New grad. ICU. New York City. Spring of 2020.

Karlina started her first PA job in the intensive care unit of a New York City hospital, and then the pandemic hit her city harder than almost anywhere in the country. She watched her unit change from a normal ICU into something none of them had trained for.

She's honest about what that did to her and to the people she worked with. She's also clear about how much she learned in a very short time, and how much of getting through it came down to the team around her. Nobody was doing that alone.

This is a hard listen in places, but it's an important one, especially if you're heading into critical care or wondering what new grads are really walking into.

What we cover:

• Starting her first PA job in a New York City ICU
• How the unit changed as the pandemic escalated
• The emotional and mental weight on the whole team
• Learning fast when there's no playbook
• Leaning on coworkers to get through it
• What new grads should know about critical care

Resources:

Free Resume Download: https://www.thepaplatform.com/services/free-resume-download

Free Application Timeline: https://www.thepaplatform.com/services/free-application-timeline

Pre-PA Counseling: https://www.thepaplatform.com/services/pre-pa-counseling

Pre-PA Academy: https://prepaclub.thepaplatform.com/landing/academy

Mentioned in this episode:

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Can you imagine being a new grad PA in the ICU for a few months and then Covid hits in New York?

Yeah, me either.

But Carlina did and she's sharing her story with us today.

Welcome to the Pre PA Club Podcast.

If you want to learn how to become a physician assistant, you're in the right place.

I'm your host, Savannah Perry.

Let's get to it.

I want to thank mypa Resource and PA School Prep for sponsoring the Prepa Club podcast.

So mypa Resource is a personal statement editing service that edits only PA school essays, only edited by PAs, and most of us have admissions experience, so I am one of the editors.

Definitely check them out if you need help with your content, grammar, flow, making sure that you are on track for turning in your application.

And you can use the code futurepa for a discount on any of their service options.

PA School Prep is an online course that focuses on the anatomy, physiology and med terms that you'll need for PA School to make sure you feel confident going into that first semester and that you are able to handle what PA school throws at you.

So check that [email protected] and also use the code futurepa for a discount.

There was that not a super dramatic intro?

Just kidding.

Thank you for tuning in to the Pre PA Club Podcast.

Savannah here, and I'm excited to get to share today's story with you with Carlina.

She is, as I said earlier, a PA who works in New York, and you'll hear all about it.

But she works in the icu, which got really crazy recently, very unexpectedly.

And so I really appreciate how she reached out to me on Instagram and offered to share her story and just talk about what that's been like, giving some insights into working in so many different ways as a new grad PA in an ICU during COVID in New York, all these things.

So we really get to talk about some cool stuff as well as how she's grown as a provider, you know, in her knowledge, but also emotionally, mentally, and what that's looked like these past few months.

So I again very much appreciate her doing that.

And she wrote a blog post she'll talk about in our interview that kind of debriefs her feelings on all of this.

And so I have a link to that in the description.

I'll also be posting it on Instagram, so make sure y' all check that out.

So I'm very thankful for her.

All right, before we jump into the the interview, I just want to put a Quick.

I don't know.

Not reminder, but word of advice, word of encouragement, maybe out there, you know, I'm getting a lot of messages like, I still haven't heard anything.

Some people are getting interviews and acceptances, and for a lot of schools, it's still early in the cycle.

Every school does so many things differently.

So don't give up hope.

Keep.

Keep pushing forward.

The waiting is awful.

It just is.

It's such a tough process, and there's.

There's not a ton you can do about it.

I think being connected in the pre PA community, whether that's on social media or in the Pre PA club on Facebook, is great, just because your family and friends may not really understand what you're going through and what it feels like and the kind of gravity of the situation.

But I do, and all of your prepa colleagues do, so we can definitely support each other through that.

All right.

I do want to talk about a couple events coming up before we get to the interview as well.

Let me look at my calendar, actually.

So tentatively, and I think this.

I don't see any issues with this.

Tentatively.

On September 27th last night, we did an event called A Day in the Life of a Derm pa.

This was a virtual shadowing event.

And I'll be, you know, adding that information to the podcast in the upcoming months.

And next week, I'll let y' all know where you can watch a replay of that, because it will be available, but that I want that to be something we continue with, just PAs and different specialties, as well as making that information available afterwards.

So the next one is scheduled for August 27th, and it's with a fan favorite, Mr. Brian Palm.

So he's gonna be talking about his life as a nocturnal erpa.

So he only works night in the er.

So we're going to be kind of deep diving into his job on that date.

These are free sessions, and I will post the link to that.

I'll have it up on social media next week, and then I'll post in the description next week and remind y' all as well.

The other thing I wanted to mention is I am planning a session specifically for leaders of Pre PA clubs at universities and schools.

That was something that came up as kind of a need in the Facebook group.

So if you are on, you know, whatever y' all call it, the board or leadership of your Pre PA club, I would love for you to join me on September 13th at 8pm we are.

That's gonna be a lot more interactive than these webinars where I'm pretty much just gonna facilitate and try to kind of lead the conversation of brainstorming ways to, you know, increase engagement and spread the word about your club, what to do for club meetings, how to make your club as beneficial as possible to your members so that we can all just kind of learn from each other.

Because I know there are some really great prep pre PA clubs out there.

So I will post.

I'll be posting a link to that this week as well, and so be on the lookout.

And that will go out in the newsletter at the end of the month as well.

So if you're not on there, get on there.

The signup is in the.

In the description, but I post a lot, so if you're not following on Instagram, that's the easiest way to stay up to date.

So HEPA platform.

Post all the time.

Okay, that's enough.

Let's hear from Carlina, and thank you so much for joining me.

My name is Carlina.

