For my sixth rotation, I had the opportunity to attend Woodhull’s surgery department. Before starting the rotation, I was honestly very terrified. Surgery does not exactly get the nicest of reputations in the realm of a PA student, so understandably, I started this rotation expecting the worse. I thought that I was going to be pimped out of my mind, I thought the attendings and the residents would make me work until I dropped dead, I thought I was going to have a horrible rotation. But that really was not the case at all. I’m not sure if it was just the staff at Woodhull, but I honestly met some of the nicest, most caring surgeons during my rotation there. Sure there were always surgeons that were nicer than others, but overall, everyone was very willing to teach and answer questions that I had regarding a patient. I had the opportunity to share my rotation with several medical students, as well as two PA students towards the end of my rotation. I will discuss the most important aspects of my rotation below. Overall, I would say I had an amazing rotation and I am very grateful for this opportunity.

One of the greatest weakness during my surgery rotation was my lack of assertiveness. I know myself, and once I know how to do something well, just like anyone would, I take charge of it, and I do not expect help. I like to get things done on my own and get them done effectively. However, if I am unsure of how to do something, and I do not have someone that is more than willing to help me learn a certain technique, I easily become very discouraged and I let someone else take over. This was my issue, especially during morning rounds. Every morning, the surgical team would assess their patient, and most patients would need a dressing change. Even though I have done many dressing changes in the past, every wound is different, making every dressing change a little different. So in order for me to follow grasp how to preform a dressing change, I would have to not only watch the dressing change a couple of times, but I would also have to change the dressing, completely by myself, in order to have the confidence to take initiative and change the dressing. I also have this insecurity about myself, in which I feel that I am always holding people up and that is something I definitely did not want during surgery. So when the residents would spend less than a minute in the room with the patient, and I had all these medical school students that had been there many weeks before me, who knew how to change the dressings, for time’s sake, I would let them assist in the dressing change. I believe this was one of my biggest mistakes because I was letting the opportunity of being proactive in surgical patient care slip though my fingers, and it was all because I was too shy to ask someone to walk me through the steps of the procedure. I guess I also felt very insecure that I was around medical students that knew more than me, so I just felt dumb asking questions, but now looking back at it, I should have demanded to be more involved in wound care because unlike the medical school students, unless I decide to go into surgery, I will never get another experience like this. I am not trying to make the medical student’s sound bad, but I felt there was a huge difference aggressiveness between the medical students and me. I will a hundred percent say that not all the medical students were overly aggressive, as a majority were extremely nice, but there were just a few that seemed a little overbearing and being the pushover that I am, I just stood by and watched them, and I honestly hate admitting this, but I did feel inferior to them, and I felt like they should be able to get any procedure that they want because they are becoming doctors. I feel like I am just ranting, but I know that I should have not felt that way and I should have been more assertive with the procedures that I wanted. I should have voiced my opinion when appropriate so I could get the most out of my once in a life time experience. I have much regret of how much I let things be and did not stand up for myself. I feel like this has been my problem since day one. I can’t express how I feel until I become very comfortable with people and I need to fix that as soon as possible.

Aside from being a complete pushover, my second greatest challenge was scrubbing. I could not for the life of me scrub. I don’t know what is wrong with me, I know I am slow in catching onto techniques, but oh my God. I just could not scrub. I got yelled at the scrub nurse every single time I was in the operating room, it was so humiliating, but she was only doing her job, and I could not blame anyone but myself. The problem with me is that I don’t really learn until I am put to the test and so when I had received scrub training, I did not really learn much. Everything was just passing over my head and I had no idea what was going on. When I got to scrub in for the first time, it was horrible. The scrub nurse yelled at me so much, that even she felt bad afterwards and apologized. I just don’t know what is wrong with me, there were too many steps for me to follow. I misunderstood which string I was supposed to pass to the scrub nurse, and I did not know what it was until after the last time I scrubbed. I wanted to scream out of frustration every time I scrubbed and I was so terrified of being yelled at after the first time. Obviously, the more I scrubbed the less mistakes I made, but still, up until the very last time I scrubbed I was still very unconfident about scrubbing. I felt like the only student in the history of students to be so confused about scrubbing. With that being said, the scrub nurse was very patient with me while scrubbing and she was a complete sweetheart outside of the operating room. I prefer having someone that is very stern in protecting against infection, rather than have someone that is nice, but takes concern for well being of the patient. I made sure I scrubbed my fingers, hands and arms properly before I gowned, even though no one else would, because if a patient that I scrubbed into had gotten a post-operative infection, I know that I would believe that it was my fault, so I made sure my conscious was clear after every surgery.

