Professional Documents
Culture Documents
N O T E:
The health field consists of numerous
occupations and I myself want to
enter the health field in the near
future as well. For the longest time I
have wanted to become a Physician
Assistant, and I still want to be. Since
there are many different occupations
in the health field, comparing between
a Physician Assistant and a
Registered Nurse will interpret how
different occupations within the same
field have different responsibilities.
Actresses
Actors are people who are apart of a figured world. The
people I observed for the observations are the actors
within the figured world of the healthcare field. These
actors were chosen for the observations because they
represent the figured world of healthcare occupations.
Lianne:
Lianne is an Urgent Care
Physician
Assistant in
North Carolina. She
graduated
from UNC
Chapel Hill in 2004 with
a Bachelors
of Science in
Radiologic
Experience
and graduated
from PA
School in 2008 from
Duke University.
Lianne
does a good job at
explaining
the
requirements needed for
PA school
and giving a
gist of what Physician
Assistants
do.
Stethoscope:
In order to be a PA or an RN,
one must have specific medical
tools to help determine their
vitals. A stethoscope is used to
determine ones heart rate. A
Physician Assistant or a
Registered Nurse will always
have this significant artifact
with them at all times
Artifacts:
These are items that are a
significant part to the
actresses listed above
which are apart of the
figured world of the
healthcare field.
Planner:
This is also a significant artifact of
a Physician Assistant and a
Registered Nurse. A planner is very
helpful to keep track of patients
throughout the day and to have a to
do list to make sure either
profession doesnt forget anything
important for their patients or work.
Observation One:
Note: For this observation, I observed a 22 minutes long career chat
YouTube video about Lianne and her experience becoming a Physician
Assistant. She also did a question and answer section where she
answered questions from her social media about PAs, PA School, or
just facts about her experience becoming and being a PA.
Here is the link to the video: https://youtu.be/IaDLrJMFKdA
4:15 minutes: Lianne is an Air Force wife, mom, Physician Assistant, a YouTube
blogger, and is actually lives in North Carolina. She graduated from UNC Chapel Hill
in 2004 with a Bachelor of Science in Radiologic Experience and became an x-ray
tech. Lianne
was a x-ray tech for a little over a year before she realized she didnt want
to be an x-ray tech for the rest of her life so, she went back to school. Lianne decided
she wanted
to go to med school so; she took prerequisite classes at UNC Chapel Hill
and bought
an MCAT prep book. When taking her MCAT test for med-school, Lianne
realized then she didnt want to become a doctor either. She then began researching
different occupations and came across a Physician Assistant. From then she started
one of her colleagues at the ER where she worked. Once Lianne finished
shadowing
her prerequisites
she applied to three PA schools: Duke University, George
Washington University, and Wake Forest University. She got denied from GWU,
from WFU, and then she became accepted to Duke University. Lianne
waitlisted
started Dukes
Physician Assistant School in 2006 and graduated in 2008. Dukes PA
program is 24 months long but, other program could be anywhere from 2-3 years long.
Once Lianne
graduated, she first worked as a PA in orthopedic surgery in Virginia but
then had to move to Texas because her husband is in the Air Force. In Texas, she
pain management but didnt really like it all that much. Lianne and her
worked in
family moved
back to North Carolina where she is now an Urgent Care PA in a local
hospital.
13:00 minutes: From this point on, Lianne answered questions that she
received on social media about PAs or PA school. PA schools definitely
look at everything about each person that applies, more than just their
GPA. They are interested in a well-rounded person with an above average
GPA and the required amount of clinical hours and shadowing hours.
These patient care and shadowing hours are required but the amount may
vary between each PA school.
Liannes favorite thing about being a Physician Assistant is that it
definitely gives her a good balance of work and her personal life. She
works 40 hours every week and is home by a certain time everyday and
that she is allowed to do overtime if she wants to as well. Her least
favorite thing is having some patients not trust a Physician Assistant
verses a Doctor. Some patients arent aware that a PA works under a
Physician and if any questions occur then the PA can always go to the
Physician for help.
