ED Volume: Loud

Holy cow, has our volume picked up! And from colleagues it’s not just here, it’s throughout the ED’s of North Texas. Less than 3 years ago my ED occasionally held admitted patients. This morning, we were holding 27, and that’s nowhere near the high for the last several weeks.

We have theories, but no facts, as to why this is occurring, and there’s no end in sight (we’re looking). One of my favorite quotes has to do with personnel management: “You ride your best horses to death”; in this instance, our staff are all thoroughbreads, and they’re tired. Troopers, but tired.

Tangentially, this has made me have some uncharitable thoughts: who were the genuises in the mid to late 80’s I kept reading about who had meetings and decided we had way too much hospital capacity, too many beds, and we needed to close them to avoid disaster. I’d like to have them carry urine samples in my ED, all day long. It’s a fitting punishment.

And, again, we lack any prolonged surge capacity. We’re running full, at top speed, all the time. We could handle something like a plane crash, but an epidemic (natural or manmade) would be nearly impossible to manage.

Where are the pointy haired fortune tellers who set us up? Send them to me, I have something for them to carry.

Emergency Medicine, Hunter S. Thompson style

The Cheerful Oncologist

“When the going gets weird, the weird turn pro.”

FEAR AND LOATHING IN THE E. R.
(written in the manner of one Raoul Duke)

Why am I here? Who is this woman in a giant muu-muu, standing before me squeezing what appears to be a copperhead snake in her hands? She spoke to me in some strange language – obviously disrespectful of the country that took her in after a long canoe trip across the oceans. I thought of screaming “Back! Get Back!” but suddenly sat bolt upright and remembered:

I am a doctor…on call in the emergency room of the world’s greatest hospital. My shoes were smeared with thick crusts of vomit and blood, as were my pants, except I wasn’t wearing any. I must find them, I thought. The lights above my head burned into my skull like the first kiss of the electric chair. I reached for my pistol to shoot at them, but it, too, was missing. The situation was rapidly deteriorating. I began to sweat like a champagne fountain at a coal miner’s wedding.

As I reached the lounge I realized that the sun was shining, meaning my hell-night was about over. All that was left to do was clean up the forty or so charts that I had tossed behind the soda machine, locate the rest of my clothes, sign in to the intern relieving me and slip out through the window in the men’s room. Before leaving I decided to eat – after all, being a servant of the needy gives one an appetite like a crazed Samoan wrestler. My forged I.D. card was good for at least one more trip through the outlet store for the local waste dump, also known as the hospital cafeteria….

Utterly inspired insanity, the best tribute I’ve read to the late Mr. Thompson.

via Shrinkette