Second Year Student Blog: Heather Dumke

Monday, August 21, 2017

Heather Dumke, PA-S

Lessons from Clinical Year

July 21, 2017: My last day of clinical year. I awoke that morning and immediately felt a flood of emotions: excited that I had accomplished another PA school milestone; exhausted from adapting to new rotations, new places, and new medical knowledge for twelve straight months; grateful for the wonderful preceptors and patients who helped me advance my clinical skills; and sad that I will never again be able to immerse myself in so many diverse clinical experiences in such a short period of time.

I had the chance to interact with some very impressive PAs during these past two years. You know, the providers that just make you stop and say, “wow!”  These PAs always seem to have a few things in common: they know their stuff, are confident, and actively practice excellent patient-centered care. My clinical rotations, and these inspiring PAs, pushed me to reflect honestly on who I was and how I could grow in these areas.

My confidence over this last year has grown tremendously. My first rotation was in the emergency department where every day I had a new preceptor to impress and a new set of expectations to uphold. It was terrifying. I remember my heart pounding and hands shaking as I made my way through the ED doors that first day. As you may have guessed, I survived my first shift, and every other clinical day to follow.  

I did not know the answer to every question my preceptors asked. But with every passing day — as my medical knowledge and clinical skills grew — so did my confidence. Instead of doubting myself I began thinking, “I know this. If I don’t, I’ll admit it, go look it up, and learn from it.”

I learned that being confident means being bold enough to ask questions. Preceptors respect courageous learners. They appreciate when you speak up and suggest a treatment plan or ask to perform a procedure for the first time. They value a willingness to learn. I strongly believe the attitude I developed toward my clinical rotations is a direct reflection of the experiences I am leaving PA school with.

A Lasting Impact on Our Patients

I had the privilege of learning from hundreds of patients throughout my clinical rotations. Patients will teach you more than any textbook ever will. One day on my internal medicine rotation my preceptor asked if I wanted to watch a procedure for one of the patients I had been working with. I knew it would be an interesting experience, but couldn’t help thinking about the notes I still had to write, the lecture I would miss, and the end-of-rotation exam I could be studying for. My love for new experiences prevailed and I decided to go with my patient. As I was standing beside them in the cold, sterile procedure suite, they reached out to hold my hand. The patient began to open up to me--telling me how scared they were, how they didn’t have any family, and how much my presence meant to them.

Sometimes we let the long hours and stress of PA school take precedence over patient care. We forget that as students we can also make a lasting impact on our patients. That patient reminded me to slow down, take time to practice compassion, and stay true to the reasons why I wanted to become a PA.

Being a PA is not about how fast you can complete morning rounds or finish documentation. It’s about a commitment to making a positive impact in patient’s lives every day. This patient’s vulnerable and honest words helped me realize my shortcomings. This patient’s words serve as a constant reminder to start each day with a desire and openness to learn from my patients.

Clinical year was a truly unique and formative experience. I expected to grow academically in my history-taking abilities, physical exam skills, and medical knowledge, but I wasn’t expecting this year to change me so much on a personal level.

The whole experience was somewhat paradoxical: I wanted to become a PA to help make a positive impact in people’s lives, and I’m leaving PA school feeling overwhelmed with gratitude by the people and experiences that have helped me become a more confident and compassionate provider. Who knows, maybe one day I will be one of those “wow” PAs.

Heather Dumke was a second-year PA student with the Duke Physician Assistant Program.

Editor’s note: Duke Physician Assistant Program students blog every month. Blogs represent the opinion of the author, not the Duke Physician Assistant Program, the Department of Community and Family Medicine or Duke University.