multisystem organ failure, and DKA. I'm learning lots!

I mustered up the energy to go to the gym after work. Today was leg day. Ugh! But it was one of the most intense workouts I've had in a while. I needed it badly! Threw in bi's and tri's since I skipped out on in last week. I'm feeling pretty good now. Let's see how I feel at work tonight!

Change of Heart

2009-02-23T05:55:00.000-08:00

LOL...no not about that. Are you kidding me!

Part of the reason why I took this new job is that it's located in one of the most beautiful areas in my state. I love southern living! I love rolling hills, cows and horses, and homes with land! All of this is a plenty in the town where I work. I can easily see myself working hard in the hospital, rounding on my patients, running the local clinic, and playing just as hard at home with the cop and Linc. But my dream is crumbling before my eyes.

It's becoming obvious to me that my hospital is run by the nurses. And PAs are at the bottom of the totem pole. I work at night, so I don't get a chance to see them rounding in the mornings. The NP's there greatly outnumber the PAs, and they are more office assistants than practitioners. I refuse to work in that capacity, and I don't know if I have the energy or the time for being the first PA to really be utilized properly. That's an uphill battle that I'm not willing to fight, and my first few years as a PA should be about getting my skills up to snuff. Once I pass the PANCE I may have a different outlook. But it sure would be nice to hit the ground running in a practice that knows what a PA is and how they are used. The cop says if the right opportunity comes along, he is willing to move anywhere after I graduate! Sweet!

Patients And Their Families

2009-02-21T05:28:00.001-08:00

Back to work tonight! I'm looking forward to it. Last week was CRAZY! Lots of admissions, not too many sad stories, but lots of drama to make up for it!

I'm beginning to realize just how much families can interfere with the care of a loved one. We had several instances like this last week, but one stands out above all others. We had a patient come in with respiratory failure. He was ventilated and subsequently trached. His family was outrageous. Two by two, they would switch "shifts" with one another to make sure the patient has someone in the room with him at ALL times. They kept a detailed notebook of drugs given, for what purpose they were given, the name of the nurse or repiratory therapist that administered those drugs, and names of all techs (including me). They refused to let us turn the patient because it would cause him pain, even after being told that this would surely cause skin breakdown. They would run out to the nurses station anytime they felt a vital sign was too low, or when the monitor alarms went off. They demanded the patient be given his pain meds well before it was time. And they hovered over anyone who was rendering care to the patient, even to the point of becoming a hazard. They were unbearable. Furthermore, they somehow got the doctor to order the presence of a family member in the patients room at all times. There was nothing we could do to get rid of them. What makes all this so bad is the patient was one of the sweetest I've had since I started working there. He was in horrible pain, but always managed to smile and crack jokes. I loved him, but hated his family.

I wish families would understand why their loved one is in ICU to begin with. When one walks into the ICU, 1) they are usually very sick, and 2) require special care that requires lots of knowledge and expertise. If this patients family felt they had the expertise to take care of him, why didn't they discharge him and take him home???

I think what made me more upset is the lack of authority on the part of the nurses. Not once did they sit down and talk to the family about their behavior. Not once did they draw the line. I can only recall two people who made it clear in one way or another that the family needed back off: me, and only one nurse! I know this is risky business. I know the family thought they knew what was best. But clear lines must be drawn when it comes to rendering care. And if anyone gets in the way of that, we have a problem. The night techs rotate units every week, so fortunately, I will not have to deal with this family anymore. But as the saying goes, the grass is NEVER greener on the other side!!!

Happy V-Day

2009-02-14T13:02:00.001-08:00

It's a bit gloomy in my part of the world, but it's still been such a lovely day.

The cop and I went out for breakfast this morning, then went horseback riding. The sun came out for a bit, and we were able to get some great pictures! Tonight we are going out for dinner! And dare I sa the cop managed to plan all of this on his own. There is a God!

I go back to work tomorrow night to work a 12 hour shift. After today, we could use the overtime pay, and hopefully there will be some interesting cases to read up on. Time flies, so enough about work for now. I'm off to continue celebrating this day of love and happiness. Cheers to you all!

