My schedule includes shift-work, thus hours can vary. Outpatient clinics are typically 8:30-5pm, evening call shifts are typically 4pm-12am, and weekend call shifts may be 8am-5pm or 8am-8pm. The schedule is very flexible depending on which staff are on service and where the gaps are in the call-schedule.
In theory I work 37.5 hours per week, though this is often higher in practice. Specific shift lengths vary depending if it is an “on-call shift” (8-12 hours) versus an outpatient clinic shift (8 hours).
My roles include working in both inpatient and outpatient settings. Outpatient clinics are either new consultations, follow-ups or post-operative assessments. Procedures are occasionally done in the clinic (ie, lumbar punctures).
Tracy inserting an external ventricular drain
The number of patients I see a day depends on the clinic I am working in. In outpatient clinics, the PA will typically see between 8-10 patients per day (though the surgeon’s roster will be between 20-25 patients). Inpatient management can consist of up to 25-30 inpatients.
I see a mix of new consults and follow-ups. In the outpatient clinic, it is a mixture of new neurosurgical consultations, follow-ups for non-operative patients (ie, screening for benign tumours, unruptured aneurysms, degenerative spines, fractures) and post-surgical follow-ups.
I do call – typically during evenings and weekends when there is limited residency coverage.
I am in the Operating Room. PAs can function in all clinical domains for surgical patients (inpatient, outpatient, OR) which promotes continuity of care. This is especially appreciated in centers without a dedicated residency program. The PA functions as a first-assist under direct supervision and our intra-operative scope increases as competency is obtained.
I review investigations daily on every patient. Inpatients are categorically more medically complex or acute and will therefore have investigations ordered on an “as-needed basis” depending on clinical status. As such, bloodwork, ultrasound and imaging are frequently ordered and reviewed on a routine basis. Outpatients, however, are typically followed with either clinical reassessment or serial imaging (CT, MRI, X-ray) depending on the medical condition in question.