Life as a New Grad PA in the ICU During COVID-19

By: Savanna Perry, PA-C

TL;DR

Karlina Nguyen reflects on her first year as a PA, from her white coat ceremony to working on the front lines of COVID-19 in a New York City ICU. She shares the anxiety, grief, and burnout of caring for critically ill patients as a new grad, and the honest truth that the journey gets harder after graduation, not easier.

Last Updated: June 12, 2026

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What did the start of your PA journey look like?

A year ago, I was at my white coat ceremony, walking across the stage as my mom coated me, still not quite believing I had made it through the toughest years of PA school. During my program, my mom was diagnosed with Stage IV ovarian cancer, and later her cancer metastasized to her brain, requiring surgery and radiation. I remember praying in the waiting area, my biggest wish being that she would live to see me graduate.

And then there I was, walking across that stage with my mom coating me. That moment meant everything. Everything I wanted was right in front of me: my mom, my degree, and my career. It felt like I was on top of the world, like nothing could go down from there.

In this post:

What was it like working in a NYC ICU during COVID-19?

A year later, I was on the front lines of COVID-19 as a critical care PA in an ICU in the middle of New York City. Within my first five months as a PA, I was facing a pandemic I never imagined. My hospital received the first COVID-19 case in NYC, and the numbers quickly doubled and tripled. We went from one intensive care unit to three, plus a new step-down unit and a unit for weaning patients off ventilators after prolonged intubation and tracheostomies.

As units kept opening, we became short staffed. With only half a year of experience, I became one of the seniors in the ICU, helping run the unit and training travelers, surgical interns, and floated PAs. I went from being the person who asked seniors for help to the person others relied on, even though I was far out of my comfort zone too.

In Our Experience

This is a guest post, and Karlina's honesty about the emotional weight of new grad life, especially during the pandemic, is something every pre-PA deserves to hear. In coaching, we spend so much energy on getting in that it is easy to forget the transition to practicing clinician is its own steep climb, and asking for support is a strength.

How did you cope with the anxiety and grief?

My anxiety worsened every day. Everyone was pushed past their limits, exhausted physically and emotionally. I started hearing alarms in the shower and having nightmares about my patients. School taught us not to get too attached, but how do you do that when you are the only person your patient has seen in months? Family members couldn't visit unless a patient was actively dying. I would put my phone in a specimen bag to call families into the room, choking back tears behind my PPE.

I came home exhausted, sometimes breaking down in my car. I couldn't even visit my own mom for months out of fear I might be an asymptomatic carrier. It was two months before I saw her from afar, and three months and four days before I could hug her. Six months out, I am still recuperating mentally, still working through the anxiety, but I know healing takes time.

Every Pre-PA Should Know...

Burnout and grief are real parts of new grad PA life, and they don't mean you chose the wrong path. They mean you care.

Free Application Timeline → https://www.thepaplatform.com/services/free-application-timeline/

What advice would you give your past self?

If you told me a year ago that I would be battling a pandemic with my mental health failing me, I would have said you were crazy. If I could give one piece of advice to the person I was a year ago, it would be this: it doesn't stop once you graduate. It actually gets harder. You no longer have a program guiding you, and you are on your own from here.

You are going in for one heck of a ride. Hold on to all the good intentions in your heart to heal people, but also know you won't be able to save everyone. You will face battles you may not be prepared for. You'll sink, you'll float, but you will get through it in the end. They don't teach you this in school, but life will.

Need to Know:

The transition to practicing PA can be harder than school itself
New grads sometimes take on senior roles faster than expected
Grief and burnout are common and valid in clinical work
Schools rarely teach how to cope with losing patients
Protecting your own mental health is essential, not optional
Recovery from a traumatic stretch takes time and support

Listen: the full conversation

We covered this in a conversation on The Pre-PA Club podcast. Press play to hear it first-hand, in their own words.

Episode show notes & key takeaways

New grad. ICU. New York City. Spring of 2020.

Karlina started her first PA job in the intensive care unit of a New York City hospital, and then the pandemic hit her city harder than almost anywhere in the country. She watched her unit change from a normal ICU into something none of them had trained for.

She's honest about what that did to her and to the people she worked with. She's also clear about how much she learned in a very short time, and how much of getting through it came down to the team around her. Nobody was doing that alone.

This is a hard listen in places, but it's an important one, especially if you're heading into critical care or wondering what new grads are really walking into.

What we cover

Starting her first PA job in a New York City ICU
How the unit changed as the pandemic escalated
The emotional and mental weight on the whole team
Learning fast when there's no playbook
Leaning on coworkers to get through it
What new grads should know about critical care

Resources

Episode: Karlina, PA-C's Experience as a New Grad ICU PA in NY during COVID-19 · Follow The Pre-PA Club on Apple Podcasts or Spotify · Browse all episodes

FAQ

Is the first year as a new grad PA hard?

It can be very hard. Karlina describes the transition as harder than PA school itself, since you lose the structure of a program and take on full clinical responsibility.

What was it like being a PA during COVID-19?

For Karlina, working in a NYC ICU during the early pandemic meant rapidly expanding units, short staffing, high patient deaths, and significant emotional and physical strain as a new grad.

Do PA programs teach you how to cope with patient loss?

Often not in depth. Karlina notes that school taught her not to get too attached but did not prepare her for the grief of losing patients she had cared for closely.

How do new grad PAs handle burnout?

There is no single answer, but acknowledging the strain, leaning on support systems, and giving yourself time to recover are all important. Mental health care should not be optional.

Does it get easier after PA school?

Karlina's honest take is that it gets harder before it gets easier, because you are now on your own. With time and support, though, you do find your footing.

CLOSING

Karlina's story is a reminder that becoming a PA is a beginning, not a finish line, and that caring for yourself matters as much as caring for patients. If you are heading into the profession, build your support system early. And if you ever need to talk through the realities of this path, our community is here.

Pre-PA Counseling → https://www.thepaplatform.com/services/pre-pa-counseling/

Life as a New Grad PA in the ICU During COVID-19