First Day of School

2009-02-10T06:50:00.000-08:00

Yes, I'm a student once again! But this time, the material isn't nearly as interesting.

I began taking my Music History course for my degree yesterday. I can't say I'm excited about taking it; I just want to do well and get my degree at the end of the summer. I had another great weekend! I surprised the cop with salsa lessons, dinner at a restaurant downtown, and salsa dancing afterwards. It was great! My feet still hurt. I can honestly say I have found another love! As soon as I got home, I ordered some ballroom shoes. The cop got us some DVD's so we can improve our dancing skills, and we are planning on going to our next salsa social in a few weeks. I can't wait!

Work is still going well. I think my secret may be out, though. I'll write more about that later. There have been lots of interesting cases lately: the DKA guy who made a complete turnaround, the ruptered pancreatic pseudocyst that led to sepsis, and the brain dead paraplegic that is having her organs procured as I write. Lots of learning opportunities for me, that's for sure.

Well, there's not much else to write today. I'm exhausted, so I'll call it a day.

Back to Work

2009-02-02T07:05:00.000-08:00

I had a blast this weekend! Spent time with my sister, went to the doggy park with Linc and the cop, and got some much needed rest. Tonight, I return to work. I'm looking forward to it.

I've been really successful with keeping this PA school thing under wraps. I don't know how much longer I will be able to do so, though. I've been searching for a list of PAs that work at my hospital, and it had been an uphill climb until late last week, when I make a contact in the Medical Services office who has a complete list of PAs that she is willing to share! Furthermore, she made it sound like they would be more than willing to let me shadow.

SUCCESS!!!!!!

So, tomorrow morning before I head home, I'll be stopping by to get that list, and then I hope to begin shadowing soon. I really miss it.

Also, I begin school on the 9th! Music History...what fun. NOT! The only thing that excites me about thsi course is that it brings me one step closer to completing my degree. I can't wait to get it over with.

Long Night

2009-01-29T06:11:00.001-08:00

Boy, was it ever!!! And to make matters worse, it was dead silence throughout the unit. No action, no codes, no glucose readings, very little talking, and...I forgot to take a book with me! So, I was stuck reading the online journals and the medical dictionaries. Yep, that makes me an even bigger nerd!

I guess I earned it after a night like the night before. One of our patients coded three times in a matter of an hour. And as the saying goes, three times is a charm. It was a tragic case: sepsis, end stage renal failure, CHF, and a recent MI. The prognosis was poor from the beginning, but her two sons requested that everything be done for her. So, we coded, and coded...and coded again, to no avail.

The whole night I felt a sense of urgency. Even in the cafeteria on my lunch break, I was scarfing food down my throat trying to get back to the unit. I kept telling myself that I didn't want to miss out on anything. Sure enough, when I turned the corner to enter the unit, the nurse yells, "Call a code!" She and I were the only two there! As I ran to the adjacent unit to get the code box, 4 nurses ran in the opposite direction to offer their help. Within seconds respiratory, the time keeper, and the ER docs were there. It was a circus. To make the night even more interesting, we had a non-compliant NIDDM/HTN patient with an intracranial hemorrhage right nextdoor. It's unfortunate that we had to put her through all of that. The prognosis was so poor, and she had even mentioned to one of her family members weeks prior that she was tired of fighting. I left work so drained that I skipped the gym, went home and got right into bed. As for the NIDDM patient, she passed away a few hours after shift change.

In comparison to yesterday, tonight was an absolute bust. Just mind-numbing silence, and no responsibilities whatsoever. Well, at least I earned it honestly! What's certain is that there is another hectic night just around the corner! I can't wait!

America's Next Top Tenor

2009-01-24T22:44:00.000-08:00

I've just returned from seeing Lawrence Brownlee in recital with Martin Katz. Both singer and accompanist are two of the world's most talented artists, and I am so happy that I got a chance to see them perform.

