What is a normal working environment like in ER?

[LUCPM]

I'm a family medicine resident who recently started moonlighting in an ER (at my residency hospital) and I'm doing this solely for extra income for my family. This is my first job in a hospital setting and I would like to ask what it's like to work in a small community ER.

We have a separate fast track where we (mid-levels and residents) only see low-acuity patients. The charge nurse sometimes asks us to come up to the main ED to work when they are short-staffed, which I have no problem with, but I often feel I'm treated like a janitor as they do not even have a space nor a decent working computer that I can use with dict-a-phone, and they don't even bother accommodating me or helping me find a working computer to use. This has happened every time I come up to the main ED, but knowing my current position at the bottom of ladder and my financial situation, I do not complain and I've been always happy to oblige. However, they recently reduced my shifts to almost nothing, like one shift a month (I used to work at least 6-7 shifts a month to support my family) with no notification, which really made me feel like I am indeed at the same level of janitor or factory worker.

Am I overthinking this or am I having unreasonable expectation?

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[gro2001]

I'm a family medicine resident who recently started moonlighting in an ER (at my residency hospital) and I'm doing this solely for extra income for my family. This is my first job in a hospital setting and I would like to ask what it's like to work in a small community ER.

We have a separate fast track where we (mid-levels and residents) only see low-acuity patients. The charge nurse sometimes asks us to come up to the main ED to work when they are short-staffed, which I have no problem with, but I often feel I'm treated like a janitor as they do not even have a space nor a decent working computer that I can use with dict-a-phone, and they don't even bother accommodating me or helping me find a working computer to use. This has happened every time I come up to the main ED, but knowing my current position at the bottom of ladder and my financial situation, I do not complain and I've been always happy to oblige. However, they recently reduced my shifts to almost nothing, like one shift a month (I used to work at least 6-7 shifts a month to support my family) with no notification, which really made me feel like I am indeed at the same level of janitor or factory worker.

Am I overthinking this or am I having unreasonable expectation?

The quality of the physical set up in terms of having a reasonable workspace, enough computers, etc varies widely among different places. Various annoying inconveniences like this are not uncommon. Does not mean they should be tolerated if you have options though. One might decide to not take a particular job because the daily annoyances like this add up and might not be worth it. However, if you are stuck at a particular place, there is often not much you can do about it. Certainly not as a moonlighter. One thing I would look into is if it's possible to bring your laptop in and log in to the EMR on that (like you would through remote access at home, if your system allows that). That could help get around the not enough computers issue.

In terms of shifts being cut down... first of all, moonlighting during residency is a privilege, not a right. Your program and hospital really doesn't owe you anything except good residency training and whatever benefits and compensation are in the contract. Everything else should be seen as a bonus. Also, 6-7 shifts a month seems like a lot of moonlighting to do on top of a residency schedule. It's almost half time on top of your full time residency job. Your PD approved for you to work this much? Unless this is happening exclusively during some cushy rotation I can't imagine most PDs being ok with you taking on this much additional work.

 

[BoardingDoc]

I'm a family medicine resident who recently started moonlighting in an ER (at my residency hospital) and I'm doing this solely for extra income for my family. This is my first job in a hospital setting and I would like to ask what it's like to work in a small community ER.

We have a separate fast track where we (mid-levels and residents) only see low-acuity patients. The charge nurse sometimes asks us to come up to the main ED to work when they are short-staffed, which I have no problem with, but I often feel I'm treated like a janitor as they do not even have a space nor a decent working computer that I can use with dict-a-phone, and they don't even bother accommodating me or helping me find a working computer to use. This has happened every time I come up to the main ED, but knowing my current position at the bottom of ladder and my financial situation, I do not complain and I've been always happy to oblige. However, they recently reduced my shifts to almost nothing, like one shift a month (I used to work at least 6-7 shifts a month to support my family) with no notification, which really made me feel like I am indeed at the same level of janitor or factory worker.

Am I overthinking this or am I having unreasonable expectation?

Your internal moonlighting program sounds significantly different than most moonlighting jobs out there in that they have you working fast track in a resident role. That is honestly not a bad idea, but for most moonlighting gigs you are the attending and you handle all of the patients for better or worse. I suspect the reason that you aren't being treated as well as you like is that it doesn't seem like you're actually being expected to act as an attending. If you are able to moonlight in an external ED as an attending, you'll probably get the perks you seem to be looking for. That said, if you have so much free time that you've been working 7 extra shifts a month, I'd be extremely worried about the quality of education you are receiving in FM. I won't even address the issue of the insane risk involved in acting as an EM attending.

 

[LUCPM]

Thanks for replies. I should say 6-7 shifts equivalent to roughly 36 hours a month, composed of short evening shifts and long weekend shifts. Of course, I can't do this when I'm on a busy service.

I certainly don't expect to be treated like an EM attending as a frickin' FM resident, and I'm not looking for fancy perks but reasonable work accommodations. I'm not usually a whiner but it really slows me down when I have a computer with a crappy mouse or without a dict-a-phone.

I might have an option to work at external EDs. Unfortunately, credentialing and getting a 'privilege' usually take 3 months and with my residency training winding down, I'm not sure if I should start the whole process all over again. I do understand this as a privilege, and they pay us very well, so I was really bummed out when my 'extra' income suddenly shriveled. It just reminded me of those bad days (before I started med school) jobs being cut down with no notification. Hopefully, I won't have to worry about this kind of thing when I finally become an attending in 8 months.

 

[bikERdoc]

Never heard of FM residents moonlighting in an academic ED. When I was in residency, I had to drive to podunk areas that were fairly under served in order to moonlight. That or local urgent care. I'd say you're lucky. If it's not a great setup, I'm sure there are other places that would gladly underpay you.

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