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It’s Showtime!

25 Dec

After weeks of preparation and planning it finally comes down to the last night. My last chance to conquer the Christmas Empire. Little did it know, I have a few secret weapons. 

Just because I don’t have a knack for decorating doesn’t mean I have to settle for subpar trimmings. I happen to have a mother that can take drab to glam in minutes. Take a look at my mantle.

Before my mother’s involvement…

After my mother’s involvement…

The presents are wrapped, the cookies are baked, the memories are waiting to be made. But even though I had high expectations for perfection, many blemishes emerged. Burnt caramel corn, Christmas cards that never made it to the mailbox, errands that I forgot to complete. It might look to some that I failed miserably in my quest to create a memorable Christmas in spite of the fact that I work and have three kids. But you would be wrong! I have one last secret weapon that will trump all my errors. Behold the best Christmas present ever!

Happy Holidays to everyone and I hope that your day is filled with beautiful imperfections and surprises 🙂 Peace to you all!


Twinkle Lights

3 Dec

I never even considered the idea of putting up Christmas lights prior to yesterday. The absurdity of the idea was almost laughable. There was barely enough time with little ones to put up a tree and stockings and still make time to do the daily tasks of parenthood. Now my kids are a little older and I feel as though I can take on those extra tasks, like eating sitting down and showering regularly and putting up lights! Well, at least I thought I had time. Here was what yesterday looked like. 

So the lights went up. But I underestimated them. They were wily and uncooperative. Luckily my husband let me use his industrial stapler so I was able to muscle them into submission. They don’t resemble icicles. But while I was wrestling the lights some other things didn’t get done…

Compost bin did not get emptied. 

Recycling bins overflow

Mount Laundry is looking ever so majestic. 

So I will be playing a little catch up today. And my kids will probably be doing a few more chores than usual, but I’m ok with that. We all have to sacrifice for my great quest to create the perfect winter wonderland…which may end up smelling a little like my compost bin. 

Me Vs. Christmas: The Tools

2 Dec

Yesterday I declared a state of war with Christmas. I will not except anything less than a perfect holiday and refuse to be that “working Mom” that can’t get it together. Call me delusional, call me overzealous, but I prefer “Mrs. Claus”. I’ve decided to share some of the weapons I gathered for the month of December and I share them with you below.


One cup limit, be damned! I will drink as much as necessary to keep my heart rate at a steady 108. Coffee will be my drink of choice in the AM and throughout the day. Sleep will be limited until December 26th so I need to make sure that my tank is fully loaded.


Calendar. This is usually blank, filled with doodles or three months behind. But not this month! I will be organized and keep this thing current. I will check nightly what is going on the next day, and I will get things arranged for those activities. ACK! Looking at this just reminded me that I have no childcare for the last 2 weeks of December. See?!? Killing it.

Wine. Check. Hot glue Gun. Check. Real Simple Magazine Holiday Edition. Check. Target Coupons. Check. Just as Coffee will be my fuel for day time, wine will be my fuel for night! Glue guns for all the sweet crafts and decorating I will be doing (note to self, must by glue). And of course my Target Coupons. This month I will not only be organized, but thrifty as well.

Do you think I have a chance?

Dear Reader, please send me good vibes. Love, Rachael.


The Perfect Christmas

2 Dec

I know in the past I have written about how difficult it is to be a working parent. I encouraged everyone to have balance and to let go of perfection. For some reason, this Christmas, I am having a very hard time doing that. Instead of following my own advice, I plan on setting unrealistic expectorations for myself. 

I am going to go full throttle and take my Christmas game to the next level, and I invite you to watch as I self-implode. Yes, for the month of December I am going to be the craftiest, most organized, thoughtful, PA Mama around. I will bake, I will wrap, I will create cozy memories and then I will crash and burn.  

Why, you ask? Maybe it’s because there is a slight chance that it is possible. Maybe, even though unlikely, I can pull it off. I just want, for one month, to feel like I can get my shit together. Do you feel me?

The end of the story seems obvious because I’ve done this before, as you probably have too! Maybe this time the underdog will win. Maybe the Universe will look kindly at me and finally let me be the best mom and wife EVER while still killing it at my job. I plan to keep you updated on this journey through hosting dinner, sending Christmas cards and finding the perfect gift for my quirky kids, all while managing to see twenty patients with varied complaints during an Urgent Care shift.

Holiday Season, I’m gonna win this year!

PA-C Networking

13 Nov

Recently, a past colleague reached out to me for the sole purpose of networking. We’ve run into each other occasionally over the last few years, but haven’t worked for the same employer for a long time. He heard about my new position in management and wanted to get together to chat about my journey into leadership.

It was the first time someone contacted me for this purpose. It was an odd feeling to have a peer look at my career choices and desire to know how I got there. We met for a beer and he was dressed in a suit. After we shared some friendly banter, it was all business. He had an agenda and also a vision of where he wanted to be in his own career. One aspect that I found very interesting was his resume. It wasn’t so much a list of his work experience as it was an aggressive 5 year career plan. It went into detail about which companies he would like to work for and what talent he would bring to those companies. He asked about what I perceived were the biggest struggles for a PA in leadership and what I felt were my greatest accomplishments. I had kind of a mind blowing moment after this one hour informational interview. My PA education never touched the idea of career advancement or how to network. This guys was organized, driven and had a plan. After the meeting, I came away with the feeling that he was going places and would be a part of advancing the PA profession.

Since this meeting, I’ve researched a little about how to successfully network and what purpose it serves. The informational interview is one component of networking that I find to be especially helpful for PAs because there aren’t that many opportunities for bigger events to network, like the AAPA conference. Here are a few tips to help make the informational interview worth your time.

