illegallysmooth

Smooth member
10+ Year Member
May 21, 2008
1,506
82
Buffalove
Status
Attending Physician
Hello everyone,
I've received several PMs recently asking me about how I obtained certain hospital positions, which positions require training, which will provide on-the-job training, etc. I'm posting this to help clear up some information regarding clinical employment, using my experience as an example. This is in NO way intended to be a cut-and-dry guide to clinical employment, as policies and practices will vary by region and by facility.

Generally, when seeking clinical positions it is a good idea to identify major health care companies in your area and search their websites for job openings. Often, they will outline specific requirements or training necessary for the job. For instance, in my area of Buffalo, NY, most hospitals fall under the rule of the Kaleida network or Catholic Health.

Unit Clerk - This was my first job in health care, which I found by searching the Catholic Health website. The only requirement was a GED, and it was suggested that familiarity with medical terms would be helpful. Office experience may have also been required, but I had previously worked as an office assistant on-campus. Every pre-med should be able to do this job. I work in the ER, and this position can be quite hectic there. I am responsible for updating the on-call list, receiving ER orders from physicians and entering them into the computer and/or notifying the appropriate staff to carry out the order, receiving admission orders from physicians and entering them into the computer, faxing documents, answering the phone and directing calls, placing calls to specialists and primary care providers, calling consults for specialists, etc. The phone doesn't stop ringing, I hear it in my sleep, and sometimes answer my real phone "St. Joe's ER, Nicole speaking," but stop before getting to "how may I help you today?" This situation is not uncommon: I just took an ambulance report for a code that will be here in 3 minutes and I need to alert the ER doc, the charge nurse, the nursing supervisor and the respiratory therapist, I have 3 sets of admission orders, 2 people need STAT EKGs, a possible stroke needs to get to CT and the computers aren't working. You wouldn't think a "unit clerk" would be responsibile for making sure all of this gets done in a timely matter, but you'd be surprised.

Clinically-speaking, this is not a patient-care, hands-on job. However, I work side-by-side with the charge nurse, communicating with doctors and patients all day. CBC, BMP, CMP, BNP, CKMB, EKG, Troponin, Myoglobin, Lipid Panel, UA, Blood Cultures, CXR - all very common language for me now. Docs will sometimes let me see procedures or other cool stuff, and I have developed a professional relationship with several of them. One wrote me a letter of rec.

Nursing Assistant/Nurse's Aide/Immediate Treatment Assistant/Patient Care Assistant/Medical Assistant - I got a job as an ITA in the same hospital, in the same manner as I got the first one. I'm sure it helped that I had been employed for two years in the ER and had a good reference from my boss down there. I had also taken an EMT class and had some clinical knowledge and skills. I don't know a single NA who got a CNA certification before being hired in the hospital. Every CNA I know was hired in a nursing home or old folks home. One must realize the NAs who are working there are not likely to have any college education or health care/medical knowledge. They are not going to be nurses or doctors. This is why many nursing homes employ CNAs or at least pay them more. Most of the NAs I know are nursing students, and some are pre-med. An ITA/PCA is basically a glorified NA who can draw blood, do EKGs, etc. All of this training was on-the-job training, and I know that it's the same deal at many hospitals in my area. Even if a CNA were to be hired at my facility, they must go through the same on-the-job training.

I got a job as an MA after a year of working as an ITA. I wanted a change of shift and department. I don't believe I would have gotten the MA position without prior experience, and this seems to be the case in many facilities. There are programs out there to become an MA, and I think they are bullcrap because you can get an LPN in the same timeframe. Again, these programs to be a CNA or MA are more suited for people who have no education beyond high school and don't plan on getting one. They have to learn basic biological/anatomical terms and very basic clinical skills (like taking a pulse). If you are pre-med and have taken some college coursework in the biological sciences, you should be able to get a job as an NA/ITA/PCA with no prior experience on some floor of some hospital near you.

If you have this sort of position in an ER, expect to do a lot of patient transport (to various departments, for tests), vital signs, blood draws, helping people to the bathroom, assisting for codes, assisting with procedures, doing EKGs, getting water and blankets, etc. On the floor, expect more patient hygiene duties (butt wiping), feeding, caring for surgical or medical equipment (drains and the like), etc.

As an MA in a pediatrics clinic, I do weights and measurements, vital signs, record complaints for a sick visit, and basic labs (urinalysis, rapid strep tests, fingerstick hemoglobin, etc).

OK, that's all I can think of at the moment. If anyone has any questions, feel free to PM or me or respond to this thread.
 
Last edited:

mvenus929

10+ Year Member
Jul 6, 2006
6,856
1,630
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Fellow [Any Field]
I just want to add something. I work as a phlebotomist in the hospital. Technically, my job requires experience, but I've found that a willingness to learn and show up goes a long way. My supervisor is currently hiring 5 people, and they went through something like 15 interviews and made offers to 10 of them (or so) and still don't have the positions filled. It's a high turnover-field, so if you're willing to work, you can go places. But, don't expect to get away with doing a weekend a month or anything. We had one pre-med come in and train for 6 days spread out over two months, she got sick one weekend (or so I heard), and was fired as a result.

I was trained, and it took me a couple months to get my foot in the door, but I started as a PRN, filling in the schedule where needed. They ended up firing a full-time person because she was sick too much (as in missing every other day), and I got that job. Been working full time for over a year now. There have been several people trained on the job; some have lasted and some have not. The ones who last are willing to go that extra mile to learn and get better.
 

hobbes23

10+ Year Member
Dec 11, 2007
587
65
Status
Resident [Any Field]
Scribe (ER, ICU, maybe other places) - I accompanied the Emergency Medicine physicians into the exam room, created the chart, and transcribed the history and exam as they were occurring. I sometimes wrote the medical decision-making, tracked down labs and imaging, and flagged non-normal values. Part of my job was to alert physicians to relevant past history after I looked up old medical records. I applied for the job through the local EM physicians' group. No prior training was required, but they had a formal application process complete with PS, LOR, and interviews. YMMV.
 

organdonor

10+ Year Member
Jul 29, 2009
863
178
Midwest
Status
Resident [Any Field]
In my job as a Patient Care Technician (PCT) on a floor, I do alot of the aforementioned patient hygiene (butt wiping), assisting with walking, and such. I also take vital signs, empty drains, remove IV's, remove catheters, and do alot of fetching. That said, I love it and appreciate the view it gives me on healthcare. I was trained in everything I needed here. My facility will also train you (no prior education required past high school) as a pharmacy tech, cardiac technician, phlebotomist, or unit assistant.

I wouldn't have been able to get this job without first working in the kitchen. That job sucked, but it gave me the opportunity to network my way to transfer into my PCT job.