How I burned out in the ER

I hope that when you think of emergency medicine, you think of minor community medicine problems, urinary tract infections, ethanol intoxication, and people who had too wild of a night.

My ER rotation was exciting a few times, but I didn't see enough trauma to keep me interested.  Also, ER docs are pretty limited in the emergencies they can really take care of, at least at an academic institution with a level I trauma centre.  

For cases requiring advanced care, you usually do most of the work-up, and leave the rest to the specialists, like surgeons, or see that the patient gets admitted to a service like internal medicine.

I mainly saw things like elderly patients with CHF exacerbations, hundreds of species of abdominal pain, and a tiny amount of real, blood-pumping trauma.  It's safe to say that's common all around, unless you're in NYC, Baltimore, or in a city with a high violent crime rate.

I burned out so quickly because I kept getting pulled in 20 different directions every minute of my shift.  A lot of the cases I saw didn't even require an ER, but rather, an appointment with a GP.

I saw a lot of patients presenting with the need for medication refills, while I had to go take a history and physical from two patients who had attempted suicide that night, while compulsively checking to see if an outside hospital had faxed back medical records to help me diagnose a patient from abroad who presented with a confusing medical history and cluster of signs.  

I kept getting chased around by patients and their family members asking when they'd be able to go home, when their test results would come in, and when they'll be getting their medicine.

I met a doctor in another specialty recently who originally wanted to become an emergency doctor, but he went on to say the majority of things he saw weren't the "cool" emergencies everyone gets excited about.  So, if you're really interested in the ER, do a rotation in it.  

Shadowing is great, but you need to get as much experience you can, like being a medical student on an emergency medicine rotation at a county hospital.  See my next entry for a brief summary of the specialty.