PA interview questions #2

"How did you like your undergraduate institution?"

Class sizes are typically small, giving you the opportunity to easily interact with the professor and other class members. The MTSU campus is a safe and friendly environment with a diverse student body. The science department opened a new science building of costing about 147 million dollars with the latest technology in research and labs for science classes.

Why biochemistry?

Biochemistry is one of those majors where you'll find that everyone you talk to will say, "Oh, you must be smart," unless they too are in the major. The best reason for studying Biochemistry is that it is the study of ourselves and our chemical relationship with the environment. At the core, it provides the required knowledge for the advancement of medicine and its effects on our biology.

"What do you think about socialized medicine?"

government pays for all aspects of healthcare: all care, employs providers, runs facilities (canada, gb, finland, and spain)

What would you do if a patient adamantly refuses to be seen by a PA?

I actually asked Mrs Lacy, PA in orthopedics and she explained that maybe every year, there will be one or two that will refuse. She explains you let the physician know and let them give the care to the patient. She did explained how refreshing it is though that more and more every year, people would request her as a pa over her physician. The physician was not at the clinic everyday, it was just one of the clinics he owned in the area and the patients preferred having her since they would have to see just one provider through out their experience at the clinic and if they vwant timely, affordable, competant medical care...

What is your opinion on the US and Canadian health care systems? Which is better and why?

I believe Canada's healthcare system is misunderstood. Its not entirely free, Canadians still have to pay for medications, ambulance services and dental. 75 percent is publicly funded but it is delivered privately. Central agency sets standardized fees so wages are low. They do have better life expectancy, lower infant mortality rates, obesity and lower rates of cardiovascular disease and diabetes. However, there are disadvantages due to longer wait times sometimes triples that for speciality. I think at a base level, where necessary primary care should be free. I believe individuals should have the opportunity to obtain private and better care if they are financially available to.

"How do you think physician assistants learn to be compassionate?"

I believe during clinical and from their past patient contact hours, you realize that patients are more than someone who you need to treat, they become relatable, they become something you look forward to coming into work for, you realize that this person could one day be your grandmother in need, I believe that student and PAs learn that placing themselves in the role of the patient in a vulnerable situation to understand what it may feel like.Be genuine when you speak with your patients. If you are insincere, most patients will sense it. Treat patients with the same kindness and empathy you would treat a friend.

"Who is someone that embodies professionalism in your eyes, and why?"

I believe one of the nurses I work with at Saint Thomas embodies professionalism. She always puts the patient first (not sitting down for hours, she will not take break,) she will care for the patient for the benefit of their health even if the patient's views and actions are negative), she communicates effectively with me and coworkers, and I love that she shares her knowledge. She will always offer insight into a patient's condition knowing I want as much clinical experience as i can have, she has the right attitude at heart and its shows in her actions that follow the hospital guidelines

Who is the most important person on the healthcare team?

I believe the patient is the most important part. The PA, doctor, nurse are there to primarily there to help patients feel valued and respected, and by listening and communicating effectively with our patients we can develop a treatment plan specifically around "their" needs. Patients are the center and the most valuable part of the team. It is also important for the patient to feel that its ok to question the healthcare provider when in self-doubt and encourage them to be proactive. There is no hierarchy and the patient has the right to express themselves freely.

Should physician assistants change their name to "physician associate?"

I do see the disadvantages of the term assistant where it may imply ....education level below a masters where medical assistants and pas are sometimes interchanged where does no justice for their advance training, however associate is very vague and nowadays any employee is called an associate and would not describe the job very properly. The public has come a long way to learn assistant and changing it would cause more confusion. May being called a physician extender would be more appropriate but in the long run it does change what we do for patients and thats what important. I believe if the status and title is what is important in the job as a pa, then you are in the wrong field! The patients are reason, not the salary or reputation, people with this attitude would have a hard time going through the rigorous education and commitment.

Should be PA education be standardized to a master's degree?

I do understand where some might have a shorter education due to having tremendous amount of healthcare experience before hand but I believe there should a standardized level of education because a physician assistant's responsibility is the same when providing for the patient. What you provide as a provider the training and education needed for that comes from having academic discipline and balance that comes from years of higher education.

