How did it go? What have you learned? What can you improve? How do you plan to improve these new skills?

My surgery rotation was an unforgettable learning experience. The hours were very long but I actually thoroughly enjoyed absorbing so much clinical knowledge and making friendships with the people I worked with. An interesting lesson the chief resident taught me was that a good surgeon doesn’t just know how to operate, but he/she knows when NOT to operate. Before coming to surgery, I thought that I would be focused on the OR and how certain surgeries were done. What I’ve learned, especially as a future PA, is that what is more important than that is knowing how to manage patients outside of the OR. Many of the patients I saw admitted under the surgery service were managed conservatively, often with IV antibiotics, hydration, and continued monitoring. I learned how crucially important vitals are in surgical patients, with emphasis on detecting tachycardia and the causes of that. I was taught to be familiar with the common complications of certain procedures and how to detect them. While practicing my presentation skills during morning rounds, I learned that something I can improve on is formulating a plan for patients. I realized that I was confident in presenting the patients’ history, overnight events, and physical exam, but when I was prompted to give my plan for the patient, I was unsure and less comfortable. I tried to better myself in this area by listening to how the residents presented their cases and plans to the attending, and I will continue to improve on this skill by doing the same in my future rotations.

 

What one thing would you want the preceptor or other colleagues to notice about your work in this rotation?

It is known that our surgery rotation in PA school takes many hours of our schedule and is one of the toughest rotations to go through. One of the things I would want my preceptor or colleagues to notice was that on some days I would stay even longer than I had to so I could see procedures that I was interested in. For example, I have an interest in cardiology, so I stayed late one shift to watch a pacemaker implantation. I recognized that I was there for a limited amount of time (5 weeks) and wanted to get exposure to as much as I could. I would also want others to notice that I went out of my way to offer help to the residents during their work on the floors; I assisted them with wound dressing changes and accompanied them during consults. As for the patients I was assigned to, I would take time out of my day to ambulate them because it was my duty to play a role in ensuring clinical improvement.

 

Exposure to new techniques or treatment strategies – how did that go?

As expected, I learned various suturing techniques, and I was taught how to suture more efficiently. The residents were helpful in showing me how to make things easier for myself while also suturing effectively and safely. I learned quickly and I was praised by a resident I worked closely with on my skills, most memorably with my first attempt at a running subcuticular stitch. I also learned new scrubbing techniques which were different than what was taught in class during our didactic year. With the new addition of these Avaguard hand antiseptics, the use of the scrubbing sponges was eliminated. In addition, when I first started scrubbing into the ORs, I was not very comfortable with gowning and gloving. I was slightly hesitant as I did not want to break sterility, and the scrub nurses would sometimes get frustrated as they would with any new student, but they gave me great tips and taught me. After a few times in the OR, I quickly became more confident with scrubbing, gowning, and gloving, and I was much more comfortable in the OR. Even if I do not choose a career that involves me being in the operating room, all of these new skills will contribute to my qualities and knowledge as a future PA.

 

What did you learn about yourself during this 5-week rotation?

I learned that I enjoyed suturing and that I was better than I thought I would be. One big revelation I discovered on my surgery rotation was that I have “tougher” skin than I thought I did. To be blunt, surgery as a medical field is known to have a more “cut-throat” or coarse working environment than other fields. With this in mind, I was apprehensive going into this rotation in fear that I would crack under pressure. Instead, however, I was determined to receive rough personalities or harsh critiques as a learning lesson and not to take them personally. By the end of these 5 weeks I would say that I accomplished this goal and I learned not to be as tender to the behavior of others. I also learned that the people I surround myself with in a working environment is very important to me and my satisfaction with where I am. One of the greatest things I appreciated from this rotation was the comradery of the residents and students I worked with. I will carry this lesson with me in my PA career in that I will take the social culture and coworker’s characters into consideration before accepting a position in a workplace. This not only applies to the attending physician’s I’ll work with but also my fellow PAs, nurses, and other supporting staff.