I am a PA that's right now in New York City, practicing in the ICU.

So critical.

I graduated from a dual master and bachelor's degree program.

Cool.

That's awesome.

So you knew in high school you wanted to be a pa?

Yeah, I mean, I knew I wanted to do something in the medical field.

You know, it was kind of like back and forth in terms of what exactly I want to do.

But in high school, I was lucky enough to have this career fair, and one of my alumni actually came in, and he was practicing as a PA at the time, and he kind of exposed us in terms of the profession and what it is and exactly how different it is and different clinicians and practitioners.

So after that, I started doing some research.

I went along with the program that he went along with, you know, and I just applied and, you know, went from there.

Awesome.

That's really cool.

So your applications looked a little different because you didn't really have to go through the process with picking schools and all of that later on.

Right?

Yeah.

So it was a little bit different.

So I was exposed to time where I can, you know, do the four years traditionally of undergrad and then apply for PA school.

But at the time, he did tell me about this program.

So I graduated from Wagner College.

It's a program on Staten Island.

So he told me about the program along with looking into other programs that provided, you know, the bachelor's and the master program, given that I was coming straight out of high school.

So the idea in my head at the time was let me apply for these programs and if I happen to get in, like, that's wonderful, but if I don't, I'll just do the four years of undergrad and, you know, apply for PA school again.

So it definitely was different, but because of the program giving two degrees within a short amount of time.

So my program was a five year program.

It was a little bit more competitive, so it was a little bit harder to get in.

And I applied not thinking I would get in, and then it actually happened.

But the interview process itself is like the process of going to the PA school.

It's pretty similar.

So you're applying and you're still doing the pa, like interview and everything like that.

The only difference is that you wouldn't have to do the four years of undergrad first.

Okay.

At any point in that process, did you doubt what you were doing or feel like too young or this is too quick, or were you pretty confident throughout that you're making the right decision for you?

So it definitely was hard to begin with just because.

So when I first got on, like got into the program, you know, I was really happy, excited.

And then the first two years of my program, essentially you're doing all your gen end requirements and finishing that.

And then third year would be your typical, your didactic year.

So the first two years, you know, it felt normal, like the normal college life.

And then once I hit didactic year, that's when things kind of just started being a little bit more different.

So I was with traditionally my PA program from 9 to 5, you know, every single day in the library.

And it was a little bit different because I had friends outside of the program who were living the college life and you know, like, it just looks so much more simple out there.

And here we are in library setting 247 for many exams throughout the week.

So definitely, if there was a question of whether this is the right decision, if the timing was right, if this is what I wanted, it definitely did pop up.

And with how rigorous the curriculum was throughout didactic year and even through clinical, I did question it a couple of times, like, is this the right thing?

Just because, so being so young and kind of put under that pressure and also being out on, you know, in the clinical sites expects you so professional, but you're also so young, so you're also meeting with, oh, you're so Young with your about to be a PA in two years.

So it's kind of like that, you know, proving yourself to other clinicians that you know what you want.

So it definitely was a little bit more difficult.

Gotcha.

Was there any part of PA school that was especially challenging for you?

I think the most challenging part was actually going out to clinicals.

So, like, you know, in didactic year, like, you can hide behind your laptops and your textbooks and, you know, memorize everything, but it definitely got more intimidating going out to the rotation sites.

You know, so many personalities out there in the healthcare field and really just kind of figuring out where you're grounded.

So that definitely was a hard part.

And my program gave us two years of clinicals.

So the first year, general ones, yeah, so we would do typically the general surgery, obgyn, so the main core ones.

And then the second year would be a little bit more of the electronics.

So if you want to do, like, cardiac surgery, you could do CT surgery.

If you want to do nicu, you could do that.

So I was really thankful for that with my program because I had a lot more exposure typically than other PA students would, but definitely my senior year.

So the first year of rotations was very hard.

You know, it was between basically working and being in the hospital all the time, then coming home and studying for your EORs.

So that definitely was, like, you know, really hard.

But other than that, it went smooth.

It was good.

All right.

So when it came time to get a job after you graduated, what were you looking for?

So it's kind of.

It's a little bit different.

So when I first.

My last year of VA school, I won something that was in the more critical area.

So typically, a lot of us in my program actually want to apply for the ER positions, but I don't know how it is in other places.

But in New York, it's really hard to kind of get that without prior exposure and prior experience.

So there's actually some programs out here that give you, like, an EM residency for PAs, so those are also really competitive as well.

So looking into that, and then I came across one of my alumni from my program telling me that her ICU in one of the hospitals in New York City was hiring and was looking for actually new grads as well to train.

So, you know, I was like, okay, like, icu, like critical care, and let me try it out.

So I actually ended up applying there, but I did apply for a whole bunch of special cities.

I've applied for hemonc.

I've Applied for CT surgery because I did do a rotation there.

So it was kind of just picking and choosing.

It was really hard.

I think the hardest part coming out of PA school is kind of figuring out what you want to do because you just have so many options.

But the best thing that I can, like, really say is that the interviews really did it for me.

So, like, me being able to talk to, like, my future employers and see how we actually connected through the interview, have that kind of, like, bonding conversation, that really did it for me.

So.

All right, so you ended up in the icu, and when you say New York, are we talking, like, what I think of as New York?

Like, Big Apple, like, in the city?

So do you, like, walked work?

Do you take a taxi?

Do you take a subway?

I guess that's what y'.

All.

What y' all do.

Yeah.

So I live in Staten island, so typically people put take the ferry over.

So before COVID I used to take the bus and the train over, but now with everything going on, I've been driving myself.

Okay, so we'll get to Covid stuff for sure.

So when you first started your job, did you feel equipped to jump into that role or did they train you?

