I haven't written since I've had the last couple of days off, and I was just too tired on Friday after another super busy day in the E.D. At one point, we had 6 charts waiting to be seen and ambulances kept arriving with even more critical patients that would have to be seen first.
I was seeing patients at 4 in the afternoon that had been triaged (assigned level of severity) around 11:30 that morning. Part of the problem, and something I am sure is going on around the country, is that issues that would normally be handled in a primary care office setting were being sent to us. I must have talked to 5 or 6 patients, that when I asked why they came into the E.D. with their problem replied, "I called my primary medical doctor (PMD) who told me they were booked and to go to the E.D."
On a couple of those, my attending and I looked at each other and went, "and what are we supposed to do with this...?" For example, we had two patients who came in complaining of breast pain. One thought she felt a lump, and the other thought she had drainage from one of her nipples. Unless they had an abscess that needed to be drained, which neither did, we wouldn't do much other than refer them back to their PMD to follow-up with a mammogram.
These patients tie up our time from more serious patients, like the man having a heart attack, the young boy with the severe asthma attack or my LOL NAD who fell face forward and needed almost a trauma work-up since she managed to injure herself pretty well. Also, it took me almost 2 hours to put sutures in another patient because I kept getting pulled to other rooms.
Nurses don't get enough credit sometimes. We were so busy that the nurses were preemptively putting in orders, so that on a few of the later patients all I did was basically walk into the room and be ready to discharge or admit the patient on the spot given I had labs and/or films already done.
I stayed late to help clean up a bit. When I left, there were only 2 more patients waiting to be seen, and no one waiting in chairs. Starting tomorrow night I work the night shift, so I will be staying up as late as I can tonight and then taking a nap tomorrow as I try to adjust my clock to vampire mode.
We'll see what the night brings to this some-what sleepy little town...
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I can't believe PCP's would send their patients to the ER when some insurances might not pay for the visit perhaps since its not emergent but perhaps urgent; makes no sense. I know I type reports from ER physicians and as I'm typing them, I'm thinking "why didn't they just go to their regular docs" now I know.
take care of yourself working the night shift; be careful driving afterwards if you are tired after your shift
betty
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