job begins...

it's been two weeks of work, with ups and downs:

Ups:
- MONEY!!!!! where is my first paycheck??
- feeling "important" and appreciated
- helping people daily
- getting my own little office space
- meeting great co-workers (pac's and md's)
- hours decent so far

Cons:
- feeling dumb, confused, or lost every second
- not feeling very "integrated" into group yet
- bottom of totem pole in our ortho practice being the newbie
- wearing the white coat (gives ppl impression i know something) = responsibility

Let's recap the best and worst days so far.

Worst day, Friday 12/29:
In operating room at 7am sharp, surgeon asked if i rounded on the his patients from previous days surgery, i said no, he didn't respond but left room abrupty (to go round). didn't know i had to round BEFORE surgery, 6am is just too early! anyhow, 1st knee total replacement was fine. 2nd surgery we did shoulder arthroscopy, which i've never done before. stood to the side completely helpless and useless. even better, i was cutting the suture needle for the surgeon, and upon retracting my hand back, he stabbed me with the dirty needle...went through both gloves and pricked my finger. so i had to un-gown and go to Emergency for needlestick precaution, which included blood draw for Hep B/C and HIV testing, tetanus shot, and ask the patient (whose blood is in my system) for his consent to have his blood tested as well. I declined HIV prophylaxis meds--i think the risks are low, and my pt seems pretty "clean". let's hope--i find out in 10 days. the tentanus shot hurt like a *itch, the nurse stabbed me like a foot away and went clear down to my bone--my arm is still horribly sore 2 days later. she admitted after that she's bad at giving immunization shots--if only she told me early, i would've stuck myself and saved the pain. =P anyhow, back to surgery #3, which was carpal tunnel release. the surgeon felt bad for pricking me accidentally, so he let me be 1st assist. surgery was short and dull and it was 2:30pm and i hadn't even sat down yet for a break. instead of letting me go for lunch, he asks me to come to surgery #4 which was an IMHS (intramedullary hip screw to fix hip fracture), but NOT scrub in. so i had to stand there with 20lbs of lead on (xrays going constantly) watching. meanwhile, i help anesthesize the pt, and threw away a couple vials of used medications, only to later found out that was a big NO-NO, and they made me dig thru all of the surgery trash to find 2 tiny vials of meds (supposedly they were controlled substances, i dunno). quite embarassing, as the anesthesiogist nurse had to go telling everyone that the "new PA" threw away narcotics, blah blah. so at around 5pm, i finally head back to my office with my head down, a sore arm, a pricked finger, and growling tummy. and that ends my week. thank goodness it's a 3 day wknd!!!

Good day, Tues 12/26:
First day of my own clinic with my own patients!! i've never had this before where i didn't have to report my findings to an attending physician--whatever i said could go. nervewracking!! first pt was an older man with shoulder pain, and he must've sensed my "newbie-ness" as he quizzed me on and on about what could be going on, made me explain his problem using picutres, etc etc. finally got him out of room! next few were good, i felt more and more confident and really enjoyed having my own set of pts to care for and follow-up with. had to write a pretty long note after for medical records. now they are making me type up every note instead of handwriting or dictating 'cuz it saves the office money from having to hire a transcriptionist. i don't mind for now yet, but i'm sure as pts are scheduled into 15min slots it'll suck as typing takes longer than dictating!