I could not do this job for long…

Last week I worked in the pediatric emergency room for three days. I find it extremely difficult to stay positive and motivated in an emergency room. The work in an ER is never done. There is no goal to reach. You can never close the door and say: “Sorry, we’re full.”

There is no chance to stay on top of things, people keep coming in ALL-DAY-LONG.

There is always a long line behind the check-in filled with sick people. By the time you discharge one patient, another ten patients were admitted. Ambulances keep coming in all the time. Chest pain. Shoot. Gotta check him quickly, could be AMI. ECG normal? Don’t forget ruptured aneurysm. 

Four hours after the start of my shift I am hungry. Taking a break? Only with a terrible conscience. I mean, there are people who have shortness of breath, fever, a broken bone. And you are taking a break?? Are you serious? There is cake in the nurses room, take a piece and move on. 

The worst part of the job: everybody is mad at you (at least that is my impression):

  • The nurses, because you don’t discharge or transfer fast enough. Come on, get these people out of here.
  • The patients because they have to wait three hours until they are seen by a doc. Then again two hours to wait for the results of X-rays and lab.

Should I explain them that in an outpatient setting they would have to wait two to three week for this kind of diagnostics? Ask them, why they didn’t go to their general practitioner with their dizziness lasting since three weeks? Tell them. No, no time. Just apologize for the long wait and move on. 

I will never get used to a waiting room full of really sick and probably seriously ill patients that wait for doctors. But probably that’s what it takes to be a good ER doc.

Good triage of course is important, too. But to treat your patients well, others have to wait.

Can I finish my shift on time? Seriously? The waiting room is full, your colleague is here by himself, two ambulances just pulled in the driveway and you are leaving? What are you, kidding? 

I deeply admire the doctors who work there over a longer course of time. Respect, to those guys! You are doing a tremendous job. Couldn’t trade with you.

15 Things I Like About Working At The Charité.

I have been working at the Charité University  Medicine Berlin since 2008. Me and many of my colleagues are very content with working here, but every now and then you hear cynical voices about how bad, slow and misorganized things supposedly are.

As I have written before, I think that this discontent should always trigger some kind of constructive action. You always have a choice:

  • change things to the better or ultimately, if you just can’t stand it anymore:
  • you can look for another organization that may fit your needs better.

 

However, how do you protect yourself from cynicism and depression when  people around you are whining?

Gratitude is always a great move. I like to point out the good things of life. For that matter I created a list of things I like or even love about working here. Here is my Top-15-List of things I like about the Charité:

  1. I am trained here by amazing physicians.
  2. They pay me money. Fair and on time.
  3. Fast internet at every workstation and coming up:
  4. Reliable WiFi on most wards.
  5. Uncountable numbers of experts for every topic: I call them and they will help me and the patient.
  6. Experienced nurses.
  7. Access to Uptodate at many departments.
  8. All patients are treated equally: regardless of country of origin, race or language they speak.
  9. Equipment that works.
  10. If equipment doesn’t work (and the responsible department is informed!): things are fixed.
  11. We come in contact with a wide variety of diseases and conditions.
  12. We now have a Kebap cart on our campus 🙂
  13. Social prestige: Many people are impressed, when you tell them you work here.
  14. Opportunities to do research.
  15. The campuses are beautiful.

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Organize Your Workflow On The Ward With This Strategy And Get Things Done!

Basically, there are two strategies of spending your day on the ward:

Courtesy of IStockphoto.com
  1. Go with the flow and look what’s coming up.
  2. I have a well-structured plan. When unexpected things come up, I modify my plan.

I am a big fan of strategy number 2. Over the years I have learned that structuring your day gives enormous value to the patient, the nurses and myself. With the right plan, you can get more things done and don’t have to put out fires all day long. Here is my plan:

 

In this post I would like to share with you how you can plan your day proactively and an ideal schedule of your own.  I have created an excel template, that you can download for free here.

Click Here For Your Template.

So here is how to create a schedule for yourself and the day on the ward.

Four Easy Ways To Connect With Your patient. 

Having a good connection to your patient has a positive impact on your work in several different ways:

Connecting to a patient on a personal level helps you..

  •   to keep in mind that you are dealing with people, not with body parts or diagnoses.
  •   to remember other important information about him. (Your brain makes a connection)
  •   to have a lot more fun at work.

Sleepless On Call – 5 Things To Do Before You Wake Up Your Boss

A couple of weeks ago I was on call in the ICU and I was called by a 2nd year resident. “Mr. Miller isn’t well and has desaturated repeatedly.”

How was I supposed to reply?

“Thank you for the information, good night.”

“I’ll take care of the problem, why don’t YOU go to bed.”

Obviously, the way this piece information was presented neither helped me, the patient or the poor guy on the other side of the phone.

When you wake up your boss during the middle of the night, you should be a little more prepared than someone, who calls 911.

So what can you do to make your boss happy at 3 AM in the morning. Let’s try these six steps:

6 Keys To Getting The Most Out Of Your Next Medical Conference

Every other year, depending on my scientific efforts, I get to go to a conference abroad. Going to a conference is kinda like going to Disneyland: Countless things to do, but only very little time.

The opportunities there are overwhelming. There are

  • numerous great presentations
  • interesting topics
  • amazing researchers
  • great speakers you can get to know.Time is very sparse and it’s easy to lose focus. Many times I felt depressed because I felt I missed out on  so many great things. To avoid this feeling, here are my 6 steps to getting the most out of your next conference.