Memorable time at Saint Thomas and teamwork

I had a gentleman who had been admitted into the hospital from a nursing home for a . Every first wednesday night I believe they do a generator test and all the lights would go off for about a 20 seconds. I was in another room changing a patients telemetry box leads while another nurse was in the room giving medication I believe. Once the lights went off one night, I heard the man yelling and his bed alarm going off. I quickly asked the nurse if she could take over the leads and agreed. I saw on his telemetry screen, his heart was in tachy. I raced in and called another nurse and tech inside. When he realized there was a couple of people in the room, he calmed down, I held his hand and shoulder while the nurse helped with his legs and helped him back to bed safely and he explained he thought he was in Katrina again where he had been stuck for days and abused. I quickly explained it was a test and that I would stay by his bedside until all of the lights would go on again. I made sure the nurses and my other CNA knew of the situation. They agreed to keep an eye on my patients. He asked me where I was from and explained that I was kurdish and his eyes opened wide and was very interested. It was the first time I saw him smile and happy. As I was leaving his room I asked if there was anything else I could do before I left. I thought he had responded by telling me to give him good news. Knowing there was no good news, I believe he was being sent to Hospice for cancer, I asked him what he had said. He said " I asked the doctor for a good nurse so they sent me you", (he thought I was a nurse, not CNA) I will never forget that man or his kind words that night. He made me remember why I had became a CNA!

"Is there a time where you witnessed a physician assistant interacting with a patient in a manner you believed to be unprofessional?"

I have always experience professionalism with the PAs, NPs, and residents that come into patient's rooms. I have at time seen you know either the resident or pa come in the room and see that i'm changing the patient and ask apologize and wait outside the door for their privacy. They always are smiling and polite to the patients even with their busy schedules!

What part of becoming a PA and practicing medicine as a PA do you look forward to most? What parts will give you the most difficulty?

I look forward to the smiles and look of relief on the faces of patients and their families I can bring one day after a successful surgery or being able to treat a patient properly after a long journey from not knowing their illness. I definitely want to allow them to feel involved in their treatment plan and allow them to give me the best through communicating changes and observations that can make a real difference in their medical care. I would always encourage patients to bring list of questions and concerns. I want to change the way patients think of their provider, I want them to be able to feel comfortable, involved and have an easier experience. For example its the little things that count, I had one patient who doctor came to just visit and check upon him after his surgery at another hospital, he spent a couple hours of just talking and the patient's confidence and depression from losing his phalanges demineshed.

If you had to be a member of the healthcare team other than a PA, what would you choose?

I only want to be a PA. I have a past as a nursing assistant but I have noticed a cap to my skills and education. I chose to be a PA to expand on this. If I had to choose, I would still be a nursing assistant becuase I enjoyed working with the many patients I have met.

"What is a time you experienced failure and what did you do?"

I played softball throughout high school and during college, I tried out for my university's team. The majority of the girls on the team made it on the roster. Me and another girl did not make the cut for the softball team. I felt extreme embrassment. However, my advisor who was a PA at the university explained that things happen for a reason. He explained that I should go talk to the coach and see where I can improve. I did and she told me that the athletic training department needed assisting in the clinic and that way I could also see how the team was doing and interact with the team in a clinical setting. It was perfect and I do see how sometimes a door closing in a direction might open up to a room to a bigger advantage.

"What do you think of evidence based medicine?"

I think its an important for modern medicine where key to clinical effectiveness & decision making in terms of effects of therapy, utility diagnostic tests, prognosis of disease and etiology of disorders. - determines which treatments should be made available within the NHS. Health Technology Assessments (HTA's) based on the evidence based medicine are generated NICE and other bodies.

"What do you think makes a good leader?"

I think most people are able to give orders but what sets apart a greater leader is emotional intelligence, credibility. People who are in control of their feelings and impulses, people who are reasonable, are able to create an environment of trust and fairness. In such an environment, tensions in the team are sharply reduced and credibility and productivity is high.

"What have you learned in your current job?"

I've learned that life is oh so precious, we tend to take being healthy for granted, Having the opportunity to take care of these elderly patients, and hear stories about their lives and how they came to value the meaning of them, brings a special perspective into my life. I now see that getting bogged down in daily difficulties results in missing out on the absolutely priceless moments and events in life. Additionally, Ive learned I'm mentally tough in an environment that can is unpredictable and easily overwhelming to the average person. Every shift is going to be a collage of feelings. Residents are going to be unwittingly hilarious. Individuals are going to tell you they want to die. You will cheer the smallest successes people have. And how you feel about your actions at the end of the day makes all the feelings worth it.

