Staff in Pediatric Urgent Care
A Medical Assistant’s Perspective

The first article in this series focused on pediatric urgent care from the perspective of management. This is the first of two that center on the evolution of a student, Kalvin Cruz, in the Medical Assistant program at Hunter Business School, how he ended up choosing pediatrics as a specialty, and what his plans are for the future in clinical health care.

What Brought Mr. Cruz to Hunter Business School?

Mr. Cruz was 19 years old when he enrolled at Hunter with his cousin and a close friend. He had already been manager at Burger King from the young age of 16, so he always had drive and ambition in his heart.

On his way to deciding on a career and life profession in health care, he had explored and received formal training in photography, the culinary arts, modeling, and singing. He also gained experience in cosmetology and the martial arts. And if all these endeavors were not enough, Mr. Cruz plays the flute, clarinet, and harp and isn’t a bad chess player, either.

So one can understand why it was so difficult for him to choose what he wanted to do with his life.

Mr. Cruz decided, after weighing all his options, that photography and becoming a chef were not viable choices, as these are hit-or-miss professions. Either you make it, or you don’t. Health care seemed to be a safe choice, while at the same time offering the promise of an interesting and fulfilling career.

Before deciding upon medical assisting and coming to Hunter, Mr. Cruz did his research.

He explained, “I was quite sure of taking the steps, but I thought to myself, if I was going to be in the health care field in the way I wanted, did I want to be a nurse?

“But then I thought that was going to be too much for me because I had no experience, and I felt like that required a lot of experience, of which I had zero. I don’t want to say that I wasn’t capable, but maybe at the time it wasn’t the right choice to make.

“I didn’t know the profession of medical assistant even existed. I always thought everyone was a nurse because they all wore scrubs and they all looked the same.”

Upon further investigation, Mr. Cruz discovered that he did not need a college degree to apply to the Medical Assistant program at Hunter, that only a high school degree was required.

“I thought that this would be a great way for me to put my toes in the water in the health care field.”

Mr. Cruz’ cousin, Gloria, enrolled in Hunter’s Medical Assistant program at the same time he did. She was already working at a doctor’s office at the time but decided to get more formal training than what the doctor offered. He asked his cousin how she liked working in medicine, and she described to him what it was like. He replied, “O.K. That sounds interesting.”

Mr. Cruz continued, “I showed her what was on the Hunter website, and she said, ‘That doesn’t seem like a bad school.’ They looked like really great people. It was professional. It wasn’t a school that goes too long. It was a short-term school, which is something that I was looking for at the time, because I was working a lot of hours in my other job as a manager at Burger King.

“So I decided, well, this is perfect for me because the program’s not too long, and it’s something that can fit around my work schedule. And I discussed it with my cousin at breakfast one day.”

Mr. Cruz and his cousin sat down with their longtime friend, Melenie, and discussed the possibility of the three of them enrolling together. She had already worked for the same doctor as Gloria, but like her, was looking to get more formal training as a medical assistant. She had childcare to consider, but ultimately the three of them became the newest members of the Medical Assistant program.

It is not uncommon for friends, relatives, and even mothers and daughters to enroll together and be in the same class.

When Mr. Cruz phoned the school, the first person he spoke with was Diana, the receptionist (though she is so much more than a receptionist).

Seeing Hunter for the First Time

“We went to the school, and I actually thought it was going to be smaller than it was. But when I went inside the building, I was like, ‘Wow!’ You can’t judge a book by its cover. The school was really big, and I liked the environment. Everybody looked professionally dressed. There was a good vibe in the school.

“Something about the school made me feel comfortable, and I liked it.

“So we sat down and spoke to one of the Admissions reps, who was really, really nice. We asked him a couple of questions. I told him that I wasn’t sure because I had a full-time job and would have to make some changes to my schedule.”

The Admissions representative described classes in phlebotomy (drawing blood) and instruction in the taking of a patient’s blood pressure, pulse, temperature, respiration, height, and weight (vital signs). He explained a little bit about everything and gave them a couple of brochures. They told him they would talk about it among themselves and think about it, and they went home.

They went back to the school the following week, and all three applied. They did all the paperwork.

“The Admissions rep explained everything nicely, thoroughly, telling us what we were signing, all the agreements, and all the stuff that we needed.”

Externship

Externship comprises 160 hours at the end of the Medical Assistant program when students work at an actual medical facility to get real-world experience as part of their studies. A student cannot graduate the program without completing an externship.

Though students are assigned externship sites, Mr. Cruz felt he wanted more practice with clinical skills in an environment that was already familiar to him. While not the normal process with externships, he requested that he be allowed to spend his externship hours at his personal physician’s office, and he was granted permission. Another friend of his had worked there as a medical assistant for nine years, and Mr. Cruz felt that she could be invaluable to him in his training.

When asked what he did on externship, Mr. Cruz responded, “I did everything possible. Everything.”

He learned things you can explore at an externship site, such as how to draw blood from an autistic child and what to do if it’s just impossible to get an accurate blood pressure reading on a patient.

At the beginning of his externship, Mr. Cruz was watched to make sure he knew what he was doing, but in a very short time, he was trusted to work on his own. The doctor had Mr. Cruz draw the doctor’s own blood as one of the “tests,” and he passed with flying colors.

“I got to take people’s blood pressure. I got to register new patients. I took phone calls, faxed paperwork, did EKGs. I did everything possible. I learned everything. I called insurance companies, did preauthorization for surgeries. I learned a lot. I did a lot at my externship. I was really grateful because I didn’t expect that I would learn and grow.”

A Medical Assistant Career at PM Pediatrics Urgent Care

When asked about how he feels working at PM Pediatrics in North Babylon, he replied, “It’s amazing that you see a lot of these beautiful, innocent kids who unfortunately come back when they don’t feel well. You try and help them out to feel better. You know, it’s a great feeling, I do have to say.

