I’m proud of the fact that I’m self sufficient in the emergency
department. And it irritates the fire out of me to see prima donnas
(read surgeons) come into the department and require the entire staff to
follow them around to do little things they could do for themselves. I
guess you could say that I was trained well by a charge nurse by the
name of Beatrix where I did my residency.
Something had just happened that I didn’t understand. A man had stared death in the face and winked. But more than that, the life he had exuded, even in the moment of dying, seemed to still be present. His son was different. I was different. More alive. More human.
According to the Rand Report, the ED routinely makes the most important decision for hospital survival – whether or not to admit. The next question is what the healthcare system will do with that information.
I love it when the lecturers say the same thing: “Take a good history…”
They act as if we don’t know what questions to ask. Don’t they get it?
The right questions are written on the template. But sometimes I just
didn’t know what to do with what the patient told me. Let me give you an
The jury is still out among EPs as to whether tPA helps more than it
hurts, yet ACEP has forged ahead with clinical guidelines which seem to
ignore controversial findings.
As I entered the room my eyes went immediately to the elderly lady
sitting halfway off the chair beside the bed. She appearing as if she
was about to slip off onto the floor at any moment. I introduced myself
and reached out to shake her hand, but her hands were occupied gripping
the seat in an attempt to support her weight while lifting her hip off
“Can we pleeease feed that little girl in room two,” the nurse pleaded.
“Her mother is driving me craaazy asking if she can go down to the
vending machines and get something. I think she needs to smoke and needs
an excuse to leave the baby with the dad. All she has is a bladder
“Hey sweetheart,” I said, interrupting my wife’s thoughts as she
concentrated on writing her blog. “How would you rate me? You know, as a
It had been a long day when I sat down by the roaring fire to enjoy a
glass of red wine. My father-in-law, who lives with us now, sat down
nearby and began to describe his worsening, but stable angina. While
attempting to pay close attention to his story I began to notice
something strange that I initially mistook for the effects of the wine.
“That’s it! I’ve had it!” I shouted to the air, throwing the envelope on the floor.
“What is it now?” my less-than-sympathetic wife said, dramatically emphasizing now.
“They’re already hiking our taxes, that’s what,” I said, rising from the breakfast table and starting to pace.