Student Diary - Class of 2006 / PAS-2
April 2006
I just finished with pediatrics which turned out to be one of
my favorite rotations. I enjoyed not only working with the
kids but with their parents as well. One of the best aspects
about this rotation was the knowledge I gained about educating
the parents on everything from basic anticipatory guidance
(when to start regular food, when to take them out of the car
seat, advice on discipline) and then on medical issues also
(what situations can be handled at home, when they should be
brought in to the office or ER). As physician assistants we
should remember that patient education is an important part
of our job and we should offer it at every patient encounter.
This past month gave me a great opportunity to work on this.
This was our 11th rotation and we have only one more to go!
February 2006
Clinical rotations are finally coming to an end! I'm happy,
sad, scared, anxious, so many feelings all at once. I never
thought these 3 years would ever be over. This month we had
to register for the PANCE and made me realize that I have
to study harder. This month I'm doing my 3rd rotation on
primary care in Laredo. There are a total of 9 people in
a 5 bedroom / 3 bath house.
Two of us are doing primary care,
five girls are doing the STEER project, and there are two
PTA students from another school. It is quite an experience.
January 2006
I’m late writing this “Rotations Dairy”.
I thought on writing at the end of surgery, since I would have
more time for that in the next rotation. Well, not so… I’m
doing Primary care II now. More time to do other things? No
way!
For this rotation I’m assigned at the UHS downtown clinic
aka “Brady Green” clinic.
Three days of the week I’m with an excellent pediatrician,
and his work hours are from 8am to 8, 9, 10, 11 pm, when ever
there are not more patients coming in. The other two days of
the week I’m with an excellent PA-C, and I have worked
with her only one day and it was decent hours, but since I’ve
worked with her only one day, I don’t know how the rest
of the rotation will be. One thing is for sure, no matter how
many hours you have to be there, the time flys by, you are
busy all the time, seeing patients, checking charts, lab tests
and results, etc. So in reality you don’t know what time
it is, until somebody tells you to go and have lunch, with
the advice of “just don’t choke”, as a means
of saying “HURRY UP! We have 40 more charts out there,
and its already 2:30 pm!!!”.
To tell you a little about the infamous surgery rotation,
no matter where you do it, it is long hours, little sleep,
little studying, little family time, not even time to shave
your legs in the shower, nor for love!!!
To succeed in surgery at the UHS:
- Get there at around 5:30
am.
- Introduce yourself to the medical students, the interns,
the residents, the chief resident, and eventually to the
staff doctors.
- You will usually meet the other team members in
the 7th floor, to “do the list”.
- Have the information
about your patient(s), latest lab results, how he/she spent
the night, any bleeding, vomiting, transfusions, etc. Meds
added to his plan in the last 24 hrs. Check the wound, dressings,
if they are clean and dry, or wet and bloody, if there are
signs of infection, redness, pus, exacerbated pain, listen
for the BMs, and ask about the very celebrated flatus! Has
there been gas? Sometimes patients don’t understand
what you are asking about, so be specific and ask if he has
been farting (I’m serious, hold cracking up!), and explain
that gas is very expected, important, and will determine if
the patient will be allowed to eat! Notice I&O, Ins and
Outs, see the urine bag, if they have one, and notice color,
and quantity.
- Talk to your patient and know his feelings,
concerns, questions, and you’ll be ready to present
your patient during the rounds!
- After you gathered all the Subjective
and Objective info on your patients, go and do the list with
your team’s
medical students. Share the job with them.
- In the OR “Look,
listen and feel”. Well,
be very attentive, pay attention to the staff, the chief,
the interns, the nurses, the circulating nurse, etc.
- Students
(PAs and MS) are expected to see the patient before, during
and after the surgery. There is more to tell about this rotation
and I have no more space to write, so sharpen your senses
and don’t complain! It’s all part of your
formation as a PA!
