Coming into the clinical year, emergency medicine was the rotation I was anticipating the most as my experience coming into school was in both EMS and inside of a level 1 trauma center emergency department. My rotation at Queens Hospital Center, a level 2 trauma center, still provided me with so many opportunities to see a plethora of medical conditions and verify that this is an area that I would love to work in after graduation.
The emergency department is split into 4 separate teams, ranging from the “Fast Track” urgent care style area to the “Acute Team” where the highest-level ESI patients were triaged to. Every shift, I was placed on a different team and was able to work with many PAs, NPs, and attendings. Because this particular emergency department did not have a residency program, many of the responsibilities in patient care were at the discretion of the PA, later verified with the teams’ attending. Seeing this gave me real motivation to see how large the scope of practice was in the life of a PA in the right setting. With their supervision, the team trusted me to see my own patients, develop a plan, and communicate all aspects of care. I believe this teaching model gave me immense confidence in my clinical abilities. Over five weeks, I was able to perform many procedures, including splinting, placing IVs, venipuncture, suturing, cerumen impaction removal, and draining abscesses.
Seeing my enthusiasm for wanting to work in this type of environment, during our downtime many of the attendings and PAs would give me great constructive feedback on presentation skills and how to tailor a plan to each patient. Additionally, to ensure I was not constantly seeing the same types of cases, I would frequently be asked to research a topic and present it to my team for the day. We would then discuss how this knowledge can be brought into extracting key information from patients in the future in an effort that will make me a better provider. Finally, I learned that a key to surviving in any emergency department, and healthcare as a whole, is to know when your team needs help. Because QHC is a city hospital, there were countless services that we could call should a consult have become needed. Being able to present to another service, the pertinent information that they need to know before seeing the patient is something that I will continue to work on moving forward. But it shows that healthcare truly is a team approach.
Coming from an urgent care on my previous rotation, I believe my ability to create a plan has grown extensively. My patient interviewing skills continue to develop but I believe this practice of seeing higher acuity patients is helping me learn from previous mistakes. With my surgery rotation coming up next, I hope to keep learning as much as I did here from seniors on the team and growing my confidence in taking the initiative of being involved in patient care.