My emergency medicine rotation started this week, and it has been crazy! My schedule is a little sporadic - I have three or four 12-hour shifts each week. For the first three weeks of my rotation I'm at an Urgent Care center and all of my shifts are 10 a.m. to 10 p.m., and the last two weeks will be in the actual Emergency Department in a hospital in downtown Pittsburgh.
So, this week I've already worked two 12-hour shifts, and have today off, which I desperately needed. Twelve hours, plus the never-accounted-for extra time at the end of the day for finishing paperwork and getting those last patients out, plus a 25-30 minute commute, is much more taxing than my last rotation!
The Urgent Care center I'm at right now is really great for learning because there's only ever one doctor there, so I just work with the doctor. That means I get to see more or less all of the patients that come through, and it can be a lot! The last two days, I think we had about 20-24 patients per 12-hour shift. Since it's Urgent Care and not an ER, I haven't seen anything too stressful or life-threatening, though we did have to send some people with chest pain over to the actual ER for further evaluation. I have seen plenty of corneal abrasions, ankle sprains/fractures, finger fractures, finger lacerations, a few cases of vertigo, and some abdominal pain. The doctors that work there are good about letting students do things, so I've done a bunch of injections (just tetanus boosters for people with cuts or burns), some suturing, and some eye staining/examination for the people with corneal abrasions. I've always loved eyes, and I finally got to use the slit lamp - the machine used by eye doctors - and it was so cool!!
I have noticed that the doctors here are more brusque than the other doctors I've worked with, and I'm not sure if that's the nature of medicine in a city, or just the nature of the typical ER doctor. They're still nice, but way more fast-paced and serious. Also, a LOT more tests and procedures are ordered here than would have been ordered in a place like Kentucky. The doctor I was working with on Monday told me that patient satisfaction is really important, and a lot of patients don't really care if a test is necessary or not, but will feel better if more is done. So...for example, a younger guy came in on Monday with a cough and sore throat...that had only started about four hours before he came in. It wasn't anything out of the ordinary for him, and his physical exam was fine. In Kentucky, he would have been told that he had a cold and it would clear up in a few days, and to take over-the-counter decongestants and cough medicine if he wanted. In Pittsburgh.....he got a chest X-ray and an inhaler to take home, and a note to get out of work for the afternoon. Talk about the rising costs of healthcare!!
But, I love the nature of Urgent Care. Lots of procedures, and most things are pretty quick fixes that leave people happy! Also, it's not super stressful because, like I said before, nothing is life-threatening. I'll get to see that in a couple of weeks, and I'll be glad to have that experience too, but for now I am perfectly happy diagnosing fractures and giving tetanus shots. I also love driving back into Pittsburgh at night - the skyline is so beautiful, and the city feels alive! I'm definitely glad to be back here. :)
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