What is one problem that you see in patient to provider contact?

It can be hard to speak up if the doctor or nurse if perceived to be rushed and ready to move on to the next patient. I believe there should be no sense of a hierarchy in the medical field where the patient should feel as a proponent of their own health care. Many times patients are intimidated, or sometimes bewildered, by the medical world around them. Sometimes they have self doubt questioning the health professionals. We need to let them know that it is okay to ask questions and to take charge of their health. I mean its true we are the experts of the body but they know their body more than anybody else in the world and intuition is a key player. I definitely want to allow them to feel involved in their treatment plan and allow them to give me the best through communicating changes and observations that can make a real difference in their medical care. I would always encourage patients to bring list of questions and concerns.

How has your previous clinical and non-clinical experience prepared you for a career as a medical clinician?

My experiences in college and at work not only prepared me for my career, it prepared me for life outside of my career. I gained skills that cannot be taught in a classroom. Through interactions with fellow students, professors, supervisors, and coworkers, as well as other college staff, I earned a "degree" in people and social skills that I did not even sign up for. Being a medical clinician has much to do with patient interaction and social skills. Being able to comfortably communicate with each patient is very important as a physician assistant.

"Tell me about a time when you disagreed with someone or something. How did you work that out?"

On the renal med surg floor when I was on orientation, I was placed with different preceptors who were to supervise and train me to transition to the floor for a couple of weeks. Before and after shift, the CNAs are to give bedside report on the patients to the next CNA on the shift. I was trained for a with a preceptors that went into each room, introduce the next CNA on duty to the patient and would give the next CNA on duty the report they had on the patient for the day. I was placed with a preceptor for a couple nights and noticed that in the beginning of the shift she would not discuss with the CNA on the previous shift about the patients. She would explain to the CNA that she had them from a couple nights ago and she knew all about them and didn't need report. I asked that she had wrong risks for some patients and she would explain that the charts in the computer were wrong and that some patients were not fall risk or skin bundles. However, the patients were put as fall risk in the charts based on the evaluation from the nurse they were cared for. I was very concerned she might have a fall incident and have incorrect information on the patients. I explained to her that information that was true from a couple days ago can change over night and diagnoses change and order are sometimes put as stat! For example, you could have some go NPO in a matter of minutes if the doctor puts them in schedule for a procedure. She explain she didn't need the report and it would delay her vital rounds. I knew this was wrong even though she was my supervisor. I went up to the charge nurse of floor and explained my concern for the patients. I believe the managers had a discussion with her and I now see that she does bedside report now for every patient on every shift. I always try to make sure she gives me the report throughly.

Tell us about a time when you had a conflict with someone who supervised you, and how you handled it.

On the renal med surg floor when I was on orientation, I was placed with different preceptors who were to supervise and train me to transition to the floor for a couple of weeks. Before and after shift, the CNAs are to give bedside report on the patients to the next CNA on the shift. I was trained for a with a preceptors that went into each room, introduce the next CNA on duty to the patient and would give the next CNA on duty the report they had on the patient for the day. I was placed with a preceptor for a couple nights and noticed that in the beginning of the shift she would not discuss with the CNA on the previous shift about the patients. She would explain to the CNA that she had them from a couple nights ago and she knew all about them and didn't need report. I asked that she had wrong risks for some patients and she would explain that the charts in the computer were wrong and that some patients were not fall risk or skin bundles. However, the patients were put as fall risk in the charts based on the evaluation from the nurse they were cared for. I was very concerned she might have a fall incident and have incorrect information on the patients. I explained to her that information that was true from a couple days ago can change over night and diagnoses change and order are sometimes put as stat! For example, you could have some go NPO in a matter of minutes if the doctor puts them in schedule for a procedure. She explain she didn't need the report and it would delay her vital rounds. I knew this was wrong even though she was my supervisor. I went up to the charge nurse of floor and explained my concern for the patients. I believe the managers had a discussion with her and I now see that she does bedside report now for every patient on every shift. I always try to make sure she gives me the report throughly.

"What is the worst book you have read?"

