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Promoting the Physician Assistant profession in the UK since 2005

A Day in the life of a Geriatric Physician Assistant

…or should that be a day in the life a Physician Assistant who works in Geriatrics?

My working day starts at 9 o clock on the Acute Medical Unit of the Leicester Royal Infirmary. I work as part of the Frail Older Peoples’ Advice and Liaison (FOPAL) Service. The idea behind the service is to offer specialist geriatric intervention for frail older adults within the acute medical setting. The aim is to try to improve their care and reduce unnecessary hospital admissions, lengths of stay and readmissions. I like working in Geriatrics as it enables me to look at the person as a whole, from medical, social and psychological aspects and not only a particular disease or system.

I work closely with the Acute Care Admissions nurses each morning to identify patients who would benefit from FOPAL intervention based on their Identification of Seniors at Risk (ISAR) score. This looks at things like how many medications they take each day, how many times they have been in hospital in the last 6 months and how much support they need to carry out their Activities of Daily Living. This morning Sue, the Acute Care Admissions Nurse and I, have identified 13 patients to see so we had better get cracking! I see each patient and take histories and collateral histories, examine patients and develop management plans to present to the Consultant Geriatrician of the Day at around 10.30am. This morning the majority of patients have come in with falls or collapse so it’s an interesting and challenging job putting together the bits of the jigsaw to try and work out exactly what’s going on! Believe it or not, it’s not all UTIs! My Consultant joins me at 10.30am and we see the patients together. We manage to send 2 patients home with outpatient follow up and 1 patient to a rehabilitation bed, all of whom could have spent unnecessary time in hospital. Not a bad morning’s work and 3 very happy patients and relatives! I wish I could say every day was like that......!

Then it’s time to grab a bit of lunch and as its Thursday it’s the Geriatrics/Stroke lunchtime meeting. I enjoy attending the weekly meeting to keep up to date and learn from my colleagues and catch up with other members of the department. I did my presentation last week on recommendations for artificial feeding in dementia so I can breathe a sigh of relief and enjoy the session this time!

Then it’s off to a falls outpatient clinic at a community hospital to assist the Consultant geriatrician by seeing the new patients whilst they start seeing the follow up patients. It must be my lucky day as I get offered a cup of tea as soon as I get there! I like the change of pace and scenery that coming to the community hospital gives and the fact that the services provided through these hospitals are helping to keep older people in their home environment for as long as is possible. Also as there are only 2 new patients today I get time to spend with each one. The first lady is very tricky as she was a 90 year old lady who came in with ‘dizziness’ sent in from her GP as nothing seemed to be working.....had to get my thinking cap on for that!

And then it’s time to head back down the M69 towards home to read up for a delirium and dementia conference I am going to next week. Never a dull moment!

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