How did that transition kind of look like from being in PA school to actually taking care of patients and being responsible for them?

So the reason why I chose my current job right now over the other job offers that I did get is because of the training that they were able to give me.

So in my icu, it used to be a medical ICU and then a surgical icu, but when I started, actually, they combined it.

So it's not like a med surg icu and it's a PA and resident run floor.

So I work really closely with the residents and the attendings.

There's also the pulmonary critical fellows as well that I work with.

So how it's designed, it's 16 beds, and the beds are split among the interns and the PAs.

So with that, with my training, it took about six months of training.

So the first couple of months, it was really getting used to everything.

The intensity of the critical care, really just getting hands on, learning things and learning kind of applying the medicine that you've been learning throughout PA school and then later into my training, I was a little bit more hands on where I was able to do focuses.

So, like bedside ultrasounds, I've also been able to place central lines and arterial lines with the fellow.

So I have to say the training's really nice.

And the relationship with the Fellows and the attendings and along with the other residents, we work really closely together as a team, which I really appreciate, being that my hospital is like a teaching hospital.

The training process was a little bit better.

So during my interview, I was speaking to my ICU director at the time, and she basically walked me through telling me the role of the pa, basically working with the residents, which I really love.

But in terms of the training process, it was difficult to adapt to being that you're a PA student, and now they're like, oh, you're a pa. Like, it still takes a little bit to kind of adapt.

And a lot of people have told me you won't get comfortable within your first months of training.

It's going to take maybe a year or even two to start getting a little bit more comfortable.

So definitely the hardest part was questioning what I knew.

So I. I had an idea that I knew something.

I'm like, should I speak up?

Should I not?

And really putting yourself in that position.

So coming out of PA school, I knew I made it through that.

But then actually working in the real world, it was another learning experience.

So I knew that there was just so much more that I had to learn.

And it doesn't just end at PA school, unfortunately.

So I'm very grateful for the team that I work with.

They're really helpful in terms of if I had any assistance that I needed, they would be there.

That sounds like such a great environment for just working and learning.

And I was definitely very nervous going into it because I was like, oh my goodness, like the icu, like, what can go wrong?

But I do.

Like, I was drawn to that job just because of the support that I knew I would be able to get, especially coming out as a new grad.

Like, you need your hand to be held a little bit more.

So it definitely did help.

That's awesome.

Yeah, you.

Great experience.

So what.

What does your.

And we're kind of talking pre Covid now because I don't know how things have changed, but what kind of was your schedule like?

And like kind of a day in the life as an ICU pa.

So for my schedule, you work for me.

I work 40 hours a week.

So typically that would be three days a week.

They're around like 12 and a half hour shifts.

So I work from like 7 to like 7:30, 7 in the morning to 7:30.

And then we started actually covering nights.

So it's usually the same hours that we typically work a day in the life just being an ICU pa.

So it's the typical, like, no being in the hospital, rounding for a long couple of hours, and then just kind of going about your day and like, you know, doing the to dos for each patient.

There are some busy days in the icu, you know, where patients do crash on us.

So a lot of that comes with the training that I was able to get, luckily, in terms of running codes, doing CPR and everything like that.

So it is a high acuity.

But the good thing is that it's only three days a week or so.

Sometimes I'm able to even line up my days where I can do six days within two weeks and have a little time off, too, to kind of recuperate as well.

So the flexibility of the NCPA is actually really nice.

You get the high intensity that you want, but you also have the time off, you know, pick up a per diem job or whether it's, you know, to do whatever you need to do.

That's awesome.

Okay, so let's jump into Covid stuff, which obviously no one saw coming at all, and especially not how crazy New York was.

What just what was that like?

I mean, what happened?

Well, honestly, I look back now, and I still can't believe how we made it through.

So when Covid had hit New York, that was, I believe, the end of February into the early March.

And I think I was probably about seven months out working at that point.

I was getting comfortable with, like, you know, everything that I had to do.

You know, I kind of knew everything, the flow, everything.

And that's when Covid hit, when I started getting a little bit more comfortable.

So it kind of really threw everything back to where it was.

So it came in March.

So we have one ICU in my hospital for 16 beds.

Within that month of March, we opened two more ICUs.

So I had three ICUs in my hospital, and all the medicine floors all became basically Covid floors for patients who didn't need the hifudi for icu.

So it definitely was a big kick.

So it was very different.

So in terms of the scheduling for PAs, there are two PAs on the floor with me.

So we got split up, where one person would stay in one icu, another person would say in another icu.

We have our medicine residents that we typically work with because we were so short staffed with the three ICUs that we opened, the medicine residents were floated to the newer ICUs, whereas the ICU that we typically work in was filled in with floating residents.

So we had the surgery interns come in, so everyone was kind of out of their scope, you know, being pulled left and right says things that they're not used to doing.

So the PAs actually got to step in and act as, like, the senior resident in a way.

So that was kind of a very different thing for me because me being only seven months out, I was, like, freaking out in my head, like, oh, my goodness, like, what do you mean?

I have to, like, help run this score.

So, you know, it definitely.

A lot of the PAs that I work with are also new grads as well, so it definitely pushed us to see what we're capable of out of our comfort zone.

But looking back now, it's actually made us grow so much from it.

It definitely was really tough.

We made makeshift rooms in our ICU.

Not all our ICUs have this negative pressure room where the COVID patients would go.

So we actually created negative pressure, made thick doors.

It was definitely a very crazy time.

We had a lot of travelers come in and help us, so.

Travelers, MPs, PAs, nurses, CRNAs.

Really grateful for them.

Honestly, without them, they really.

They did a lot of, you know, the help.

But in terms of the intensity of it, I always said, like, pay school never teaches you how to grieve your patients.

