My experience (so far) Volunteering at the ED

[schooltill30]

Well, it's officially been one week since I started volunteering and already my previous assumptions about hospitals and medicine have been turned upside down, shaken, and beaten out of me like a bad habit. Let me first say that the ER I'm at is not a trauma center, and is more like a clinic than an "emergency" room. Needless to say, my first big revelation was the overall lack of intensity. I knew that it wasn't going to be all dramatic and movie-like, with countless people dying and screaming in pain as a handsome doctor seamlessly slices and dices until all are healed, all to the musical accompaniment of indy music. But one code in a whole week? I was shocked. The most serious thing that happened when I was there (three hours a day, 6 days a week) was that a woman had a seizure and vomited all over herself in the waiting room. Other than that, almost everybody who walked in the sliding door had nothing even remotely close to an emergency. Most of these people are using the ER as their doctor's office, clogging up the system with their colds and stomach aches. I can count the emergencies this week on my hands, with fingers to spare. This really bothered me, how the system is abused, and was my first foray into the ugly world of the national heathcare system.

The second thing I came to realize was why people wait so long. I know it's hard to focus on anything other than yourself when you're in pain in a hospital gown, but people need to understand that there are usually 2 doctors for 30+ patients. One of my jobs is going around to patients' rooms and making sure they have what they need (blankets, pillow, drink if allowed, call button, etc.), and almost every time they want their doctor. Eventually they get cranky and some even try to leave. I've come to see that nobody is to blame for this other than people clogging up the system. It's not an easily solved problem.

I also have a newfound appreciation for nurses. At least in the ER, they do all the work. The doctor's job is to treat and to talk. The nurses have to do everything else. I rarely even see doctors, so I work with the nurses for the most part, and I have sworn to myself I won't be the doctor who disrespects the nurses. Without them, there wouldn't be healthcare.
There was something I was right about, however. Nurses, EMT's, doctors, etc. have a really twisted sense of what's "cool". I love it. I was about to leave my first day, and one of nurses stopped me.
"No, don't leave yet. Just wait five more minutes, and you can see something cool. A father just called in saying his daughter broke her leg, and the bone's sticking out. You gotta stay and watch."
I don't believe you will find something like that in any other profession. And I love it. Either way, there were 7 or 8 nurses and EMT's plus me waiting in ambulance bay waiting for the girl to come in (with bated breath, of course). As they roll her in, it's obvious that it wasn't as bad as reported. The skin was broken, there was blood, but no bone. A collective sigh rolled through the dissappointed spectators.

Anyway, I do enjoy what I do. Even though I'm not doing much, it's a great feeling when you help someone out and you know it was exactly what they needed at the time. Someone to ask for water, to turn off the lights, little things that nurses and doctors don't have time for. After a month, if I'm still not getting the exposure to the dirty work of medicine I'm ultimately looking for, I may transfer to a trauma center. For now, I'm enjoying the work enviroment, the people, the twisted humor, and the beyond ugly blue jacket I'm wearing.

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[deleted50541]

For my eyes and readability, paragraphs please.

 

[schooltill30]

sry bout that. Edited paragraphs.

 

[deleted50541]

Much better.

 

[curlywurly]

Sounds like you're having a great experience. I start volunteering this week in a fairly busy ED in milwaukee (the hospital MCW is attached to) and I'm a little bit nervous. I know that really the only way to see "cool" stuff is to get to know the doctors and nurses and basically invite yourself in, but seeing as I'm a little shy, I'm afraid I won't be able to do this. Do you have any tips for getting more involved with the staff?

 

[Meatwad]

I'm kind of in a different position. I'm not an adrenaline junkie that needs constant emergency situations to be interested. I started working with a urologist in his practice during the week, and it's great. There's no emergencies, but talking with patients and even watching minor procedures being done is real interesting. I also get to see the doc go over boring paperwork, and I'm still just as interested in medicine as ever. I think it's a good thing to see the less-glamorous side of it all. Of course, he said he'll take me to see a kidney transplant on Tuesday, so that will be pretty sick.

 

[Meatwad]

Sounds like you're having a great experience. I start volunteering this week in a fairly busy ED in milwaukee (the hospital MCW is attached to) and I'm a little bit nervous. I know that really the only way to see "cool" stuff is to get to know the doctors and nurses and basically invite yourself in, but seeing as I'm a little shy, I'm afraid I won't be able to do this. Do you have any tips for getting more involved with the staff?