  1. You can network and connect with others even when you are perfectly satisfied with your current job! You have to think about how to be well aligned for future opportunities.
  2. Set up an informational interview with leaders in the industry and come prepared with thoughtful questions about their careers and how they got there.
  3. Dress as though you take the other person seriously. Even if you know this colleague outside of work, dressing professionally will send a clear signal that you aren’t wasting their time.
  4. Be confident, just like a regular job interview. Ask clear questions questions, look the person in the eye, and smile.
  5. Take notes! You will be surprised about what career gems you may learn during your time together.
  6. Bring your resume and career goals. Talk to them about where you see yourself in five years and see if they have any insight as to how to get there.
  7. Listen first, talk about yourself second. This is the time to learn from another professional. If you spend too much time talking about yourself, you will miss a valuable opportunity.
  8. Leave them with a business card or contact info, and make sure you get theirs as well.
  9. Follow up! Don’t forget to send a personalized email or send a paper (gasp!) thank you card.

This is just the beginning. PAs are viewed as, and view themselves as clinical work horses. We are interested in taking care of patients, but I think that we are limiting ourselves to other possibilities. RNs and MDs lead the way when it comes to career advancement. Networking, at a minimum, lets us get a taste for our own possibilities in clinical settings and beyond.

Police Violence and the AAPA

1 Nov

copyright morgue file

Folks, there is something we have to talk about. As a PA, I am deeply concerned about the current relationship between the police and people of color in this country. I believe that it has become a public health issue.

The CDC states that “public health is concerned with protecting the health of entire populations”. As I write this article, I am outraged by the recent police shooting of Keith Scott. Another police shooting of a black man. Another community shaken to its core. Another family, devastated.

I support the blue. As we all know, there is a close connection to and respect for police in the medical community. Our paths cross often, especially in the emergency room. They are the ones to respond and run headfirst into a threatening situation and have given their lives for their communities. But there is something gravely wrong when a situation escalates to a point where an unarmed person of color is killed by the very people who have been charged to serve and protect.

There was a time when it  was easier for me to go about my day and pretend this wasn’t happening. I can do that, because I am white. I decided that I I could no longer ignore the cries and protests of my neighbors, of my colleagues, or my friends. I think as healthcare providers we need to speak out for the health and safety of our patients and communities. That means we need to speak out for the people who are experiencing an unjustified use of force by the police.

Will the AAPA take a stance against police violence? What will happen if we don’t?

This is a public health issue. Look at the effects it is having on our communities. There are psycho-social implications that are affecting the health of our patients of color. We can help push for positive change, while maintaining our close ties with police enforcement. There have been studies conducted on the use of force; you can read one such article here.

I am supportive of the police, and I am grateful for the safety that they provide many of us. But their policies, their training, and their accountability needs to be closely evaluated and changed.

My recommendation? The AAPA needs to talk about it. We need to discuss police violence and race. As medical professionals, it is our duty to look at public health issues and take a stance. We need to be aware of who our patients are and what their needs are, beyond medicine. The medical community needs to start speaking up about the unjustifiable use of force against people of color. If we don’t, we are part of the problem. “In the end, we will not remember the words of our enemies, but the silence of our friends”. – Martin Luther King Jr.

Freeloaders in the ER

28 Oct

Rae pills help blue

I recently read an article written by an ER physician.  The article was filled with disgust for healthcare in the US and how many entitled patients come into the ER with less than life or limb threatening emergencies.  He spoke about their cigarettes, their inked bodies, and their well-groomed nether regions.  The doctor complained that these people spending our tax dollars on luxuries are coming into the ER expecting free care. They apparently aren’t poor enough. Part of his concern stems from the Emergency Medical Treatment and Labor Act. In 1986 EMTALA was a way to protect those less fortunate, making it illegal to turn away patients based on their insurance, or financial status.  In 2015, this is seen by many as a burden, a way for freeloaders to get convenient medical care.

I think that it is time for practitioners to take a look at their negative attitudes projected at the poor, or uneducated, and reevaluate the issue.

So, what is the issue?  ER practitioners are upset that their time and waiting rooms are filled with non-emergent medical and social issues.  They make the assumption that it is the patient’s fault for not going to their primary care provider or even go as far as to judge the way patients are spending money.  How dare a patient come to the ER at 10 PM only needing reassurance and ibuprofen!  They have money for a smart phone but need assistance getting their prescriptions?!?  The nerve!

I have a confession to make.  I have this same attitude all too often.

There was a patient that came into my ER and after reading the nursing notes, I was appalled.  This goofball off the street came in with a “red mark” on his foot that had been there for a month.  He had not gone in to see his PCP.  I tried to put on my “compassionate” face and walked into the exam room.  He had a wart.  A wart on the bottom of his foot.  I started to get really irritated but I knew there had to be more to this story.  I asked him what was it that really concerned him about this “red mark”.  The patient started to tell me about his horrific struggle in his home country in east Africa.  The war torn area stripped people of their families, their lives, and their access to basic healthcare.  His friend recently died from an infection that started out as a “red mark” on his foot.  The patient was scared.  He likely suffered from PTSD.  I reassured him and educated him about plantar warts. He did not have a primary care doctor or insurance, which was not remedied that night.  We talked for a while and it was a reminder to me that we can never understand the whole story and it isn’t our place to make judgements about our patients.  It is our job to help them.  It is our job to listen. It is out job to educate.  Our frustrations with the healthcare system do not need to be directed at our patients who are often the victims in this mess.

This is a complicated issue and there are pressures put on us to preform well.  Patient satisfaction scores, reimbursement, politics, and hospital executives distract us from our main mission, patient care.  The blame does not lay on the patient’s shoulders.  The ER will never be like it was prior to EMTALA, thank God.  We will care for anyone that walks in the door.  The healthcare crisis can be solved when our shift is over.

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