"Elliot Hospital, Elliot hospital, AMR 2 coming to you with a status 1 patient how do you copy?"
"This is Elliot Hospital, go ahead AMR."
"Coming to you with a trauma activation for a patient involved in a high speed MVA. Patient was unrestrained, driver found outside the vehicle with multiple injuries, rapid pulse with shallow respirations. Currently has a GCS of 3, in full spine precautions, IV established with fluids wide open, working on a second line, Vitals as follows" ... "2-3 minutes out any questions or additional orders?"
"No questions, Trauma Room 1 on arrival Elliot out."
"ALS 2 clear, Thank you"
The Emergency room sprang to life, the PA [Physician Assistant] I was shadowing looked at me with one simple question "want to go in?". I nodded emphatically as she got up from her seat to immediately offer her assistance to the trauma surgeon preparing in Trauma Room 1.
An ER that had otherwise been quiet at two thirty in the morning, suddenly became a hub of action, all centered around one room. I stood behind the red tape line on the floor, hands in my pockets, afraid to get in anyone’s way. Even if I was in the way, I'm not sure anybody noticed me there. Everyone walked right by me with such calm determination, as if this was just any other day of work; and, I suppose for them it was. The patient arrived and was transferred onto the bed. The players in the room all knew their part. The choreography of the moment was profound, each person moving from place to place as if pulled by strings.
The truth is there are a lot of very good reasons for why I decided to go to PA school. More autonomy, the ability to use the knowledge I gained from being a medical assistant, the ability to touch people and help them every day, not to mention a stable career field and a million other very logical and legitimate reasons. All this aside, that moment in the ER is when I knew for sure that I was on the right path.
Amongst the chaos there was a level of intensity and organization that I have never seen before. From the doctor at the head of the bed trying to establish an airway, to the nurse wrapping the patient in warming blankets and attempting to get a pulse-ox at the foot of the bed, every person in that room had a job to do. I yearned to be part of that, a part of the struggle to save a life, to be part of that fight.
I would like to say that this story had a happy ending, that the patient made it, and like in a sitcom, I was there to watch her get wheeled out of the ER to the loving embrace of her family members. Instead I saw her whisked up to CT once she was stable enough to send. It wasn't until the next day, while watching the news, that I learned her injuries had resulted in her death. I won't say that didn't affect me, or stop me in my tracks for a brief moment, but there was a definite solace in the fact that I knew with one-hundred percent certainty that all of the people in the trauma room that night had done absolutely everything that could be done for her.
Our lives are made up of little moments like these, where we can see with crystal clarity what the meaning behind them is. Moments when we know with absolute certainty that we are in the right place at the right time.
What do you think makes a person whole? I think it is the ability to recognize how profound these little moments are, and to take them with us. The sum of these parts is what I believe makes us whole.
Without this experience at my job shadow I would never have known how deep my desire to be a PA ran. Even seven years ago when I completed my medical assisting program and decided to continue on for my bachelors, I couldn’t have told you why I wanted to do this. Why I wanted to work full-time, go to school part-time at night, and spend hundreds of thousands of dollars on an education, all while raising a child as a single mom, was an enigma to my family, friends, and sometimes even myself.
This desire to become a PA took on a life of its own, evolving and changing as it grew. At first it was about the challenge, the studying and late nights were a thrill, but once I was working as a Medical Assistant this morphed into a real love of helping others; watching patients who were once in pain on a daily basis walk out the door from their last follow-up visit was undeniably gratifying. All this considered nothing compared to my experiences in the ER that night, or equally in the OR on occasion.
I was given the fortunate opportunity to shadow two PA’s who are both extremely knowledgeable, but that is not even their strong suit. They both knew how to talk to patients, a skill that I think is possibly the most difficult to refine and the most vital in the medical profession. On multiple occasions I watched both PA’s go into a patient’s room and change the tone with just a few words. A patient who required a pelvic exam after a possible miscarriage was put at ease by my supervisor Lauren Fournier, PA-C. The fears of another patient, who was confused about why he required a nasogastric tube after surgery, were alleviated by my OR supervisor Megan DeSantis PA-C, who explained to the patient in simple terms why he required this device.
This ability to teach patient’s without causing more fear, or distress is something I have worked on for years as a Medical Assistant, but until this job shadow was never able to watch others do. This requirement to watch quietly and learn was priceless.
I am so pleased that UNH Manchester requires this capstone project as part of the Biology program. This experience was and will continue to be a valuable part of not only my experience here as a student, but also going forward in my application to PA school, and eventually in my own career. I can never say enough about how well prepared I was for graduation, and I owe quite a lot of gratitude for the format of my senior year.
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Marialaina Abbene graduated from the biological science program at UNH Manchester in December 2013.
