Er Pa

Started by PharmDFisher
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PharmDFisher

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So what's life like as a PA in an ED. What duties do they allow you to do? I can't find too much information about it, so far i got they can do physical examinations, take histories, do injections, ext... but what in the lines of surgery and life saving procedures are they allowed to perform?
 
It really depends on the state and the relationship btw the PA and the SP. I work as an RRT in Ft. Myers, FL and down here at our downtown campus, the PA is one of the heads of trauma. She(PA-C) does everything that comes in if need be as the other trauma docs respect her as a colleague and dont get in her way. What sort of "supervision" is going on....idk, but ive seen the PA's here do A-lines, intubations, I&D, central lines, conscious sedation, lac repairs, set fx....etc, etc. Then again....I work closely with a pulmonary group who just hired PA's and they dont change vent orders on my shift (maybe cause they are fresh grads?).......just depends on the docs i guess.
 
thank you... i live in jacksonville, so im sure the state laws are pretty much the same, so i guess it just depends on your attending
 
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PharmDFisher said:
So what's life like as a PA in an ED. What duties do they allow you to do? I can't find too much information about it, so far i got they can do physical examinations, take histories, do injections, ext... but what in the lines of surgery and life saving procedures are they allowed to perform?
Click to expand...

I would check out http://www.physicianassistantforum.com/forums/
There are a number of threads on this. All of the items that you have listed are in the scope of practice. The job can rage from fast-track only to solo provider in a rural ER for experienced PAs.

David Carpenter, PA-C
 
I work at an ER in Richmond, VA and our PA's pretty much take the less severe cases and do them fully w/o supervision. Lots of lacs, and lots of colds. They do occasionally get more serious cases which they occasionally confer with the docs on, but usually they can handle whatever it is on their own, perhaps with consults to specialists of course.

We're not a major trauma center or anything (intubations are pretty rare) so if something really bad comes in, the docs are gonna take it anyways.

Hope it helps.
 
Totally depends on a myriad of factors.

1. Experience. Both previous (paramedics etc, and as an EMPA.)
2. The hospital of employment. Some use PA's as fast track, some integrate them more part of the er team and they take whatever comes in much like the doc's do on an availability basis and just what they are more skilled at, for example one of the PA's i rotated with could work up and tx an MI better than any of the providers. He got the MI's and the docs just let him do his thing.
3. Sometimes it may depend shift to shift on the doctor. This is obviously less than ideal and can lead to a ****ty continuity of skills and care for the PA and patients. :/

All and all I think the er can be one of the places of the most autonomy for PA's in the entire profession. If you dont get that job at first, you're bound to find one especially after getting some experience. 🙂
 
PS, how much does it suck that us PA-C's (and NP's, RN's) are stuck with the 'non-student" designation. I'd settle for mid-level provider.
 
EMDream said:
PS, how much does it suck that us PA-C's (and NP's, RN's) are stuck with the 'non-student" designation. I'd settle for mid-level provider.
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agreed.
or how about pa-c, np, etc
wouldn't be that difficult.....
 
Anyone know of ER PA jobs in NE Ohio? I have shadowed in the ER at Akron General Medical Center, Wadsworth Rittman Hospital, and Akron Children's Hospital and never saw a single PA. Only the attending(s) and residents.

Just found this article that states:
(http://healthinfo.akrongeneral.org/content.asp?pageid=P08589)

"In addition, 97 percent of those arriving by ambulance were evaluated by a staff physician, rather than a nurse, physician assistant, or physician-in training, compared to 89 percent of walk-ins and 82 percent of those arriving by other means."

Also can't find that they CNPs? Maybe I stink at this job search thing 🙂

Just searched for Summa Health Systems and received zero results for physician assistant or nurse practitioner. eeek.

Akron Children's is hiring for a few NPs and one PA, but the job descriptions are identical between the two.

University Hospitals is hiring for a PA in pediatric CT surgery, but I called on the job and they don't get to scrub in. boo 🙁
 
foreverLaur said:
Anyone know of ER PA jobs in NE Ohio? I have shadowed in the ER at Akron General Medical Center, Wadsworth Rittman Hospital, and Akron Children's Hospital and never saw a single PA. Only the attending(s) and residents.

Just found this article that states:
(http://healthinfo.akrongeneral.org/content.asp?pageid=P08589)

"In addition, 97 percent of those arriving by ambulance were evaluated by a staff physician, rather than a nurse, physician assistant, or physician-in training, compared to 89 percent of walk-ins and 82 percent of those arriving by other means."

Also can't find that they CNPs? Maybe I stink at this job search thing 🙂

Just searched for Summa Health Systems and received zero results for physician assistant or nurse practitioner. eeek.

Akron Children's is hiring for a few NPs and one PA, but the job descriptions are identical between the two.

University Hospitals is hiring for a PA in pediatric CT surgery, but I called on the job and they don't get to scrub in. boo 🙁
Click to expand...
You can try the SEMPA site listed above. I don't see any listed in OHIO now. The AAPA web site has one ER position http://www.healthecareers.com/cst/myjobsearch/index.cfc):
"MedCentral Mansfield Hospital, located in central Ohio approximately 1 hour north of Columbus, is seeking a qualified PA to work in the Fast Track of the emergency Department.

The hospital is a full service community hospital with all major specialties represented. It is designated as a level 2 trauma center and has an approximate annual volume of 52,000 patients.

Emergency Medicine Physicians is a democratic group of EM residency trained physicians based out of Canton Ohio. We currently operate 33 contracts in 8 states. EMP offers an exceptional benefits package including full family / domestic partner health insurance from date of hire, $2,500 annual CME allowance, fully funded retirement (15% of earnings), malpractice including tail and much more."

Also using the search function for Emergency comes up with this:
"Forum Health has an immediate opening for a PA-C to join our dynamic cardiothoracic and vascular practice. Responsibilities include first and second assisting on all cardiac surgical procedures, endoscopic vein harvesting, H&P´s, clinic follow up and patient phone calls. Additionally, the candidate will help assist in the coordination of care in the Cardiac ICU/floor and office.

The candidate will join two other PA´s and 4 surgeons and share pager call for emergency surgeries only. The ideal candidate should be NCCPA-certified or board eligible and graduate from an accredited PA program. The candidate should have prior cardiac surgical experience; however, new graduates with an interest in surgery are strongly encouraged to apply."

Bottom line is probably less than half of the jobs out there in the PA world are advertised. Word of mouth is the key. Realistically it is impossible to predict the PA job market in Ohio and what it will be in two years. Ohio only recently joined the rest of the civilized world in granting prescriptive authority. This has significantly improved the PA job outlook.

David Carpenter, PA-C
 
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