I almost didn't make it to the concert tonight. I've been so tired lately with work and responsibilities at home, but I knew this was a recital I could not miss. I've been a fan of Brownlee for some time. To hear his recordings is to be mesmerized, but to see him in person is quite a different experience altogether! His voice is so pure and seamless, and he's a fantastic actor! I would love to see him perform in the opera house. What's remarkable is that he is quite young, but his technique and stage presence are that of a seasoned professional. He IS a seasoned professional, I guess, when you take into account his CV and performance history.

You know you've been a part of something special when it brings tears to your eyes, and you leave the venue emotionally spent. I look forward to seeing him perform again soon!

TGIF

2009-01-17T14:16:00.000-08:00

Yep, thank God it's Friday....or Saturday. I'm still trying to adjust to the whole working nights thing!

I've practically slept the whole day away, but at least I don't have to go to work tonight. Not that I mind at all...I love my job! We had a code towards the end of the shift last night. Poor guy had been combative all day, trying to work himself out of his restraints, and tearing his skin in the process. His wife passed away a few weeks ago, and not too long after, he was brought to the hospital with a temperature of 88 and a pulse of 15!!!

The children, still grieving over the loss of their mother, wanted a full code if something were to go wrong, and that's exactly what he got. He stopped breathing first, then went into V tach...after a few rounds of amiodarone and an ETT, he was stable but unresponsive.

This guy clearly doesn't want to be here. He is grieving over the death of his wife, and has no desire to live without her. I can understand the children's grief, but why make this man suffer any longer? When all the vital signs are leaning towards death, why prolong it? If the tubes were pulled and the warming blanket were removed, he wouldn't be alive! I doubt he will survive the weekend.

Ironically, for both father and child, love IS the most powerful force on earth.

Full House

2009-01-16T18:11:00.000-08:00

All beds are full once again. I must admit, it's been pretty low key lately; no codes, no deaths, and that's a good thing! What's the purpose of Western medicine if lives are not being saved?

We do have some interesting cases going on, though: thrombotic thrombocytopenia pupura, subdural hematoma acquired during sexual intercourse (I lie not!), and my personal favorite, Fournier's gangrene. I just found out that this guy has been with us for about two days. While speaking to another tech, she informed me that she got a chance to sit in on the debridement of the man's scrotum. He was so drugged up, however, that he was smiling and winking the entire time. Needless to say, she had to excuse herself. So...I'll be making my way to his room tonight in hopes of getting a glimpse of THAT!!!!

Coolest thing so far this week: standing bedside as the neurosurgeon performed a stat ventriculostomy on the SDH guy. Talk about AMAZING! I got as close as I could without contaminating the sterile field. I'm hoping this guy pulls through, but it's not looking good.

There's always a gleam of doubt when you're switching from one profession to the other. I often wondered if medicine was really the career for me. Sure, it seems interesting enough, but will my curiosity and love for learning leave me one day? It was paramount that I leave long term care in order to find the answers to these questions. Despite the good days, the sad days, and the slow days I can honestly say I have made the right decision! I am so happy to finally be on the right track in my life.

Very First Code

2009-01-10T19:44:00.000-08:00

Last night has been the busiest so far. Although 3 of my 12 beds were empty, the events of the night kept me more than busy. Being busy is relative...my new job still can't compete with the amount of running, lifting, turning, pushing, and sweating that I had to do in long term care.

We've lost quite a few folks lately. I'm finding that in intesive care, and perhaps in all areas of medicine and surgery, you see lots of the same: respiratory failure, renal failure, MRSA, HIV, diabetic ketoacidosis, overdose. Perhaps part of becoming a strong nurse/doctor/respiratory therapist/PA is being subjected to the same diagnoses, and in turn, similar prognoses, drugs, complications. I find myself writing down things I'm not familiar with...mostly treatments and drugs. Last night, I became familiar with atropine and epinephrine.

Mr. A had come in two days earlier for only God knows what. I never could get my hands on his chart. Either the nurse had it, or it was nowhere to be found. You could tell he was sick just by looking at him: xanthoderma, anxious, restless, distended abdomen, not to mention the bloody stools that I helped clean up. He just had the look. His nurse, Tina, called his coding a few hours before he went into asystole. Once the code was announced, herds of people from all over the hospital came to pitch in. Respiratory, nurses, the resident, the doctor, and little ole me! Can you imagine 15+ people in a tiny room, moving around like ants in an ant farm? That's what it was like.

