Anonymous wrote:

Anonymous wrote:Op here.

Chest pain that turns out to be anxiety is something I'm happy to see someone for. I prefer when people come to the er to rule out stemi, cva or appy. It's fine if you think you are having an emergency and it turns out that you aren't. I'm thrilled when my possible cvs patient is actually a migraine and they don't need to go through all the hospitalization that a cva would require. I can bring in neuro to follow up with them and get them feeling better. Same with people who are anxious, I can get them the appropriate help to deal with the condition.

What I'm not okay with is when people come in requesting a check up at 1 am. Or the people who have been referred out to a specialist but keep coming to the er expecting something more than comfort measures.

Doesn't your ER have a triage and say no to those wanting a check up? Ours has an triage and you see a nurse who does the basics, including medicating kids with high fevers (she got medicine in my kid gratefully that he refused from us even when we tried to force it).

Be grateful you've never had a bad migrane or any of the conditions you treat. I have them daily and most have no clue the pain involved. I gave up going to doctors as most like PP have said give you the blow off and act like you are faking.

ER staff here at a Level 1 trauma center - 99% of patients who are coming in for a check up don't say they want a check up at triage. It is always some vague complaint and then once they get to the back it is, "can i get this form filled out for work saying I got a physical..." Also ERs cannot turn you away due to EMTALA laws.

Anonymous wrote:Op here.

Chest pain that turns out to be anxiety is something I'm happy to see someone for. I prefer when people come to the er to rule out stemi, cva or appy. It's fine if you think you are having an emergency and it turns out that you aren't. I'm thrilled when my possible cvs patient is actually a migraine and they don't need to go through all the hospitalization that a cva would require. I can bring in neuro to follow up with them and get them feeling better. Same with people who are anxious, I can get them the appropriate help to deal with the condition.

What I'm not okay with is when people come in requesting a check up at 1 am. Or the people who have been referred out to a specialist but keep coming to the er expecting something more than comfort measures.

Doesn't your ER have a triage and say no to those wanting a check up? Ours has an triage and you see a nurse who does the basics, including medicating kids with high fevers (she got medicine in my kid gratefully that he refused from us even when we tried to force it).

Be grateful you've never had a bad migrane or any of the conditions you treat. I have them daily and most have no clue the pain involved. I gave up going to doctors as most like PP have said give you the blow off and act like you are faking.

Op here.

Chest pain that turns out to be anxiety is something I'm happy to see someone for. I prefer when people come to the er to rule out stemi, cva or appy. It's fine if you think you are having an emergency and it turns out that you aren't. I'm thrilled when my possible cvs patient is actually a migraine and they don't need to go through all the hospitalization that a cva would require. I can bring in neuro to follow up with them and get them feeling better. Same with people who are anxious, I can get them the appropriate help to deal with the condition.

What I'm not okay with is when people come in requesting a check up at 1 am. Or the people who have been referred out to a specialist but keep coming to the er expecting something more than comfort measures.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I get some of what the OP is saying. It's not so much that the ED is boring. It's that a lot of people use it as an urgent care center and/or primary care center; this clogs the system and takes attention/time away from more serious cases.

+1

But in many cases people don't know that their case is not serious. It is serious to them. And if they try to identify their own symptoms and help figure out a dx, yeah the nurse or doc will roll their eyes and say, "oh, did you google that?". And then they turn out to be wrong as in the case above. Damned if you do, damned if you don't.

Yes well it is hard to get time off work and you want to be seen sooner than 6 weeks.

Anonymous wrote:

Anonymous wrote:I get some of what the OP is saying. It's not so much that the ED is boring. It's that a lot of people use it as an urgent care center and/or primary care center; this clogs the system and takes attention/time away from more serious cases.

+1

But in many cases people don't know that their case is not serious. It is serious to them. And if they try to identify their own symptoms and help figure out a dx, yeah the nurse or doc will roll their eyes and say, "oh, did you google that?". And then they turn out to be wrong as in the case above. Damned if you do, damned if you don't.

Anonymous wrote:I get some of what the OP is saying. It's not so much that the ED is boring. It's that a lot of people use it as an urgent care center and/or primary care center; this clogs the system and takes attention/time away from more serious cases.

+1

Anonymous wrote:

Anonymous wrote:Wow, op. Just wow.

You sound like the jerky dr we had to deal with in the ER at suburban a decade ago. He basically accused my husband of being a wimpy faker and then accused me of enabling him. Here's the thing: the ER Doctor simply didn't know enough to dig deeper. Good thing I persisted. I'm a lawyer and I knew the magic words to get my husband admitted for tests which proved we were right and led to surgery.

After the dust settled, I went back to the ER to leave a message for the jerky doctor who basically wrote off my husband as a wimp with a tummy ache.

Literally every ER Doctor I've ever encountered in my nearly 50 years has been arrogant and condescending...and oftentimes very wrong. I vividly the recall the ER Doctor who said he couldn't diagnose my "rash" and told me to follow up with a dermatologist. Turned out I had MRSA related cellulitis from a MRSA infection I picked up in the same hospital during surgery. My primary dr diagnosed it and basically told me that any dr should have been able to diagnose it...he asked me if the ER dr seemed young or just clueless, then he told me never to go back to that ER.

The reality is that the best and brightest aren't drawn to the medical profession anymore. So many bad doctors are out there. We are all so screwed.

Tip: don't blindly trust any doctor. Get multiple opinions, and do your own research. I basically diagnosed my husband's illness which required surgery. The ER Doctor and attending missed it because he didn't fit the classic profile when you google the symptoms (it's more prevalent in older fat women, and my husband was young, fit and male...but the symptoms were spot on).

cholecystitis?

