What do EM residents think of off-service rotators?

[IJL]

At my institution (and presumably most large academic places), psych, optho, radiology, and anesthesia interns all rotate through the ED.

What do you think of these rotators (since I'll be one next month...) ? Do they get in the way? Slow things down? Obviously we'll be behind the actual EM residents/interns as far as the workings of the emergency department goes. I'm just a little confused at the expectations.

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[RPedigo]

My main expectation is that you do an outstanding job on the patients you do see. I don't need you to move patients quickly -- but if you are seeing patients in the ED where I train, you have to present to a senior resident before you present to the attending, and I basically co-follow patients with you. So if you present to me and I have to re-do all your history, exam, have to hover over everything, change your documentation, etc. then it doesn't save me any time. On the other hand, if you take an accurate history, do a good focused but accurate physical examination and after presenting to me follow up on all the tests, etc. then it makes my life much easier. I would never want an off-service (or even EM) intern to take more patients than they could optimally handle. At the end of the year I push the EM PGY-1 to go faster, see more patients -- but not for off-service residents and certainly not in the beginning of the year.

 

[deleted547339]

My main expectation is that you do an outstanding job on the patients you do see. I don't need you to move patients quickly -- but if you are seeing patients in the ED where I train, you have to present to a senior resident before you present to the attending, and I basically co-follow patients with you. So if you present to me and I have to re-do all your history, exam, have to hover over everything, change your documentation, etc. then it doesn't save me any time. On the other hand, if you take an accurate history, do a good focused but accurate physical examination and after presenting to me follow up on all the tests, etc. then it makes my life much easier. I would never want an off-service (or even EM) intern to take more patients than they could optimally handle. At the end of the year I push the EM PGY-1 to go faster, see more patients -- but not for off-service residents and certainly not in the beginning of the year.

Out of curiosity, how many patients are your EM interns seeing at a time at the end of the year?

 

[DreamingTheLive]

Pretty simple really. Just do your best and work hard. NOBODY is expecting you to "move the meat."

Oh, have some fun too!

 

[RPedigo]

Out of curiosity, how many patients are your EM interns seeing at a time at the end of the year?

We have pretty high acuity, but I would say with a complete mix of patients and our inefficient system, anywhere from 1.25-ish to 1.5/hr.

 

[Sam212]

My main expectation is that you do an outstanding job on the patients you do see. I don't need you to move patients quickly -- but if you are seeing patients in the ED where I train, you have to present to a senior resident before you present to the attending, and I basically co-follow patients with you. So if you present to me and I have to re-do all your history, exam, have to hover over everything, change your documentation, etc. then it doesn't save me any time. On the other hand, if you take an accurate history, do a good focused but accurate physical examination and after presenting to me follow up on all the tests, etc. then it makes my life much easier. I would never want an off-service (or even EM) intern to take more patients than they could optimally handle. At the end of the year I push the EM PGY-1 to go faster, see more patients -- but not for off-service residents and certainly not in the beginning of the year.

Lol what should we expect of EM residents on other services such as ortho?

 

[Old_Mil]

At my institution (and presumably most large academic places), psych, optho, radiology, and anesthesia interns all rotate through the ED.

What do you think of these rotators (since I'll be one next month...) ? Do they get in the way? Slow things down? Obviously we'll be behind the actual EM residents/interns as far as the workings of the emergency department goes. I'm just a little confused at the expectations.

They range from arrogant and uninterested to pleasant but unequipped for the environment. But there is nothing better on a shift than to have an OB rotator in the department when the inevitable pregnant < 20 week patient rolls through the door.

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[Seville]

I have had some amazing off service rotators come through the department who ran circles around even the EM interns. Certain fields tend to have better equipped residents (for rotating through the ED) it seems. Biggest thing is be interested. Seriously. We know you aren't going into emergency medicine, but for the love of Pete, go see patients when placed in your beds, take an accurate history, do a thorough physical exam, and talk to the residents about what you think is going on and what you would like to do with/for the patient. No idea of a plan? That's cool too. Let's talk about it and come up with a plan together. Work hard, be a part of the team. Remember, you may only be rotating through for one month, but you have residency at that institution for years and we will likely have to consult you in the future on a patient. If you show us that you are a hard worker, can be trusted with patients, and so on, we are much more likely to listen to your suggestions when we consult you in the future.

 

[Titrate2Life]

At my institution (and presumably most large academic places), psych, optho, radiology, and anesthesia interns all rotate through the ED.

What do you think of these rotators (since I'll be one next month...) ? Do they get in the way? Slow things down? Obviously we'll be behind the actual EM residents/interns as far as the workings of the emergency department goes. I'm just a little confused at the expectations.

Lol. This question is like my wife asking me if she looks fat in this or that dress.