I don't work in an ED, but I'm already really comfortable with the staff and nurses in my department. The number one reason is that I'm lucky they are such nice people, but I also attribute it to the fact that I just tried to be myself. I haven't curbed my strange sense of humor around them, and I think they like that about me. They'd probably hate me if they thought I was some gunner kid trying to look squeaky clean so I could get a nice LOR one day. Just be yourself and be relaxed and I'm sure you will make friends in no time. Nurses, doctors, etc. are just regular people, and they know you are too.

 

[StringerBell]

Let me first say that the ER I'm at is not a trauma center, and is more like a clinic than an "emergency" room. Needless to say, my first big revelation was the overall lack of intensity...
almost everybody who walked in the sliding door had nothing even remotely close to an emergency.

This is true, though for those of us who have worked in the emergency room, this is considered a "good day." But even if you're not in a trauma center, you'll find lots of very interesting things happening, most often in the form of cardiac/respiratory distress. ("Code 3's" that are not really "Code Blues.") If you're going into Emergency Medicine, get used to that. I find that really fascinating, myself, and if you ever get to participate in CPR and the patient is eventually revived, that's an awesome feeling. That being said, you'll also find a bunch of nosebleeds, flu-like symptoms, and altered level of consciousness that are sometimes not-so-interesting. However, Basic Emergency is still emergency...I hope you're not in an "urgent care" setting, which is a little different.

almost every time they want their doctor. Eventually they get cranky and some even try to leave...I also have a newfound appreciation for nurses. At least in the ER, they do all the work. The doctor's job is to treat and to talk.

Part of the reason why clinical experience is important is to realize these aspects, as well. You want to be able to respond to the needs of patients and work well with your fellow team-members, be they fellow physicians, nurses, or techs. And remember - if you're going to be the physician, you may now believe that the nurses do all the work, but you're going to be the one making all the important decisions. That's what that nice degree on your wall represents.

After a month, if I'm still not getting the exposure to the dirty work of medicine I'm ultimately looking for, I may transfer to a trauma center.

Partway through my employment at this hosptial, we changed from basic emergency to Trauma I. Of course, that meant an increase in trauma cases, but the basic workload was the same. You're still going to see a lot of basic emergency, and if you're going to be an EM physician, you should expect that...unless, of course, your end-goal is to be a trauma surgeon...and that's a different beast altogether.

 

[schooltill30]

Sounds like you're having a great experience. I start volunteering this week in a fairly busy ED in milwaukee (the hospital MCW is attached to) and I'm a little bit nervous. I know that really the only way to see "cool" stuff is to get to know the doctors and nurses and basically invite yourself in, but seeing as I'm a little shy, I'm afraid I won't be able to do this. Do you have any tips for getting more involved with the staff?

I have two different tactics:
1) Don't straight up ask someone to participate in something. Usually you're just getting in the way. I just keep asking people if there's anything I can do. They'll love you for it, and they know that you want to be involved even if you don't outright say it. They will come over to you and invite you instead.

2) You don't have to know everyone in the ER. Find one or two nice nurses and stick with them (don't attach, that's just annoying). The point is to be comfortable one or two people that you ask things like "Hey, do you think you can get me into the [insert procedure] in rm. 8?" Usually, that's more than enough.

I also have problems going up to relative strangers and asking them for favors, I think everyone does. The idea is that it doesn't have to come out that way. I hope this helped.

 

[Auron]

I volunteer at my ED and its preety worthless for the most part. Yes I learnt about trauma when it happened (almost never) and the general workings. I learnt just about everything I cared to know within a week.


Sadly, I need to demonstrate "commitment" and keep doing this chore every week. oh well...when I get in it'll all be worth it.

 

[jochi1543]

I volunteer at my ED and its preety worthless for the most part. Yes I learnt about trauma when it happened (almost never) and the general workings. I learnt just about everything I cared to know within a week.

Yeah, I didn't like ER either - I was a "float" since I was available for 20 hours a week, so I worked in lots of different places throughout my 3-4 months at the hospital. ER was my least favorite of those. Boring, everybody hates you, and it's filled with screaming delirious 90-year olds in the back. Then someone dies and they just freaking leave him in the same hallway where you walk in with the family members - yeah, how thoughtful that you covered him with a sheet, I'm sure the relatives of the other patients are REAL inspired by having to walk by a corpse that came out of the very department where their family member is currently being treated.

 

[corbis11]

The best part about my volunteer experience in the ED was conversing with the nurses and hearing all the hilarious stories about the people they have encountered (especially the transvestites).

 

[jochi1543]

The best part about my volunteer experience in the ED was conversing with the nurses and hearing all the hilarious stories about the people they have encountered (especially the transvestites).

