Attitude adjustment

Okay, so my first day of neurosurgery wasn't stellar. But, as I suspected, it got much better during the rest of the week. Still not ideal, but better!

Being there for rounds in the early morning made a huge difference, since I could see each patient and know what they were there for, and therefore just be more informed when my preceptor and the other PA were talking about them later in the day.

So, a typical day starts with sitting with my preceptor and looking up all of our patients in the computer to see how they did overnight. This includes looking to see if we need to order any labs or do any procedures (like remove a drain) that day. Then, at about 8:00, we round on all the patients with the other PA and an attending from the neurosurgery department. We see all patients on the Neuro Trauma floor, then go see our patients in the Trauma/Burn unit, the ICU, and other medical floors in the hospital. After seeing all of them and deciding what else needs to be done for each (usually about 25-30 people total), the PAs sit down to write their notes on each while the attending goes to the OR to operate. Note-writing usually gets interrupted by questions that arise from other consulting departments, consults from the emergency department, or who knows what. As of right now, I haven't been writing many notes, since the PAs said they usually have students just shadow the first week, but they said that next week they'll put me to work!

After the notes get finished (or at least mostly finished), the PAs go down to their on-call room to "run the list" - meaning they tell each other about each patient, so they both know everything that's going on with all of the patients. Then we eat lunch, and after lunch we just finish notes and see any other consults that came up during the day. The earlier shift (which is what I've been doing this week) is over at 2:30pm, so I go home after that!

The PAs on this service are incredibly overworked right now. Normally, there are five of them, but two are on maternity leave and one left for a different job. Hopefully I'll be able to help them more next week and relieve some stress! I hate having to just stand by and not be able to do much to help them. But, they're both really nice and easy to talk to. It's refreshing to finally see a PA in action, and so encouraging to know that I'll be doing what they're doing in less than a year!