A day in the life of one of Nova Scotia Health’s first physician assistants

Today I woke up at 5:50 a.m. 

This morning was busier than most as I needed to see our admitted patients in Halifax, before heading over the bridge to Dartmouth. I debated getting another ten minutes of sleep, but thought it was best get up right away.

When I arrived at 6:20 a.m. I printed my list of admitted patients for my three supervising physicians - thankfully everything went as planned. Everyone was discharged as scheduled from the day before. 

Then at 6:30 a.m. I went up to the floor and started my rounds, and see how our patients were feeling. 

My rounds began with a lovely morning chat with patient X - they just loved hearing about how the surgery went. 

Physiotherapy said patient X is doing well but needs more practice on the stairs, so they will likely be discharged tomorrow. 

Off to see my next patient – patient Y who was sitting in their chair, completely dressed and ready to go home! I completed a dressing/incision check, assessed for normal feeling and pulses in the foot. Patient Y is doing well. We talked about discharge and patient Y has no questions, so they got to go home today. I still had several more patients to go.

Once rounding is finished, I raced over to Dartmouth to attend the Orthopedic Assessment Clinic for an 8 a.m. start. 

With COVID-19 restrictions, there were less patients than we would normally see, but it was still busy. 

I checked the schedule to see there were 22 patients booked for today. This included a few new consultations and a few follow up patient visits – and I recognized a lot of their names. 

I always love seeing familiar faces. Between myself, my supervising physician, our nurses and physiotherapists – the day was busy but efficient!

I saw one third of the patients on our morning list and gave a patient a cortisone injection in their knee. Injections are often tried before surgery to help alleviate pain. 

I am hopeful that this patient will benefit from the injection, in order to hold off on surgery for as long as possible. 

Perhaps I’m biased, but we truly have the most pleasant patients. 

Between meetings with patients I received a call from the Halifax Infirmary inpatient unit, about patient Z – They needed clarification around their medication. Lucky for me, this was done with the nurse over the phone.

I finished up the clinic day around 4 p.m. Most of my patient dictations are completed to be added to their health record and I’ll finish the rest tomorrow. 

Before leaving I connected with my supervising physician. I reviewed the patients I saw today and the patients I will assess in the morning before I assist in the operating room. 

Tomorrow we will have four orthopedic surgery patients in a 10 hour day – two total hip arthroplasties (replacements) and two total knee arthroplasties. I assist surgeons during the surgical procedures performing duties such as: positioning the patient, placing the surgical drapes on the patient, holding retractors, using suctions and helping with closure of an incision site (stitches or staples). I will often then take the patient to the post-operative recovery room and give the report to our nursing staff. 

I spend a few hours reviewing these patients’ files to prepare myself for tomorrow, before heading to bed around 10 p.m. What a day!

Erin Sephton is one of three physician assistants working at Nova Scotia Health as part of a three-year pilot, supporting care in orthopedic assessment clinics, aiding pre-op care/surgeries and working to support the care and discharges of patients on inpatient orthopedic units. 

The pilot, which began in January 2020, is supported by the College of Physicians and Surgeons of Nova Scotia and the Department of Health and Wellness. 

It is assessing how physician assistants could help increase capacity to allow more joint replacement surgeries to take place and help enhance the care being offered. 

These are the first physician assistant roles in Nova Scotia, outside the Canadian Forces. 

Sephton, along with her colleagues, Laurel MacInnis and Brittany Belair, are part of the Division of Orthopedics at the QEII Health Sciences Centre and support the care of joint replacement patients at both the QEII Halifax Infirmary site and the Dartmouth General Hospital. 

Their positions are among approximately 100 full-time roles funded through the Hip and Knee Action Plan.