So I'm about half-way through my first Emergency Dept month as an ER intern. And it's been painful at times.
But overall, surprisingly not bad. Whereas the first week I was seeing about 6 pts a shift and feeling pretty overwhelmed during it, staying 2-3 hrs past to finish typing notes; now, I am seeing 7-8 pts/shift and, in accordance with ED policy, finishing each note before physically discharging the pt from the dept. Probably the only pts whose charts I sit on are admissions....and for those I usually have the clerks come and find me to have me put down timestamps and diagnoses so they can release the chart.
There were 2 shifts so far where I had 3-5 fairly sick & complicated pts each time who ended getting admitted. Those were sort of bad. The hardest pts are the ones who are old, have multiple medical problems, come in with multiple complaints and you're standing in the room with the nurses looking at you waiting for orders while you're trying to listen, jot history notes, and think about all the things that could be stealthily and steadily killing this person right before your eyes.
I mean, jeez, the pimping during board rounds is anxiety-provoking enough. I have now realized that the practice of emergency medicine means going to work knowing that you could save someone's life or kill someone based on how well you know your stuff. And I'm just an intern. At times it feels like everyone else knows more than I do. Of course, everyone has thoughts of insecurity like that. But the scary thing is that I'm almost convinced that most of my class DOES know more than I do. Maybe even some of the med students. Christ.
Anyways, as mentioned, this is the first of many months of training - 36 to be exact. Three years sounds like a lot, but actually it's not. I have just over 1000 days to learn everything I can about emergency medicine under the supervision of more senior physicians. Yikes.