Before doing her prerequisite classes, Lianne had a cumulative GPA of a
3.3. While doing her prerequisites Lianne became very focused and
improved her cumulative GPA to a 3.6 along with completing her clinical
and shadowing hours. There are multiple ways to get clinical hours, one
could become a CAN or an EMT, etc. With Liannes job as an x-ray tech,
Chapel Hill counted those working hours as clinical hours.
Observation Two:
Note: This observation was taken place at West Forsyth Pain Management
Center where Amy G. Berry, PA-C was observed of her normal routine day at
work. Before the breakdown begins, Amys day is basically set up into two parts,
a "morning clinic" and an "afternoon clinic".
Arrival: At the beginning of everyday day, Amy always checks her email for
work to see if there were any important emails for patients or the physician. She
then prints off a copy of her schedule, which, this is what she does personally.
She has the original copy on her computer, but has found it to be better and easier
for her to have it in black-and-white versus looking at the computer. She also
makes notes on her schedule and checks off everything she has completed so she
does not get behind at work. All of the patients records are on an EMR
(electronic medical record) which is very helpful and less time consuming for
Amy to access her patients documents when they come in for appointments.
Before Amy has her first patient she looks at the information that were left on her
desk. Since this is a pain management center, the majority of patients have some
type of pain medication. For them to receive these prescriptions, Amy must sign
off on the Rx's (prescriptions) reports, prior authorizations for medications, or
referrals. She also calls back any patient that left messages from the previous day
or weekend. While doing this she checks their EMR to make sure the patient is
getting the right medication.
The Morning Clinic: After all of this, Amys day finally begins at 8:15am
with her first patient. When the patient comes in, the nurse always sees
them first. The nurse gathers the patients vital signs, asks a summary of
what's
going on and why he/she are here today, asks about any major
changes
since their previous appointment, and does any medication
reconciliation.
Once Amy goes in with the patient, she first introduces
herself
as if it is a new patient, or if it is a returning patient she greets them
and ask
how they are doing. She then goes over a complete review of the
body systems. Troubleshoots any problems that may have been occurring,
and goes
back over the medications that they are taking and the
effectiveness.
If there are issues with the medications for their pain
management she then decides on what treatment change is needed or
consults
with the supervising physician. During a patient's visit she tries
very hard to either do her documentation completely or make many notes
patient so at the end of the day she can have information for the
on each
legal record. A quote from Amy, There is no way you can see 20 plus
patients and want to document at the end of the day. Making mini notes
gives her the key words to help her remember each patient if she doesn't
complete a complicated patients documentation. This entire process is
repeated with each patient.
Observation Three:
Note: For this observation, Wendy Wrenn,
RN was observed during her normal day
of work at the Winston-Salem
Gynecology. Wendy graduated from
Forsyth Tech Community College in 1997
and has been a Registered Nurse for
almost 19 years. One thing similar between
a PA and a RN is that both have to work
under an actual Physician.
Arrival: Wendy arrives to the office around 8am to begin her day. Once she arrives
at work she picks up the copy of the day's schedule and writes mini notes just like
Amy does. One difference is that they do not have an EMR/ electronic medical
record like Amy does at her work. She then listens to the voicemails or reads
emails from the receptionist and jots down important information from those
messages and reviews the messages with the physician, if needed. After this,
Wendy goes over lab results and other reports with Doctor. Finally, the first patient
is at 8:30 am.
First patient: Before patient is brought back, Wendy reviews the patient's
chart checking the last time a pap smear, bone density, labs, and
mammogram were done with the patient and writes down the results so it's
easy for the doctor to glance in one place for the results so he/she does not
have to search for them. If the patient is here for a routine exam/pap smear
and breast exam, Wendy then fills out the lab request for the pap smear to
be sent. She then gets the patient back to go in a room where she takes
their height, weight, BMI, and blood pressure. Wendy also reviews over
their medications and reconcile any changes since the previous
appointment. She asks a brief summary of any issues or problems that they
are having, if any, and instruct the patient on using the restroom to empty
their bladder before their examination with the Doctor. If the patient is
here for a problem visit or talk, she gets the patient back and discusses
what exactly is going on with them and instruct them accordingly. Wendy
then reviews the information obtained with the physician and then help
assists the doctor with the patient. Nurses assist the physician with any
procedure: from Pap smears, endometrial biopsies, colposcopies, breast
exams, STD testing, placement of IUD's, and other various procedures.