December 2005
Well we are officially well over half way done!! Many
of us has had some great experiences. I, in particular, have
enjoyed most of my rotations. There will be times you feel
really good about your knowledge base then real quickly you're
reminded of the realization that there is so much more to learn!!
This to some causes frustration however, I am reminded that
is what makes this profession so great and exciting. There
is always something new or different to explore no matter what
stage in our career.
At this point there has been some really
great rotations thus far some better than others. But no matter
how “bad” a
rotation may seem there is always something to be taken from
it. My advice to a new student starting rotations, enter a
rotation with an open mind and heart, understand that every
place has its own dynamics. Be ready to adapt and shift your
thinking provide yourself a place in the “team”,
because in the end of it this is what we will be doing. Good
luck to all.
November 2005
Yesterday I had the privilege of examining a
19-month old little boy with a 5-week history of intermittent
diarrhea and abdominal pain. It was a milestone for me, because at
the beginning of the encounter, that was all I knew of him. At
the end of the encounter, there was a bond between him, his
mom, and I that is unique to our line of work. I was
able to focus so well on the history and physical that I was
confident, and remembered a few tricks of the trade in pediatrics
that made an otherwise-miserable child a fascinated participant
in the exam. He wailed loudly as I left the room to review
my findings with my MD preceptor, and calmed again when I returned,
smiling and pointing at me as the MD performed his own exam. These
are the good experiences you will remember from the clinical
year – the feeling that it’s all finally beginning
to gel. I love this work!
October 2005
I just finished my Surgery rotation. I am so exhausted. I
was working on average 15 hours/day, 6 days a week. But,
the long hours were well worth it.
I learned a great deal this past month. I saw cholecystectomies,
mastectomies, biopsies, and much more. I was able to suture,
staple, and help with the camera with laparoscopy procedures. It
was a lot of fun. Although I know surgery is not for me,
I am glad I was able to experience surgery first hand! Now
I am off to rotations #6….I can’t believe we are
almost half way done!
 |
|
|
Class of 2006
White Coat Ceremony |
|
September 2005
Well, we're almost done with our fourth rotation and have just eight more to
go. This rotation is my last primary care rotation, and I've been working at
the Kelly Family Medicine Clinic on base. Working on base has been a great
experience. You're able to perform most of the decision making concerning your
patients, and it allows you to realize all the responsibility you will carry
when you're out and finally practicing. You also have the opportunity to
order countless diagnostic studies and most of your patients are compliant
since they get their medications for free…yea! For your PC3 rotation you also
have to come up with a project that will help out the clinic where you are
rotating. It can be anything from creating patient education forms to
implementing a system to obtain patient's medication, information, etc. The
important thing is to find out from your preceptor what the clinic is lacking
and then work with them on a solution so that you're sure it is something that
they'll actually put to good use. This has definitely been my favorite
rotation so far and I'm looking forward to what the next few months have in
store.
August 2005
Working in the emergency room can be quite interesting. People have so many
different stories. The fast track part of the ER serves as "non-urgent"
complaints. Most of the time it's for people that cannot make an appointment
soon enough with their regular doctors or people who don't even have any
primary doctor. The emergent side serves as anything else (chest pain,
abdominal pain, etc). Working here has showed me the true picture of how a
medical team works together. Since the schedule is dynamic, I have been able
to work with various doctors, PAs and even a nurse practitioner. Not to
mention, nurses and medical assistants are your greatest allies. The best
thing about working in the ER is that you see evaluate a variety of
complaints. Having access to a plethora of supplies, onsite labs, and other
resources makes everything easier. The worst thing about the ER is that you
really don't get to follow up with your patients. So if you do any suturing
or locate a lymph node suspicious for cancer, you never really know the
outcome of that patient. ER has been quite an experience.
July 2005
We've almost completed our second rotation. Time is flying by really fast.