Yes, while filing case histories, I've definitely read many a page-turner. However, I wasn't really supposed to be reading stuff, so I had to do it on the downlow, which made it less fun because I couldn't laugh outloud.

 

[schooltill30]

Yeah, I didn't like ER either - I was a "float" since I was available for 20 hours a week, so I worked in lots of different places throughout my 3-4 months at the hospital. ER was my least favorite of those. Boring, everybody hates you, and it's filled with screaming delirious 90-year olds in the back. Then someone dies and they just freaking leave him in the same hallway where you walk in with the family members - yeah, how thoughtful that you covered him with a sheet, I'm sure the relatives of the other patients are REAL inspired by having to walk by a corpse that came out of the very department where their family member is currently being treated.

Wow, my ER is so not like that. I guess the experience varies from place to place, because where I am most people are nice, and most everyone is respectful. Of course, this is the south, so everything's just better regardless

 

[bioteach]

Yeah, I'm having the same experience. Luckily I volunteer on friday nights, so its jumping the whole time, but we are not a trauma 1 either. I'm mostly ignored by all of the staff, I only really interact with the triage nurse. I do get some decent patient interaction when I take them back to their rooms, set them up with gowns, blankets, etc. That's pretty much what I expected, so I'm okay with it. Sometimes I wander around trying to look busy until I have something to actually DO. The male nurses and EMTs have been way nicer than anyone else. One pulled me in last friday to watch a bone being reset into place. I'm pretty much invisible to the docs, just another wide-eyed schmuck in a blue polo shirt.

I do the "can I help with anything" alot, to try and get on everyone's good side.

 

[45408]

The best part about my volunteer experience in the ED was conversing with the nurses and hearing all the hilarious stories about the people they have encountered (especially the transvestites).

One of my best stories happens to involve a tranny as well.



curlywurly, check your PMs.

 

[Doc Henry]

I just thought I'd add a few cool things I've seen while doing clinical research in a level 1 trauma center.

-On my first day a man came in after having his hand torn off by a piece of construction machinery. I got to stand by and watch the surgeons and ER docs evaluate him and ask tons of questions

-On my 3rd day another construction worker came in...this time it was a circular saw to the neck. He cut through his trachea and one of his external jugulars.

 

[jochi1543]

I just thought I'd add a few cool things I've seen while doing clinical research in a level 1 trauma center.

-On my first day a man came in after having his hand torn off by a piece of construction machinery. I got to stand by and watch the surgeons and ER docs evaluate him and ask tons of questions

-On my 3rd day another construction worker came in...this time it was a circular saw to the neck. He cut through his trachea and one of his external jugulars.

I briefly dated a tradesman who had accidentally castrated himself while at work.

 

[winthug]

I find that really fascinating, myself, and if you ever get to participate in CPR and the patient is eventually revived, that's an awesome feeling.

Out of all the patients I helped the doctor resuscitate, maybe less than half of them have lived and those that lived are now on a respirator, feeding tube, eyes wide open and pupils non-reactive to light and are basically not functional. There is no awesome feeling unless they are able to live a normal life a week later (which almost never happens). That is why DNRs are so beautiful.

But one code in a whole week? I was shocked. The most serious thing that happened when I was there (three hours a day, 6 days a week) was that a woman had a seizure and vomited all over herself in the waiting room.

You are volunteering there 3 hrs/day, 6 days/week. What do you expect? Also, you're a volunteer so no one is going tell you that there's a code in the ICU, or a full arrest is coming by ambulance. I don't work in a trauma center, but I see a lot of wierd crap because the doctors/nurses order me (as an ERT) to treat the pts. Within this week, there were 3 GSWs (two arms, one head), probably ~5 codes, pretty nasty lacs and fractures, probably a hundred chest pain/SOB/CHF/CVA pts, and the list goes on. I had a pt seize in the gurney while his family members were there. They were like, DO SOMETHING! I was like, "ok". Then I suctioned his mouth and just let him finish. Easy. Trauma centers get cooler pts, but other ERs still get their share of coolness.

Eventually they get cranky and some even try to leave.

Nothing makes me more happy then calling their bluff. "You want to leave? Go ahead." Then they say stay. w00tz. And if they do leave, we still get paid by their insurance, so it's their loss.

The doctor's job is to treat and to talk. The nurses have to do everything else. I rarely even see doctors, so I work with the nurses for the most part, and I have sworn to myself I won't be the doctor who disrespects the nurses. Without them, there wouldn't be healthcare.

