Hi readers of AP the PA blog! My name is Rachel and I have the honor of calling Aashna my classmate, but also one of my dearest friends. I have watched her diligence over the past 27 months in the way she studies, but also in the way she serves others like YOU who read her blog. It takes time to write these posts and I know she sets aside the time to do this because she cares about the future generations of PAs and their success. She is smart and kind, and I was so pumped when she asked me to be a “guest writer” on her blog. We just finished up our last rotation (WOW!) as PA students and I actually was able to go home for my last 2 rotations. Home as in I lived at my parents’ home all summer and it was a blast!
I just completed my cardiology elective, so I thought it would be a good idea and maybe helpful for some of you to read a version of Aashna’s “Day in the Life” posts on cardiology. Cardio is a very common elective and it is the highest percentage of content on the PANCE/PANRE, so if you are considering picking cardio as your elective, DO IT!
6:30 am- Push snooze on alarm that I once again had high hopes of not pushing snooze on.
7:00 am- Finally get myself out of bed, head downstairs to the Keurig, read my Bible and get ready for the day. My rotation was mainly in hospitals so I was able to wear scrubs every day which made getting ready a little easier. (Things to consider in future jobs….)
8:00 am- Leave home (don’t forget to tell mom and dad goodbye!) and drive to the hospital. My hometown traffic is nothing compared to Nashville traffic. I was very thankful for that! The cardiology group I worked with has multiple offices at hospitals in my hometown and my preceptor mainly worked at one hospital, but would float to others as needed. This made each week a little different. I loved the variety and felt like I saw multiple EMR systems and how things work differently at each location.
8:30 am -12 pm- Meet up with my preceptor in the hospital and start rounding on patients. Every day we have consults waiting for us for many different reasons that may have come in overnight through the ED, or consults requested from other specialties. Many patients have cardiology related complaints/problems. One patient with atrial fibrillation, one with chest pain, another with a congestive heart failure exacerbation. We are consulted by GI on a patient with a GI bleed and the management of their coumadin dosage. Another patient is admitted by her primary care provider for a Betapace load (medication for Afib that often requires hospitalization for the first 5 doses in order to monitor EKGs for QT prolongation, which is a common side effect of the medication). This is a boring hospital stay for most patients.
In the midst of rounding on the hospital floor units, my preceptor receives consults from the ED on patients with chest pain, CHF exacerbations, and pulmonary embolisms. While in the ED we receive word that the paramedics are bringing a possible STEMI patient in. We wait around until they get there. Turns out, the patient does have some EKG changes consistent with ST elevation and we start the process of caring for the patient. Everything moves really fast when a STEMI patient comes in, but very smooth. The patient is usually not calm because they have just heard the words “heart attack”, but for us cardiologists, it is just another day at the office. We ride the elevator with the patient to the cath lab and I get to watch the whole case start to finish. We see which coronary artery has a blockage and the doctor is able to put a stent in. It is very exciting to be a part of and I love seeing the patient’s get better under our care.
12-1 pm- Lunch in the doctor’s lounge (for free!). Definitely a perk of this rotation was not having to worry about packing a lunch. My preceptor had the hospital weekly menu memorized (Wednesday is apple cobbler day). Some days we would have drug reps bring lunch. My first day on the job we learned about a vest that acts as an external defibrillator. It is awesome for patients that have a low EF, but less invasive than getting an ICD.
1 pm- 4:30 pm We finish rounding on any patients left to see in the hospital. Over the course of a day, we receive consults from other physicians and the ED. Some days are busier than others. My preceptor sends me to one floor to see a patient while he consults one on another. We work as a team with each other and with the other mid-levels covering the hospital. The doctors often see the patients behind us and they handle most of the rechecks. We start seeing some of the rechecks once we finish consults. We go see a patient in the cardiovascular intensive care unit who just had open heart surgery for a valve replacement. There is so much to monitor after these operations, and I still don’t comprehend all the tubes and lines I saw!
When rounding is done, we head over the cath lab to see if anything is going on there. We look at the results from the day on the EMR system. My preceptor goes over echo, stress test, and doppler results for patients that had testing that day. Often times, those test results are what we need to discharge a patient from a cardio standpoint as “normal”. Then we handle those discharge orders.
On some slower days my preceptor and I would study flashcards together. My preceptor was studying for his PANRE, while I was studying for my PANCE I am scheduled to take at the end of August. This made the rotation so fun because I had a study buddy and we would question each other on different topics. He made sure I understood all the cardiology I could! It was such a blessing that the timing of the rotation worked out this way! Not many people study with their preceptors.
4:30-5 pm- Drive home, sit on the couch and log my patients from the day. My parents go on a walk most afternoons so I went with them while I was home this summer. It was a great break from my day and got my heart rate going (got to build that cardiovascular health!).
7 pm- Eat dinner and study for an hour or two. Many days studying was tough. One thing I found helpful over rotation year was to keep all my patients and learnings from the day in a little notebook. At the end of the day when I logged my patients I would retype what I had learned in an ever lengthening word document. This helped me solidify what I learned and I would look up anything I was confused or wanted to know more about. Definitely a good study tool!
9 pm- Watch a little TV with dad, do some wedding planning, and then head to bed.
Extra tip: I got engaged between our 6thand 7throtation so I have started planning a wedding (YAY!). This is fun and all, but it is the BEST distractor when it comes to studying. I have had to learn to prioritize my time wisely, because most people would agree looking at bouquets on Pinterest is wayyyy more fun than studying hemorrhoids. Right? So my piece of advice for any of you who might be in this same season reading this, ENJOY planning your wedding. Seriously, enjoy it! For me, it helped to study and do my PA related to-do list first and somewhat “reward” myself with doing some wedding things. That way I was able to stay on top of both. Right now my goal is to graduate, pass the PANCE, and *fingers crossed* get a job, so the wedding is taking a back seat right now. Some nights I did only wedding things and watched TV shows with my dad, which I learned is ok too because some days you need a break. Rest is good for the mind and soul!
Extra extra tip: If you just so happen to live at home for PA school, that is a whole other blog post. If you love hanging with your family like I do, it is a little harder to study and get things done. I only lived with my parents for the summer, but I knew it was going to be different than living in Nashville with my roommate. BUT it was such a joy to be with my parents because they love me so well (and I love them too!). My advice for this scenario is to find a place in your home or a coffee shop that can be your “study zone”. Carve out time for studying and kindly let your parents know that’s when no distractions are allowed. Also, carve out time to hang out with your family and do fun things! This may be an unrelatable topic for many of you, but I know someone out there is out to save the big bucks by living with mom and dad and eating their free food. J
Overall, cardiology was SO fun and I learned more than I ever thought I would. It was great getting to watch the interdisciplinary team work together among many different specialties. For example, a patient with syncope might be consulted by cardiology, neurology, and gastroenterology so determine the source/cause of their syncope. I loved getting to work alongside so many specialties and watch the puzzles fit together. Also, this was the most inpatient experience I had all year and I loved it! The mid-levels have a lot of autonomy in our practice, so I really felt I saw the “PA cardio role” in action.
If you made it this far, thanks for reading! I love being to share my experiences in hopes it will encourage someone else. Thanks, Aashna, for the opportunity as well! Now on to gradutation TOMORROW.
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