Archive | December, 2014

The “B” Word

31 Dec

dog pic

This article, Valued Reader, may seem redundant.  I have written in the past (see this article) about sexism in the PA profession but lately I have been having conversations with female professionals outside of healthcare and wanted to discuss something that is more global.  I want to discuss the “B” word.

First of all, the word bitch does not roll off the tongue easily for me.  I do use it occasionally in a playful way to encourage a person to quit complaining.  This is the verb form of the word and I feel can be appropriate in some situations.  Like when your coworker is complaining about having too many undesirable shifts in a row, or when they accidentally signed up to see the drug seeker that has been to the ER three times that day, or was too busy to eat lunch.  Wow…now that I actually wrote that out I’m thinking that maybe its a little bit harsh in that context as well.  Moving on to more pressing issues.

The concerning use of the word bitch is when used to describe “a spiteful or unpleasant woman.”  First of all, this is certainly not very nice to say in any situation.  Secondly, many women are mislabeled because they are smart and opinionated.

There it is, folks.  Nothing too complicated.  Hard to believe that when you have two people say the exact same thing, one will be viewed as a bitch and the other competent depending on their sex.  You can understand, readers, how this can be quite irritating at the very least.

The truth is we ladies can get on pretty thin ice as professionals at work when we are too opinionated.  We are asked to apologize for assertiveness.  We are “talked to” when we have differing opinions from our superiors.  Not only in the health care field but in many work settings do women have to think before they speak to make sure they are not viewed as “spiteful or unpleasant”.   This is a generalization, and I will do a happy dance for you if you are in a more progressive situation.  Please understand that many women are having to deal with double standards every day in the workplace.

Specifically in the healthcare field, women have had to fight to make it in  traditionally male dominated positions.  Luckily the PA profession is well populated with women, although we don’t get paid the same as our male counterparts.  We have a good representation in the PA field.  Many of our supervising MDs, consultants,  and management are males.  I have no problem with this.  I am confident in myself and in my knowledge base and also in my areas where I don’t have as much knowledge.  My only request is that when women clinicians  disagree with how a patient should be managed we are not seen as disagreeable, but as competent.  That women who are assertive in their workplace are viewed as a strength, not an irritation.  What are your thoughts, reader?  Am I overly sensitive or is there an underlying sexism problem in the workplace?


Masks and #11 Blades

23 Dec


What a dichotomy we working mamas live in. I am running around in blue scrubs putting out fires in the ER and I can’t stop thinking about sausage stuffed pork tenderloin. I’m in the “fast track” which typically means low acuity patients, in and out, treat em’ and street em’. I was looking forward to this shift because I am hosting Christmas Eve dinner for my in laws and I wanted to think about recipes, place settings, presents. Instead I was bombarded by actual sick people that needed my full attention. Fast track, my ass.  Bleeding ulcers, pulmonary emboli, kidney stones did not leave me free to daydream about side dishes.

It is a strange place to be in. Feeling the desire to make a cozy home, raise honest children, browse the internet for a new recipe and the desire to put in a chest tube. How in the heck do we bounce back and forth between these two worlds?

Sometimes I feel like a masked crusader. I am a mom by day, and a physician assistant by night. My husband, kids, and I snuggle up to read a book, and I leave them, making a hole in the puzzle to go suture, put on a splint, or deescalate a psychotic person.  This can be incredibly exhilarating, or incredibly lonesome.

Maybe I am looking at it too grandiosely.  It is, in fact, just a job.  It pays the bills, gets the baby new shoes.  But as a working mama I feel that it is more than this.  The time I spend at work is the time I miss the small moments.  The loosening tooth, the new trick, the skinned knee.  These small, yet monumental moments, are irreplaceable.  And missing them at times is part of choosing to work.   Whether out of necessity or desire, it doesn’t change that in a way we are super heros.  The trick is to remember which mask you are wearing at the moment so that you don’t get caught dissecting the pork tenderloin with an #11 blade.

National Lampoon’s CME Vacation

19 Dec

travel pic

Continuing medical education, or CME, has the potential to be a welcomed break away from the fam, or a family reunion, if you plan it right. It’s really easy to use up CME money when you are single and don’t have spouse or little ones to consider.

“Hmmmmm, I think I’ll hop a plane to the tropical, warm, relaxed climate du jour and cram in 40 credits in 3 days….and I’ll leave this weekend!”

I never had this luxury. Pregnant with #1 at the end of my clinical year and after passing my Pance I immediately started working. I became a mommy six months into my first job. When I get near the end of the year, my search for CME consists of finding something that quickly and cheaply accommodates my schedule.

One year, I decided to take a risk and plan a family CME vacation in Georgia. My husband and I planned to take our 2 year old and 7 month old for a week of family time far away from our chilly residence. When my parents heard that we were going to Georgia, they thought it would be fun to come along and see some family down there. My older brother also thought that maybe it was time to pay the ol’ cousins a visit. We happily….or should I say naively, agreed.