The nurses and therapists took turns performing CPR, and Tina prepared the atropine and epi. One round of drugs after another were administered, and Mr. A toggled between V fib. and asystole, his body bouncing off the table with every compression. The nurse mentioned that he could feel the ribs cracking beneath his hands. After four rounds of medications and no change in cardiac rhythm, the doctor called it.

Codes are nothing like television makes them out to be. There was no yelling, no passionate plea for Mr. A to pull through. On the contrary, there was laughter, idle chit chat, and smiling. Immediately after pronouncing him, everyone left as quickly as they arrived. Tina, myself, and the other nurses on the unit were left behind to clean up the mess. Overall, I think I did well for my first code. I didn't cry when Mr. A passed, and I didn't run out of the room when, while assisting the nurse with removing the backboard, a melodious sound of air escaped from his throat. I did, however, learn that Mr. A died a lonely man, estranged from his family, and befriended by a certain "colleague" who was his power of attorney.

Only two weeks on the job, and so many lessons have been learned. This is the kind of stuff I need to see and experience before the end of the year.

Dead Man Living

2009-01-08T09:03:00.000-08:00

While attending to Mr. Steven's oral care, I studied his face. Here is a relatively young man whose body is riddled with lines, needles, tubes of various sizes, all of which are trying to sustain his life. He looked defeated. He looked tired. But I still tried to offer him some positive words. I wished him happy birthday (he celebrated his 67th), and as I walked out of his room, I inquired about his prognosis. Of course, it looks grim...it is grim. The doctors are d/c'ing his comfort care this afternoon.

Out of curiosty I pulled his chart to find out what was ailing him:

COPD (cigarette smoker), bilateral pleural effusions, acute renal failure, chronic bilateral subdural hematomas, lung cancer, prostate cancer, and coagulopathy (facilitating hematomas?)...

Mr. Steven's in indeed a dead man living.

Fortunately, his family has agreed to let him go. I thought about Mr. Steven's and his family on the way home. Death, for most of us, is usually not a planned event. We are subject to its will, and are forced to deal with the chaos it leaves behind. But how does one deal with death when the day and the hour of its arrival are known? One thing is certain: Mr. Steven's is no longer suffering. Somehow that makes his death easier to deal with.

The Night Shift

2009-01-06T17:04:00.000-08:00

There's something about working at night in the hospital. For the most part, it's eerily quiet; patients are sleeping, nurses are documenting, and us techs are giving patient care. There are no big bosses; no doctors, no administrators. It's peaceful...until the guy in room 15 stops breathing, and the meth addict/MVA case comes up from ER.

Then all hell breaks loose...nurses from all units are rushing to help. Someone's bagging, someone else is calling for the crash cart, and us techs...we are scrambling around to find the code box with all the medications in it. The new admission is getting hooked up to the monitors, while the nurse starts pushing Zofran to control her vomiting. It's all a bunch of hoopla, until the patient begins breathing again, the new admission falls asleep, and then silence covers the unit again.

I live for the hoopla-hell moments. It's what makes working nights exciting. You never know when a patient will crash, and you don't know what new patient will be coming through those double doors. Medicine is such organized chaos. In the midst of all of the uproar, something beautiful happens: a team of people come together to deliver quality care to someone in need. We take all of our energy, and focus it on the patient. And no matter the outcome, the feeling of accomplishment and satisfaction is undeniable.

Life As a Tech

2009-01-04T21:37:00.000-08:00

So far, I'm really loving my new job! It's only been a week, and I have learned more in that time than all of my time in long term care. Amazing!

My primary duties allow me to get close to the patients. I am expected to read charts and become familiar with why the patients are there in the first place, and for me, this makes all the difference in the world. Tomorrow I begin working the night shift. I can't wait!

So far, I've seen all kinds of conditions. Respiratory failure seems to be the most prevalent, but we have patients in for renal failure, HIV, diabetic ketoacidosis, stroke, MVA, the list goes on and on. One case, however, really struck me last week.

