Today is actually my 90 day evaluation, which makes it a fitting time to share this post! I started my APP Fellowship in Emergency Medicine in September, and let me tell you, I had a TON of fears starting out.
I still do.
But with every day, things do get just a little bit better. Every day I feel less overwhelmed and *slightly* less terrified. I feel a little bit more like I actually know what I’m doing and that I’m NOT going to kill someone.
I’ve been asked a lot to share some of the fears I faced during the transition from PA-S to PA-C, and I honestly struggled with how to write this post for some time (which is why its being shared now – roughly 3 months after starting my job). I had SO MANY fears starting out that I was actually embarrassed to share them with all y’all. Would you guys think I was insane if I actually wrote down all the fears I had? I’d like to think that I seem on top of things, and I was worried that if I shared my fears I wouldn’t seem like I knew what I was doing. And then how could I possible have a blog were I posted tips?
So I put the post on the back burner and ignored the requests I got asking me to do this. It was the easy way out. And I’m disappointed in myself that I did it.
Part of my goals for 2019 is to be more active here on Stethoscope and Sparkle and impact others lives in a positive way. And so, I am finally doing this long over-due post because this is what all y’all have requested!

I think the easiest way to go over all of these fears that I, and maybe some of you, had is to just list them all. I’m not going to discuss specifics or how I overcame these fears (maybe this will be another post?)
- What if I can’t remember anything I learned during school?
- What if I kill someone?
- What if I miss something really obvious?
- What if I order the completely wrong medications for someone?
- What if I keep making mistakes and don’t learn from them?
- What if I’m behind when compared to all of my co-fellows?
- What if all of my coworkers think I’m an idiot?
- What if I’m that person no one wants to work with?
- What if I put in the wrong orders?
- What if I piss off the nurses and then can never get anything done?
- What if I can’t remember what exactly to order for a workup?
- What if I can’t remember what all of my patient’s home medications are for?
- What if I miss something obvious on a scan?
- What if I can’t do all of these procedures I’m required to?
- What if I leave someone with a huge scar because I f***ed up their suture repair?
- Oh shit, what if I can’t remember what suture material I’m supposed to use for what kind of laceration?
- What if I knick an artery when I’m doing an incision and drainage?
- What if I send someone from Fast Track to the main side for a stupid reason?
- What if I never learned this?
- What if I have to say I’m in over my head?
- What if I actually am in way over my head in the Emergency Department?
- What if I’m not cut out for working in a busy ED?
- What if I hate my job?
- How will I handle it if I’m burnt out?
- What if I can’t handle the acuity of these patients?
- What if I mess up because I’m handling multiple patients at once?
- What if I don’t know enough of the medicine?
- What if I get sued?
- What if I never feel confident as a PA-C?
- Seriously, what if I kill someone?
These were just the “big” fears I had. And I honestly had so many more in the moment.
For the first month solid, I felt overwhelmed by work and my fears. I left every day feeling exhausted. I went in to work feeling stressed. My days off were focused on sleeping and frantically looking things up.
But somewhere along the way, those feelings of being overwhelmed and overly stressed got smaller and smaller until they were almost nothing.
Do I still have fears? Absolutely.
But now those fears are the big ones; the ones I think that every provider needs to have. The “What if I kill someone?” “What if I miss something?” “What if I don’t treat someone appropriately?”
I hope all y’all have enjoyed this LONG over-due post. I’d love to hear if you had any similar fears or even something totally different than any of my fears!
And as always, feel free to subscribe to get emails with new posts sent directly to your inbox! I promise not to spam you (I actually probably send less emails than I should). And follow along on social media (FACEBOOK, INSTAGRAM, TWITTER) as I try to survive life as a PA-C with a stethoscope and some sparkle
-ER
I 1000% agree with all of those fears!!! I graduate in August from my program and I’m already worrying about the transition. I keep telling myself that one day I’ll know just as much as the providers training me. Thank you for being brave and posting this. I’ll be sharing it with friends.