Hello again from beautiful Dillingham, Alaska. I have been back here for a week and am all settled in my apartment. Everyone has made me feel welcome to the point that I really don’t feel like I have been gone for almost three months. As usual, there are several new faces. For a few of the “newbies” this is their first Alaska experience, the rest are like me, here because they enjoy working here. The official term in Native Facilities for what I do is (TDY). There are TDY positions in just about every licensed healthcare position in these facilities: physicians, nurse practitioners, physician assistants, dentist, dental hygienist, radiology techs, registered nurses, and some I probably haven’t even thought of.
I originally planned to blog two or three time a week, but Ralph and I have been discussing some of the things that we have noticed about the newbies. We have been trying to understand the thought processes, or lack of thought processes, for someone traveling many miles from home to work for several months in a setting they have never been in. In some previous blogs, I have told you how I prepare to go to a new place or state. The research I do about “little things” like: scope of practice, licensing, prescribing laws, and many other “little things”.
Now I am in no way finding fault, Ralph and I are just making observations. We are going to tell you a “pretend story” about Sally (no we ain’t dumb enough to use real names, except our own). We are going to pretend that Sally is a Physician’s Assistant (PA) who is coming to a state that she has never practiced in before. There are a few things that Ralph and I think Sally should have known about BEFORE she got to Alaska.
1) Sally is coming from a state where she can not prescribe medications (her sponsoring physician has to write prescriptions).
2) Sally has only worked in a large emergency room and has NEVER practiced rural (much less frontier) medicine.
3) Sally does not have a DEA number.
4) Sally does not know that she can only get a “provisional license” in Alaska until she has worked for 160 “directly supervised” hours in Alaska.
5) Sally does not know what schedules of drugs a PA can prescribe in Alaska.
6) Sally is going be assigned to a remote village clinic and will be doing and seeing “everything that comes through the door”, but when she gets here, Sally says: “I don’t do OB or skin, who comes and takes care of them?”
7) Sally made a statement to us that really upset Ralph: “you are just a mid level, why don’t you know what schedules of drugs I can prescribe?”
8) Sally didn’t know that Alaska is a ZERO tolerance state as far as drugs and alcohol in the work place.
Now those of you that really know Ralph and I are probably betting about know that we probably said some “un-nice things” to Sally. Well I hate to disappoint you, but for once the filter was working, at least for my “out loud” voice. And other than number seven, our mouths were gaping open too wide to utter a response.
Ralph and I can not even imagine coming here and not knowing the answers to the above questions. It has nothing to do with PA, NP, RN, MD, Rad Tech ……….
IT IS ALL ABOUT BEING A PROFESSIONAL!
You have “paid the price” to earn you license (at what ever level), you say you want to be treated like a professional, yet many evidently do not even know the definition of the word “professional”. In order to be respected, you should earn it by your actions and preparation. Too often healthcare workers want to “talk the talk” about being treated as a professional, but Ralph and I find very few that really “walk the walk” every day.
My response to number seven is:
First, I hate the term “mid level”, but I tolerate it at this point in my career because I have much more important sand boxes to stick my flag in where I can choose to “die on my sword”. Anyone that puts the word “only” in front of their profession, well I don’t think their opinion of themselves is very high on the “notching stick”, so it is really their problem to address. But I can recommend several good therapists.
Now Ralph’s response to number seven can not be posted here, because this is only a PG site. He did reference sunny beaches, miles and miles of desolate tundra, and something about Sally’s figure cause he kept talking about bodies.
Have a great weekend, and be PROUD of your profession by ACTING like a professional!
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