The Giver - utopia, jonas shows that we need to feel hardships to enjoy the good, love the amount of sacrifice done in the book

Memorable time at NHC

The time that sticks with me the most is when we got a homeless gentleman in with bladder cancer recently admitted. He was a veteran and was having a hard time getting situated in life. I noticed he had a the small bag of clothes with one pair of socks, jeans with holes, and a couple shirts was all he had. We all pitched in and the nurses on our floor ended up getting him a couple suitcases full of new clothes and some warm winter clothes as well. I helped him get shaved and showered. In his new clothes he looked like a new man. He was very grateful for everything we did for him. The look on his face when he woke up and found the clothes was priceless. The social worker ended up getting him help with his living situation also. Helping people is why we do this job. I'm very proud of the coworkers on first floor for all pitching in and making a difference in the man's life.

Why UT?

There are several reasons I want to go to UTHSC PA program, and they all have to do with the structure of the learning that takes place here. I've read about many programs and yours seems progressive in its curriculum. The online resources for learning physical examination, for example, show me how hard this program has worked to keep current and to evolve with medical technology. I want to attend a school where what and how I am taught really matter to the faculty. The fact that many of the courses are taught in small group seminars tells me that student interaction and relationship with faculty is a priority. With that, I know that I won't be just a number. I love that as a student I will have the opportunity to put my new knowledge to use right away by working in student-run programs like Clinica Esperanza in downtown Lexington. I've worked at community clinics in Kentucky already, and that emphasis on helping the Latino community is refreshing to me!"

"What is the biggest problem in health care right now?"

Too much unnecessary care (receiving an MRI when not needed), Its costs, primarily, its universal access which the ACA or the ObamaCare tried to get out by having it a mandate that people have insurance. And so I would say access to care, it would be cost of care, and how much care do we consume. One of our sessions is how do we care for aging population. It's just a huge challenge for us when we have about 70% of health care costs are spent in the last six months of life. Now, forgive me for the details on that. The point I'm making is we spend way too much for what seems like futile care, not really extending quality of care but just a few months. A physician I spoke with concerning a hospice patient explain this to me that It's been said that we delay death, not continue life

What is the most important factor between a PA and his/her supervising physician? Why?

Trust and communication. They go hand in hand honestly. If someone lacks communication, how can you trust their decisions and actions.

"What was a mistake you made and what did you learn from it?"

When I first started working at Saint Thomas, I had a patient who was staying at the hospital for quite awhile till they had fixed her insurance to send her to rehab. She was incontinent and a skin bundle and used a bariatric bed for that. She was very obese and hard to turn. For a couple weeks, I would turn her for bed therapy and change her brief all by myself because the other staff would be busy with other patients for the majority. My back started hurting very badly and the charge nurse asked why I was in distress after coming from the room. She quickly explained that I should always ask for help even if they are busy. She showed me slide sheets we have in the supply room and that made the job a lot easier to pull her up in the bed as well. I learned that there are ways to work smart and not hard. You do always want to give your patients the best care but also keep an eye out for your health as well.

What are three things you want to change about yourself?

When interacting with a patient, I've come to realize its basically socializing, there are times at work that there some patients that you will connect to right away and you will be in the room for a long time without realizing the time! So I definitely try to keep an eye on the time now and manage my tasks during my shift to allow some extra time to visit and interact with my patients. I can't let my enthusiasm and drive alienate other patients. Additionally another weakness is i would dwell too long on evaluations and criticism, I've come to realize that success is not achieved on the first attempt, in order to learn and improve you must be able to accept and use the criticism as an advantage to fix what is wrong.

"What was the hardest class you had and how did you overcome it?"

my hardest class was probably organic chemistry. i was in the process of acquiring a visa for my husband to come to america where he had to go to the baghdad embassy to gain his visa. the place was very dangerous at the time. in addition i had started organic chemistry. The class required a different thought process. mastering the different reactions and mechanism was different than other science classes, you couldn't just memorize them! I was able to obtain an A in both semesters of the class because I was able to create a plan to be successful. Staying after class and reaching out to the professor helped tremendously because the professor was able to show different resources such as ball and stick models and simulations online. I was able to master the class by learning visually, i realized the reactions required critical thinking and each had their own preferences similar to how people do. I kept a study schedule and created a study group, where talking it out to others and teaching what I knew created the confidence that i used to study through chapters and achieve my A in the end. Since the class, i know the difference between studying hard vs studying smart. Since then I have been able to take heavy academic load in addition to working by having the skills to manage time and studying efficiently.