I have a question about doctors working in the hospital setting mainly in the ER. Like in the show “ER” I notice that everything is so face paced obviously because there is no time to waste when trying to save someone’s life. I wanted to know if every physician has to go through this regardless of your specialty? When you first experienced this did you kind of just freeze and hesitate or draw a blank because everything was so sudden?
How you react has a ton to do with your underlying personality and the depth of your training. For a novice, the first time is rough and generally results in the frozn, deer-in-the-headlights response. However, for folks who have trained extensively and literally lived in this environment, how I react is instinctive. As a matter of fact, the procdures become so 2nd nature to your hands, that you are literally thinking three steps ahead & problem solving while you are intubating, placing lines or coding the patient.
That said, it is not for everyone. Some people’s personality make up inhibits or even precludes them from ever being truly effective in a crisis environment. They ae more well suited for other equally important areas of medicine. Rarely will you find a psychiatrist who performs well in a code, but they are fa far more well suited for intervenig with psych issues or counseling…and area that critica care or ED folks are not too spiffy at.
Actually, I think that the pace in the ER varies. There will be times where everything seems chaotic with major traumas coming in, but then there will be times where the majority of the work is taking care of the people coming through the ER for a variety of issues. I think if you had everything at high tension every minute, you’d probably burn out pretty fast.
- etam_OMD Said:
Every physician has to know how to do at least *some* of it during residency training and yes, initially you hope to God that someone more competent gets there first. Over time, though, even if it is not part of your daily routine, you gradually get a lot more competent at all sorts of things, including fast thinking and dealing with various emergencies.
Yesterday in my office I saw a woman with abdominal pain. She looked... different. Miserable. Much of the time people come in *saying* that their bellies are hurting, and I'm sure they are, but not like THAT. When I was a less experienced physician, I might've consulted with a colleague, or quickly looked up some things, or put her through a much more thorough exam. Now, though, it took me about a minute of talking to her and a very brief exam to decide to send her to the ER for a presumed appendicitis.
Why? 'Cause I've done it before. I know what it looks like. Maybe she doesn't have appendicitis but it looked too much like it to really spend time considering anything else... she needed blood work and radiology and so I didn't waste any time on other stuff.
And because I am relatively new at being able to make this sort of quick decision - and feel relatively confident that I'm right - it is still exhilarating and satisfying. It feels waaaaay better than being a second-year resident, unsure of pretty much everything!
As Dave said, doing things over and over and over again makes you much more confident. There's no substitute for experience.