I got "kicked out" from ER at the beginning of the shift....

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bestcoast

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It was a messed up situation this month.

I'm a psych resident doing this elective at the children's hospital this month. It's all clinics during the day.
I started the rotation after receiving my rotation schedule 2 weeks ago.
2 weeks in, during my specialty didatics, a colleague said that she was asked to do several weekend ER shifts during the winter when she was doing the same rotation.
This time, no one emailed me about the ER shifts and I was NOT aware about it until the end of last week

I emailed two people: 1) my rotation supervisor and 2) the chief resident in charge of ER schedule.

I got two different response:
From my rotation supervisor: You don't have to do it. They now only have peds residents doing it. You can do it if you really want to.
From the chief resident: Yes, you have to do a couple shifts. We couldn't put you on the list because the coordinator in charge of off service rotators is no longer working and we had no idea about you. I will put you on the schedule.

At the end, the chief resident added 2 evening shifts for me this week in order to make up for lost time. She can't give me any weekend shifts because I already requested my vacation months ago and booked my flights.

So I showed up today at the ER today after my clinics. I finished seeing my first patient in over 30min because I didn't know where everything is. The attending was confused why that is, especially given that it's 2 weeks INTO a rotation, "this isn't your first day here, is it?"
I explained the whole situation to her and showed her the emails.
She was like, "We don't have elective residents do shifts now. I was confused too why a psych resident would show up here. They even put you in the fast track section where you see nothing but mild viral syndrome and minor injuries. They should've put you in cat 3 or 4 where you will often see psych cases. You won't be helping us much here and you won't learn anything useful for you. Beside, you have clinic during the days.. we can't have you stay til 1-2 am and have you work at 8am the next day. Go home"

I'm not in trouble right? How should I tell the chief resident?
 
As a former chief resident, I would say tell exactly the above (what happened) to your chief resident before going to your rotation supervisor or PD. The chief should be able to resolve the problem for you, or he/she can bring it up at the next faculty meeting to both resolve your situation and ensure it doesn't happen to residents in the future.
 
Your attending tells you to do something, and if it won't result in a patient dying, you do it.

You're program didnt want you doing it and neither does the attending. Be happy, right?
 
You can't do back to back day shifts and an overnight shift between, it breaks work hours...

Also it sounds like according to pretty much everyone you shouldn't be doing any shifts in the ED at all as a psych resident. I'd ask a few senior people what the current policy is before talking to the chief resident again.
 
You can't do back to back day shifts and an overnight shift between, it breaks work hours...

Also it sounds like according to pretty much everyone you shouldn't be doing any shifts in the ED at all as a psych resident. I'd ask a few senior people what the current policy is before talking to the chief resident again.

The only thing you should get from an ED rotation as a psych resident is what is necessary for medical clearance anyway 🙂. And you can learn that in a single day. I'd have told you to go home myself unless you wanted to learn how to suture better. That said, you're not in trouble at all, you just need to inform the chief and/or your program director that they said it wasn't necessary for you to see patients as a psych resident.
 
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