Not even going to try to hide it, I was terrified about my Emergency Medicine (EM) rotation. Why? Besides our didactic course, I had no experience in it prior to PA school (all my patient care hours were in family medicine/primary care). My EM rotation was supposed to be towards the end of my clinical year. But, when my first rotation fell through (this happens often), my schedule got switched around & there I was…going into my first clinical rotation in the Emergency Department. Eeek! In hindsight, being in the ER my first rotation was a blessing in disguise.
The weeks leading up to it, all I could tell myself was “It’s only 6 weeks. I just have to get through it.” I knew I would learn so much medicine, but I would also picture myself fainting or freezing at the sight of a motor vehicle accident (MVA), trauma, etc. Luckily I didn't faint, ha! And, once in the ER, running a code, intubating, suturing….I LOVED it! I found myself looking forward to each day & the rush of being in the ER.
Prior to my first shift & throughout the rotation, I spent hours reading, working up differentials for common complaints, learning dispositions, and listening to podcasts. Below you’ll find what worked for me & also amazing advice from Josh & Mike, two fellowship trained ER PA-Cs. I wish I had their advice prior to starting my own rotation! Be sure to check out their blogs about this too
If you’re scared about EM (like I was)…just breathe, take a moment to process everything, and keep on reading. Trust me, you’re way more prepared than you think!
What is it like?
I spent most of my rotation in the main ED, with little to no time in the fast track. I was also at a stroke/STEMI center in the middle of downtown Los Angeles, so we were busy! ER’s are noisy, and anyone in the ER will tell you that you come to embrace the constant beeping of machines, yelling, and running in the hallway. Controlled chaos. If you feel out of place on the first day, this is normal. It gets better with time.
I usually worked four 10 hour shifts, or three-four 12 hour shifts. The majority being early morning (4 or 5 am starts) or night shifts. No matter what, they’re long shifts. Invest in some comfortable shoes and/or compression socks. Also, if you’re doing night shifts, earplugs, dark curtains, and eye covers go a long way! Coffee/tea also isn’t a bad idea!
By reference books, I mean they’re slightly big to lug around
Books that fit in your white coat pocket:
I have mixed feelings about pocket resources, mainly because there is very little time to open up a book & look up a topic during your shift. I did carry either one of these around & came in handy a couple times but these were mainly used these as a means to solidify/review info for my end of rotation exam. They're straight to the point, so I found it helpful. Take a look at these if you're interested
What I carried in my white coat pocket every shift:
"Top Tips to Crush your EM rotation"
by: Mike G. & Josh F, fellowship trained ER PA-Cs
On Instagram: @PAlifeinEM
Alright, that's all! Let me know if this helped you on your rotation!