It's fast paced and challenging and there a ton of variety - everything from run-of-the-mill vomiting and diarrhea and hot spots to DKA and status epilepticus and gunshot wounds.
I think that in order to be happy in the ER, you have to be able to shift priorities quickly and be comfortable with ambiguity.
You won't necessarily have anything close to a diagnosis, just an incomplete problem list. You have to have the confidence of your team, quickly gain the confidence of the client (a total stranger), and have strong confidence in your team's abilities.
The lack of long-term client relationships is either a blessing or a disadvantage, depending on your personal preferences.
I was an assistant in the ER of a specialty referral hospital for about two years, and echo what VS said. You really have to be adaptable and flexible, ready to tackle whatever craziness rolls in the door at 2AM. Think fast, quick decisions with minimal info, take charge of your team. And often the emergencies are not polite enough to come in one at a time; you could have several critical cases circling the drain at the same time.
At our hospital, ER was running 24/7, and during regular hours there were always probably 7-9 docs working in the other services who could jump in and help if needed. But overnight, it was one doc, and usually from about 12A to 6A there would only be two other staff, one tech and one assistant. THAT could get very scary, and honestly I think a lot of times the patients suffered due to poor staffing. The doc could be up to his/her elbows in one dog, barking out orders to the staff who are running around like headless chickens, none of the regular treatments are getting done. A LOT of great docs are not up for that, it just takes a certain personality type to be able to do well in that environment.
That said, the truly crazy shifts are fairly rare. There are a lot of down times, where you can be pretty bored hoping for something exciting to roll in. And most ER's are not just truly for emergencies. We got a lot of transfers from referring vets who close at night and need to send their post-op patients for monitoring. A lot of people who don't have a regular vet, so they come to us for what should be routine care. And all our own in-patients from the other services, who usually we would just be monitoring overnight.
The lack of long-term client relationships can be frustrating. Typically, you are only seeing these people and their animal for that short crisis, usually the worst of times. Often, there are many underlying conditions - obesity, dental dz, skin conditions, etc. - that should be addressed but as the ER vet you walk a fine line. The emergency has to take priority, and you have to be careful not to "bad mouth" an rDVM who *should* have been addressing these issues long ago
I really loved the ER environment, but like someone else mentioned I felt I never really had the training I should have had in order to be more useful. So many hospitals are just really shortsighted - they skimp on training and CE to save money upfront, but it really costs a lot more long term if you've got inefficient poorly-trained staff, not to mention the impact on patient care. ER is not my #1 goal, but I do hope to be able to work PT in that environment eventually.
