I just finished a run of two shifts at Tiny Community Hospital. Each was 24 hours in duration, separated by a 24 hour break. As I have tried to explain to many of my colleagues, places like this are enjoyable. First of all, the volume is low; I saw about 15 patients in each 24 hour period. I worked, I napped and I capped last night off with about four relatively uninterrupted hours of sleep in a recliner. Considering I get paid for every hour I’m there, it’s not a bad deal! (And wonder of wonders, the facility uses dictation for the physician record!)
Although the patients are typically not very complex, there are times. Trauma victims still arrive due to the distance from referral centers. Patients with concerning chest pain still come to see me. I have cardioverted and incised and splinted and all the rest. Yesterday, I even performed one of my favorite procedures: I used the EZ-IO drill to put an intraosseus line into the humerus of a very sick patient. (When it’s you and one nurse, there isn’t a lot of time to mess around.)
But perhaps the most remarkable thing about my last two shifts was this: in 48 hours of patient encounters, I wrote not a single prescription for a narcotic, nor was I asked for one.  That may be a record.
So do not despair, fellow traveler. There are good days and bad days in emergency medicine. But wonders and miracles still occur.
Makes me think of what John Cancella said to Ray in Field of Dreams….
John: Hey…is the Heaven?
Ray: No…it’s Iowa.
John: Funny…I could have sworn it was heaven.
Ray: Why did you think that?
John: Because Heaven is where dreams come true.
Ray: Well…maybe this is Heaven.
Ed…those two shifts sound like heaven. Unlike the hell I recently faced with a waiting room with 28 patients at 1am.
I have to admit, they were nice. 15 patients per 24 hours each day (one day off in between). I’m sorry to hear about how things are back at the mother ship. That’s truly miserable.
Michael C
8 years ago
Edwin I’m a nurse in Texas although I am no expert on everything, I have a moderate amount of experience with pain. Nerve pain inflamation ,a herniated disc type suffering. Since the DEA has forcefully made efforts to eradicate opiate type med administration the increase in patients suffering from uncontrolled pain has spiked. Not to mention the increased episodes of opiate withdrawal widespread throughout our free country. Sanctions to countries like Pakistan and Afghanistan are essential to world peace. but for our government to halt the import of opium and then spin the data into persuading the American people to… Read more »
John jennings
7 years ago
I’m a PA in Tucson. I work for a local ER group that has staffed the same two hospitals for nigh on 40 years. I slavered with envy reading of your light rural workload … but the part about dictation puzzled me. Until I took this Tucson job last fall, I had always used t-sheets – supplemented at will & liberally by addenda on progress-note sheets – or else more modern EMRs … the execrable Cerner, the user friendly but medicolegally indefensible ProMed, and my favorite, MedHost. Here we have ‘partial’ Cerner, which we use use strictly for ordering tests… Read more »
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Makes me think of what John Cancella said to Ray in Field of Dreams….
John: Hey…is the Heaven?
Ray: No…it’s Iowa.
John: Funny…I could have sworn it was heaven.
Ray: Why did you think that?
John: Because Heaven is where dreams come true.
Ray: Well…maybe this is Heaven.
Ed…those two shifts sound like heaven. Unlike the hell I recently faced with a waiting room with 28 patients at 1am.
I have to admit, they were nice. 15 patients per 24 hours each day (one day off in between). I’m sorry to hear about how things are back at the mother ship. That’s truly miserable.
Edwin I’m a nurse in Texas although I am no expert on everything, I have a moderate amount of experience with pain. Nerve pain inflamation ,a herniated disc type suffering. Since the DEA has forcefully made efforts to eradicate opiate type med administration the increase in patients suffering from uncontrolled pain has spiked. Not to mention the increased episodes of opiate withdrawal widespread throughout our free country. Sanctions to countries like Pakistan and Afghanistan are essential to world peace. but for our government to halt the import of opium and then spin the data into persuading the American people to… Read more »
I’m a PA in Tucson. I work for a local ER group that has staffed the same two hospitals for nigh on 40 years. I slavered with envy reading of your light rural workload … but the part about dictation puzzled me. Until I took this Tucson job last fall, I had always used t-sheets – supplemented at will & liberally by addenda on progress-note sheets – or else more modern EMRs … the execrable Cerner, the user friendly but medicolegally indefensible ProMed, and my favorite, MedHost. Here we have ‘partial’ Cerner, which we use use strictly for ordering tests… Read more »