This month, my rotation has been community medicine. For this rotation, a
group of four PA students work together on a project that will help improve
the lives of people in a targeted population. The project I'm involved with is
called AHEAPA-S (A Health Education Attainable from Physician Assistant
Students). Our group writes health related articles and submits them to
participating rural newspapers throughout Texas. This project has involved a
lot of time and hard work, but has been well worth it.
June 2005
We're finally out on rotations! On one hand, I can't believe I'm
participating in the "real world" of medicine, on the other hand, it
feels so right. I'm rotating at a Pediatric clinic on the West side. The
clinic is fast paced and my preceptor is well liked amongst the
patients. From scabies to inguinal hernias...the best part is seeing the
parents smile knowing their kid is going to be okay. I've seen drug
seekers (using their kids) and kids that are victims of neglect and
abuse...it all reminds me how desperately I want to make a difference in
this world. I'm grateful that we learned how to educate patients, for
ICS (I can't believe I just said that!), and for gel shoe inserts
(this standing all day is a killer!). Next week I'll see all my
classmates (friends) and we'll share about how our first rotation
was....this year is going to fly by. =-)
April 2005
The semester is finally coming to an end. We have five finals in the span of
one week. This semester marks the end of our didactic years and the beginning
of our clinical rotations. We have long awaited this moment. It seems like
since we got back from spring break, everything has been flying. It feels
like this semester has been the fastest one yet. We will be getting one month
off before we start rotations. What a treat!
March 2005
This month we began to go to several clinics around town for patient
encounters. Although, we?ve done this a year ago during our first year, this
time it seems more real. This time around we have to be able to see a patient, perform physical exams, come up with a differential diagnosis, and hang our hat on one thing we believe it might be. At first it seemed intimidating to think of hanging our hat on anything, and even being able to come up with something to hang our hat on.
Nevertheless, after our first encounters, we were all amazed at how much we
have learned and were able to put together medicine class, pharm, physical
exam, with real life patients. It was truly an encouraging experience for
everyone. Especially when we often feel like nothing is staying in our brains. Some of us performed pelvic exams, incised and drained cysts, sutured, and the like. The best part is that all those patients were kind and trusting with us, but it?s also a good thing that they are doing great after all those procedures.
February 2005
We had really been looking forward to learning and performing breast and
pelvic exams in clinical skills, and the time finally came to do just that.
Although many of us were nervous and some of us just a little bit scared, it
was one of the most valuable experiences we have had since starting PA school.
The women that helped teach us technique and how to interact with our patients
during the exams were absolutely remarkable. They helped put us at ease and
helped us obtain the confidence and skills that we will need on rotations
while giving pelvic/breast exams. Speaking of rotations....they're just two
months away, boy have these first two years just flown by. Now we just have to
be careful to not get senioritis, so that we can finish the year strong.
January 2005
It seems like all our time this month has been spent studying for our medical
and pharmacology classes. It?s a good thing we now only have one more test in
pharmacology and we won?t have to worry about that class once we come back
from spring break. We?ve all been getting pretty nervous now that it?s
getting closer to the end of our in school learning and we have to go off for
rotations. How exciting!!!! Our clinical skills class has been really
interesting; this month we learned how to do casts and splints on each other.
Can?t wait for next month when we learn pelvic and breast exams, I?m going to
feel that much more prepared for rotations!
December 2004
I cannot believe this semester is finally over.
We have been going on strong
since July and we can finally have a break to spend time with our family and
loved ones. This past semester was one of the most challenging semesters yet,
but I must admit I have learned a great deal. The most shocking part of this
semester ending is that we have only one more semester before rotations. It
seems like just yesterday when we started our first day of PA school and now
we are only 5 months away from rotations.
November 2004
Books open,
head spinning,
I wish and keep hoping
that I can learn a few more things.
Only 2 days until the exam
I am so lost I don't know where I am
I study and study
all night and all day
Strangely enough the info floats away
Renal, Respiratory and the heart
why can't I keep it apart
it all runs together
the ink on paper
the words on the page
It is swirling around in my head so fast
I am overcome with rage.