This is done by protocol and is illegal not to have a Nurse in the room
during the examination. After the examination is complete and patient
exits the room, Wendy is then responsible for cleaning the room and all of
instruments. This repeats itself numerous times throughout the day.
End of day: At the days end, Wendy restocks and cleans the rooms. She
washes all instruments and put them in the autoclave to sterilize the
instruments. She puts all of the specimens out to be picked up by the lab
courier the
following day. Lastly, she calls all of the patients back from the
voicemails or messages than were left from the front desk, calls in refills
on prescriptions, calls patients with their report results, and fills out prior
authorization for medications and surgery patients. Usually, Wendy is the
last one to leave so; she then sets the alarm and locks the door when
heading out.
Lunch Break: At
Winston-Salem
Gynecology, they
have a short 30minute lunch break,
but Wendy does not
leave the office. In
between patients, she
sometimes calls
other patients back
so she does not have
so many to call at the
end of the day.
Interview
Note: For this interview, I interviewed Wendy Wrenn RN from the previous
observation. Wendy Wrenn RN, has been a registered nurse for about 19 years and
she is also my mother. She works at CareSouth Homecare and Winston-Salem
Gynecology. For our interview, I was not able to meet her in person, so I emailed
Wendy these five questions and she emailed me back her responses.
3. What is some advice you would give someone that wants to enter the
field?
Advice. Make sure you are going into the nursing profession because it is
something that you have a passion for, and not just to make a good living.
Being a good nurse is not just being book smart and collecting a decent
paycheck. It is part of your heart. You must have compassion, empathy,
and patience. You are dealing with human beings, not papers or
machines.
Analysis
Throughout this assignment I am comparing the differences between a Physician Assistant
and a Registered Nurse. This topic is an important interest to me because I am debating
whether or not I want to go to Nursing School or PA school. To be qualified for PA School
one must have a specific amount of clinical hours, shadowing hours, a bachelors degree with
the correct prerequisite classes, and a certain GPA. From observing Amy Berry, PA-C for my
second observation, I learned a gist of what it is like to work as a Physician Assistant and
they are capable of doing. Physician Assistants work under a Physician, they also have their
own patients. PAs prescribe medications, sign off on prescriptions, diagnose patients, and
completing appointments with patients. PAs also spend more time with their patients than a
doctor but, not as long as a registered nurse. The last observation and interview was with
Wendy Wrenn, RN. By interviewing and observing her, not only did I learn what a
Registered Nurse is capable of doing but I also learned some differences between a PA and a
RN. Registered nurses are responsible for reviewing charts, lab results, taking the patients
weight, temperature, and vitals. RNs also spend more time with their patients than a PA or
doctor. Also, registered nurses do not require as much schooling as a PA. They must earn
their associates degree at the minimum while attending nursing school. Both occupations
require clinical experience and shadowing but, physician assistants are of a higher occupation
than a registered nurse therefore. This is because PAs require more educations than a RN,
this is what gives them to diagnose patients and prescribe medications where RNs cannot.
Registered nurses are allowed to make judgment calls but they cannot diagnose. They are
required to tell the patient to ask their healthcare provider to receive a diagnosis.
Chart
Search Terms
Sources
Becoming a
Physician Assistant
Becoming a
Registered Nurse
Physician Assistant
Program and
responsibilities
Registered Nurse
Program and
responsibilities
Interests:
The similarities and
differences between
the occupations
The differences
between becoming a
PA and a RN
Proposal
In todays society of the healthcare field there are many important
occupations taking place, such as a doctor, physician assistant, nurse
practitioner, and a registered nurse. A physician assistant and a nurse
practitioner are very similar in their abilities but they are also different. Both
occupations have their own patients and are allowed to diagnose and treat
their patients, prescribe medications, and other basic things a doctor can do.
A nurse practitioner is basically an overall advanced registered nurse. There
some things a doctor can do than a PA or NP cannot do and when going to
the health clinic, there are patients who tend to think less of a PA or NP
compared to a doctor because of this. There are also discriminations and
ethical disparities and other factors that change a patients view of their
healthcare provider that I am going to discover about as well.