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Sep 05

Day in the Life: Emergency Department

Happy Monday + welcome to another Medical Mondays and my third “Day in the Life” for residency!

I had one afternoon where I found out that I had a couple delinquent charts that I never knew existed(?!) so I went in a couple hours early to finish them off and completed them more quickly than I thought I would, so I went to my nap spot in the library and took a quick power nap before my shift.

(Yes, I have a nap spot, and yes, we have call rooms, but I didn’t want to bother my fellow residents who were on FM service by lying there while they were making phone calls and working on charts.)

Day in the Life: Emergency Department

naptimelib

5 p.m. – 1 a.m. (M) / 2:30 p.m. – 11 p.m. (T) / 11 a.m. – 7 p.m. (R) / 9 a.m. – 5 p.m. (W) 

Truth be told, I kinda felt a little like I’d been thrown to the wolves on this rotation. I had no idea how to work the EMR in the ED and there wasn’t really anyone around to tell me what was expected of me and/or where to start/what to do.

…but such is the nature of the emergency department (although I do feel like my med school ED experience was somewhat calmer…). I just did the best I could and eventually stopped floundering and feeling hopelessly lost (or at least, less so).

I alternated days between the urgent and emergent sides of the ED and on my first day, I got to sew up someone’s leg. The “urgent” side was akin to urgent care (e.g. back pain, headache, toothache, minor car accidents, lacerations) and saw lots of chest pain and shortness of breath cases on the “emergent” side.

I’d pick up charts after they’d been triaged and get them okayed by my attending, interview and examine the patient, and then run over their case with my attending and discuss my plan for them and put in orders. The “urgent” side was a lot more fast-paced whereas the emergent side required a lot more waiting for labs, consults, imaging, and making phone calls to potentially get patients admitted. Somewhere during the shift, I’d sometimes manage to fish out time to run to the call room to quickly grab my lunch and eat it, but mostly, I lived off the billion snacks I’d stashed into my pockets.

palsmannequins

I had PALS training during one of my ED days and this mannequin set off alarm bells in my head while I was eating lunch, partially because I momentarily mistook it for a real child who’d for some reason collapsed under the table.

I worked with a different attending for almost every shift, so there were all kinds of different personalities to learn/work with/get used to.

I have never been a very assertive person, and didn’t know that I was supposed to tell my attending about each lab/imaging result–I just hounded the results and would update their charts as they came in because I didn’t want to bother my attending for every little thing.

That coupled with the fact that I use my phone to look up everything in the world didn’t translate too well with one of my attendings, because she thought I was just playing on my phone instead of seeing patients. (I guess it didn’t help that I was especially looking things up while working with her because I was slightly intimidated and didn’t want her to think I was stupid.)

In any case, she talked to me somewhat sternly after my shift and told me that residency goes by fast and that it’s meant to be a time to absorb as much knowledge as possible, because this is all we get. If you don’t know it after you’re out, you really just don’t know. She said she didn’t take residency very seriously for the first 6 months and one of her attendings talked to her the same way she was talking to me.

She also told me she tended to be especially hard on her female residents because as unfair as it might be, people tended to be more judgmental with young female residents so we especially had to know our stuff inside out to avoid being walked over by everyone else.

Truth be told, I was horrified by her interpretation of me not taking residency seriously, but didn’t want to sound super defensive since there’s actually a part on my evaluation form that talks about receptiveness to constructive criticism. I also knew she was taking the time to say all this to me because she wanted to help me improve, so I just went with it. I ended up having another shift with her later that week and she told me I did an amazing job, so hooray for redemption!

In other news, the Joint Commission told our hospital we were good to go so we were treated to waffles and ice cream in the cafeteria. It was glorious. 😀

jcwaffleicecream


  • Have you ever been to the ER for anything?
  • Have you ever had a misunderstanding with someone? How did you handle it?

I came up with this design ages ago for our class t-shirt contest! :]

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20 comments

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  1. Rachel G

    The photo of the mannequin under the desk–that would have startled me too! Keep up the good work! The ER is somewhere basically all humans want to avoid if at all possible–takes tough people to work there!
    Rachel G recently posted…Strawberries and Cream – Angel’s Pick from HarajukuMy Profile

    1. Farrah

      haha, right?! I thought it was part of the test and that I’d failed at first because I didn’t notice it right away. :'(

      We have some people who reallyyyy seem to like coming into the ED, but I think those are more because of social issues and such. It definitely takes a different kind of personality to work in there!

  2. Sarah

    I went to the ER for the first time this past winter and I am glad it has only been that once…I didn’t have the best care 🙁 but I know all in the medical field are soooo swamped!

    I have had many disagreements like that, sounds like she jsut wants you to be the best you can be…which is great!
    Sarah recently posted…Why You Shouldn’t Bet on Your HealthMy Profile

    1. Farrah

      Aw man, I’m sorry to hear that! :[ It definitely can get swamped, but the hope is that everyone still gets good care when they’re there. :[ I hope everything’s okay now though!

      Agreed! I figured since it really seemed like she was just trying to look out for me, it wouldn’t do me any good to argue that! Sometimes it’s hard to find people who care enough to teach/let you learn!

