This one is for my fellow qualified PAs out there!
It's easy to get stuck in a rut at work. Specially during these time when off-ward opportunities might be slim, it can be helpful to know where to look for new skills and responsibilities. Here I’ve given you my story, which isn’t very clinically exciting and doesn’t represent everyone’s options, but will hopefully give you some idea on how to get more out of work.
I've been working in Cardiology for over 2 years now (where has the time gone?!). During my first year I was mainly ward based which gave me the time to learn about the department, how things get done and the types of patients we see. After that, my supervisor suggested shadowing some echo clinics to learn how to do some basic scanning. Although this was great and I did learn, our tertiary centre already has a highly skilled echo department which deals with the inpatient and outpatient requests. So it wasn't a skill which I would be able to keep up competence without at least Level 1 BSE accreditation and having a regular clinic which didn't make sense for the department.
I knew I wanted to do something more than just my ward based jobs. I started looking at whether advanced skills could be useful in Cardiology. Now the cath labs are full of exciting activity day in and out from primary PCI to pacemaker insertions to ablations. But they are high level specialist procedures that require Consultant and Registrar input. It is not something a PA could realistically do and I've been told as much by my supervisor which is fair enough. I realised that there aren’t many advanced skills that lend themselves to Cardiology to do regularly enough and maintain competency (if anyone knows or has any ideas please send them my way!). I did look at PICC lines/long lines for our infective endocarditis patients, but need to make sure we have enough coming through to keep up competency.
Next I looked at what extra responsibilities I could take on that would be useful to the department. Last summer, new management came in and started an on-call junior rota that would cover weekends and long days during the week. Our team grew and one of the managers was put in charge of doing the rota. Unfortunately this didn’t work very well because they had little time and didn’t have the clinical insight to manage it. This quickly became a problem because of the mixed skillset in our team i.e. prescribers and non-prescribers amongst other factors. It ended up causing a lot of frustration and tension in the team.
In the end, I approached my seniors and asked if I could take over the role given that I knew the department well and understood the needs of the different clinical areas. Since January I have been the junior rota master and it has been working out well (I think so anyway!). It does have its challenges at times but I’m a control freak so it allows me to channel that energy in a way that helps the team and the department. I wasn’t given any time at work to do the rota but I discussed this with my supervisor and now I have protected time once a week.
It was actually at my appraisal that I discussed the above with my supervisor. My aim for the meeting was to negotiate a day off the ward to have as a ‘personal development day’. Since skills/cath lab didn’t seem like a viable option, I opted for clinic time instead. My supervisor is an cardiac interventionalist. This means she her sub-specialty within cardiology is diagnosis and treating cardiovascular disease by performing coronary angiograms and intervention such as angioplasty and stenting. She agreed to have me join her in clinic on a Thursday afternoon to see patients in a parallel clinic to hers. We had this meeting in early March just before Covid properly broke out so these plans have been put on hold until clinics are properly up and running again.
So now I had Thursdays as my day off the ward for personal development. My afternoons were sorted in clinic but my mornings were still a bit lacking. Although the rota is tough to sort through, it doesn’t take a whole morning each week. So next I set my sights on departmental teaching. I’m not sure why, but we've never really had proper departmental teaching… And it was something I had seen before on placement in other departments and even when I worked in Renal. It was that time of the week you looked forward to because you could count on free food and the satisfaction of learning and revising things you’d forgotten about.
After getting the go-ahead from my seniors I’ve reinstated lunchtime teaching once a week which is usually provided by a Consultant or Reg. The meetings are currently sponsored by a rep virtually and the food is delivered straight to the hospital to avoid unnecessary visits to the hospital. I’m pretty much booked up until October which is great. I’ve enjoyed the logistical side of it, rounding up people to teach, contacting different reps – I was worried about this but they’re actually so willing to sponsor so use them people! We need feeding to fuel all that knowledge after all…
So while I don’t assist in theatre or know how to insert drains or lines, I’ve had to think outside the box and take on non-clinical responsibilities. These jobs suit me because I’m more inclined to the managerial side of the role. And hopefully I get to start taking part in clinic soon which will provide the clinical satisfaction too.
Here are some tips that can help you no matter what speciality you’re in:
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