No, it's something we always like on rotations, but you never really grasp onto it until you start taking care of the patients by yourself.

Yeah.

So I think that was a big learning factor for me.

So on top of, like, you know, being thrown and, like, having to do, like, things that I wasn't comfortable with doing, in terms of, like, just being so brand new out of school, it was also an emotional factor in terms of having to learn how to see all these patients pass and not do well.

Also, like, deliver the bad news for family members and, like, you know, like, teach them how to cope with it as well.

So it definitely was a mental, like, strength that you kind of learned.

We look back now and we're like, you know, if we do have this, you know, second wave of COVID hopefully that doesn't happen.

You know, we always joke around, and I feel like it's going to be, like, a sense of PTSD for us.

So it definitely was really hard.

You know, I've had days where we couldn't round on the whole ICU because you would have so many disruptions with patients, like, desaturating and, like, coding and stuff.

So it was really hard adapting to all of that.

Honestly, like, every shift was, like, a mental and emotional, physical, like, burden.

Like, it was.

You were really tired all the time, knowing you have to go back in, not knowing what to expect.

I remember when it first hit, a lot of the.

My old professors, like, reached out to me, was like, how are you doing?

I know you're in the icu.

Like, I must be crazy.

And I always said I'm like, I never thought I'd sign up for this.

Like, right.

Like, this is, like, crazy.

Like, I would.

If you told me, like, three years ago, like, your first year, you're gonna work in a pandemic, I'd be like, you're crazy.

So, you know, a lot of the medicine that I learned, it was kind of thrown out a little bit because everyone just learning so much things about COVID that it was, like, a learning experience for everyone.

But I did have, like, you know, great, great team, great attendings to really lean on.

You know, they gave us time in our schedule where if we needed a break and kind of, like, needed time away from the icu, they do it and have someone else fill in.

I have a great team of PAs that I work with that we're able to cover each other whenever we need to.

But, yeah, it definitely was very intense.

And because my hospital is actually going to be closing to build into a new location, we had a lot of empty space, so we actually took a lot of the patients from other hospitals that were being overcrowded.

New York also had makeshift hospitals in, like, the David center and, like, in Central park, so a lot of those patients would come in intubated and, you know, come in to our icu.

Yeah, so it definitely was very stressful.

Honestly, those are, like, the longest three months of my life.

Like, I look back, and I'm like, where did the whole, like, spring and summer go?

But definitely was really tough.

And it really kind of made me have to mature as a clinician and really learn how to cope with, you know, the stressful part of, you know, having to say bye to patients and stuff.

And during the time, you know, I'm sure, you know, a lot of family members couldn't come in and see the clinic.

That's also the hardest part, too, where, like, family members, like, I just want to see them.

I want to come in.

And, like, we couldn't let that happen.

So there are times where, you know, I've had to hold my phone in, like, a little sat bag so it wouldn't get contaminated, and I'd hold it and have the family, like, talk to, like.

Like, the patient, and I would have to, like, she was like, can you help me, like, hold, like, his hand for Me and everything.

So it was definitely, like, hard.

And I look back, I'm like, no one ever taught you that in school.

Like, no one ever taught you, like, you know, like, everyone teaches, like, all this medicine and exciting and all that stuff, but no one really teaches, like, the part where, like, medicine isn't like the happiest moment, you know?

So that honestly, like, threw a lot of things into like a tornado and kind of like, really messed with like, my life a little bit.

But a lot of the hospitals, along with mine, developed like a mental health program and, like, had a relaxation center.

Definitely.

I'd say New York needed it a lot because a lot of us were really overworked, mentally and physically exhausted for the most part.

Gosh, isn't that crazy?

I mean, that.

And I just think about how, like, I have a two year old and how, like, when she's in high school, she's gonna read about this and learn about it in history.

And that's so weird to me.

And then, I mean, how it will change PA school education and change just.

I think all education moving forward.

Like, it's wild, like you said.

I mean, like, even six months ago, if you told me that this is where we'd be, I'd be like, you're crazy.

Like, even at the beginning, I was like, it's just the flu.

I was definitely one of those.

I was like, it's not a big deal.

And then two weeks later, I was like, oh, wait, I retract my statement.

This is a big deal.

Yeah.

What's happening?

Actually, the first patient that came into New York City actually went into my hospital system.

So, like, we got like a mass, like, email saying, like, we just got our first Covid pui.

And I remember, like, my group chat with my ICU co workers, like, going off, like, there's no way, like.

And then my hospital has many.

The system has many campuses throughout New York City.

So we're one of the ones downtown.

So we're like, which one is it?

Is it the main one uptown?

And, like, we're trying to figure out, is it in our ICU right now?

Like, we're like, off freaking out.

Like, oh, my goodness.

So definitely, like, yeah, it was very crazy.

Just even, like, think about it, like, flashback now.

Like, I can't believe.

And you know, in the beginning, everyone's just saying, like, oh, it's, you know, just the flu and stuff.

And then, like, we see these patients, like, in like, kidney failure and everything.

We're like, is it really.

It's not really.

Just the flu anymore at that point.

So it definitely was a big learning curve through everything.

Yeah.

So, like, looking back, and obviously none of us can, like, predict the future and all this stuff, but, I mean, a year ago, when you were looking for jobs and choosing jobs, like, if you knew a pandemic was coming, would you have.

Would you have signed up for it?

Because I feel like that's the spot that, like, pre pas are in now, which is interesting.

Like, they've gotten to see this happen and some kind of like.

Like, look, y', all, this is.

This is medicine.

It is unpredictable.

Very unpredictable and wild at times.

And, like, that's what you're signing up for, even if you could never predict it.