Yo! You reminds me of my USMLE step 1! I would pick cholecystitis.

I think you should change jobs. I'd hate to come to your ED with chest pain that turned out to be anxiety, or stomach pain that turned out to be gas. Would you roll your eyes at me and send me on my way? Maybe work in a trauma center where you can do more important things.

Anonymous wrote:Wow, op. Just wow.

You sound like the jerky dr we had to deal with in the ER at suburban a decade ago. He basically accused my husband of being a wimpy faker and then accused me of enabling him. Here's the thing: the ER Doctor simply didn't know enough to dig deeper. Good thing I persisted. I'm a lawyer and I knew the magic words to get my husband admitted for tests which proved we were right and led to surgery.

After the dust settled, I went back to the ER to leave a message for the jerky doctor who basically wrote off my husband as a wimp with a tummy ache.

Literally every ER Doctor I've ever encountered in my nearly 50 years has been arrogant and condescending...and oftentimes very wrong. I vividly the recall the ER Doctor who said he couldn't diagnose my "rash" and told me to follow up with a dermatologist. Turned out I had MRSA related cellulitis from a MRSA infection I picked up in the same hospital during surgery. My primary dr diagnosed it and basically told me that any dr should have been able to diagnose it...he asked me if the ER dr seemed young or just clueless, then he told me never to go back to that ER.

The reality is that the best and brightest aren't drawn to the medical profession anymore. So many bad doctors are out there. We are all so screwed.

Tip: don't blindly trust any doctor. Get multiple opinions, and do your own research. I basically diagnosed my husband's illness which required surgery. The ER Doctor and attending missed it because he didn't fit the classic profile when you google the symptoms (it's more prevalent in older fat women, and my husband was young, fit and male...but the symptoms were spot on).

cholecystitis?

My diagnosis is you're suffering from a systemic health care problem.

Wow, op. Just wow.

You sound like the jerky dr we had to deal with in the ER at suburban a decade ago. He basically accused my husband of being a wimpy faker and then accused me of enabling him. Here's the thing: the ER Doctor simply didn't know enough to dig deeper. Good thing I persisted. I'm a lawyer and I knew the magic words to get my husband admitted for tests which proved we were right and led to surgery.

After the dust settled, I went back to the ER to leave a message for the jerky doctor who basically wrote off my husband as a wimp with a tummy ache.

Literally every ER Doctor I've ever encountered in my nearly 50 years has been arrogant and condescending...and oftentimes very wrong. I vividly the recall the ER Doctor who said he couldn't diagnose my "rash" and told me to follow up with a dermatologist. Turned out I had MRSA related cellulitis from a MRSA infection I picked up in the same hospital during surgery. My primary dr diagnosed it and basically told me that any dr should have been able to diagnose it...he asked me if the ER dr seemed young or just clueless, then he told me never to go back to that ER.

The reality is that the best and brightest aren't drawn to the medical profession anymore. So many bad doctors are out there. We are all so screwed.

Tip: don't blindly trust any doctor. Get multiple opinions, and do your own research. I basically diagnosed my husband's illness which required surgery. The ER Doctor and attending missed it because he didn't fit the classic profile when you google the symptoms (it's more prevalent in older fat women, and my husband was young, fit and male...but the symptoms were spot on).

I get some of what the OP is saying. It's not so much that the ED is boring. It's that a lot of people use it as an urgent care center and/or primary care center; this clogs the system and takes attention/time away from more serious cases.

OP you're not going to get a ton of sympathy on DCUM, but I think I get what you're saying.

I'm an NP, was an ICU nurse for many years before I became one. In the ICU you will have a few truly sick patients, some not-so-sick patients, and many stable-sick patients. For many of those, most of the care involved is meeting with their families to discuss options and end-of-life care. I know many MDs who love critical care but I found it to be very depressing. It also involves the same hours and shifts you're doing now.

I now work in an outpatient specialty clinic and while I agree with you that the hours are much better, outpatient care is a LOT of worried well with a few more interesting cases thrown in. I do not mind worried well visits and in fact feel like it's a huge relief when I can spend 20 minutes reassuring someone and then move on. But I know many of the MDs I work with find it frustrating to handle cases of those who are not truly sick, which is what they trained for.

Remember that in primary care you will have hours and hours of non-reimbursed time that you spend on phone calls, refills, and general follow-up, plus will have to take call.

All of that to say, the grass might always be greener. You must know some other doctors practicing in other areas--what do they like/dislike about their jobs? I have found that when I'm unhappy with where I am professionally it is really helpful to get a feel for what else is going on out there.

A lot of EDs now have two tracks; an urgent care track and a track for more emergent issues. Even at trauma centers, you are going to see "BS" cases. Some people (even insured, well educated ones) often use the ED as primary care. maybe ICU would be a better fit.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I went to the ER during a thyroid storm last year. My husband worked in the ER decades ago.

I'm SO glad your days are filled with non-life-threatening issues.

What does this have to do with anything? You utilized an ER for an emergency condition. This post was not aimed at you.

Do I really have to spell it out to you?

If an ER doc wishes for more emergencies, that means he or she wishes for more suffering people in mortal danger. Having been in that uncomfortable predicament, I don't wish that on anyone. My husband, having been on the medical side, has never once uttered such a wish as OP's. And he got all the druggies as well.

I was trying not to express how disgraceful it is for a doctor to say the ER is boring, but hey, you asked for it.

NP. No, it wouldn't. Actually, plenty of hospitals have to contend with horrible, life-threatening predicaments. Seems like OP wishes she could help people who are truly in dire straits.

If she was qualified to do so someone would have hired her for that already.