The CME gods decided that my decision to sneak in my parents and my brother into the single hotel room was a punishable offense. First, they cursed me with a stomach virus. I woke up in the middle of night and started vomiting every 15 minutes. The alarm went off at o’ dark thirty. I looked at my husband and all he said was, “You’re gonna have to power through, honey”.

I had a colleague call in a prescription for Zofran and we drove through the pharmacy on the way to the airport. I drove to the pick up window and asked for my pills. They raised their eyebrows at my disheveled appearance and greenish face, but they luckily handed over the bag without any comments. We then met my brother at the airport and barely made it onto the plane while toting a toddler and a baby. They were perfect angels for the first five minutes of the trip. Then it was cry this, poop that, scream here, runny nose there. We made it off the plane and met my parents. Five adults and two kids in car seats, and one teeny van.

The CME gods laughed at my plans. They must have realized how frugal my family is. Why pay for a second car if my work is covering the costs of travel? My family decided that we should all cram into one hotel room as well. Pak N’ Play, two queen beds, and a toddler bed made from hotel comforters in the corner made the room complete.

Every day I grabbed my breast pump and ice packs and went to learn about strokes. My family played at the pool and spent my daily allowance for food. We added a few days to the trip after my conference was over and hung out with my extended family in Georgia. They dressed my husband up in full camouflage and took him nighttime turkey hunting. He had a great time and after all the work it took to get there, we had a great trip.

This year is different. I decided to push away my guilt and shame about taking time away from my family and use my CME money for….sigh, just me! I’m going on a plane, staying in a hotel room BY MYSELF, and enjoying the beach after my sessions are over. Who knows, maybe the CME gods will look favorably on me this year and maybe I won’t get a viral illness.

Rejection Happens

16 Dec

dead end

The letter came. I was sitting in my new boyfriend’s car. The envelope was little, making me immediately on edge. I pulled the single sheet of paper out and unfolded it, only reading the first line. The words are burned into my memory, “We regret to inform you….” Of what? That my dreams are crushed? That I am deemed not worthy of your facility? That I am a complete failure?

When getting into a physician assistant program you are competing with hundreds of highly qualified, passionate, and bright people. Many of us are used to doing well in school and achieving what we want in life. Many of us are people that stay late, study harder, and prioritize our future for what we want to accomplish. That is why it seems to sting when someone tells us that we are not accepted into a program that we were BORN to get into.

Here is my simple message to you today. Keep going. That one rejection letter may turn into two, or three, but if you are perseverant and you know that you are qualified, then keep going. If you are tired, keep going. If you are frustrated, keep going. If you are losing your mind….take a break!

This is a competitive field and rejection letters are common. Don’t let it keep you from your dream career. How have you dealt with rejection? Share with us in the comments below.

Does Spirituality Belong in the ER?

2 Dec

planet eclipse

During the holiday season I have seen many articles and Facebook shares about compassion in the ER. Blogs written by providers about taking an extra moment to truly understand why our patients are there and inquiring about their home life situations. Not only to evaluate whether or not the patient is suicidal, but also if they are stressed, anxious, grieving, or just sad is a part of a full medical evaluation.

The question I have is about spirituality. Have we become such a science driven culture in the ER that we do not have space in our own life, and also in the lives of our patients for spirituality? In my own practice, I feel that I often sidestep spirituality in order to avoid discomfort, for myself and for the patient. Why is it so much easier to ask about their sexual history than to ask if they have a religious preference?  The fact is that spirituality or religion is often a very large part of the overall health of the patient.

In the October 2000 issue, JAMA has an article entitled “Religion, Spirituality, and Medicine: Application to Clinical Practice” Harold G. Koenig, MD. I read this and realized that I was never taught about how to respectfully ask about spirituality in PA school. I don’t think I have ever taken a “spiritual history” unless I am seeing a mental health patient. The author suggests asking the following-

“(1) “Is faith (religion, spirituality) important to you in this illness?” (2) “Has faith been important to you at other times in your life?” (3) “Do you have someone to talk to about religious matters?” and (4) “Would you like to explore religious matters with someone?”

These types of questions are not always appropriate, but many times they are. In the ER, patients are often facing tragic losses, deaths, and serious illnesses. Our job is to not only diagnose, but to  comfort. One way to be compassionate is to  ask if spirituality is important to the patient, and if that’s as much as you can muster up, call in the professionals.  Many hospitals have chaplains, rabbis, and social workers that can help can connect people to their spiritual tradition.

Whether you are a spiritual person or not, the fact is that patients come in as they are, with all of their culture and beliefs attached.  Patients and their families with all sorts of religious backgrounds pray that their nurses and providers will help them get better.  They are praying for you.  That is humbling even if you do not have any strong religious beliefs.  We need to keep patients’ spirituality in mind when we are treating the whole person, not just the lab results.

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