Tuesday, October 5, 2010

National PA Week: Natalie E. Porcaro, Neuroscience House Staff

Wednesday kicks off National Physician Assistant Week, and we're celebrating our dedicated physician assistants at LifeBridge Health by having them share their stories this week. Sinai Hospital will also host a special breakfast for PAs at 7 a.m. on Wednesday in the Sinai Board Room.

A Day in the Life
by Natalie E. Porcaro, Sinai Neuroscience House Staff

Choosing a profession can be one of the most difficult decisions that a person has to make during their lifetime. This life-changing decision usually is forced upon someone at a young age. Studies show that most students are actually spending an extra year in college to obtain their bachelor’s degree because they want to alter their career path - more than fifty percent of college freshman change their major.

In the sense of choosing a career path, I feel rather lucky, as there was no question in my mind as to what I wanted to spend the rest of my life doing. I can’t remember a time in my life when I questioned going into the health care profession. Even as a child, my favorite game was “doctor," as my favorite toys were my plastic stethoscope and reflex hammer.

While the time I come into work varies slightly, my days are anything except routine. I awaken usually when the sun is still sleeping, and I jump start my body and mind by a thirty-minute workout. I either go for a jog or use my elliptical, and I need the wake-up call the exercise gives me to clear my mind and prepare for the day to come. I eat my breakfast, an English muffin with peanut butter and jelly, in my car on my drive to work, and always have a travel mug of coffee at my side. I usually end up getting either peanut butter, or jelly, or both, on my scrubs and, needless to say, the first thing I then do is head to the locker room to change.

The team starts sign-out/report at 6 a.m. We run through our patient list to review each patient’s status, what test or laboratory studies they will have, consults that need to be called or reviewed, and other miscellaneous tasks that need to be completed (i.e. physical and occupational therapy recommendations, social work input, etc). After report is completed, we divide and conquer.

There is no such thing a “typical” day, so referring to “a day in the life” of a physician assistant, or any health care provider for that matter, will stretch across a wide spectrum of events. We have the typical Operating Room patients that need consents, orders placed, and laboratory values reviewed. Floor rounding comes next, with the most critical patients in the Intensive Care Unit being a priority. If only rounds were as simple as seeing patients, life would be a lot easier – but as most of you know, we have to carry around a “rock” or several “rocks” that beep, bong, and screech until you respond – the pagers. To trip up your day, there are undoubtedly consults on the floor, in the Emergency Department, and throughout inpatient units. Some days, as soon as you take a break, you need to report to the ED immediately. The next thing you know, you’re either getting someone ready for the OR to evacuate a large subdural hematoma or stabilize a severe spinal fracture with spinal cord compression. You could be putting a ventriculostomy catheter into someone’s ventricle to relieve hydrocephalus. Whenever you’re finished, your lunch, which could now really be your dinner, is cold and probably no longer safely edible – but that’s “a day in the life,” and secretly, we all love it.

At the end of the madness, we regroup to make appropriate list modifications and updates before we do another round of team sign out/report. The night shift arrives around 7 p.m. and after report is given, has a whole other “to do” list to follow up and check, and I’m certain a whole other story to tell by the time the next morning rolls around to do it all over again.

My drive home at night is a time to unwind. I usually go home and have dinner while sitting in front of the television. I frequently have a glass of wine, or two – that always helps the relaxation process at the day’s end. I’ll share stories sometimes with my roommate when I need a sounding board (while of course maintaining proper confidentiality); she humors me and listens. When I first started working at Sinai as a new graduate, I’d lay awake often, going over my entire day – all my orders, my admits and consultations, my notes, my patients. I still lay awake at night sometimes, but mostly my thoughts are solely on the patients themselves – not necessarily their lab values or therapy recommendations. It’s hard to tell someone that they have a brain tumor and maybe six months to live, or to tell someone that they’ve severed their spinal cord and are now a quadriplegic. It can be hard to go home at night, knowing you are in good physical health, and have a particular patient and their family on your mind.

What makes it worthwhile? What makes restless nights bearable? Knowing that tomorrow brings a new day of new patients, new ailments, and new opportunities to truly help someone – not always by saving their life with CPR or emergent surgery, but sometimes even on a level as simple as taking time to talk to them, comfort them, and let them know that you’re going to do everything in your power to help heal them. I couldn’t ask for a better team, better attending physicians, or a better support staff than the Neuroscience Center staff at Sinai.

Are you interested in working with Natalie and the other PAs at LifeBridge Health? Click here to see our open positions.

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