Why can't I do well
and know all there is to know
I guess I should do what I can
to understand COPD, Angina & Renal flow.
The test is in 5 minutes, no worries
it's time to play the game
thousands of PA's over time have all done the same.
-- Matt Louis, Class of 2006
October 2004
We are now into our second year of PA school. The first year flew by
and although it doesn't feel like it right now, this one will too! This
year's focus is on medicine, pharmacology, and clinical skills. We have
already started IV's on each other, sutured injured pieces of steak back
to their original form, and learned how to inject certain medicines. We
spend a lot of time in the classroom so it is nice that the 24 of us are
great friends. This past year has put us through a lot and it is great
to go into our second year as life long friends.
September 2004
The summer is over and we are now getting deep into our core sciences.
Of all of our classes, clinical science (aka medicine) is the biggest
weight. This class started mid-July. We are taking it along with the
medical students which means we have the same exams. We are going to
share the sweat, tears, and smiles with the same med students that we
took anatomy with last year. Since the class has a several conference courses, we are able to
get to know them better. Medicine in an 8 hour course this semester and
requires a majority of our class time.
July 30, 2004
Annually Professor Colver hosts a barbeque at her house. The purpose is
to welcome the incoming class of PA students in an informal setting. It
lasts a few hours and allows the incoming students to get to know each
other, the upper classmen, and the professors. It allows the incoming
students to ask the upper classmen questions about the professors and
the first year of classes. The Department of PA Studies provides the
hamburgers, hotdogs, and drinks and the upper classmen bring the sides
and desserts. Toward the end of the barbeque Professor Colver has a
drawing for books that she and the other professors have donated.
Traditionally everyone at the barbeque has a good time and eats good
food. There is plenty of laughter as well as serious conversation.
July 17, 2004
On a very hot Saturday afternoon of July, the class of 2006 and student
advisors Barbara and Melissa hosted a Picnic for the 2007 student class.
The objective was to congratulate the new members of the PA program and
to get the opportunity to interact with our "little brothers and
sisters". Most of the new students attended the picnic, some of them
with their families or relatives.
They had the opportunity to ask all kinds of questions about the
program, each one had also the opportunity to introduce themselves and
to tell us about their backgrounds.
It was a good opportunity to get to meet everybody and to show them our
support as their new big brothers and sisters.
June 25, 2004
Today was our Tejeda Ceremony where we received our white coats and have
been officially accepted into the Physician Assistant profession. There
were about 200 of our family, friends and classmates present. It was a
wonderful event and lots of photos were taken, you could see the joy in
our eyes.
Summer Classes
Patient education - This was a new class that was designed to talk about
topics that the students from last year would of liked to either discuss
more or
would of liked to discuss period. Basically how to approach certain
delicate topics. One of the favorite projects that we did was when we
dressed up like
the elderly and had to walk around with all the different ailments and
conditions that they might have and have to walk all over the place to
get our
prescriptions and stuff.....GREAT SCENARIO!!!
Cultural issues in health was very interesting. We were exposed to many
of the alternative type of
"medicines" that our patients may seek. More and more patients are
seeking
their care therefore it would behoove the PA to become aware of the many
types
that are offered. We also learned medical Spanish. Luckily, a good
percentage of the class were Spanish speaking, so some of us who did not
know how to speak the language had plenty of help.
We took a preventative medicine class with our medical director. It
featured many different topics like osteoporosis, STDs, cardiovascular
disease, occupational health, etc. One of our major grades was doing a
group project on preventative medicine. We could pick any topic we
wanted, but the only stipulation was that we couldn't do a topic that
had previously been chosen from other classes. We had to make a poster
board and also write a paper. Correlating everyone's schedules and then
trying to put a coherent "publishable" research paper together authored
by four different people was stressful. Our professor wanted us to write
it in a publishable manner so we could possibly get it printed in a PA
journal. It would be cool to see some of our classmates featured in a
journal.
