This sounds about right.

This sounds about right.

Your Job Satisfaction Level: 54%

Your job is about average. There are some parts you really enjoy, and some parts that stress you out.
It’s possible that you need a small change. Maybe you should switch companies or positions.
It’s also possible that you’re simply burned out. No job is perfect, even a great one.
Give yourself a personal day to think about your career goals – and if your current job is helping you achieve them.

More great ER Doc Blogs

It’s been a long time since I went out looking for new blogs. Here are two that I’ve noted recently. Both are ER docs, and I think both are women (like me…) [EDIT: I was wrong! 10/10 is a guy. I’m not sure what I read that made me think it was a chick. I guess it’s a testament to anonymity!]Reading them is like reading my own blog, in fact, sometimes I think we must have worked the same shift!

Ten out of Ten is in HIS first year of attendingship at a small single coverage ED.

So as I’m walking upstairs, part of my thought process is here’s a guy who’s alive, and I’m going to put him in a coma, and if I can’t intubate him, and then I can’t bag valve mask him, then either he’s going to die, or I’m going to have to cut a hole in his neck to shove the tube in. And I can’t really give you my thoughts on that procedure, since the next time I do it will be my first.

Hallway Four: In my hospital, Hallway Four is where the crazy people go. This is a glimpse of their lives and mine.

Before I left, I went to check on the patient one last time. I told her that she had done a great job – that she deserved a gold star. She said that it was me who deserved the gold star. I said I wasn’t so sure.

She said that if I didn’t accept a gold star then she wouldn’t accept one either.

Come Monday, it’ll be alright…

It’s a busy Monday with patients backed up in the waiting room, and at least four of mine waiting for cat scans before I can make a decision or disposition. I go back to see the PA in fast track who is overwhelmed with charts and start seeing a few of them. The ED is so backed up that no new patients can be brought back into empty beds. We have reached gridlock, rather early in the day.

My partner runs up to me (there are only 2 of us working), and tells me he just got a call on the radio from medics who are busy delivering premature twins. They are on their way with the first one who is not doing well. My partner says, “I’ll need your help.”

We clear out the trauma bay & plug in the incubator just as the first ambulance rolls in. The baby’s skin is ashen gray. They are holding oxygen to his face. He’s retracting with each shallow breath and doesn’t cry.

I scrambled to find a 3.0 endotracheal tube to intubate the little guy with my heart pounding out of my chest. My hands are shaking. I insert the miniature blade into his mouth and am shocked at how delicate the proceedure is. I see the little tiny vocal cords open & close with each insufficient respiration. The tiny tube is too big to fit between his cords, but at least with the laryngiscope blade in his trachea he makes little squeaking noises like a kitten…he’s at least crying now.

We can’t find a smaller tube so I try a second time and fail. Knowing that trying a third time to put a big tube through a small hole is futile, I offer the proceedure to anesthesia who’s just shown up. I am able to find a 2.0 tube and can’t believe how small it is. As they continue working on the baby, the 2nd ambulance arrives with the mother and the undelivered 2nd twin.

She’s not having strong contractions. The baby hasn’t decsended and it’s been almost an hour since the first was born. The family practice resident and i disagree on the baby’s presentation. She thinks it’s breech, I think it’s cephalic. we have no ultrasound machine with which to confirm. The baby has a heart rate that seems adequate, but we’ve got no fetal monitoring equipment at our hospital thanks to the closure of our L&D unit due to rising malpractice costs.

We decide to transfer Mom to the women’s hospital. About 15 minutes later the NICU transport team arrives as well. Baby Boy A is doing better. He’s pink and warm. They take the breathing tube out and he is doing fine on his own. It looks like he’ll be OK, at least for now.

I return to the department only to see a waiting list of twenty-seven patients in the waiting room. Did I mention there were only two of us working? Seeing half that number of patients during an entire shift is a sorta-busy day. Trying to see all of them NOW just isn’t going to happen. I wonder who is dying in the waiting room. I look through my patient’s labs & imaging and still don’t have results. My fast track patients I had abandoned are yelling, “What about me?”

“I’m sorry, we have had some emergencies going on”, I offer.

“That was hours ago,” the patient informs me.

And so it goes.

Rocky Mountain Medic

I’d like to introduce a new (to me) blog, the Rocky Mountain Medic. He has a gift for writing that few others have and gives us insight not only into his job, but into the lives of his patients as well. There have been (and are) a handful of medical blogs with great writing, amongst them Hermes (rest in peace), Doc Charles, and Flat Line NYC. I believe that the Rocky Mountain Medic can join their ranks.

The front door of his apartment was already cracked, for he was expecting us. Through the crack created by the patient, I could see the kitchen counter tops and the rotting food imbedding itself into the Formica counter tops. I heard shuffling inside and someone speaking very softly. I knocked on the door politely as the figure eclipsed my view of the kitchen and began speaking.