And so I think.

And it, like, I think it's completely valid for some people to rethink their decision to enter medicine because of it.

Like, maybe they can't handle these things that you're talking about.

But, yeah, I mean, like, do you think having that knowledge as a prepay would have changed your.

I mean, like, you know, as a pre pa, I remember, like, on my, like, PA interviews, like, you know, they're like, why do you want to be a pa?

Like, you know, like, the very, like, typical questions.

And I remember telling, like, you know, I, like, I want to help people.

I want to, like, you know, have that patient interaction, bond with them, you know, develop that connection and really just help them and, like, see them walk out of the hospital that you did something to make them feel better and, you know, all of the positive.

And if they were to tell me, like, what if a pandemic hits, where you still going to be down for that?

I mean, every job has, you know, it's, you know, plus and pros and cons in terms of, like, what you sign up for.

I remember, like, during COVID like, what was really tiring was it was the shifts and then coming home to social media with some people saying, like, oh, Covid's fake.

Like, this is, like, not real.

Yeah.

You know, and, you know, personally, I'm guilty for getting into some conversations with people and, like, getting into little arguments saying, like, you don't know that.

It's not.

Like, it is real.

Like, I am living in it, like, every single day.

Like, you know, seeing all these patients and, you know, a lot of them saying, like, oh, like, well, the healthcare provider signed up for this.

Like, you guys are supposed to know how to do this.

Like, you guys are supposed to thrive in this.

And I'm just like, not really.

Like, you don't Ever really sign up for anything bad?

You know, like, it happens.

And, you know, a lot of the residents who rotate, they act like the PA is like, you guys signed up for the icu, though.

So, like, do you guys regret it now?

Like, you know, especially for, like, the new ones like me, they're like, do you regret signing up for this?

And, like, you know, like, regardless of what department you're in, like, you know, the surgery interns did not sign up for this.

They didn't sign up to be put in the icu, like, regardless of medicine.

And you're going to be placed in, like, roles where you're not comfortable when things like this happen, and you just need to adapt.

So, I mean, if it was six months ago and someone said, like, there's going to be a pandemic that hits, like, are you still going to do it?

I love the icu.

So regardless of COVID or non Covid, like, the ICU is just very.

It kind of keeps you on your feet.

And I'm someone who kind of just gets bored really easily, so I kind of need to be, like, on my feet at all times.

So I think I would honestly, I think it was definitely a very hard time to go through, but I think I've come out stronger from it.

You know, I still have a lot to learn, given that I'm still my first year practicing, but I definitely did see of, like, a lot of the outcomes that I would not have seen if the pandemic didn't hit.

Unfortunately, it made me grow.

It made me become more creative in terms of thinking about treatments and plans.

Made me a little bit more confident in knowing that I'm part of the team and I'm no longer that PA student that sits in the back and, like, you know, writes the notes and all that stuff, and now I'm part of, like, the whole intervention and stuff.

So I think I would.

Honestly, I think I would.

You're, like, the definition of a frontline worker, which.

My husband's a hospitalist, and he hates that term.

He's like, don't call me that.

Don't call me that.

But I mean, like, y' all really are, you know, hands on with those tough patients.

Were you ever scared throughout those, like, rough times?

Yeah, definitely.

I was, personally, like, so many things.

So, like, you know, another thing about COVID like, it kind of brings it a little bit more personal for every person, because when you have family, you don't want to, like, go home with it.

So, like, the anxiety that I developed in terms like, bringing it back home to, like, my parents and everything.

I actually moved out because I was so freaked out that, you know, like, I would come home.

Like, I mean, we'd go in with their casual clothes, they give us scrubs, and then we would just dispense it back into the scrub machines.

But I'm like, what if that, like, 0.5 seconds of me being in the hospital after I change, like, you know, what if it's in my hair?

What if it's like this and that?

So that in itself was an anxiety matter.

And also, like, a lot of our patients need to be intubated so oftenly that, like, it was so often to, like, you wanted to just run in the room and do everything, but you couldn't because, like, you had to gown up and put proper PPE and, like, you have to, like, take it all off the proper way and everything like that.

So it definitely was very scary because, you know, you're taking care of another patient, and that patient is someone else's family member, loved one and everything.

But you're so limited on what you can do.

Like, you can't just run in there.

So it was scary for us, but also scary for them.

And also the family members that would call, like, you know, for updates, that's also another thing.

Like, they wouldn't hear from us because we'd be so busy.

And you just hear our clerk, like, Patience family for Bed eight is calling again, and stuff, and we're like, we can't call back.

We're still rounding.

It's like 2pm and, like, I know what they're expecting, but it's just, like, so hard.

So it definitely was really scary.

You know, everyone was scared in their own way in terms of bringing it back home, ourselves even getting sick and, you know, like, just exposing so many people and being asked, like, what if we did the wrong thing?

And stuff like that.

So it definitely was a big emotional learning curve as well, because it was just like, we were so out of our, like, comfort zone and also, like, in the fear of, like, you know, everyone getting sick.

And then, you know, we had some co workers that also, like, got sick sick from going to, like, the codes and stuff like that.

And we're like, oh, my goodness.

Like, this person's out.

So now everyone's, like, freaking out.

Like, well, who was exposed to this person and stuff like that.

So it definitely was a scary thing.

And, like, you know, I look back, I'm like, oh, my God, like, I just graduated PA school.

Like, this is all happening right now.

That is a lot.

Yeah.

So like, a lot of like the PAs in my program that just actually graduated, they're like, how are you doing it?

Like, like, are you okay?

And I'm like, I don't know, I'm like, really scared.

But again, like, the support that I got from like my family and my boyfriend and like, you know, the attendings and the whole team that I really worked with, that's honestly what pulled me over.

