First thing in the morning I’ll meet with the Charge Nurse and my supervising physician to discuss any new admissions or developments overnight. We will come up with a loose plan for the day (who will be transferred, discharged etc.). Our patient list is divided up and assigned to either myself, a learner, or the staff physician. I then assess and create a plan for the patients assigned to me; which involves history, physical exam, reviewing investigations, and preparing order sets. By late morning we do bedside rounds as a team where my role is to give a case presentation with plan for patients assigned to me. At rounds I also give input for patients assigned to other team members. After rounds there are often new admissions consults to do. Other daily responsibilities include: documentation including dictations, handover patients to receiving physicians, assist procedures, update patients and family, following up on results or response to therapy.
In our department the Internal Med PAs work 8, 10, or 12 hour days. The shifts are designed to extend into the evening to cover peak times for consult and admission. Our IM PAs work weekends. On average it works out to be 40 hours a week. There are no nights, and no true call.
The patient population I encounter ranges from hospitalized patients who are stable and feeling well but requires monitoring, to critically ill requiring resuscitation. North Bay also serves Francophone and Aboriginal populations.
We are a community hospital but also a teaching site for Northern Ontario School of Medicine. I work closely with residents and medical students as they rotate through CCU for their Internal Med blocks. PA students are rare, but there has been one or two shadow me for a day (one of whom ended up coming to work with us).
Our hospital also has two excellent Nurse Practitioners. I rarely work directly with them as we are involved in caring for different patient populations.
I have developed skill in bedside ultrasound, and continue to improve in this area. There hasn’t been a need for the PA to do invasive procedures due to excellent support from our Interventional Radiology and Anesthesiology colleagues.
Fall at North Bay Regional Health Centre