Actually it was set at the fictional County General Hospital. I allow for some dramatic license with that show, because for every 10 patient’s you might have seen during the course of one episode with some crazy injury or illness there were 200 other patients in the ER that day that they didn’t show who had routine chest pain, shortness of breath, abdominal pain, cold symptoms, etc. But even with that suspension of disbelief the number of crazy things that happened in that ER was ridiculous.
Do you feel the nurses are overworked?
Well true, but people here tend to call the real thing “County” or “Cook County”, and the patients in the show did as well to my recollection. In the hospitals I’ve worked at during the time the show aired (not at CCH), the personnel there who watched the show and talked about it assumed it was a stand-in for CCH.
But yes, the sheer volume of patients with crazy stuff going on was definitely heightened for dramatic effect. :eek:
Has anything (wound/infection/bodily fluids) ever seriously grossed you out? What was it?
You’re under no obligation to answer, but how much does malpractice insurance generally cost for an ER doctor in your area?
How has your job influenced your views on political issues like gun control, drug legalization, legalizing prostitution, etc?
Does anybody ever run?
On TV, nobody in the ER walks…they are always running.
The paramedics pushing the gurney out of the ambulance and through the hallway, the admitting nurses, the surgical teams that arrive instantaneously…always at a full run.
I’ve spent many (too many!) long hours waiting in the ER to diagnose something , but I have never,never seen anybody run. Obviously, something is terribly wrong with my ER 
Are there any emergencies that are so critical that doctors have to come running?
Jeez, it seems like just yesterday you were getting into med school.
Young whippersnapper with your fancy gadgets and labs with rapid test results! I had to my own AFB stains on gomer sputums in my day…
[sub]Old! I’ve gotten so old![/sub]
I’ve had a couple of nasty abscesses that have made me gag, but the only thing I REALLY don’t like is poop.
My malpractice is covered by my group, so I don’t really see the numbers, but I think it’s around $60-70k/year
No not really, I try to keep my politics separate from my work. One issue I can’t really do that on is health care reform. I’m pretty divided actually. On the one hand, I think everyone deserves to have proper health care and it would probably help to ease our particular burden in the ER. But, I’m almost guaranteed to see a decrease in revenues at the same time.
Occasionally, but we’re talking a total distance from one end of the ER to the other of about 30yards. It isn’t like running is going to save a lot of time. 2-3seconds at most. And then you get to the room all winded.
I was a couple of months away from college graduation when I joined here! That’s a good memory for an old man!
I think I’m glad I have no idea what ‘loa loa’ is.
What is it?
Another name for it is African eyeworm.
Wiki it. I dare you.
How much of diagnostics could be accurately re-termed, “wild-ass guessing?”
I only ask because I ended up in the ER after a gall-bladder operation and the initial diagnoses were all about, “you’ve still got a stone stuck in there,” and it turned out to be a leaky bile duct instead. They didn’t really figure it out at all until they ERCP’d me. External diagnosis-wise, they seemed utterly in the dark.
Secondary question:
Is it *ever *lupus?
And does everybody lie?
Have you ever lost a patient? Not had someone die, actually lose them.
I went to the ER once after being T-boned and putting my head through the driver’s side window. I refused treatment at the scene because I felt okay, but the headache later on made me thing an X-ray or something might be wise. My father drove me to the hospital and they promptly took me back and stuck me in a cubical. Hours passed and no one came. It was only after my father kept hearing the receptionist insist to calling family members that they had no patient by my name did he tell them that yes, they did, and I’d been gone hours. Apparently they put me in the room but forgot to put me in the system or create a chart, so no one saw me. I was patiently waiting, figuing that’s how the ER was supposed to work.
StG
A lot of questions here revolve around TV shows, and it is often our only exposure to your world. That said, do you and your fellow professionals watch a lot of medial dramas/comedies/thrillers? Do you tend to avoid them now? And if so, is it a case of “I do this all day, I don’t want to see more of it at home,” or are you bother by inaccuracies and artistic license?
My wife is an ultrasound echocardiographer, and while we love medial shows (House is one of our favorites), watching them with her is…different. Especially the dramas, where she’ll laugh out loud at serious moments.
“What?” I’ll ask.
“That’s not a cardiac probe, it’s a fetal probe.”
“Bleargh? He’s convulsing on the table! You’re looking at the probe!?”
I’ve gotten used to it now.
I noticed I missed this one. At times the nurses are definitely overwhelmed. Depending on acuity of the patients, an ER nurse should have between 3-5 patient’s they’re responsible for. Often times they also get assigned to patient’s parked in a hallway. Or we simply don’t have enough nurses to keep our whole department open at critical times (like 7p-12m).
Do you ever think to yourself, “Damn, this person is so horribly messed up they might be better off dying”?
Actually quite a bit. I think there is a misconception out there that for every conceivable diagnosis, there is a test that can be done. In reality doctors as a whole end up doing quite a bit of guesswork. There is an approach to disease processes in the ER that is different from just about everywhere else in medicine. My primary concern is “will this kill you soon?” So if you come in to the ER complaining of abdominal pain. I’m going to run a few tests to make sure it isn’t a life-threatening process, but about half the time, I’m going to come up with nothing. In those cases further evaluation may be necessary. I can’t do an ERCP or MRCP or HIDA scan or colonoscopy or EGD in the ER. And most of the time you can go home and see a specialist to get those things done.
Sometimes, but usually the patient already knows they have lupus. I’ve never made the diagnosis, because the confirmatory tests take several days to come back.
Not everybody. It’s hard to keep an open mind for every patient though when you see so many people who are clearly lying and/or telling you what they think you want to hear to get what they want.
Occasionally a patient will be assigned to a room in the computer system (we have electronic tracking, no dry erase board) but then not actually taken to the room. So I go check the room and it’s empty. I want 10 minutes, go back and check and it’s empty. At that point, no one knows where the patient is. So we have to go hunting. Usually, either they’ve left without being seen or are still in the triage/waiting area.
Comedies I’ll watch because I can accept that they aren’t trying to be realistic. I’m much less interested in dramas/thrillers because they’re often so unrealistic as to be distracting. I mentioned above that I watched ER until about 2002 which was the year I started my clinical rotations in the hospital. I watched Scrubs through the end of the series, but not religiously. I’ve never watched House, Grey’s Anatomy, Private Practice etc.
I’ve heard, jokingly on ER boards (that I’m not a member of and so can’t ask), something to the effect of “if you have chest pain NEVER try to use the toilet.” What’s the deal with that? What if you really have to go?
Is it just some giant woosh on my part?
I have no idea, other than it’s an embarrassing way to be found dead if your chest pain is from a heart attack.