Lessons from the ED

This month, I’m working in a small critical access hospital’s Emergency Department as my last required rotation of medical school. The hours are long, the days are exhausting, and yet I’ve learned more the last few weeks than many other rotations in the last year. And now, I want to share some of those lessons with you.

1. You never know when something bad is going to happen. Even back in my paramedic days, one of the most common things patients say is “I didn’t plan on calling you today”. To which I’d reply “I’d be more worried if you had!” Many of my patients yesterday (Saturday) were doing home projects, driving down the highway, enjoying a much-needed family vacation, or walking around the casino just living their best life when they became sick or injured. Don’t take life for granted.
2. If you have to wait, you aren’t that sick. As a small emergency department, we only have 7 beds. Each patient occupies a bed for anywhere between 2 and 6 hours. If we get 10 people coming to the door within a two-hour period, at least three of them will be waiting at least 2 hours. Often these patients get frustrated, upset, or even leave without being seen. One family yesterday was knocking on the door to their room because we hadn’t attended to them within 30 minutes. And yet, at that moment, we were running non-stop assessing strokes, treating traumas, catching ambulances, interpreting labs, stitching lacerations, doing central lines, and medicating altered patients acting violent toward our staff. Sorry, but I’m not going to sit with you for 10 minutes talking about your sore throat when my altered guy two beds away is trying to break down his door and screaming obscenities at us. If people learned how to look beyond themselves, they would see that others are in a much worse shape than they are.
3. No matter how high your status, you’re never too big to serve. When someone learns I’m a medical student or will be a doctor soon, they often think that I am (or will be) rich or spend my days in an ivory tower contemplating the meaning of life. However, on the front lines of medicine, I spend significant parts of my day getting warm blankets, cups of water, or serving food trays for patients under my care. It does not matter my title or role, I’m not too great to serve. Now, obviously I don’t do it as often as my CNA/Tech/RN colleagues, as I have… ya know… doctor stuff to do. But when I am able to fulfill a simple request, I have no problem doing my part.
4. Enjoy the moment. Some mornings start off with an empty ED, while others start without an empty bed in the department. If we spent our down time panicking or worrying about the impending chaos, we would be more burned out and stressed than we already can be. Now, there’s a difference between studying and enjoying the moment, so I’m not advocating laziness. But when you have a moment to rest, enjoy the rest.
5. Don’t do meth.