Coasting

The Pitch:

Welcome to the Community! In this Emergency Department, you will see a wide variety of cases under the supervision of an experienced physician. You will have the opportunity to practice resource management, while providing excellent care for the people of your town. Friendly nursing staff and a safe, engaging place to build your skills!

Yay.

The Reality:

Welcome to the Community. In this ER, you will see little old ladies who have sprained their ankles (plus one who broke her foot and walked around on it until it turned black!), old farmers who have cow-bite-related infections and lots of lovely babies with coughs, colds and rashes. So far, so good.

The usual lacerations, back pain and UTI's will cycle through the department. The nursing staff will alternate between feeding you and making fun of you (this is ok). Your (one) staff doctor will let you see patients and manage them as you see best, while keeping an eye on sicker people to make sure you're doing the right thing.

Then, the ambulance phone will ring.
A VSA arrest is coming in. Vital Signs Absent. The ambos gave 3 shocks and some epinephrine, and this guy now has a heartbeat. Your boss, knowing you need this practice, will ask you to run the code. You will think over your training and stand at the door, gloves on, pits sweating. When you see the lights coming towards the driveway, you feel sick.

They roll in with the guy on the stretcher. His heart is beating, his pulse is strong, but his pupils are not reacting to light and he is totally limp. He doesn't fight when you put drips in, when you shift him onto the stretcher, when you pull his teeth out and stick a tube down his throat. You can't remember what order the drugs are supposed to go in; should you give the amiodarone now? Does he need the full dose, or can he have less cos he has a heartbeat? Do you need to paralyze him before putting the tube in? Or is his total non-resistance an indication that he's braindead and you're just temporizing? The one staff doc is watching you through this whole process and nodding, so you keep going, but then it's 5pm and shift change and she has to go home and pick up her kid so you're suddenly alone in the trauma bay, trying to remember what the next step is and...

Anyways. Community ER. It's like that whole "Air Traffic Controllers" joke; mind-numbing boredom 90% of the time, pant-wetting terror 10% of the time. This is my future.

I am trying to remember why I picked this job.
Anyone? ... Anyone?