Physician Associate Student Guide to Ward Placements
Tuesday 23rd April 2019
My experience as a PA student was that we were given 16 weeks of teaching then thrown into the hospitals on placement to try and put theory into practice in a world where colleagues often did not know much about my role. I think it would have been helpful to have some insight into the general workings of wards and advice and tips on how to get involved more with placement.
Ward rounds give you an opportunity to identify whether the patients you are seeing have interesting signs- e.g, heart murmurs, clubbing, wheeze/ crackles on the chest etc. You can ask medical staff/ nurses if it is ok to go back and take history/ examine these patients. It isn't always appropriate but most patients are happy to talk. Doing this will make your learning experience much more productive, make you much more prepared for when you are qualified and help you in the dreaded national OSCEs where you will see real signs and symptoms. Remembering the patient on placement with AKI/ AF/ Fractured NOF (for example) will more likely stick in your head than a textbook definition of management.
As a student, I found that acting as if I were the junior on that ward round helped me. So I would make a job list for each patient. If I identified jobs that I could do, I would help with this. Sometimes, this may not feel beneficial to your learning but it will help with the transition into qualifying. For example, talking on the phone to radiologists/ microbiologists/ specialities can be daunting even when you qualify. Getting used to this as a student will help your confidence as a qualified PA.
Try to engage with what is happening with each patient. Pay attention to the clinical situation and senior decision making as this will help you formulate plans for your own patients in the future.
Your area may not have handover within your placement hours. However, if it does, attend it! Attending handover gives you a wealth of insight into what is happening on the ward. You will find out about sick patients, get a chance to introduce yourself to the team and make yourself and your role known to the masses!
There are certain clinical skills that become impossible to get signed off. For me, it was blood transfusions and catheters. In this area, the nurses are your friends! Make nursing (and medical) staff aware of skills that you need to practice, so they can alert you to potential opportunities.
Turning up to placement is mandatory. You need this time in clinical practice to ensure you are safe on qualifying. Turning up late to placement is not only unprofessional but gives the impression that you are not interested in the role. Of course being late is inevitable from time to time, but let someone know as if you are an employee.
Like many things in life, effort will lead to reward. Some placement areas may take on students with uncertainty on whether to hire PAs. Working hard and acting professionally may lead to a role being created. You are your own job advert. Quite a few of us North West PAs ended up being employed after our placement area were impressed by PA students and realised the benefit of a PA. Keep the flag flying!