Half of ACLS Certification In The Bag!

Well today I was tested on my ability to lead a team of 5 other people in a "megacode" in the SIM lab. I have to say that I was pretty nervous going into the testing portion. I'm not exactly sure why I was so nervous, because I knew I knew the algorithms for each of the different potential rhythms. I guess it puts a different spin on things when you are not practicing anymore and the instructors expect you to know what you are doing. Not only know what YOU are doing, but know what the other members of your team are doing and change things if need be.

It wasn't too bad though. Like I said, I knew what I had to do. I guess I was just psyching myself out right before. The rest of my team did really well too. -- For a second I thought we were going to have to push the mannequin off the table and put a couple of our team members on the monitor because they were so nervous. -- It really isn't too bad. Apparently it used to be WAY worse than it is now. Before, you didn't leave ACLS without pretty much breaking down and crying, unless you really knew your stuff! From what we were told by our profs is that it was the worst part of PA school! (That's CRAZY!) Now it is a lot more laid back and ... dare I say fun? Well lets put it this way: after 10 months of sitting on your butt talking about doing medicine it is really nice to actually be able to DO medicine.

So anyways, we still have the written exam portion to take this coming Monday. Hopefully I pass that and I will officially be an ACLS certified provider-student.

On another related note, my girlfriend bought some CPR masks with one-way valves on them for the two of us to keep in our cars. I gotta say I was a little nervous taking it. I don't know why, but I guess I have this feeling that now that I have the mask either I am going to feel obligated to help out at say an accident, or that a situation will actually present itself for me to use the mask. Like I said in an earlier post, I really hope I never have to before CPR on someone, ESPECIALLY someone out and about. Its one thing to start on someone in a hospital where there is plenty of help from people who REALLY REALLY know what they are doing. But when you are out in the middle of a parking lot things are a bit different.

Alright, enough on here, I gotta get back to studying surgery. We have our suture lab coming up Thurs. Let's see how good I am with my hands!

See ya 'til then,

M-R

Busy Week .... Sorta?

Hey guys,

Well like I said in my last post, we have been working on ACLS quite a bit this week. It has been interesting this week because I am so used to juggling multiple classes with the assignments/tests that go along with each of them over the week. This week the only classes we have had have been lectures on emergency medicine, and ACLS classes (both hands-on and lecture based). The weird part about that is that even though we have not had that many "classes" I have still been really busy. That must be why our program has put a hold on all the other classes during the two weeks that we have emergency med and surgery. There just would not have been enough time to cover what we needed to had we not had all day to have just the module classes lectures.

Well, for me this week has still been really busy. I can imagine that the few of us that have been ACLS certified this week must be pretty easy for them. However, I have not taken ACLS so this stuff is all new to me.

A word on ACLS real quick. This is definitly not something that you can simply learn by reading a book. Being the team leader in a code situation is where it is at in terms of really learning what to do in a code. When you simply read the book and learn the algorithms it seems pretty easy. But when you are the one that is calling the shots in the code, and your team is depending on you to organize all aspects of the megacode it can be pretty intimidating. In my opinion the only way to get past the stage of being completely overwhelmed is to keep volunteering to be the team leader whenever there is an opportunity to when you are practicing.

ACLS has been actually fun, once I got over my nerves that is. I think the best part of it is that it is actually hands-on. We actually get to DO something instead of just read about it. - Come to think of it this week has been really hands on. We had the IV lab and then ACLS most of the week. - I have to say I hope that I never actually have to be in a code situation. I am sure almost no one would actually want to be in that situation. But I know that odds are that I will definitly be a part of one. (Hopefully on the provider side and not the patient side!) I just hope that when the times comes I can take a deep breath and do what I have been trained to do.

Well, we have our "test" for ACLS coming up this week on Tuesday. We will be required to act as the team leader in a code that lasts 6 mins. We have to demonstrate not only that we have the knowledge of what to do during a code, but are able to effectively and efficiently manage a team of 5 other people. It should be fun ... I hope. I just hope I don't get really nervous and forget everything I know. I did pretty well during our practice sessions, based on the feedback from the instructors and me teammates. So wish me luck! :-)

M-R

Hold On and Don't Let Go!

Some background stuff first: In my program we learn by body systems. For example, our first module was Head, Ears, Eyes, Nose and Throat (or HEENT), so all the diseases states, tests to run, labs to ask for, history questions to ask and physical exam skills, and anatomy lab/lecture all pertain to those portions of the body. At the end of the 'module' we take an exam that has all of our classes on it. (Well most of them at least) Which is anywhere from 110 to ~300 mulitple choice or T/F questions.

With that being said, PA School whips by like a flash of lightening!! I am finding it hard to believe that we are already about 2 wks into this module (Pulmonology) and we have 2 wks to the day to become "experts" enough to pass the module exam (more on passing later) .... At the current moment I feel completely lost, and frankly a little burnt out. I think one of the most difficult things for me is sorting out the different diseases. Sometimes the differences between one disease state and the next is simply the fact that one has a cough without mucous being coughed up (sputum production) and the other just has a cough without anything being coughed up. The problem is that things in medicine are rarely black and white, and the patients I will see will rarely, if ever, be textbook examples of a disease. Which basically means that symptoms will often blend in with other disease and often you have to use all that you have been taught to make the best possible diagnoses you can. (Or rather pick the correct diagnoses on the exam ... let's see is it A or B?)

Bottom-line: to all of you Pre-PAs, and PA-S that are maybe just starting out as well, start thinking clinically as soon as you can. Do your best to get out of the mode of just memorizing facts like you had/have in undergrad and start thinking more 'whole-picture'. Sometimes simply picking up the patients occupation in your history taking can make you pick one diagnoses over the other (which goes back to the "whole picture" approach). There is just not enough hours in the day or days in the week to read and swallow every bit of every class, so consolidate the best you can to make the most of your time. In the group I study with we will have one person pick a disease state, go up to the white board and make a 'fake' patient and we go through creating a differential diagnoses (possible diseases that present with the chief concern (ex.. "I have a cough that has lasted for 2 wks now."), asking questions that we would ask, perform PE exams like we would do (and what we are looking for in each), get labs/tests that we would run (and what we would expect them to come back as, or what we are looking for to rule-out a certain disease), commit to a diagnoses then how we would treat that and whether or not we would follow up, etc... In doing this we bascially hit Pharmacology, PE Lab/Lecture, Primary Care Medicine, Pathophysiology, History and Physical Exam, even some Anatomy in there.

Since I started writing this blog entry a couple of days ago and am now finishing it up, I can not recall what my point was in this one, so hopefully it made sense. I think I was just trying to give you a sense of how intense this program has been so far. Way more so than I had every imagined for sure. OK, well I have to get back to Acute Epiglottitis and the Pneumonias. Hope you guys are enjoying so far. If you have any questions go ahead and leave a comment and I will do my best to answer, them as I blog.

M-R