But otherwise, you know, there were nights that I came home, you know, crying and like, I'm like, I can't do this anymore.

There are days I go to work be like, I really can't go to work.

So it definitely, like, you know, isn't the rainbows of it all.

But I felt like that was just so important to show, like the pre PAs and those that are about to graduate that like medicine is just not the rainbows that you see all the time.

It's not the lives that you saved in the miracles.

Like, it's that.

But it's also the ones that are like, really hard to let go as well.

Right.

Did you.

So since you did a three plus two program, did you.

I guess so, like a joint program, did you have patient care experience going into that or not too much.

So I had like volunteer experience.

So it's a little bit different in terms of the interview process.

So like, I know if you do the four years of undergrad and then apply for PE school, you need like the patient experience.

So for us, they obviously didn't expect us to have those hours.

We're coming straight from high school.

So if you had some shadowing experience, like a little bit of a plus.

So that's kind of a little.

That's why it was a little bit more nerve wracking when you actually went on rotations because it's like the first.

Time you're actually with patients.

Well, that's.

I just want to ask because I think that like is.

It's kind of connected because I think sometimes that's the purpose of schools that require, you know, a thousand, two thousand hours of patient care, is to try to have students who are exposed to some of those harder parts of medicine, like before they get to people school, because that can scare people away.

Like, you are super strong.

I would have been terrified.

I would definitely been crying every day.

Like I was crying every day because my husband had to go to work.

Like, it was not good.

So, I mean, I think, I think.

And like, I didn't have a ton of experience, but I think having some.

And seeing, like, I was in a rehab hospital and hospice, like, that did expose me to some of that to a degree, like, the hard stuff and, like, losing patience and all of that.

So I wonder if that.

I just.

I don't think anything, though, could have prepared you for.

For Covid.

Like, even if someone sat you down, as I've seen, like, videos where people are like, like, sitting, like, sitting you down in January, like, listen, this is gonna happen.

Like, even if somebody did that, I think we'd all be like, what?

No,.

Definitely.

Yeah.

I can't even count the amount of nights where, like, not, like, I would just grab to work and, like, do I really need to do this right now?

Like, do I really have to go back?

You know?

And like I said, it definitely wasn't the rainbows of it all.

Like, definitely a lot of tears, a lot of, like, phone calls made to, like, our co workers, like, you know, just venting, like, you know, and everyone just became, like, really passive aggressive because everyone was just so tired, exhausted.

So that's another thing.

It's like we had all this social media showing, like, all this positive, like, you're doing so much better.

But, like, behind the scenes, it was just like, it is so ugly behind the scenes because it's like everyone is so exhausted, and mentally everyone's, like, not okay.

And we're trying to put up a front that we're okay and, like, people are stepping on each other's toes.

And, like, it definitely showed the ugly side of how it can get.

So, like, I think that having the patient exposure, like, maybe beforehand, like, maybe like, now the pre PAs, who now seen Covid, like, in action, like, you know, rethink, like, is this something I can do?

I remember in PA School, like, just going to rotation, like, is this the thing that I'm going to do?

Like, I'm sitting on, like, you know, P.S.

Was like, a really rough.

With rigorous, like, curriculum and all these hours, you know, and there were days that I come from rotation, like, crying.

Like, I don't know if I can do this.

Like, I'm so young.

Like, this is, like, a lot.

And then, you know, I graduated, and here I am again.

Like, this is a lot.

I don't know if I can do that.

So I just feel like it's.

Medicine is just hard.

It's hard.

It is.

And I feel like people should really know that.

And, like, the PA students who are applying now, I think they should kind of just keep that in mind that medicine is not what social Media makes it out to be more than that.

It's hard and it's unexpected.

And I think, I mean, I think people do give gratitude to medical workers.

I think they also don't understand it.

And so it can be a little bit thankless sometimes when, like people are trying to be appreciative, but then also, like you said, saying Covid's fake and sharing things that are questionable that make you want to respond, which is sometimes, I know, hard to have to like, hold my tongue or like, step away.

Yeah, it, like it really was after just like a really stressful shift and you just see people trying to like, take away from what you've been doing all day.

It's like, you know, and at the end of the day, it wasn't even taking away from what I like how like my team tried saving a patient.

It was just like, we lost the patient.

And like, that patient is not just a patient.

It's alive.

It's someone's loved one.

Like, how can you be so close minded and just think like, Covid's fake.

Like, these people are actively dying from it.

But you know, I've seen the worst of it because I was in the icu.

So there were some miracle cases.

But I do have to say, like, it.

After practicing Covid for like three months, it got a little bit more tiring where I was just like, I. I really don't know what we're doing here.

Like, I don't know how we're helping this patient anymore.

Like, this is like, you know, they would be on vents, like they would get trachs and then they get to like wean them off of the trachs and like, it was just like we've had patients there for like 90 days.

Like, it's.

Yeah.

So it was definitely really tough.

And it like kind of took the morale out of like medicine out.

Like, what are we really doing?

We're like, prolong their life.

But like, no, it's hard.

Like, family doesn't want to drop in care.

So it was a lot of like palliative care as well that I was exposed to.

So I never got to see the patients that really got to make it out of the icu.

So I really felt like the worst, the worst of that.

But I know when Covid started kind of slowing down in New York and my ICU, we started closing down.

The extra ICUs that we created, it was a kind of like a better sign for us and we started having like non COVID patients and it was like back to Square one.

It was like, I remember, like, talking to my fellow like, oh, we're going to do X, Y and Z and stuff.

And he's like, carlina, it's not a COVID patient anymore.

I'm like, oh, my goodness.

Like, I can practice medicine.

Yeah.