We got word that a new admission was on her way up from the floor. She had just given birth, and since the baby was 6 weeks premature, it was taken by C-section. Complications with the surgery bought her a one way ticket to the ICU. It took her a while to arrive, but when I returned from lunch, there she was...15 years old and scared to death. My first instinct was to stop and stare in shock..."a 15 year old girl...why in the world are these young girls having babies?" But our eyes met, we exchanged smiles, and that was that. She had lots of visitors come by to see her. At least she has the support she will need to raise her child. I think the diagnosis was preeclampsia.

I think what I like about Critical Care medicine is that you have to act quickly and be calm all at once. You must be master of your emotions. Time is of the essence and patients are depending on you to make the right decision...now. I hope to be able to perform according to those standards one day. Critical care, it seems, is becoming a specialty of interest for me. I can't wait to see what awaits me tomorrow night!

White Is Right

2008-12-31T18:45:00.000-08:00

Just came from visiting Voodoo Medicine Man's blog, where he posted some interesting commentary about the bastardization of language:

http://voodoomedicineman.blogspot.com/2008/12/on-bastardization-of-language.html

I agree on many points. It's disgusting how the English language is abused. It seems that folks are using english as a template for new, unfamiliar languages. I cringe when I hear our youth speak; half the time I don't know what they're saying, and what's worse, I get the evil eye for NOT understanding!

It's ironic that we look at minority leaders as those who have "risen above the fray." After all, weren't they born here? Aren't they American citizens by BIRTH, and isn't English the national language? Then, they are EXPECTED to be "masters" of it. This kind of talk infers that we don't expect minorities to speak properly. Sad but true. Furthermore, the conjugation of verbs in a language other than English should not be scrutinized. I'm sure the creators of the Spanish language didn't sit down and say, "Well, let's be sure to choose another word for "take" besides "tomar", because we want to be sure English speakers can understand us when they are translating." The language, obviously, wasn't made for us. It was made for the Spanish speaker. (By the way, the verb for "to drink" is "beber")The English language is riddled with all kinds of idiotic rules that make absolutely no sense. There are three ways to spell the word "there", and depending on the CONTEXT, we all know which one is being used. Tell me, what is the difference between the two?

The bottom line is we have a huge problem with what we are not accustomed to. The majority sets the rules, and everyone is expected to abide by them. Anyone not doing/speaking/dressing/thinking/living/believing/worshipping like the majority is labeled outcast/sinner/misfit/freak/uneducated/poor/WRONG! Poor language skills isn't something that evolved in minority communities. People have been speaking terrible English since the dawn of time, and this behavior affects all people and all socioeconomic brackets. I am surrounded by people of all races and colors, and most of them speak horribly. Race,color and status have nothing to do with it.

Again, I agree with many of the points made in the commentary. However, parts of it are the same old "stereotype" talk that we hear from so many of our friends and family members. It would behoove all of us to take as much time as we have studying, analyzing and critiqueing minority groups, and go analyze and critique the ones who think their standard of living is the right one.

Twilight Zone

2008-12-31T18:18:00.001-08:00

Finally, 2009! I for one am happy to say goodbye to 2008. It was a rough road, but we made it, and now we are ready to embark upon what seems to be an exciting year!

Every New Year's we are treated with another marathon of one of my all time favs: The Twilight Zone. Wasn't Rod Sterling an absolute genius? I stopped my my parents' house, and my mom, sister, and I watched at least 3 or 4 episodes. During commercial breaks, we recalled some of our favorites, like Willoughby...and Kick the Can! Good stuff.

Unfortunately, I couldn't stay long...I am scheduled to work tommorow. I'm not upset at all about it; the boss seems to think that I am ready to strike out on my own, and we all get paid time and a half! I'm learning so much just being in the unit. I think I've learned more in the past two days than I learned in all my time at the hellhole. No longer am I afraid to ask what a patients' diagnosis is, or read a chart. I'm EXPECTED to read the chart!

