Sunday, March 16, 2008
ER vs everyone else: Where's the love?
I have to say that there is no love between the emergency room and the rest of the hospital. The main reason is because when the ER decides to admit patients, they are creating work for the residents on the wards and in the ICU. While sitting upstairs, it's easy to criticize the emergency room staff. We criticize them for admitting patients who look too well, and we criticize them for not doing more for the very sick. What I had not realized until working down in the ER was how difficult it can be to make judgment calls about a patient when they come in. Sure, the next morning when you know how the patient did, it's easy to say what should have been done. However, in the ER, sometimes there are so many patients in the waiting room, that you can't wait to see which way the patient is going to go. You make a clinical decision--you admit the patient to the hospital or you send them home with some good instructions on what should bring them back. And then you pray that you erred on the correct side.