What you've learned.

Yeah.

So.

And then, like, I remember we had, like, a patient with, like, a GI bleed.

Like, after Covid, he was a non COVID patient who was on three pressers, and we, like, we.

The day I admitted him, he was on three pressers.

Then I was gone for a week, and he was off of pressers, walking, not intubated, talking and all that stuff.

And I'm like, I actually, like, looked at the patient, started crying because I was like, I have not seen a miracle like this and actually happen before my eyes in, like, four months.

So it kind of brings that back to you.

So Covid really was learning factor for me because it made me appreciate the times that I was able to talk to my patients.

Like, I was so used to my patients being intubated that, like, exams are so different.

Like, going in there and examining a patient was so different.

And then, like, we had talking patients.

I'm like, wow, I can talk to you again.

So it's like little things like that that kind of, you know, you learn to appreciate and stuff like that.

Does it feel kind of back to normal or still different?

It's definitely a little bit.

It's definitely more back to normal now.

So we only have one icu.

So we're back to our normal ICU with our medicine.

Medicine.

And I was literally just talking to the interns, like, last night on my shift, like, you guys are so lucky.

Like, you guys came in July 1st and just missed, like, you know, the whole Covid thing.

And they were just like, yeah, how was it?

And, like, me and, like, the residents would just, like, tell them, and they're just looking at us like, how did you guys.

We're like, yeah, like, we don't know how.

Like, we talk about it now.

Like, oh, yeah, like this and this happens.

But definitely it's better now.

We only have one icu, and we only have, like, maybe one COVID patient in the icu.

So it's definitely a little bit better, but we're hoping that it doesn't come back.

Yeah.

Yeah.

Well, I'm in Georgia, and so.

And I'm in a smaller town.

Well, so it's.

And just for everyone listening, we're recording this, like, the last week of July because it'll post next month.

But it's so we.

Georgia.

I don't know what.

I don't know what Georgia's doing, to be perfectly honest, because we, like, we had some cases at the beginning, and I'm not in Atlanta, where it's been worse, but we are, like, a little bit of a hot spot.

And so we, like, it was spiking, whatever.

We thought we peaked.

And then the governor, like, opened the state, like, straight up, said, free for all.

Do what you want.

Go bowling, go to the movies.

And so it's been interesting.

I'm in a place, too, where, like, I'm, like, divided between two cities, and the cities, like, don't agree.

It's like, one is requiring masks all the time and, like, has a lot more stringent requirements, and the other half does it.

And so then everyone just comes to the other half and then goes back to their house.

So it's.

It's very weird.

We're definitely seeing numbers, like, going up drastically as far as, like, testing, as far as people in the hospital ICUs.

I mean, I wouldn't.

The issue is, you know, are we overwhelmed?

I wouldn't say we're overwhelmed yet, but it's like, it needs to calm back down or we're gonna get there.

And so obviously, right now, the.

All the conversations around Scott, schools and whether school's gonna open and what to do about that.

And then just at work, we wear, like, all the gear.

Like, face masks and.

Yeah, all that.

So it's very.

It's very interesting.

Definitely very different, but.

Yeah.

I don't know.

I don't know what the numbers are gonna look like or.

Yeah, I just.

I just remember you're having, like, the first case.

Yeah.

And then within a week, it was, like, exploded.

This is so bad.

But also, like, in New York, everyone's kind of, like, very crowded.

Yeah.

You know, like, Manhattan in itself.

Like, everyone.

So many people.

Exactly.

And the hard thing about New York was, like, everyone came in and out of New York City, like, for work.

So we had people coming from, like, New Jersey who would drive in and, you know, take public transportation.

So it was a big connecting thing.

You couldn't really.

Couldn't trace it.

Yeah.

You couldn't trace it so far.

You know, we were like, you know, we're the big apple.

Everyone comes through here somehow.

So, you know, the only thing to do was to really shut it all down and, you know, like, try to clear it out.

But definitely, like, the numbers, it's, like, pretty high for us.

And I remember, like, Talking to, like, family members.

Like, oh, can you tell me, like, what your husband was like to do before all of this?

And, like, you know, I would try to kind of, like, reconnect them and, like, not have them focus that, you know, their loved ones in the icu and like, you know, some people would be like, oh, like, he's a bus driver.

And I'm just thinking like, oh, my God, all these people who got on the bus, like, he's a guy who wasn't wearing a mask and, like, he got infected.

And, like, just, like, stories that I was hearing and I was just like, this is, like, insane.

And, like, I never, like, while in.

And I never thought we would make it out of it.

I'm like, this is never going to end.

Like, I remember, like, transferring patients and just bring new patients that come in.

Like, it was pretty crazy.

But throughout the time, you know, we did have a lot of trials, like, you know, the plasma trials.

Yeah, medication.

So we were learning a lot about that stuff as well, which I really appreciated.

So it was just.

It was a really collective work.

You know, we worked a lot of departments, work with cardiology.

We worked with, like, a lot of nephrology team as well, neuro and stuff.

So we definitely, like, picked our brains with one another and try to figure out a solution.

But I'm glad we're back where we are now.

And hopefully.

Well, that's what's interesting.

And I've actually talked to my parents about it because, like, we are in such a crazy time where, like, we're watching medicine happen and, like, develop.

And so I was asking them because I was like, has anything like, this ever happened and, like, in your lifetime?

And so they were talking about, like, Ebola.

And that was a thing which I don't really remember.

Maybe I should.

I don't really remember that, but they told that.

And then even when they were, like, you know, younger, like my age, like, talking about HIV and how when that whole kind of, like, HIV AIDS started coming out, like, they, like, no one knew what was causing it or how it was spread.