I agree with you here but only for ER nurses and EMTs. They know how to handle most cases and are very quick, but if you've ever seen a RN/LVN/CNA from a different ward, you will soon realize how useless they are in terms of emergencies. THere was one code in the med/surg unit and I got there in 2 min. The crash cart was there, no doctor yet, and the nurses weren't doing ANYTHING. I basically had to tell them what to do for the next few minutes until the doctor came. "Why isn't he hooked up to the defib., why aren't you doing compressions, why aren't you even checking his pulse, shouldn't you bag him?" Seriously, many of them pee in their pants when they are faced w/ an emergency. If there was no question of practicing out of one's scope, an ER RN would probably be able to run a code him/herself successfully.

Yeah, Then someone dies and they just freaking leave him in the same hallway where you walk in with the family members - yeah, how thoughtful that you covered him with a sheet, I'm sure the relatives of the other patients are REAL inspired by having to walk by a corpse that came out of the very department where their family member is currently being treated.

Yah. That's awful. My ER at least tries to put a curtain around the body, but the body does sit there for a while before it can be moved to the morgue. I have had patients walk into a multi-bed room with a corpse in the corner before, but they got to realize that it's an ER

 

[StringerBell]

Out of all the patients I helped the doctor resuscitate, maybe less than half of them have lived and those that lived are now on a respirator, feeding tube, eyes wide open and pupils non-reactive to light and are basically not functional. There is no awesome feeling unless they are able to live a normal life a week later (which almost never happens). That is why DNRs are so beautiful.

You're right. I should have qualified the statement by saying that in my experience, a lot fewer than half survived, and only once would I even call it a marginal success. (Rescuscitated only 2 out of maybe 20+.)

And I do agree about DNR's...in most of the patients I've seen code, if they don't have a DNR, it's the family that wants to keep the patient alive, more so than the patient.

Nevertheless, though, in reference to the OP, I am hoping that he gives his "non-trauma center ER" a chance, because there is an opportunity for him to learn about, or at least be exposed to, emergency medicine. Point being, not to jump ship for the "sexiness" of a trauma center.

 

[IWant2BeADoctor]

I look forward to more volunteering this summer. Though some nurses can really be abusive towards volunteers.

 

[schooltill30]

Ok, I have to share this one. I was waiting in the waiting room for something to happen (nothing goin on in the back either), and woman walks in, pulls out her phone, and tells someone that she just got to the doctor's office. DOCTOR'S OFFICE????

I sincerely hope she just screwed up and meant to say something else.

Either way, to the previous posters, we're not a very big ER, so if anything happens, it's hard to miss. Nothing happens. I do enjoy what I do for the most part. I love just being around a medicine enviroment (I think that's a good sign). And while I would like to be in "sexier" medical situation, it's just because the only exposure I have to it is through TV, and I don't want to start medical school with those kinds of pretenses.

 

[winthug]

That's great that you're looking for a more realistic view of medicine. You will certainly see if you volunteer as much as you do now. Just try to avoid situations where you are stuck doing a task with your back to the action (paper work). If one of your duties is to escort patients to certain beds/cublicals, one good suggestion to learn more is to look at their chart for their chief complaint. If it's something interesting, keep an eye on that patient and try to follow up on what happens to him/her, though it can be hard to read a doctor's writing. For all of us, let's try to write more neatly when we become doctors . Sometimes I work as the unit secretary when we are short staffed and 99% of their writing looks like some form of chinese/grafiti. Remember, 1) lift your pen between letters, 2) no cursive writing, 3) don't write what seems to be pubic hair in place of your signature, 4) write between the lines, and 5) only use commonly-used abbreviations (no one will understand CPTRTTJALA - chest pain that radiates to the jaw and left arm).

After having worked in the ER, I start to see how BS the TV shows are when they use medicine. Why do doctors like to defib patients when they are asystole? It's mainly used for V-Tach and V-fib and it's function isn't to jump start a heart like one would do for a car. LOL. CPR is not that effective without all the meds (Epi, Codeine, Lido, etc.). I remember watching Jack in Lost doing CPR a bunch of times in the first season and he's like, 5/5, even if the other has been in full arrest for a LONG time. Oh yah, the compression:breath ratio isn't 1 compression:10 french kisses. LOL. What kind of doctor is House MD? He seems to do almost everything. LOL. Adn lastly, I know it looks cool to defib someone with paddles, but I've NEVER seen anybody do it because the sticky paper paddles are usually slapped on to them. Haha, I wish I had an excuse to shock someone w/ the paddles for the coolness factor.