My New Year's resolutions? Too many to count, but I have a few at the top of the list:

To stay fit and healthy
To work hard and learn much at my new job
To save as much money as I can
To spend time with family and friends before I leave for school
To take a much needed vacation with the cop

2009 will be a great year if I can accomplish just a few of those goals. As excited as I am to see 2009 roll around, I have my eyes and heart set on 2010. I can't wait to start studying medicine!

As Expected

2008-12-29T14:11:00.000-08:00

Yep...orientation is boring!

There are only three of us taking part in this round of orientation. Out of the three, I'm the only one not in nursing school. One young lady has one semester left to finish, and the young guy just finished his very first quarter. When asked if I was in school, I simply answered, "No."

Everyone seems very, very nice and welcoming, which is refreshing to say the least. Not a single bed is vacant on the floor, and all the patients look awfully ill. I can't wait to get a better look once I hit the floor on Wednesday. Tomorrow morning we report at 6:30 (ouch!), but at least we will get to leave at a decent time. We got so much information thrown at us today: got name badges, covered 5 hours worth of orientation modules, received parking decals, took a tour of the floor, filled out paperwork...it was neverending. I must say, however, that there is a feeling in the hospital that you will not find in LTC. An energy, if you will. I love it. I wonder if that energy disappears during the night shift. Ha...I seriously doubt it.

I learned that my addition to the floor will be an immense help to the young lady who serves as PCT for the ENTIRE floor on the night shift. I'm sure she'll be happy to have an extra set of hands to help out. As for me, the more patients I'm exposed to, the better. There are an awful lot of patients in isolation due to TB. I guess TB will be the first disease I will learn about. Harisson's...here I come!

Bring It On!

2008-12-28T17:09:00.000-08:00

They say changing jobs can be one of the most stressful times in ones life. Not so here! I say bring it on!

I've been giddy all day, just like a popular high school kid returning to school, who hasn't seen her friends all summer. I have my lunch packed, my scrubs ironed, notepad to write important notes, and an assortment of writing pens. What can I say...I like being prepared! I haven't been this excited in a long time. I sure hope I'm not setting myself up for disappointment. Besides, tomorrow is the start of orientation.

Orientation to a healthcare setting, or any new job for that matter, has to be the most boring process ever. You are subjected to an insane amount of paperwork, exchanging of pleasantries and names (I don't know why I attempt to remember names), and watching one boring video after another. Talk about tortue! Half of your job during orientation is staying awake.

No, I'm not terribly excited about orientation, per se. I'm just thrilled to be in the hospital; to be submerged in a sea of doctors and nurses who are willing to impart just a bit of their expertise. I'm telling you, just being in an environment where people actually laugh and smile at one another would be like night and day compared to the hellhole. Being able to learn some pathophysiology, see some cool procedures, and actually participate in codes would be icing on the cake.

The cop is preparing for work. I guess I better see him off. I'll be sure to write about my first day at the new job!

Why not MD?

2008-12-27T16:11:00.000-08:00

Good question. Why not MD?

As Ed Begley said in 12 Angry Men, "There's always one!" As a pre-PA, I've only taken part in one round of interviews for a PA school seat, but I'm sure at every PA interview there's always that one applicant: the snotty overachiever, who thinks he/she is the best thing since sliced bread, who has to boast about where they've studied and where they've traveled, who feels the need to pick the brains of the other applicants simply to feel more superior. Yeah, that one. I remember that one during my interview; he was a hoot. Constantly asking questions that no one wanted to answer. One of those questions was, "So...why not MD." It was totally inappropriate at the time, but I think it's a question that every pre-PA thinks/should think about. Why? Because everyone else will ask you this question, even some ADCOM's. Because knowing the answer to this question solidifies your reason for pursuing a career as a PA.

My high school English teacher taught me never to answer a question with a question, and I admit I was fueling the fire when I responded to "that one," but on both accounts, I couldn't resist when I replied with, "Why MD?" He simply shrugged his shoulders, and soon, the other applicants began detailing why they had chosen otherwise.

