Day in the Life of a Pediatric Surgery Physician Assistant Fellow at Texas Children’s Hospital

​Chelsea Hartwig PA-C is the lead author for this blog. Edits & Contributions made by: Abby Young, Brittney Knudson, Kelly Wiseman, Sara Mullinax, Thian Nguyen, Jordan McAndrews (Fellowship Coordinator) and the Class of 2015 PA Fellows.

Have you ever wondered what a day in the life of a Physician Assistant Fellow is like? Here is a glimpse of a day in our shoes. 

4:45 a.m. I am awakened from my beautiful slumber by the sound I dread each morning:“BRRRRRING-DING-DO-DING… BRRRRRING-DING-DO-DING…” I blindly reach for my phone to pound the snooze button. 

4:55 a.m. “BRRRRRING-DING-DO-DING… BRRRRRING-DING-DO-DING…” In a semi-lucid state, I conclude that the benefits of arriving to work on time do in fact outweigh the benefits of ignoring the world for a little longer. 

5:00 a.m. After donning fresh scrubs, I glance in the mirror to begin repairing the damages my pillow made last night. Thoughts of my schedule for the day start to seep back into my blurry mind. 

5:15 a.m. I arrive in the parking lot of the hospital and need to quickly decide if I need to take the shuttle to The Pavilion for Women or the Feigin building. While we step off the bus a few minutes later at Feigin, the driver wishes each of us: “Have a great day!” 

5:30 a.m. As I print off the patient list for the day and review my patients’ charts, the resident physicians trickle in one-by-one. It’s pretty evident who took call last night. I hand out a copy of our patient list with updated information to each team member to review before rounding on our kids. 5:45 a.m. We immediately start rounding on our patients on the floor. I knock on the door of my patient’s room who is preparing for surgery later today. “Good morning! Can we come in?” The resident physician and I answer the family’s questions and ensure everything is in order for the day and that nothing has changed overnight. 

6:15 a.m. My stomach rumbles and I think everyone heard it. We still need to see three more patients before attending morning report. We are all so grateful for the lady who delivers coffee to the Operating Room lounge at 6:30 each morning, hopefully I will have a spare minute to grab a cup.

​7:00 a.m. With coffee in one hand and a pen in the other, I settle into my seat as we get ready for the morning report in the office. We begin to discuss the surgical cases of the week and our current admitted patients. I love learning about the ground breaking surgeries that are performed at this hospital on a daily basis! 

7:45 a.m. I’m looking forward to assisting​ in surgery this morning. Should I wear my barn animal scrub cap or the one with polka dots? It’s important to make the patients feel comfortable when we walk them back to the operating room. My patients seem to like my barn animal cap best, I’ll wear that one today. 

8:10 a.m. As I pull my patient in a red wagon towards the operating room with the team, we look back and wave to mom and dad. Prior to our wagon departure, the surgeon and I were able to sit down with the family and discuss the procedure in detail and answer any final questions. We assured them  their child is in great hands and  we would come out to discuss the case as soon as we finished. 

8:15 a.m. [Once in the operating room I turn to the Scrub Technician] “Good Morning! I’ll be scrubbing in. Can I grab my gown and gloves from you?” I begin to gear up for the case. Prior to any surgical procedure, it is crucial to prepare the sterile field and scrub in. Keeping this in mind, I walk into the hallway to begin the scrubbing ritual. 

11:15 a.m. Woah, what a great learning opportunity! The strength and courage of these patients never ceases to amaze me. The patient did great and the family was updated on the surgery. Now I need to find an available computer so I can put in the hospital admission orders for my patient. 11:50 a.m. Time for the fellowship lecture series. I’m really looking forward to today’s lecture on transplant surgery. It’s pretty amazing that world-renown surgeons take time out of their busy schedules to lecture to us, and other providers throughout the hospital, every week. Over the course of this year I will receive over 40 lectures just from this lecture series alone. 12:45 p.m. The lecture comes to an end. “Do you have any questions?” The presenter answers our questions and further explains the intricate details of the topics he’s been presenting. 

1:05 p.m. Time to head to clinic. I review the schedule for the afternoon and prepare so I can be a productive member of the clinical team. 

1:30 p.m. I knock on the door then walk into an exam room. My patient is a 5-year-old female who is coming into the clinic for hip pain. We discuss how long she has been experiencing  pain, then I perform a physical exam. I step out to discuss my patient with the attending surgeon. After formulating our treatment plan, we go back into the room to talk with the patient and her family. 

4:45 p.m. Whew, clinic was so busy I didn’t have time to complete my clinic notes. Thankfully I can head back to the office to add the finishing touches after our quality improvement conference. 

4:47 p.m. As I’m waiting by the elevators, I see one of my patients walk by with a bright smile. She runs up to give me a hug and says, “Bye, Bye! Thanks for the sticker!”   

4:50 p.m. I punch in the door code and burst into our office to find two other PA fellows typing away ​at their own notes. “Hello! How was your day? Who has snacks? I might go down to the surgery office to get a Rice Krispies treat, do you want anything?” I either need to stop eating all the delicious snacks in the surgery office or find time to work out. Wait, who am I kidding, I won’t have time to work out until the fellowship finishes next year. 

5:00 p.m. I settle into my seat at the conference, watching all the resident physicians in light blue scrubs and white coats find a place to see the projector screen. “Is everyone present? Then we can start.” I take out my notebook to take notes while the attending surgeons start to discuss learning points of recent surgical cases. The surgeons offer suggestions on upcoming surgeries to ensure  every patient we treat receives the best care possible. 

5:26 p.m. ​“BEEEEP-BEEEEP-BEEEEP” Everyone in the room pats their waistbands to find the source of the disturbance. I quickly realize my pager is the one going off and step out of the room as discretely as possible to return the page. It is the emergency room consulting surgery for a patient after recent imaging has revealed the need for surgical intervention. With these new results, I need to head down with the attending surgeon to examine the patient and confirm the diagnosis. We then talk to the family about the procedure their child will be needing tomorrow, explain the risks and benefits, and get their consent. Now, I will schedule the surgery for tomorrow with the surgery schedule coordinator. 6:40 p.m. Okay! I finished my last clinic note, logged my surgical cases from today… now I need to print articles to read for my case presentation next week. Am I fo​rgetting anything? 

6:46 p.m. Nice, the shuttle is here… [Begin walking briskly] IT’S PULLING AWAY! My power walk turns quickly into a jog. 

7:19 p.m. To my delight, I sit down on my living room couch. What a day. I can’t help but reminisce about today’s events. Who knew being exhausted could be so satisfying! The fellowship has been such a rewarding experience, I feel so fortunate to be taking care of children at Texas Children’s Hospital. 

​Time to relax and review for tomorrow, so I can do it all over again!

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