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Physician Assistant school CASPA Narrative: From EMS to Physician Assistant



dillinjl 1 / -  
Aug 3, 2013   #1
Any feedback would be greatly appreciated. I've chosen to lead with a compelling story with the hope of standing out from other essays that may read more as bullet points as to why they are the prefect candidate. I feel like this story really answers the prompt and shows my motivation to become a PA.

writing prompt:
In the space provided write a brief statement expressing your motivation or desire to become a physician assistant. Keep your statement general as the same essay will be sent to all schools you will apply to. Your statement must be written in your own words and may not exceed 5,000 characters (not words).

My narrative:
"Priority 2 call to the town of Brattleboro. This will be 980 Putney rd. for a 26 year old male patient, severe abdominal pain, nausea." The call comes over the speaker, followed by a loud siren, disrupting my morning routine of checking the truck for supplies. "Dispatch, this is Rescue Inc. A2 responding to Putney Rd." I reply, as the diagnostic wheels start turning in my head. My heart rate quickens but I take a deep breath, remembering the importance of being a calming influence in the presence of fear and anxiety in others. Abdominal pain: which quadrant, onset, quality of pain, does it radiate, severity, length of condition, allergies, medications, changes in diet, medical history; these are all questions needing answers to develop a picture of possible conditions.

As we enter the dimly lit conference room of a telemarketing office, I see our patient doubled over in a black desk chair on the right side of the conference table clutching his stomach. He flashes a smile placing his hands on the arms of the chair, as if to say he is in no pain, as he sees me draw near. His attempt to hide his discomfort fades quickly as his grin turns to a grimace and his arms snap back to his stomach; a lightning bolt of pain shoots down his midsection. He is a large man with a bodybuilding physique. As tears well up in the corners of his eyes he makes a point to say he has a very high pain tolerance and feels embarrassed that he asked his boss to call us. I feel gratitude for being allowed to share this genuine moment of uncertainty and pain with him. As I cycle through my medical assessment the pieces start to fit together like a puzzle. The discomfort started an hour ago, first with a dull ache in his upper right quadrant, graduating to intermittent sharp pain in the lower right quadrant. He then developed severe nausea, regurgitating the contents of his breakfast, proceeded by dry heaves. The patient has no related medical conditions or history of surgery.

We are in the ambulance now. I palpate the patient's abdomen trying to determine the origin of the pain. Beginning with the upper right quadrant I work clockwise. As I reach the lower right quadrant I push down firmly, hold, then release quickly. He moans indicating rebound tenderness; I nod knowingly. His forehead scrunches in a show of anxiety and apprehension, he asks me what I think is wrong. At this point I have a good idea of his condition. It gives me a feeling of fulfillment that I am able to relieve some of his stress by providing insight into what is happening with his body. "Well, I don't have the ability to make a diagnosis, but you have textbook symptoms of appendicitis." It bothers me that I must stop at this point; that I am not able to offer a diagnosis and my involvement in his treatments ends here. As an EMT I have reached the ceiling of my ability. I can tell a patient I think their wound will need to be closed, but I cannot apply the lidocaine and insert the sutures. I can tell a patient that the "heartburn" they have been feeling could actually be a blockage of coronary arteries and could lead to myocardial infarction, but I cannot order the tests or make referrals to specialists. EMS has shown me that patient care is my passion and that I want to be involved on a more in-depth level.

Working in EMS, it is striking the number of patients I see with treatable or preventable conditions that end up requiring ER visits do to a lack of PCP availability. As an EMT I am aware of the importance of preventative care, and look forward to working as a primary care provider to ensure more patients in my rural community receive the care they deserve. Since graduating college I have made it my purpose to work in small communities with underserved populations. I have volunteered with AmeriCorps in Montana, worked with at-risk youth in North Carolina, and worked at a methadone clinic in Vermont. Having the opportunity to shadow Peter Durling, PA-C has given me great insight into the role of a PA as a member of the healthcare team, from his interactions with his patients to his teamwork and collaboration with the physicians. I've also had a chance to see some of what Pete refers to as the "less glamorous" side of being a PA: the paperwork and stress of meeting patient quotas to make things financially viable.

As our country faces great shortages in primary care providers, especially in rural environments, I see the position of Physician Assistant filling this void. There is a trend of primary care being transitioned to mid-level providers and that is where I want to position myself. Becoming a PA will allow me to expand my scope of practice and provide valuable medical services to patients with limited access. I think my commitment to rural and underserved populations, and my desire to provide primary care makes me an excellent candidate to become a physician assistant and fill a crucial role in our healthcare system.



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