For me, it is quite simple. I can do all I ever wanted to, medically, as a PA. For me, having MD behind my name is meaningless. I care nothing about prestige and social status, and I've been in school long enough as it is. I don't feel the need to be in charge all the time. I enjoy the thought of being a dependent practitioner, working with doctors and being an intergral part of the team. My interests lie in getting my hands dirty, working my hours,studying and learning as much as I can, treating my patients, making a decent living doing what enjoy, and going home.

It seems that many people think MD is the end of the line, and those who pursue the career of a midlevel ( I really hate that word) are "settling for less." How absurd. Becoming a PA is not a stepping stone to becoming an MD. It is a career that beautifully compliments that of a doctor. There is no competition between the two. To be honest, I would be foolish not to pursue PA. I get to do all kinds of cool medical stuff, come away with less loan debt than doctors, make a pretty good living, and, get this, I'll have the lateral mobility that very few doctors have. Ya can't beat it, folks. It is the right fit for me!

I think a lot of people wrestle between these two careers because of all the misconceptions. Some think becoming a PA will warrant them no respect from other healthcare professionals. Let's face it, there are lots of doctors/nurses who despise PA's. Some docs feel PA's are moving in on their turf, and some nurses feel they don't have to take orders from PA's. On the whole, though, I think healthcare professionals who are secure in their role, and have no inferiority complexes, realize the value of competent PA's and have great respect for them. Becoming a PA is not settling. For me, it's just plain smart!

Just peruse the vast amount of literature that's out there. PA's are not what they used to be. They are specializing, just as the docs are, and they are making a difference! Patients on the whole are very pleased with the level of care PA's provide. They are performing procedures and working with a level of autonomy that, for some, is mindboggling! It's truly amazing, and I can't wait to be a part of this group of medical practitioners. Pre-Pa's, do your homework. Sit down, and really take a look at the pros and cons of each career path. Outline your goals, and highlight those of greatest importance. Most importantly, be honest with yourself. It makes no sense to take a seat in a PA program when you really desire to become a doctor.

PS: I know there are lots of folks who have already heard "yea" or "nay" in regards to acceptance to PA school. To those of you who are still waiting, good luck!

Merry Christmas and Happy New Year

2008-12-27T15:56:00.001-08:00

I know, it's a bit late for the former, but just in time for the latter. I thought I would kill two birds with one stone.

Seriously, I hope you all (is anyone reading this blog?) had a wonderful Christmas, and I hope the New Year brings you happiness and peace of mind. Not much going on 'round these parts. I start my new job in exactly two days. Time surely flies. I'ts been great having time to do all the cleaning/cooking/cuddling that I've been wanting to do for so long. Even the cop got an extra few days off for the holidays. It's been great!

I've been back to the hellhole a few times since quitting. The place feels so unfamiliar, like I never worked there a day in my life. Sure, I recognize the faces, but the place just feels foreign. I stopped by today to bring one of my favorite patients two hefty pieces of cake. I stayed and chatted with her while she ate and moaned, and complimented my cooking. I swear, by the time I left, the cake was all gone. I think I'll go and have a piece of cake myself!

Down Time

2008-12-20T15:51:00.000-08:00

It feels so good to have it...just a little. Especially since Christmas is just around the corner, and my new job begins soon.

I've spent the last two days cleaning up the house. Goodness...what a nasty mess! I got quite a few rooms done before the cop woke up. He is quite impressed, and commented on how nice the house looks. It really does look a lot better. A clean home can conjure up so many wonderful emotions. This house is happy and vibrant once again!

All the paperwork is done for the new job. I am scheduled to begin orientation the week after Christmas. In addition, I have another TB test to take, and I have to be fitted for my respirator mask. Cool! I'm looking forward to working nights and being in a hospital setting. I hope I learn a lot over the next year.

So, the year is winding down. What are my aspirations: to continue learning, finish my degree, work hard and save lots of money, and begin purchasing the things I need for school.

Joy

2008-12-16T10:22:00.000-08:00

Yesterday was my last day in LTC. The day went by so fast...I felt like I was floating! I found my smile, my energy, my joy for medicine again..even as I was met with frowns, attitudes, and jealousy.

