A Day in the Life of a Critical Care PA
Kristen Young is a Pulmonary Critical Care Physician Assistant at Norton Audubon Hospital in Louisville, Kentucky. Kristen has been a PA for 14 years and has extensive experience in acute and critical care ranging from Pulmonary ICU, Cardiothoracic Surgery, Hospital Medicine, and Emergency Medicine. She has also been an Adjunct Professor at Sullivan University’s PA Program for 6 years. She is passionate about critical medicine as well as PA advocacy and education. In the Intensive Care Unit, she plays a crucial role in ongoing critical patient care including rounds, admissions, responding to codes, as well as performing several advanced procedures including intubation, placement of chest tubes, central lines, arterial lines, and temporary dialysis catheters. She also has specialized training with VADs (Ventricular Assist Devices) and ECMO (Extracorporeal Membrane Oxygenation). Because of increased ICU admissions during the pandemic, the need for well-trained Critical Care PAs has become even more significant. Kristen is a true role model and champion of the PA profession. She is dedicated to patient care in collaboration with the healthcare team and is a shining example of the extensive roles PAs play in healthcare.
Read below for a day in the life of a Critical Care PA…
Walking into the hospital, I never know what might be in store for the day. I enter the ICU by 6:30 a.m. to meet up with my night shift partners. My shift begins by reviewing the overnight events in the unit. I am always hopeful for a good report, but many times an emergency jump starts the day.
One morning, the emergency room physician called me to assist with a resuscitated cardiac arrest. This patient was extremely hypotensive with no IV access. I promptly placed a central venous catheter in the patient’s left internal jugular vein. This insured multiple medications could be administered to assist the patient in keeping an adequate blood pressure.
In order to monitor the blood pressure most accurately, I placed an arterial line in the patient’s right radial artery. Now that the patient is more stabilized, I am finally able to talk to the patient’s family and look up laboratory values and radiological imaging in the computer. The patient could then be transferred up to the ICU.
Daily rounds are next on the list in the ICU. I look up my patients in the computer to evaluate any events overnight, check laboratory values, radiological imaging, medications, and other details. Once I am up to speed, I have conversations with the nurse and respiratory therapists for any additional details.
A multi-disciplinary team approach is vital to providing great patient care. My next step is my physical examination of the patient. This includes looking at all of the continuous medication drips and ventilator settings. My assessment starts from the head and ends at the toes, including all body systems in between.
I update family members and create a plan for the day. Plans are discussed with the other consultants, nurses, and respiratory therapists. Multidisciplinary rounds occur daily at 10 a.m. These include the assistant nurse managers, dietitians, case managers, pharmacists, etc. After patients are settled in, I get started on charting and documenting.
Throughout the day, my phone is constantly ringing with new consults and patients that need to be seen for various reasons. Many of the patients may require procedures such as temporary dialysis catheters, arterial lines, central venous catheters, intubations, and bronchoscopies. I collaborate with my fantastic team members regarding all patients, so we are aware of what is happening to each patient. I am extremely fortunate to work in such a positive, collaborative environment.
Toward the end of the day, I re-round on the critical patients. I make sure everything is taken care of before my nightshift partners return. I frequently have either nurse practitioner or PA students with me.
I enjoy watching the students learn and start to connect the dots. Seeing the transition from student to practitioner is quite fulfilling. At the end of the day, I love what I do. I enjoy providing high quality patient care, while educating future practitioners to be the best providers possible.