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.