r/physicianassistant • u/tundao330 • 3d ago
Simple Question The Pit
My wife and I started watching The Pit, and I was wondering if any PAs operate in that specific kind of emergency medicine. I’ve heard some PAs work at an urgent care or the like, but didn’t know if full trauma emergency medicine was possible/common for a PA.
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u/djlauriqua PA-C 3d ago
Honestly PAs are way underrepresented on the Pitt, it’s one of my gripes with the show. Most ERs have them. In my state ERs hire them preferentially to NPs
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u/TooSketchy94 PA-C 3d ago
This.
PAs are insanely underrepresented in the series.
I’m an EM PA in several emergency departments.
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u/ckshin 2d ago
I firmly believe that if we could get a PA character on the show it would do so much for the profession, more than what the lobbying orgs for PAs are currently doing.
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u/FineOldCannibals 2d ago
Jeanie Boulet was representing back in the 90s on ER.
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u/ckshin 2d ago
The age of someone who watched that TV show today is probably at least 45 years old
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u/FineOldCannibals 2d ago
Yes. And?
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u/ckshin 2d ago
Just that the demographic is aged and we need new and updated representation
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u/FineOldCannibals 2d ago
I’m not disagreeing, just reminiscing that ER was pretty cutting edge at the time for dealing with HIV and hepatitis and the way it can impact clinical practice
It was a sidebar, that’s all. She was my main vision of what a PA was before I got into PA school so indeed representation helped me.
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u/RunBrundleson 3d ago
We have about 40 PAs on staff covering multiple ERs and many of them are crazy experienced and practice at a full EM scope. We actually have a group of PAs that come in twice a week and only do procedures. LPs, central lines, thoras paras, anything. We have two PAs that also work in IR that are managing it and they are easily two of the most crazy talented PAs I’ve ever met.
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u/guamo17 PA-C Trauma Surgery 3d ago
I currently am working as a trauma PA, responding to all trauma activations. I used to work more general emergency medicine.
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u/UchihaRaiden PA-S 3d ago
How’s the pivot to trauma surgery from ER? How’s your scope of practice? Currently in ER and I love it! But considering other fields in the future, mainly ICU/Surgical sub specialties.
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u/guamo17 PA-C Trauma Surgery 2d ago edited 2d ago
I actually went from ER to ICU, then to trauma surgery. They’re all different in a lot of ways, but all still resuscitation and critical care. Both transitions felt like starting over in many ways and I had to study hard to make it work. But they were easier than the first year right out of school. I really liked all the specialities I worked in, and love that being a PA gives me such flexibility. My scope is fairly extensive. I actually was much more autonomous in the ICU, because I worked at an APP heavy hospital, without residents. I work at a teaching hospital now, so my scope is more limited, just by necessity. But I still get to do pretty much everything in the trauma bay, including the occasional thoracotomy, chest tubes, central lines etc. I don’t get into the OR as much as I’d like, but still get a bit of OR time too. That’s mainly down to it being a teaching hospital and the residents getting first dibs on surgery (completely fair in my opinion, they gotta learn to be surgeons after all).
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u/Minimum_Finish_5436 PA-C 3d ago
Shows like the pit and ER way over dramatize how much real trauma occurs is a shift. Yes, trauma and zebras happen. Not at the level of any show on TV. I worked in an ER during COVID. Both on code teams and triage/ESI 4/5. Most shifts, not much exciting happens.
TV is entertainment. Not reality. Yes you can be on a code team or trauma surgery team. Just know it is 95% boring with 5% excitement. And the pay isnt worth the 5% excitement.
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u/secretburner 3d ago
How many episodes of the Pitt have a timeline that includes two COPD exacerbations, one 8 week pregnant lady with light spotting and no other symptoms, five kids with runny noses/sore throats, a couple of elderly confused people with multiple comorbidities, two lacerated fingers, one broken wrist, one idiot who saw a raccoon once and is demanding a full rabies pep protocol, and a single NSTEMI? Because that's a run-of-the-mill day for me, ha.
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u/Minimum_Finish_5436 PA-C 3d ago
Yup. Exactly. Don't forget the work/school notes. Pain control for chronic nonsense etc. TV ratings on those real type shows would be pretty boring.
People want to see what is stuck in your butt. What make believe trauma happens daily, etc. Not the mundan reality of most ERs.
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u/secretburner 3d ago
Oh yeah. I forgot the guy who stubbed his toe and wants a note for 5 days off work LOL
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u/Agreeable-Ad4806 2d ago
They didn’t really over-dramatize anything. They just picked really busy days at a lvl 1 trauma center.
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u/Gallant12587 3d ago
I have worked as a PA in a community hospital ED for 15 years. I do central lines, intubate, LPs, sedation, joint reductions, and basically everything the docs do. It is very hospital dependent, and you probably won’t get that a trauma center as they tend to have residents who take most of the critical cases. That being said, traumas walk in to our hospital all the time, so I’ve had my fair share of them.
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u/ElectronicClass9609 3d ago
i actually did my ER rotation at the hospital that the Pitt is based on! they employed PAs. from what i recall the PAs tended to handle the lower acuity cases there. i don’t necessarily believe that’s the case at every ER though!
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u/FrenchCrazy PA-C EM 2d ago
An ER like the Pitt would absolutely have PAs running around and caring for people but the show decided to make everyone residents and med students instead.
A typical day in the ER is not like The Pitt.
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u/No_Advertising4407 3d ago
https://www.reddit.com/r/physicianassistant/s/oHIxgmpL29
Above is from 6 years ago. My experience at Level 1 trauma centers is that the trauma PA would respond to trauma alerts along with the trauma surgeon. When I covered neurosurgery at Level 1 trauma centers I responded to all trauma on my shift.
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u/Cosmicharlie18 2d ago
I work in the ER and I do everything including intubation, central lines, pigtails. I love it. I didn’t do a residency but worked my ass off and interviewed hard to find the right fit for me. I asked in interviews if I could do those procedures and take care of sick patients
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u/EmergencyMonster PA-C EM 2d ago
I watched one episode of the Pitt and it felt exactly like work so I haven't watched anymore.
So that to say, yes I guess my ER is very similar.
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u/bmc8519 M.D., PA-C 2d ago
When I was a PA I had two main jobs. Full time was trauma surgery/critical care in an urban level 2 trauma center where PAs were the continuity of the trauma team. We did everything resus/OR/ICU/floors.
Also worked in an ED covering when residents were off for education. Worked in main ED seeing whatever was up next.
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u/DangerousDeer7246 Pre-PA 1d ago
At a level I academic center you probably wouldn’t see PAs doing all the trauma stuff but at a community trauma center absolutely and that’s what I wanna do. Trauma or EM. I want to practice at a great community level II trauma center in my area
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u/Mrmikeoak 1d ago
I work in the county hospital in a city on the west coast, It's a lot like the Pit
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u/littlespo0n2 PA-C 23h ago
im a trauma PA, those trauma that come in are my job on a regular day 🙋🏻♀️
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u/NewPossible4944 6h ago
I hope people know that most ERs are run by PAs, NPs and resident doctors .
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u/bananaholy 3d ago
Yea there are trauma PAs that work like that. Its very region/hospital/doctor specific.
Even for me i can pretty much do anything but also nothing depending on which doctors are working at the day or which hospital im working at.