I spent the last four weeks on the Emergency Service clinical rotation. The first two weeks were nightshift (8PM-8AM) followed by two weeks of dayshift (8AM-8PM). I was terrified for this required rotation -the idea of pulling all-nighters through 12 hour shifts, caring for patients when I had yet to barely grasp even basic medicine (impostor syndrome, much!), and how to know what to do when that critical case would come to the front door… did I mention I was terrified?
Shockingly to me, I gained more confidence in ER than I had during any other clinical rotation. Not being a spontaneous person, I was terrified of not knowing what would come in next. We saw everything you could imagine: dog attack bites, hit by cars, cardiovascular-induced collapses, seizures, bleeding disorders, traumatic brain injuries, accidental poisonings including recreational drugs, and lots and lots and lots of vomiting and diarrhea.
It was amazing how quickly we students all fell into place amongst the ER team. One person would grab IV catheter supplies and another oxygen while a third applied an ECG. By some unspoken SOP, we would begin stabilizing critical patients in seconds. I thought this was something I would have to be taught, but then a critical case came, and I just started working. Near the end of the four weeks, I was allowed to explain results of tests and next steps to my clients (under the quiet presence of my clinician oversights), and I started thinking through possible causes (differentials) and their treatments with less and less prompting. ER was one place where I really got to feel like a doctor and part of a greater team.
If someone told me I would love ER, I would have laughed aloud. If someone told me I would have purposely worked with administration to incorporate the ER elective into my schedule, I would have thought it was a joke. Yet, I am happier than ever to share I will be jumping back into ER for the elective next month!