EM is good but utter chaos. In addition, they know slightly more than a good ED nurse who's been at it for 20 years.
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Gotta love the obligatory EM insult, as someone who is currently weighing going into EM vs IM this is utterly ridiculous. Sorry but ED nurses do not put in chest tubes, intubate, LPs, central lines, conscious sedation, manage traumas, and code people daily. Sure anyone can order CBC, Chem 12, UA, lipase, urine hcg on any female with abdominal pain, it's brainless. And Yes and a nurse can order ekg, serial troponin, asa, nitro, morphine, oxygen on chest pain, but that doesn't mean she can manage an acutely decompensating patient. EM deals with EVERYTHING in medicine, children, adults, OB, geriatrics, psych, ortho, ect.
IM is much different, and has it's positives and negatives, like any field of medicine. I like the intellectualism/workup in IM that is somewhat lacking in EM, but don't kid yourself, more often than not the diagnosis is made in the ED before it hits the floor, and a lot of IM is spent deferring to specialists to help manage the patient.