Transitioning from classroom to clinicals: Advice on starting rotations
Dear Seniors,
Before the first day of my first rotation I didn't sleep at all! It's nerve racking to go somewhere new, not knowing what they'll make you do or how the day will go. You will not know everything— I promise you that. But I promise you that Wagner has prepared you for a lot. You know more than you think. Here are my best words of advice for starting your clinical year.
Senior PA students preparing for their clinical rotation
Speak with confidence....
Maybe you don't know the exact answer, but saying "I don't know" is never the best option. You can always look it up later or dance around the question with things you do know. It's okay to not know, but be confident in your deficits and be willing to learn for next time. Being wrong, making mistakes, and asking questions are why you are there. You are a student. Sent to learn. It’s okay to be wrong.
Never be afraid to ask questions....
If you show you are interested people will take the time to teach you or show you things. It is hard to find the balance between being helpful and in the way. It takes time to learn and some days I feel completely useless, while others I am utilized. Being a student is hard because everyone else has a job to do, and taking time out of their day to teach may be inconvenient for them. So please always be appreciative and respect whoever you are working with.
Remember everyone can teach you...
Nurses know the most about the patients and are often willing to teach if you are interested and try to make their lives easier. Do little things like running blood to the lab or handing supplies as the nurse is changing a wound dressing. In exchange, they will often let you do procedures like putting in IVs. Respiratory therapist will teach you everything you need to know about ventilators and arterial blood gases. Social workers and case managers know about the patient's whole history. They are able to tell you the future problems they predict occurring and give you better insight about the issues of access to health care.
Always volunteer...
Volunteer to run something to the lab or do a procedure. Even if you've only practiced doing an NG tubes on the mannequin in Cunard say yes to doing one with supervision. This is your chance to practice and learn even if you’re nervous. I’ve missed more blood draws than I’ve been able to get, but each time I get better. Getting "pimped" (Put In My Place) or having to present patients can be scary and intimidating, but it gets easier. I once looked like a fool by not knowing the pathway of vision, but now I know it well because I never want to not know that again. I suggest always answering the first question if someone is pimping a group of students. It is usually easier and it shows great initiative.
Know what to bring...
On the first day only bring what you can fit in your pockets. Bring a pen, notebook, stethoscope, snack, phone, and ID badge. You can bring more, but you never know where you're going to be able to store things on the first day or what they will have you doing. Your white coat can get surprisingly heavy without having much in it.
Everything you learned junior year will make you mentally ready for rotation but physically it is a drain. Buy comfy shoes. Those ugly, expensive shoes are worth it after a day of standing or running up and down stairs doing scut work. Also always keep a granola bar in your pocket. You never know when lunch will come and you will get hungry.
Remember to take care of yourself…
It’s so easy to forget to eat or drink on rotation, but it makes you run down in the end. Also on your pediatrics rotation I suggest taking vitamin C. We have all experienced the colds, rashes, and agony of going to rotation and being sick. Try to prevent as much as you can by taking care of yourself. Eat as healthy as possible. Sleep as much as possible.
Stay motivated...
One of the hardest things about going to rotation all day is getting all the work done and motivating yourself to study at the end of the day. It’s so easy to just want to relax after a long day, but you shouldn’t. Make sure you don't leave all the assignments till the end. 20 SOAP notes is a ton and you will regret it if you leave it all till the end... plus having to study for a test. It’s so easy to say, “oh I have four weeks, I’ll do my H&P tomorrow” but don't fall into the trap! Get them done as early as possible or you will be very stressed at on the weekend before the call back day.
Try to make friends with the other students...
They can share secrets, resources and sometimes their numbers. They can show you the ropes when you first start a rotation and you can pass on the secrets of each rotation to future students. They often know where to find the free food, who the best teachers are, and who to avoid on bad days. They share resources like books and can be helpful to study with in a dull moment.
Here are the best things to get before rotation:
-Maxwells pocket book: Everyone has it and it's always a good reference to have for lab values and to help you do an H&P. Technology can be a great asset. There are a lot of medical apps that are very helpful.
-Epocrates: It’s an app that gives you all the drugs and dosages.
-Medscape: Is another app that is always a good reference and great to read in the slow moments. It is also helpful for H&Ps and SOAP notes to help with a differential diagnosis.
-Qx calculate or Med Calc: These are good calculators for things like BMI and risk factors.
-AHRQ ePSS: This is a tool where you plug in a patient's age and gender and it gives you the screening tests you should run on the patient.
-ASCVD Risk Estimator: It gives you a patients risk of cardiovascular disease.
-AccessMed: This is the new database that the program bought for us and has a lot of our textbooks online. There is also an app that has five important books and is a great reference as well.
Some rotations you will hate. Others you will love. It’s the way it works, most people can’t love everything. No matter what the most important thing is to show you’re interested. If you show interest people will teach you, you will learn, and if nothing else it will make the time go faster. So jump in without your floaties on and swim! Good luck on rotation!
