Experience Enhances Preparation
Friday was my last day as a full-time PA in
orthopedics. We had two knee
scopes. The day seemed typical. I arrived early so that I could read more
from the Tintinalli Emergency Medicine Manual. The supervising physician noticed my studies and made some comment.
I said, "Yeah, I have to be constantly
reading because I never know what will come through the doors.Honestly, I keep reminding myself that the
ability to practice medicine in the ED will come with experience." He then said, "Yeah, but you can't miss the
stuff that will kill people." I sat
there. The overwhelming sensation came
back over me. I have to know all of this
stuff so I won't kill anyone. Sigh.
As defeating as it was to hear his direct statement, it was
also somewhat encouraging. Throughout
the weekend, I noticed a confidence building; not one that says, "I know it
all. Bring it!" Rather, one that says, "Although I know
little, I've been there before." Yes, I
had a 1-month rotation. Yes, I have
spent the last 8 months working in orthopedic surgery.
I have helped patients both in the controlled
educational environment, as well in the professional. Now when I read through Tintinalli, I remember
what was once taught, paired with what I have personally learned on the
job. My "experience" is actually aiding
my preparation for the next chapter.
No matter how long a PA has been practicing, everyone
becomes the new guy when changing jobs.
However, I imagine that this transition becomes easier for those with
many years of experience. Sure, they are
reviewing "foreign" material in preparation, but in essence, the things they
read are enhanced by their past clinical exposure.It no longer becomes methodical protocol paired
with common presentations. The various
conditions/diseases are brought to life because you saw them, you dealt with
them and you helped that person.
In school, I remember feeling exceedingly bewildered by all
of the knowledge a physician assistant should possess. How could someone possibly know all this
stuff and properly assess and treat a patient?
It's now apparent.
Each day, my
experiences solidify what was once learned. The knowledge is locked away. It
is up to me to pause, reflect and use what I have. I hope to never miss anything that would harm
a patient. If I do, that encounter will
forever inform my future decisions.
Studying gets better with time because we have the real-life
encounters that add color to the mundane. The emergency medicine text I read now is meant
to wash over me as I remember the past and press on towards the future.