It's amazing how people can envy you when they don't really know you. I had a few coworkers who were sincerely happy for me, but most were not thrilled at all. They spent the whole day avoiding me, rolling their eyes at me, and barking orders at me. Oh well! It's their problem, not mine! I painstakingly said my goodbyes to some of my favorite residents. Ms. Hazel started to cry (that just tore me up), and before I left, she gave me a Christmas gift...and lapel pin that says "Joy."

So, today I was scheduled for the new hire physical exam and screening at my new job! I got poked and prodded a few times and had to pee in a cup. My physical was done by an NP/PA. She inquired about my educational pursuits, and I told her about PA school. She seemed genuinely excited for me and wished me well. She also offered me some great advice! So, it seems like I'm all set to start at the end of the month. I can't wait. I hear working in the hospital as opposed to LTC is like night and day. Bring it on!!!! NOW!

The Sooner, The Better

2008-12-13T13:53:00.000-08:00

Ok, so now I'm leaving the hellhole in exactly two days! I just can't take it anymore.

I have a pretty thick skin. I'm good about standing up for myself, and I can shut anyone down with my sarcasm. In short, I can cut it. But, I can't spend another week in the hellhole. I just can't.

I'm gonna miss the patients dearly. I love them so much!

Happy Dance!

2008-12-10T15:57:00.001-08:00

Thank God. I'll be leaving the hellhole in exactly one week!

I got the call today that I've been chosen for the PCT job. I can't express how thrilled I am to have a hospital job on an ICU floor. The interview yesterday went extremely well!

Once the formal interview was over, I got a chance to take a tour of the ICU floor. 24 beds total, which houses the sickest patients in the entire hospital! Yes! The floor is comprised of 4 separate units: MICU, SICU, NICU (neuro), and EICU (still don't know what this is all about). I'll be working nights, so I will have 12 patients on every assignment if all beds are full. Walking into an empty patients room made me feel like a kid in a candy store. All the buttons, lights, lines, sounds...I can't wait to work there! I start orientation on the 29th. That means I will in fact have Christmas off this year.

The job of a PCT has grown over the years. PCT's are a fairly new addition to the hospital setting. As the years go by, they are able to do more and more. I've heard of PCT's inserting IV's, foleys, doing EKG's, and even administering meds. Of course, there is some controversy due to scope of practice, and nurses feeling like their turf is being taken by unlicensed personnel. My take! Who cares! A PCT will never be a nurse, just like a nurse will never be a doctor. A doctor can start an IV just like a nurse, but you don't see nurses complaining about that. Everyone wants to be respected for the job they do. In my book, there is room for everyone in healthcare.

My duties will include all the normal CNA stuff, but I will also be responsible for vital signs, glucose finger sticks, running EKG's, and connecting monitors. Hopefully, I can also use my phlebotomy skills, too.

Interview Tomorrow!

2008-12-08T14:46:00.001-08:00

Yes! Fnally, I have secured an interview for a hospital-based PCT position in my hometown!

This has been a long time coming. I know, it's not a job offer, but at least I feel like I'm making some progress. Now, all I have to do is sell myself. I really, really want this job. It's time to leave the hell hole.

I think the main reason why I detest my currrent position is because no one wants to teach. Why would they? They have their degrees and certifications. But...a huge part of healthcare is teaching; see one, do one, teach one. No one at my job wants to show you where the bathroom is, let alone allow you to draw blood, or show you how to place a foley. It's terribly frustrating for someone like me who loves to learn, and needs these skills in order to put myself ahead of the game once PA school starts. Also, CNA's are expected to be supermen. We take a patient load of 12+, but are yelled at if things aren't absolutely perfect. Somethings gotta give with numbers like that. I work on the floor with the highest acuity. My assignment consists of patients with severe dementia, cancer, heart failure, renal failure, and MS, with tubes all over the place. This add a challenge to the job that I do enjoy, but it's hard to tend to the needs of 12+ patients who are so, so sick.

The new job sounds great: nice sized facility, pay increase, tuition reimbursement, 11p-7a, and on an ICU floor! Can't beat it. I'm so glad that I took the phlebotomy course last month, and finished learning how to read EKG's. I'm hoping these new skills will help me land the job. I'll keep you posted!