And I mean, they said, like, yeah, my, you know, dad would not touch a doorknob because he didn't know, like, if he.

How to spread it.

And so, like, it's just crazy.

And if you think about that, like, that wasn't.

That was like, the 19, like, 70s, 60s, 70s.

And so it's taken this long to get to a point where things are, like, very different.

There's a different mentality.

There's, you know, Medications.

And so, like, to me, it's just crazy to think that we're just starting this Covid stuff.

And I hope things develop a lot quicker, but it could be a long time before we really understand it.

Yeah, definitely.

So I work as a per diem urgent care as well.

Oh, gosh.

You're like, you deserve a vacation even though you can't go on one.

Like, you deserve one, though.

So, you know, a lot of the patients that I had, I was doing a lot of telemedicine at the time when Covid hit for the urgent care.

And a lot of them would ask me, like, oh, well, I saw on the news like, this and this is supposed to work, or this and this.

And like, I was using Plaquenil and as its Remy, I saw all of that and I had to sit there and explain to them, like, these are medications that you use in the hospital because we can monitor you.

And like, it was a lot of patient education and like, I think Covid was learning experience for everyone, especially for, you know, like, non healthcare people.

Like, it was just like, they would read something and be like, oh, like that should work.

And like, you know, it was like a really, a lot of patient education that, that I got to do, which I really love to do.

And the hard part of all that, like, you know, they're like, do you know when this is gonna end?

Or like, you know, when the treatments are gonna come?

And you know, a lot of my attending is like, oh, like, you know, when HIV first came out, like, it took this in this amount of time to, you know, find a treatment.

And now we, like, you know, patients have hiv, we know like, how to treat them, you know, all that stuff.

And I'm thinking, I'm like, we're literally in history right now.

It's crazy.

Something new just came and we're going to have to, like, figure out, like, how to treat this and stuff.

And I'm like, I don't know, like, how long is this gonna last?

Like, like, I want it to come faster, but, you know, it's hard.

And like now, you know, in New York, everyone's kind of like starting to get back to their normal lives.

Like, we're still working from home, but in terms of like, a lot of outpatient facilities are now being back open.

Like, they're doing some telemedicine, but sound like, in person now.

So things are kind of getting a little bit back to normal.

So, like, that's a good thing.

But I think of how it just like the pandemic just hit.

A lot of people just can't grasp the idea of how it happened.

And now, like, people are just wanting, like, normalcy back in their lives.

They're trying to, like, go about out and about without masks and stuff like that.

And, like, for me, like, I'm just looking at him like, it's not over.

Like, I'm nice.

I don't want, you know.

Yeah.

So it's definitely, like, hard.

Like, I, like, asked the attendings, like, were you guys ever part of, like, a pandemic in the past before?

Like, you know, and they would tell me their stories, but they're like, yeah, this is, like, something.

It's different.

Yeah, yeah, yeah.

It's been crazy.

So, well, hope hopefully no more.

No resurgence or whatever in New York or anywhere.

But, yeah, where can people, like, find you or follow along?

I don't know.

If you're on social media.

Yeah, I have an Instagram, so they can follow me there.

I also have a medium that I've just started blogging and everything like that, so that actually became, like, my little outlet during COVID really putting, like, my thoughts and my emotions onto paper.

It kind of got a little bit overwhelming during COVID where, you know, people would ask me, like, how are you feeling?

And stuff.

And I felt like I was saying the same things over and over.

And then, you know, like, some people, I replied, like, shortly, saying, like, oh, it's like, it's all right.

But, like, I wouldn't just.

I just didn't want to talk about it.

Yeah.

And then now that everything is kind of over.

I've been working on a blog post for.

Since the beginning of March, and I have not published it till this very, like, moment right now, because every time I, like, write, I just, like, feel everything I've felt in the past four months, and it, like, it's so triggering.

Yeah.

So, like, I look back down, like, wow.

I once write this four months ago, and, like, that was when we were in, like, the heat of.

And now that I'm writing back, it's, like, a little bit different reflection.

So I definitely have that as well.

But we'll link to all of that so everyone can read it, and I'm sure they'll be very appreciative of you sharing your experience.

Yeah, definitely.

Really wishing the best luck for the new grads that just came out from PA School.

It's different.

Yeah.

And also, I'm sure, like, their jobs are not 100% back to normal.

It's hard to.

And finding jobs is difficult.

Too.

Yeah.

Right now.

Yeah.

So, you know, I've told a lot of the grad students that just graduated from my program, like, you know, take it easy.

Like, your job description may not be what you want it to be because of how Covid is right now.

You might be shipped to another department if Covid hits again.

So, you know, like, I told them to kind of where.

Yeah, many.

You know, I actually.

One thing that I did love about COVID is that I got to work with a lot of different PA, so I had actually, like, plastic surgeries, PAs that came into ICU surgery.

PAs a lot of, like, travelers that I got to really, like, learn what they got to do, like, a lot of trauma people.

So I actually got to talk a lot more about the specialties and, like, kind of be like, oh, what do you guys.

What do you.

You guys do before all of this?

And they told me, and I'm like, wow, I didn't know you can do that at the.

Really nice to meet, like, you know, other people coming in and, like, from different locations and stuff out of New York.

And I'm like, oh, wow, that's, like, pretty cool and stuff.

So it's, like, a little plus in terms of, like, just networking.

Yeah.

Yeah, definitely.

So I was, you know, I told an advice for all the new grads.

Like, you know, just keep your eyes open for any opportunity.

You know, just network and, like, figure out, you know, how to kind of just thrive from moving on from PA school.

It's hard.

Well, you're doing great.

I'm very impressed by you, so.

Well, thank you for sharing your experience.

Thank you for having me on here.