Back on ER. Today was my first weekend day and I woke up feeling like I got hit by a truck. I’m at a high volume private emergency/referral hospital and yesterday’s shift was especially long and rough, but ugh...
I almost always have to dedicate the first day off after a week of ER shifts to trying to recover/feel like a human again - more so than any other specialty I rotate through.
Anybody else experience this? ER veterans, does it get better?
Mmmm. Depends on what you mean by better. It takes less and less 'brainpower' the more you do it and things become automatic and you quit worrying about the weird cases that you aren't sure what's going on, and so that reduces your mental/emotional fatigue. It's the difference between your first ever blocked cat where you're nervous and worried and debating what meds to use and still trying to figure out exactly how to do it and what instruments to use and blah blah blah vs your 500th where, like I mentioned above, I tell my staff drug doses and then have them go unblock it and call me when it's time to look at the placement rad. So yeah, it gets better. The schedule itself is more brutal than people give it credit for - it is mentally and physically crushing to be going back and forth between days and nights, and no matter how much we kid ourselves, the mountain of evidence in human medicine says that never gets better and you are at a very high risk of metabolic disease, mental illness, etc., if you do it long term. I get paid a lot for what I do, and in my opinion, I think it's underpaid given the long-term risks.
It sounds like you're doing an internship? It also varies a lot from hospital to hospital and whether or how quickly they are having interns take solo shifts, how much support the intern has for difficult cases, what their overall caseload is, etc.
In my experience, our interns are more burned out than us staff docs because they stay many more hours later than I do to finish up their records, whereas I can mostly keep caught up on mine as I go (or at most stay for an hour or so to do them). It varies from intern to intern, but many of them are there for 3+ hours after their shift just doing records, which really hurts them by reducing their down time.
Also depends on who you work with. When I have an intern with me, I try to give them challenging cases for growth, but I also try to keep their case count manageable. I'm a fan of giving them
more difficult cases but
fewer cases. I think some people have interns take a lot of the 'easy' cases (laceration repair.... the boring 2-year-old lab that vomited 6 times in the last 4 hours and needs rads then either surgery or some cerenia/SQF ... etc.). I feel like those cases give really diminishing returns in terms of growth of the intern's skills, so I try to push difficult cases on them that force them to grow, but I try to make sure they have the space/time to do a good job with them. You'll learn a lot more managing an anaphylactic dog than suturing a 2" laceration in a young healthy beast.
Absolutely incredible! The whole hospital was rooting for him and his recovery. I’ll never forget that dog.
). originally told the owners on the phone that I’m scared for a foreign body, which honestly I still am based on rads sadly as there’s some very suspicious gas patterns going on, though I have been burned on things that totally looked like an fb on rads and then there was nothing there at surgery, before. Regardless, he’d for sure not withstand an exploratory as of present. So now I get to push him some dex and leave him on fluids and lay awake at night pondering it all. Woof.