“For me, a big difference between my externship and working at PM Pediatrics is that at PM it can be intense in the way everything’s fast paced. There are higher volumes of patients coming in than there were at my externship site. I get more experience because everybody comes with something different at PM Pediatrics.”

In urgent care, Mr. Cruz sees a little bit of everything; a myriad of medical conditions. As he describes it, “It’s a great experience for me to learn.” He refers to the difference between externship and working at PM Pediatrics as “going deeper into the water. It’s more advanced. It’s deeper. It’s a different environment, which I like.

“I, myself, like to do everything at a quick pace. I like to do as many things as I can. I can’t just stay sitting still, doing nothing. I have to do something. So it worked out perfectly for me because I got to do so many things to so many patients. And we have a lot of rooms, our facility. So the more rooms, you know, the more patients. It’s even better for me than externship.”

The Parents

When asked about the parents of the child patients who come into PM Pediatrics, Mr. Cruz had this to say.

“A lot of parents are very understanding. Sometimes it is a little difficult because the parents may be frustrated because their child is not feeling well and may be in pain.

“And sometimes they get a little nervous and tense and they worry. I’m not a parent, but I raised my sister as if she were my own child. So I totally understand the issues and where the parents are coming from. I totally understand that. I’m a very understanding person.

“We treat based on what we see and what the doctor decides to do. We do the best that we possibly can for the kids.”

The Staff

When asked about the other clinical staff members at his office, Mr. Cruz replied, “We have medical assistants, X-ray techs, registered nurses, physician assistants, physicians. At our practice, there are also scribes, nurse practitioners…we have a little bit of everything there. So it’s great because everybody gets to learn a little bit about everybody else because every position has a different responsibility and a different job.”

Mr. Cruz was asked if working at PM Pediatrics was just another job to him. After all, as young as he is, he already has a long history of employment and knows what it’s like to work in different environments and for diverse employers.

He explained, “I love everybody there. They’re amazing people, they’re really understanding, they’re an amazing staff. I feel so blessed. It’s not every job that you get that. At a lot of jobs, they don’t like to work as a family. At PM Pediatrics, we all have each other to help one another out best that we can.

“So it’s the little things that make you feel comfortable and happy, an environment where you feel loved and appreciated, that somebody has your back. It’s sad that my past jobs didn’t feel that way.

“Sometimes there are difficult moments, but everybody tries to help each other.

“Whether it’s the doctors, the physician assistants, the registered nurses, or other medical assistants, we always try and help out as much as we can. We do everything as a team because nothing works better than a team and allows us to serve the patient better. We do a great job and try and have the patients satisfied.”

Interpersonal Skills

According to Mr. Cruz, so much of medical assisting, and really any clinical position, is about interpersonal skills, also referred to as soft skills.

Mr. Cruz was asked if he thought anyone with the proper credentials (license, certification) could get hired as a nurse, medical assistant, or any other clinical health care worker at PM Pediatrics. Can everyone properly care for and interact with children and teenagers?

“I want to say yes, but at the same time no. I believe anybody can do anything. I am a huge believer that you always have to try your best, and no matter what, you have to succeed. So I never want to say it’s impossible.

“But it definitely takes a lot. We have some special needs kids, kids with autism who sometimes don’t understand, so you have to have a little bit of patience. You have to be very understanding, very compassionate.

“Some people are very sensitive toward kids dealing with blood and seeing them cry. Parents obviously don’t want to see their kids crying or feeling in a bad way. So I, as a medical assistant, have to put myself in the parents’ shoes.”

Teenagers

Teenagers, a subset of the pediatric demographic, present a different dynamic in the type of care required and the kind of interpersonal skills necessary. They’re not children anymore, but not quite yet adults. This is what Mr. Cruz had to say:

“It’s interesting because with every teenager, things are different. A lot of teenagers tend to stretch the truth. But they can also open up to you, and you can build a bond with them—even with younger kids or any age group. You create that bond with people they trust. It’s a really great thing because sometimes teenagers don’t tell their parents everything because they’re nervous or they’re nervous of their parents’ reaction.

“It’s a great experience working with teenagers because of how their mindset is. We know where they’re coming from because we already went through that stage in our life.

“So it’s intriguing to work with teenagers, having them as patients. I think it’s amazing. I love every age group, from newborns to teenagers.”

Newborns

The thought of treating and caring for newborns would probably frighten most people considering entering health care since they are so young and delicate.

Mr. Cruz usually takes newborns’ vital signs. Vital signs are body temperature, pulse rate (number of times the heart beats in one minute), respiration rate (breaths per minute), and blood pressure.

PM Pediatrics triages newborns along with all other patients, but keeps them distanced from others and has a special pulse oximeter that measures an infant’s blood oxygen level with a clip-like device that is placed on a toe. With adults, a finger is used. To check weight, the infant is placed on a scale that measures in kilograms. Mr. Cruz has also done COVID testing on newborns.

Mr. Cruz explains, “The registered nurses give children medications. For us medical assistants, we comfort them because they’re newborns and not feeling well. They have a lot of discomfort. Obviously they can’t talk, so they can’t tell you what hurts and what’s wrong.

“So, you kind of have to try to do your best to make the newborns feel comfortable. I also try to relieve some stress off the parents because sometimes the parents haven’t slept, or they’re worried, or they’re stressed. They’re worried about their kids.”

Next Article in This Series

In the next article in this series, Mr. Cruz talks about what other new things he learned at PM Pediatrics that he had not experienced on externship, what it’s like to work in a profession that centers around illness and disease, difficult or emotional medical situations, being truthful with patients, and his greatest challenges.