  3. Rebecca @ Strength and Sunshine

    A little “tough love” I guess :/ I probably would have burst into tears, haha! I’m not good with those kinds of interactions!!
    (p.s. I’m reading this FANTASTIC medical thriller right now that takes place in a university hospital…I think of you while I’m reading 😛 Haha!)
    Rebecca @ Strength and Sunshine recently posted…Vegan “Fried” Ice Cream BombsMy Profile

    1. Farrah

      I’m generally not good at those sorts of interactions either, but I think my internal panic stopped me from tearing up (that tends to happen when I get angry/really frustrated ._. it sucks).

      Ooo, what’s it called? 😀 I have lots of driving up ahead for my next rotation, so I’ve been getting into audiobooks lately!

  4. Susie @ SuzLyfe

    Alex saw a lot of drunks in the ER. But he was named for an ER award because, well, he is Alex and everyone loves him.
    With regards to the attending, I would probably have gotten pretty upset (I don’t take that kind of thing well), but if you still feel that you need to clear the air, do so–and then move on. You are a great doctor, don’t let a misunderstanding undo your confidence!
    Susie @ SuzLyfe recently posted…Happy Labor Day Weekend RecapMy Profile

    1. Farrah

      That’s awesome that he was named for an award! :]!

      Thanks so much! <3 I was really unsettled after that shift, but I had another shift with her later on that week and she said I did an amazing job, so we're all good (whew)!

  5. Valerie

    I have a certain respect for anyone and everyone that works in an emergency department because they work so hard. Thank you for being a brave soldier who is willing and brave to work in the E.R.

    1. Farrah

      Thanks, Valerie! It’s definitely been a lot of learning!

  6. Jess @hellotofit

    I’m not very assertive, either, but it’s getting better. And I feel like there should be less of a stigma attached to looking at our phones nowadays! I use it a lot to communicate with clients while at work, but recently we’ve had to look at our phones away from the “public eye” if possible to seem more professional to gym members! 😛
    Jess @hellotofit recently posted…Tomato Basil Cauliflower FlatbreadMy Profile

    1. Farrah

      I wish! :[ But I guess if people don’t know what you’re doing while you’re on your phone, it can definitely look unprofessional!

  7. Kristy from Southern In Law

    I feel you on not being assertive! I struggle to say no to people and I often struggle to speak up and ask people for help as well as I’d much rather figure it out myself!
    Kristy from Southern In Law recently posted…Recipe: Easy Vegan DIY Coffee Creamer (Or Sweet Cream!)My Profile

    1. Farrah

      Aughh! I feel ya! I used to have such a hard time saying no to people because I wanted to be able to help everyone–I like to think I’ve gotten better about it over the years, but…definitely something that needs continuous work for me!

  8. Joanne

    Hey Farrah, glad to see you’re doing well. 🙂 Totally get you – constructive criticism is hard to take sometimes, but I also learned to realize that it’s meant to help me improve as a student doctor and this is the best time for me to learn as much as I can, because no one will be holding my hand through this process later. I hope you’re taking good care of yourself, eating well, and sleeping as much as you can. Good luck!

    -Joanne from Cali! 🙂

    1. Farrah

      Thanks so much, Joanne! Definitely agreed! I think residency is much the same as being a student doctor (just more added responsibilities and yay for finally having an income, hehehe), so I appreciated that she wanted me to learn as much as possible (and I really hope I do!!).

      How’s second year going? 😀 I hope you’re getting enough sleep too! The food you’ve been posting looks amaaaazing! <3

  9. Kerri McGrail

    I think that interaction with the attending would be hard for me too. I never like people to think that I am not taking things seriously or trying my best. I know you will be a great doctor and the attending will be sure of that soon as well 🙂
    Kerri McGrail recently posted…WIAW: Vegan Fries, Smoothies Bowls & Dental School LifeMy Profile

    1. Farrah

      Thank you! <3 It actually ended up turning out rather favorably with her (I had a shift later that week with her and she said I did an amazing job), but I must be on a roll or something, haha. I had several super un-fun interactions with one of the doctors at the hospital today. Thank goodness the attending I had was awesome though!

  10. Sonali- The Foodie Physician

    Ok, well I guess you’ve won’t be switching into EM any time soon 😉 It’s too bad you didn’t get a better orientation or introduction to the EMR, getting thrown to the wolves definitely isn’t fun!! I really don’t like to hear about that attending being so harsh (we’re all on our phones all the time!!), but like always, it seems like you made the most out of a tough situation. And that’s awesome that she was so complimentary after your second shift with her.
    Sonali- The Foodie Physician recently posted…Dining with the Doc: Raspberry Coconut Smoothie Bowl and a KitchenAid ® Blender GiveawayMy Profile

    1. Farrah

      Thank you! <3 I liked the side of the ER that was more similar to urgent care (possibly because that was closer to things I would do as an Fm doc), and I did really enjoy working with almost all my attendings (even the one who was initially kinda harsh--I'm so glad I managed to redeem myself! :O )--they were wayyyy better/more fun to interact with than the house doc I came across yesterday!

      P.S. Apparently there was an FM resident a couple years back who really did switch to EM! That caused a bit of drama/awkwardness! 😮

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