As for procedures, as I mentioned before, I feel like I could have done a lot more than I actually did. I tried to scrub into as many surgeries as I could but because I was rotating with another eight medical school students, it was very difficult to stand up and say that I wanted a particular surgery. For the most part, outside the operating room, the majority of the procedures involved dressing changes, and I think I have exhausted that topic enough. It was a little disappointing because there were only a few incision and drainages that were surgical consults and even then those patient’s all happened to pediatric patients, so for some reason, the general surgical team could not preform drainages on them. Those patients had to be transferred to pediatrics and from there it would have been decided on what needed to happen. One of the procedures that I became very sufficient in was unna boot changes. The first time I changed an unna boot, I was sure I had broken my back, I was complaining about it for hours. But after that, I was very confident in changing these boots and I actually liked doing them, because they took so long, and while doing the changes, you would get to talk to the patient and it was a time where I would really get to bond with them. So whenever there was an unna boot change, I would kind of be excited to do it. One of the things that I learned about unna boots was that they are based off of patients preference. Some of the patients preferred their boots very loose while others wanted them so tight that they would bleed, but that was okay I guess. Overall, I enjoyed doing these small procedures and it really made me realize how much I actually like getting to know my patients and putting a smile on their face.

Towards the end of my rotation, when I had about one week left, the medical students were leaving. On their last day, two new PA students had just started, and honestly, they made my last few days so much better. They were two girls from City College and were on their last rotation. One of them had a rotation where she was a student in the ICU for an entire five weeks, so she was preforming procedures left and right. This one girl in particular was so outgoing and willing to help me out when it came to doing and teaching me procedures, I got to do so much in the last week that I was there because of the new students. Of course, not having the medical students hogging up all the procedures was also a benefit, but the three of us worked as a team and we stuck together for every procedure. We encouraged each other to scrub into as many surgeries as we could, and we were all so good to each other. I really wished that I had started my rotation with these girls because they helped me break out of my shell and become more confident. When my rotation first started, I was terrified to ask the resident questions, and by the end of my rotation I would be openly joking around with them. There was a huge difference in my assertiveness by the end of the rotation and I honestly believe it was because I had such a good support system. I became very close to the two girls in a very short period of time and I hope to continue our friendship throughout our careers.

The more rotations I have the more I start to realize why I got into medicine in the first place. It is not because I love science, or because I love medicine. But it is honestly because I want to help people, I want to listen to their concerns and help them in the best way possible. I know it is horrible to say at this point in my schooling, but sometimes I feel that the PA profession is not for me. I am unable to separate the physical body from the character of the person, which is something that was always done in surgery. When I would be in the operating room and only one part of person was exposed, I felt so disconnected from the patient and I was not satisfied until I would see the patient either before or after the surgery. When the patient was undergoing anesthesia, I felt an overwhelming need to hold the patients hand, telling them that everything was going to be okay and when they woke up, I wanted them to know that they did great throughout the surgery. Even though I had an amazing rotation, I know for sure now that surgery is not for me. I am glad that I can confidently cross that area of practice off my list. I think surgeons are absolutely brilliant in patient care and they have this incredible ability to focus purely on the physical aspect of the body, but it’s just not for me. I enjoyed every part of my rotation, even the part where I was constantly being yelled at, and I would not have it any other way, expect for the whole assertiveness problem. I hope this rotation has prepared me for obstacles that will face in the future, where I might have to separate the physical aspect form the person themselves. I am very grateful for this opportunity that I had and I hope the best for the future.

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