Whew! Here I am on the other side of a 3:30 PM to Midnight shift week in the Emergency Department (ED). I made it! I have to say that as much as I love working in the ED, this shift certainly takes its toll.
I arrive in the ED when the flow of patients has already started to back up. Ambulances are coming en mass interspersed with a trauma here and there. The exam rooms fill up with people who are having chest pain, (dangerous) shortness of breath, intense nausea/vomiting and, finally, the psychotic people that it would be dangerous to leave in the waiting area. Unfortunately, this means that people with broken bones, lacerations needing stitches and relatively minor aches and pains have to wait long hours in the waiting area. They do not like this, so another thing I do is try to tell them how far back they are in the line of people waiting to be seen when they come up to the Registration desk and ask. It is not fun. Sometimes is seems that even intelligent people don’t understand the concept of ‘triage’.
And then I feel bad when people decide they don’t want to wait so they leave (even though some of them really didn’t need to be in the Emergency Room in the first place; it is sad when we can’t meet their needs). All these people leaving without being negatively effects the overall perception of the hospital’s ED, no matter if the patient was actually having an emergency or not (although, I can fairly say that I never saw anyone leave that was actually having an emergency). The clinical staff out back has mixed emotions when this happens; they are sorry they could not meet the patient’s needs, however they are relieved there is one less person to worry about trying to fit in to the hectic department.
As I said, I really like the ED, but the emotional toll can be wearing sometimes. I just have too much empathy for our patients, even the ones who don’t really need to be there and should go to their Primary Care Physician instead.