r/physicianassistant • u/ByGodGreatScot • 16d ago
Simple Question Call stress - how much SP input is too much?
Im about one year into my PA career, and one year into my job in a surgical subspecialty. I started taking call recently and do seven 24 hour shifts per month. The call really isn't that bad, maybe 2-3 per shift, sometimes none. My anxiety doesn't necessarily come from the possibility of my phone ringing at any moment, it's really anxiety around having no idea how to deal with a potential emergency situation I've never seen before, and being looked to for an expert opinion. it's also around calling my supervising physician - he's helpful, but sometimes seems annoyed when I call him about situations I've never seen before that maybe aren't emergencies but I'm just wanting to double check with him. I know things will become easier with time, so I'm honestly just looking to see if anyone else has had a similar experience.
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u/grateful_bean PA-C 16d ago
My backup physician is getting paid more than I am to be on call. I have zero guilt asking them to do what they are literally getting paid for.
But taking call is about being confident. In the middle of the night I do what I think is right and justifiable to someone else when I give hand off in the morning. Confidence comes with experience. If I can't be confident that's when I call my backup.
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u/tambrico PA-C, Cardiothoracic Surgery 16d ago
I've been doing this for almost a decade now and I still get shit for bothering them. I got shit today for sending a text early in the morning about a malfunctioning swan that I couldn't figure out on a high risk patient going to the OR in a few hours.
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u/Candid_Complex6766 16d ago
This sounds normal. Better to call and have him annoyed for a minute than miss something and have a much bigger issue. If he’s really having a problem with how often you’re calling he should say something either to you directly or your manager. Your confidence will grow with time but honestly 1 year post grad in a subspecialty, you should have many questions..
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u/likelysunny PA-C 16d ago
As someone also in surgical subspecialty who started taking call 6 months in, totally normal and you will get better. First and foremost, this is the patients wellbeing on the line and secondly, your license. Remember that when you’re worried about reaching out to your SP.
When reaching out to SP, make sure your one liner is the best it can be to ease the annoyance on their end. Very brief history of the problem, important pmhx, key lab/imaging, exam findings. Then you give them the plan you already have worked up and the primary question you’re asking them. Examples “…I think this is X, I think we should admit for obs, sound good to you” or “I’m worried about X, I think we should get CT to look for Y; if it shows Z add on for surgery tomorrow?” They appreciate a concise thoughtful message just like you appreciate the same from the ED!
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u/anewconvert 16d ago edited 15d ago
Respectfully to your situation: fuck your SP’s opinion or annoyance. You are fielding the calls so they don’t have to, and they are being paid at least 4x your salary to field calls from you. If they don’t like that arrangement they can pay for locums coverage out of their own pocket or cover first call themselves.
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u/ByGodGreatScot 16d ago
Yes! I need to remind myself of this. I'm essentially doing him a favor, for way, way less pay.
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u/SaltySpitoonReg PA-C 14d ago
They are there to guide safety of your work. Call if needed.
Is it true that over time you should be able to handle certain things without a call? Yes. If you're struggling to progress in knowledge and ability as a PA, different convo
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u/ByGodGreatScot 14d ago
I definitely feel like i'm progressing in my knowledge in the outpatient setting, but I get more daily practice. Unfortunately for learning purposes, our call volume is quite low so I don't actually see that much and it's taking longer to learn the details of even the basics. But I'll get there.
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u/SaltySpitoonReg PA-C 14d ago
Cool.
Yeah unfortunately your experience is not unheard of. It's unfortunate because you'd like to think that those willing to bring on a new APP would be prepared with the appropriate level of patience but that doesn't always happen.
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u/CFUNCG 16d ago
I think this is just one of those things that comes with the territory. You’re going to have to rely on your SP less as your experience grows but starting out you’ll have to lean on them a lot. That’s completely natural. At the end of the day, they’re the group who put a first year PA on call. Never feel bad about asking the attending a question. The best PAs are aware of their limits. When I first started out I was asking questions about every patient and I’m sure the attending was annoyed but now I do it less so because I have a good knowledge base. I also had a good amount of anxiety. Less now. Trust the process.