Emergency Medicine Recap: Physician Assistant Rotations

What an experience! This rotation was another one I was a bit nervous for because I am definitely not someone who naturally thinks emergently. Time sensitive, high energy, big stakes, life vs death, I was SO excited but SO nervous.

I am someone who walks into a room and likes to make small talk for a few minutes before even asking what the patient is here for lol. I want to know who they live with and if they are feeling OK mentally, and how their weekend was.

Obviously, emergency medicine is not that at all (unless you’re seeing a viral illness or a small laceration, or whatever). But it’s definitely more fast paced and the way that you think as a provider is very different from other specialties.

To note, even though I (and you too) might feel “better” in a certain area of medicine compared to another, even in 4-6 weeks of a rotation, you can adapt, learn the norms, and feel confident. Personally, I knew I wanted to go into primary care, but I still enjoyed and succeeded at surgery, emergency medicine, and the like.

Every rotation is SO different and learning to think differently, act differently, and adjust is really what being a PA is all about. Being flexible, going with the flow, and succeeding no matter where you are placed. If I can do it you can too!

So without further ado, here are some things I LOVED about the rotation, and that made it stand out from others!

1. You see it all!

From 2 year olds to 90 year olds. From abdominal pain to shortness of breath. From low level trauma to emergent intubation. I loved the wide variety!

I truly do love seeing all ages which is why emergency medicine was one of my favorite rotations!  With each age your differential is so different- an abdominal pain in a 3 year old is different than in a 23 year old is different than a 73 year old; I loved having to constantly be thinking about so many aspects of medicine.

Similarly, you don’t ONLY see ortho problems or ONLY see cardio conditions. You see it ALL (seriously like everything haha). Yes, specialties are great and its amazing to know every detail about one thing. However, what I loved about emergency was you had to know a lot about everything.

You really had to know how to workup almost all medical conditions (or the life threatening ones at least).

Definitely write down the 3-5 most “scary” or life threatening conditions for every presenting chief complaint, it will really help you think more emergently and ensure you rule out the “never miss” diagnosis.

2. Procedures procedures procedures

I loved that in the ED, you have the opportunity to do a ton of procedures. From splinting to suturing to I&Ds. Pelvic exams and rectal exams and wound management and stapling. You get to DO a ton of stuff and I liked the mix of medicine and procedures. It kept the day interesting and you really get to nail down some of the more minor/simple procedures that should be taken care of in the ED like lacs and I&Ds. It was fun, especially as a student, to start perfecting those skills!

If you are wondering where to start with how to suture check out this video, and how to perform an I&D check out this video.

3. Shift work and the unexpected

You never know what is going to walk through the door! Something that is far and away different in the ED than say in an outpatient clinic is the unknown-unexpected-fly-by-the-seat-of-your-pants who knows what is going to walk through the door kind of atmosphere.

There is no set schedule. You may have 10 patients you may have 40. You may have a ton of viral illnesses, you may have to intubate 5 times that shift. You just never know what you’re going to get and I kind of liked it. You just take the day in strides, and figure out what to do as the day goes by.

You can’t plan, you can’t expect anything, you just have to take it as it comes and it’s fun because everyone working in the ED is doing the exact same thing and you’re just all in it together.

Additionally, the ED is shift work.

You are there for 12 hours and then someone takes your place. You don’t follow up on patients, you don’t have to take care of something when you get home, you do your shift and when you leave, you leave.

There’s no taking work home with you (really) and I don’t know about you but that sounds pretty good to me.

4. Team atmosphere

There are so many people needed during the shift that play so many different roles. We rely on EVERYONE and it’s one of the only specialties I really see that in.

There are soooooo many people bustling around in the department. We need our nurses, doctors, APPs, techs, respiratory therapists, consults, Xray people, etc. We all are just running around trying to take care of patients and it’s an absolute blast.

I saw a lot of camaraderie in the department and it was a really good environment to be a member of. I’ve always loved being on a team, and when on a team, everyone has certain roles that are INTEGRAL to the success of that team.

I saw this so vividly play out day in and day out during my rotation. It’s an atmosphere that I personally thrive in and a place that makes coming to work fun. 

5. Personality of the ED

One of a kind for sure! You know how they say every area in medicine has a “personality”? Well, I don’t know if that’s total BS or if it’s true… but the ED definitely has quite the personality.

You need to know how to make fun of yourself (and others sometimes!) You have to let things slide, you have to have a dry sense of humor, you have to take it and give it, you have to not take anything too seriously. You know what I mean?

It has a lot of personality in it and if it’s a particularly crazy patient or a particularly crazy day, that personality comes out! Overall it was an absolute blast and I completely enjoyed the people I was with and the experience I had.

Of course, everyone is different, but I have to say the personality of the ED in general was kind of no-BS people who were chill and confident and hilarious and smart as crap. I learned a TON this rotation and feel that it prepared me well as a primary care provider.

The experiences, injuries, procedures, and diagnoses were super interesting. The people were hilarious and brilliant. The diversity of patients and chief complaints was exciting. And finally, the bustling team atmosphere made the entire experience amazing.

Try to learn as much as you possibly can in the ED. See the crazy stuff. Do the fun procedures. Read the EKGs. Soak it all up- it will be useful no matter what area of medicine you find yourself in.

If you enjoyed this post, you might also enjoy my other rotation recaps about the Surgery Rotation and the Pediatric Rotation.

Cheers!