Posts Tagged ‘ED’

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ER 101

24 August 2008

The move is complete. Orientation starts tomorrow. And although I am technically staying on per diem, I really have ended my tenure (ha!) in the ED. So before I have tons of nursing-school hijinks to write about, I wanted to share just a little of the wisdom I gleaned from 2 years of semi-controlled chaos in your friendly neighborhood Level I Trauma Center:

  1. Don’t run from the police. That rarely turns out well. Doubly true while on a motorcycle.
  2. Remember, cartoons are for entertainment purposes only — Gunpowder is not a toy.
  3. Don’t get your octogenarian mother completely, totally, shit-faced drunk and then wonder why she’s having gait instability and slurred speech.
  4. The Vagina: Not an approved storage device. For anything. Like, say, drugs. Or glass drug paraphernalia. Cuz that shit *does* show up on X-ray.
  5. If you’re an IV drug user, don’t inject other things that might have once contained drugs. Like month- old wads of cotton.
  6. If you’re an insulin-dependent diabetic, don’t embark on a solo multi-state road trip without any.
  7. If you’re allergic to peanuts,  don’t get drunk and have a Butterfinger.
  8. If you’re male, intoxicated, and your wife/girlfriend/sister/mother/any female bystander says “I don’t think that’s a very good idea”, cease and desist, immediately. Particularly if your plans involve firearms, sharps, fire, or a moving vehicle.
  9. Parents, don’t drag your child in to the ER for a low-grade fever that they’ve had for all of three hours. It’s called Children’s Tylenol. And a phone call to your pediatrician.
  10. Oh, and moms, the ER is not free daycare, and RNs aren’t babysitters. If you do bring your child in, expect to be with them the entire time. And if you really have to have that cigarette, don’t expect the nurses to be cordial when you take your toddler outside with you for your nic fit. Especially when she’s here for an asthma attack.
  11. And finally, it’s never a good idea to threaten ER staff. For some reason the huge guys in suits ALWAYS take our side.

Alright, all joking aside. If I learned anything I’d really want to share, it’s this:

Your PCP’s practice always has someone on call. Trust that qualified professional to decide whether you need to come to the ER at 3AM for your hemorrhoids or sore throat or the back pain you’ve had for eight months — because maybe, just maybe, it can wait until Monday and a routine office visit.

Because the ED is for (gasp!) Emergencies. The MDs and RNs there are trained to manage crises. It is not their job to solve all your medical problems, diagnose and treat all your possible ailments, and update all your medications in three hours. It is their job to determine if the symptoms you are having are life-threatening or require immediate medical intervention, and once they’ve decided that is not the case, you will get the ‘follow up with your PCP’ dispo and shown the door. You may not have any answers. You may still feel like shit. You may feel like you wasted a whole day and a large copay for them just to tell you what you don’t have. But that’s how they manage to save lives and still keep one or two beds open for the MVAs and the heart attacks and strokes. Just something to remember next time you come for a visit.

Oh, and one other thing.  Use car seats.  Wear helmets and seat belts.  And for the Love of Bob, people, don’t drink and drive.

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Saving Monica

20 February 2008

Stories like this one make me proud to work at this hospital and in this ED. I’m already aware of how much I will miss this place and the environment that is acute care. One of the crazy things about working in a high-profile trauma center is that very often I’ve seen these patients that are in the news — the drunk drivers, the tragic MVAs, the sexual assaults, the stabbings, the pedestrians struck. It’s always interesting, being on this side of what gets reported in the Globe.

I’ve wondered off and on (along with the debate of MD vs. NP, a story for another blog) about whether or not I should’ve chosen Acute Care and if I’ll be bored going into geriatrics/primary/long-term care after two years of fascinating cases in the ED. But the more I think about it, I realize that I’m  just plain excited by everything that has to do with taking care of people. And I think I’ll always be eager to be a part of it.

ps. For another amazing nec fasc story, check out this book by another Boston doc. 

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A million things to do? Sounds good.

18 December 2007

So I gave my notice. This is the first time I’ve quit a job because I had too little to do. Normally you fire people when they don’t do anything for 8 hours and still try to collect a paycheck. Or if they go home in the middle of their shift to have a beer and play Wii. But oh no, not me. I gave my notice and my boss took it personally. Apparently I should be grateful to have a job that lets me sit on my ass all evening and play on the Internet. But I gotta be honest, I’m just not cut out for this kind of work.

It wasn’t always like this. When I first came on, we were crazy busy, running around the ED, enrolling patients for studies, collecting blood samples and prepping them for shipping, talking with staff, doing tons of paperwork. There were a bunch of RAs, and we always had work to do. But that all went out the window when so-and-so bought out so-and-so, and all our studies got put on hold. We let one person go, and I went part-time so that we wouldn’t have to lay off a second. It’s been three months now. We thought we’d have more work come November, November became December, I’ll be amazed if anything gets going before Feb.

So I’m going back to my previous position on the admin staff of the ED. Where the phone never stops ringing, the patients keep complaining, the equipment is always breaking, and best of all, where you know you’ll be shit on by the full complement of staff and street trash.

Can’t wait.