The past 2 weeks I’ve been on my Emergency Medicine (EM) rotation, which is a 4th year rotation at my med school. I’m working at what I think would be considered a rural hospital, but it’s a level 2 trauma center as well as a stroke center, so we still get to see some pretty cool cases. It’s one of the main hospitals in northwest Georgia. The great thing about this rotation is that I get to schedule my shifts however I want; I just have to work a certain number of hours before 4 weeks is up. I’ve been front-loading all of my shifts and today completes my 8th 12-hour shift in 2 weeks, which has really been a lot. It wasn’t until after the fourth shift that I realized how tired I was. But I had to do it because I’m going to be so busy this coming week–hence my posting on a Friday instead of Sunday.
I’m not going to lie, this whole shift-work thing is pretty nice–I see why people go into EM for the lifestyle! You come in, see whoever shows up, and you get to go home leaving your work completely behind. You don’t have your own patients that you have to follow up on, and you don’t have to round on patients in the hospital which is a major plus too. You are afforded incredible work-life balance. Because of all this, I must admit EM has been my favorite rotation of my medical school career.
Despite the fun I’m having, I quickly realized that I could never be an EM physician. I don’t like how little time you have to actually think about what’s going on with the patient. We just order lab sets based on the chief complaint and follow certain protocols. You don’t spend much time actually listening to the patient outside of their chief complaint and OLDCARTS (onset, location, duration, characterization, alleviating/relieving factors, temporality, severity). I just can’t get with that. It’s too superficial. And it gets redundant after a while. I like the procedures that you get like laceration repairs and chest tube placements, but they honestly slow your workflow. Even when the traumas come in, it’s just 3 minutes of rushing to stabilize the patient then you just go back to regularly scheduled programing. Everyone is jaded. And there’s just too much to juggle at one time for my liking–I don’t work well under pressure. Worst of all there’s no patient ownership or follow up, until the patient comes back (which actually happens way to often). But if you have the right personality for it, it’s fantastic. As a med student I’m loving it, but I know that I wouldn’t be happy long term because I just wouldn’t be fulfilled. With family med, I get the same variety, a fair share of procedures, follow up, and don’t have to juggle 8 patients at a time. *rant over* haha
I’ve seen some pretty awesome cases though that I wouldn’t see in any other setting. For every 10 people who are there for cough, shortness of breath, or abdominal pain, there’s one patient who actually has something interesting going on. I’m the only student there when I work, so they give me pretty much all the procedures and cool stuff that comes in. I’ve gotten pretty confident seeing patients and using my hands.
- My very first patient was a guy who was attacked by a pit bull and got bit on his penis. Sorry but we all had a laugh before going to see him
- My first code! We brought thing man from pulseless V-fib back into a viable rhythm. He had to receive CPR which broke a few of his ribs and was placed on a ventilator, but he’s going to live!
- 3 yo girl victim of sexual assault. Listening to her tell the story of what this 15yo boy did to her was absolutely heartbreaking.
- 72 yo man who had a pneumothorax (collapsed lung) for 2 days before he came to the ER with sharp chest pain radiating to his back. We put a chest tube in.
- 70 yo woman who fell and broke her ankle. This was my first time ever reducing a fracture! Feeling the bones line back up in my hands was a weird feeling
- Pulled a bug out of this girls ear–sickening
- Saw a man throwing up blood from esophageal varicies for the first time–long time drinker
- A few suicidal patients, most of them 18 of younger and it was very sad for me to hear their perspectives on life
- A few drug/alcohol overdoses
- A few accesses drained
- A few lacerations repaired (one guy literally got stabbed in the back)
- A handful of Flu diagnoses (get your flu shot if you haven’t!)
So, as you can see, this rotation has been interesting to say the least. I have way more stories to tell. But keep in mind that for every one of these cool patients remember there’s 10 people that don’t have primary care doctors and come to the ED for silly things.
This next week is going to be pretty hectic, but in a good way. This weekend I’m celebrating my auntie’s 70th bday and my nieces 1st birthday. Then Monday I have STEP 2 CS. Wednesday is my interview for residency at Morehouse. Friday night I’ll be presenting my poster at the AAMC 2018 National conference in Austin, TX. I’m just taking things one day at a time. I still haven’t started really studying for my shelf exam for this rotation yet! But I’m just trusting that all will be well–somehow.
Hope everyone has a great weekend and wonderful week next week!