Work Experience: Part 1

Perhaps one of the biggest parts of my preparation for PA school was gaining work experience in health care.  Most schools have a minimum requirement for hours worked in direct patient care before they will even consider your application.  And even though some schools don't "require" patient care experience, you can bet that they aren't taking applicants that don't have it, especially when you consider just how competitive the applicant pool is.  Volunteer work doesn't cut it.  They want to see that you've been in the trenches with patients.  So, experience as a nurse, EMT, CNA, RT, MA, surgery tech, etc. is not recommended, it's a necessity.

The process for gaining said experience must be set in motion long before you even think about filling out any applications.  Firstly, you have to decide where you are going to work.  All of the jobs above require (at the very least) some sort of technical certification.  Others require much more intensive and lengthy education.  Then, for the most part, a competitive applicant will have roughly 2000 hours of direct patient care in a paid position.  That's comes out to 1-1.5 years of full-time work.  For those that can't work full-time, it would obviously take considerably longer.  So, needless to say, one doesn't decide to go to PA school on a whim.  It takes a certain amount of foresight.

Anyway, why am I telling you all this?  Because this quest for patient care experience has been a huge part of my life for the last 3 years as I worked as a Certified Nurse Assistant.  Never in a million years did I think that I would be working as a CNA.  Old people and nursing homes used to freak me out when I was younger, and this is the population with whom the majority of CNAs work.  It has been the hardest, yet most rewarding, job that I have ever had.  So, I wanted to share some of my thoughts and experiences about my time as a CNA...before I move past this phase of life and on to something new.

My first job as a CNA was here.

Courtyard at Jamestown

 Jamestown is a pretty swanky 100+ room assisted living facility with a 20 bed Enhanced Care (Alzheimer's) wing.  This place also introduced me to new levels of sleep deprivation as I worked the graveyard shift and went to school during the day.  I distinctly recall during my first week of work here, looking down at my notebook in class one day and seeing my writing gradually get less and less legible until it ended in a big squiggly line down to the corner of my page.  I didn't even remember falling asleep.
There are sooo many things that I will remember about this place.  Jamestown is a pretty big facility.  It's three floors of rooms.  At night, there would only be 2 CNAs working the entire Assisted Living side of the building.  Nobody else.  And, at night, when the lights are turned down low, this place is eerily reminiscent of the Overlook Hotel from The Shining.  Every now and then, when I would walk around the third floor doing rounds, I would expect to turn the corner and see a set of dead twin girls staring at me from the end of the hallway.  Never happened, but it was still creepy.
Perhaps my funniest experience at Jamestown happened on my first day.  My trainer (the amazing Derek Figuerres) was taking me on a tour after we had finished our work on Assisted Living.  We came out of a stairwell onto the Enhanced Care unit and I had my first introduction to B.*  B was walking the halls wearing nothing but a button down shirt and an adult diaper on his head.  When we asked him why he had a brief on his head, he told us that it was "a mighty fine hat."  Couldn't argue with that.  Needless to say, B and I became quick friends.
Or how could I forget V, one of our resident somnambulists?  That lady had some serious ninja skills.  She wasn't fast, but somehow, you could look over your shoulder at a deserted corridor and then turn around 3 seconds later and she would be right behind you.  Never figured out how she could do that.
Perhaps my most significant/profound experience as a CNA also came while working here.  Mrs. B was suffering from Alzheimer's.  It must be a terrifying disease to have.  You have to understand, these people often have no idea what year it is, where they are, who you are, or what you are doing.  My job at night was to round on our residents every few hours to check on them and see if their briefs needed changing.  Now, imagine you are sleeping in what you believe to be your bed in the house you've lived in the last 40 years, and somebody comes into your room and starts asking to check your pants.  I think I would be less than compliant.  But this is what many of the residents were likely dealing with.  And night after night, they would have to relive the same experience.  So, needless to say, Mrs. B was one of our more...reluctant residents.  She would often dig her nails into your arm as you tried to care for her and would most certainly cuss you out for your efforts.  Well, after a few weeks of this, I began to put myself in her shoes.  Tried to see the world as she must see it.  And I changed my approach.  I started to open the door to her room and make more of an effort to announce my presence and ask for her permission to enter.  Then I would take the time, each time, to tell her who I was, and what I was doing, and how she didn't need to be afraid.  Slowly, Mrs. B became more and more compliant.  She stopped scratching me.  She stopped cussing at me.  She even started helping to roll from side-to-side as I cared for her.  Then, one night, an unexpected thing happened.  After I had finished cleaning her up, I told her goodnight and thanked for letting me help her.  And just as I was closing the door to her room, I heard her say, "Thank you."  Mrs. B confirmed for me that night why I had chosen to enter health care.  Those two words changed who I was as a caregiver and will forever direct how I approach my patients.
There are so many other experiences from Jamestown that I could write about here (watching fireworks from the roof, Fresh Prince marathons, postmortem care, lots of first-aid, diarrhea, watching a person and thinking they're going to die right there in front of you, and many more).  But that would get to be a pretty long and boring blog for many of you to read, since many of those events only hold significance for me.  The most important thing that could be said about Jamestown though (and especially my time working with Alzheimer's patients), was that it taught me how to communicate with patients.  (This sometimes requires a lot of creativity).  It taught me that being sick or disabled can be a very scary situation, and that all patients, no matter what age, just need a little reassurance sometimes.  Jamestown taught me how to navigate stressful, sometimes frightening, situations on my own or with little support.  But, what I will remember most about Jamestown are the people (residents and coworkers alike) that were involved in my first experience in healthcare and how they shaped me into the provider that I have become and will continue to be in the future.


It's late and I'm realizing just how long this post is becoming, so I'm going to go ahead and break it up into two parts.  I don't want to bore you all so badly that you don't come back ever again.  So, the second part to the account of my experiences will come in the next couple days.  Thanks for sticking with me.



*Full names have been omitted for privacy reasons.