ED rush

So my supervisor has got quite a reputation among the doctors in ED. Apparently, he has in the past caused some junior doctors to cry. The ED doctor often juggles many acute patients at the same time. Unlike in the ward, everyone is a new 'admission' and 100% concentration is always required. There are no pathology nurses to take blood, no interns to do the paperwork and most patients have waited for at least 2-3 hours. Everyone has their own patients and at one time, may be juggling several patients. There are referrals to make, blood results to chase and patients to discharge so that the next person waiting in the long line can come in.

ED is mainly divided into Main and Fast track. Main is generally your chest pain, abdominal pain, multi-trauma and collapse. You know, the pretty sick ones. Fast track is like your lacerations and facial fractures from drunken brawls, minor injuries and serves like an after-hour GP clinic.

There's a higher turnover rate in fast track. And twice a week I'm attached to this particular ED consultant who is known to have very high expectations. Rumor has it that he expects everyone to see 8-12 patients each shift. That's 1.2 patients an hour. This is inclusive of paperwork, drawing blood, consulting seniors and general running around the ED looking for a tourniquet and a pair of scissors. And why is it so hard to find tape??!!

My first two shifts with said doctor were not too bad. It was non-stop patient after patient and we had gone for 5 1/2 hours without a break, not even a coffee. Lunch was overdue and we asked him for a break.

"Ok. I expect to see you back here in 15 minutes."

%^&*!!!! I gulped my food with intense speed. It was not helping my chronic aerophagia. Me and the other student attached to him barely spoke as we ate. Then back to ED where the green tray was filling up with more patients to see.

I flip through the papers. Fracture. Fracture. What another fracture??!!!

I didn't sign up for orthopaedics but we plastered patient after patient. I was just getting a breather when I heard on the ED microphone - the voice of my ED consultant,

"Mun, back theatre now." (He knows my name! And here I thought I was just another random faceless medical student.) There was another patient to plaster.

We went over our shift by 45 minutes. We had worked 9 hours and 45 minutes with a 15 minute break. And this apparently is him going easy on us. Hmmm. I wonder what he expects of registrars. Superhuman effort I'm sure.

Tomorrow is my first night shift with him. Sunday night 4-12pm after a long Anzac Day weekend. We're doing fast track. I expect a lot of doozies.

This time I'm bringing my own torniquet, scissors and tape. He told us to bring snacks; in his very own words,

"It doesn't make sense to leave the ED when there are so many things to be done."

At first I thought 3 shifts a week would be easy and I wanted more. But I think I just might enjoy my four days off each week.