Multitasking

The emergency department requires a lot of multitasking. As we pick up more and more patients, we have to keep track of ongoing studies or consultations, medications, lab results, radiology results, disposition. It was really quite overwhelming at first. While on my other rotations, I'd have neat checklists of things to do and tests to follow, in the emergency department, the pace simply does not allow that. We have to juggle in our mind those things that are most pertinent for a handful of patients. What I've found is that I have to categorize patients in my head into those who are sick and require much of my attention and those who are well and awaiting results or symptom management. It is also easy to box patients into simple diagnoses: pneumonia, congestive heart failure, pulmonary embolus, appendicitis. I might be wrong in my diagnosis, but I have to start somewhere, usually assuming the worst. This allows us to juggle multiple cases at once because we've simplified it in our minds.

The other thing about emergency medicine is that the volume can change incredibly quickly. We had a slower evening a couple days ago, but all of a sudden, we had a car accident with an adult and six children coming in. It's an unpredictable place, and I think that's hard for me.