Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Exceeding the stool limit in the emergency department

Joe Bocka, MD
Physician
February 24, 2020
Share
Tweet
Share

Not long ago our emergency department got a call from the health department informing us that we had exceeded our stool limit. Not quite sure how this was measured, who sets the limits, or even why such a call would be necessary, but I do know that once again we have seen a lot of stomach flu running around. Unfortunately, we can’t just tell patients to stop pooping, so I’m sure we will be heading into stool excess again.

Other things besides illness seem to similarly come in waves that force us to exceed what we think should be our limit. We have had to give dismal reports to an excessive number of patients. A member of our ED family had her 8-year dormant breast cancer come roaring back. She would fight but lose the battle this second time. Another older patient was coughing up blood from a tumor that had eroded into a lung vein. He would die soon if the vein wasn’t sealed off. He looked at his family and our staff in the eyes and said that he was ready to die and was going home. He did both.

We’ve also had to tell the families of far too many “young” patients that their relative had died. One was hit by a car while helping another person that had been struck and injured. Another reportedly was exceeding the speed and legal alcohol limits when hitting some curves. Yet another was found with their phone in the middle of a text. Others had completed suicides or had non-resuscitable overdoses. This nasty part of our job never gets any easier.

One shaken baby is more than our limit. A recent surge of shaken babies, beaten kids, babies being born an addict, and children neglected because of substance abusing parents has our ED staff feeling like we have been beaten up as well.

Breaking records for the number of overdoses in an hour or for the total milligrams of Narcan administered to one patient or administered during a shift is something we note with our heads held low to the ground. A long time ago we all reached what we thought was our limit of obnoxious drunks, homicides, new mind-altering substances, suicides, cystic fibrosis, ALS, massive strokes, domestic violence, and being aimed at with bodily fluids, expletives, and even fists, feet and weapons.

The river of feces will never completely stop, but we’ll keep trudging through the nasty stinky stuff together — even when we are over the limit — or feel like we are in over our heads. A tip of my sweaty well used hat to all my fellow ED team members (and our families as they help also) – and especially those that have slogged alongside me over the years. We’ll plod through this.

Joe Bocka is an emergency physician.

Image credit: Shutterstock.com 

Prev

When he knew his career as a surgeon was behind him

February 24, 2020 Kevin 0
…
Next

The best teacher of medicine I ever had

February 24, 2020 Kevin 1
…

Tagged as: Emergency Medicine

Post navigation

< Previous Post
When he knew his career as a surgeon was behind him
Next Post >
The best teacher of medicine I ever had

ADVERTISEMENT

More by Joe Bocka, MD

  • A thank you from doctors to nurses

    Joe Bocka, MD
  • 36 things I learned in 36 years of medicine

    Joe Bocka, MD
  • Emergency medicine and the inevitability of death

    Joe Bocka, MD

Related Posts

  • Solving the problem of non-emergent care in the emergency department

    Michael Kirsch, MD
  • Violence in the emergency department puts patients and physicians at risk

    Vidor E. Friedman, MD
  • Solving the low-acuity emergency department problem

    Dillon Mercado
  • A place for music in the emergency department

    Thomas Scary
  • Here’s the secret to emergency department efficiency

    Phillip Stephens, DHSc, PA-C
  • Don’t blame doctors for outrageous emergency department prices

    Peter Ubel, MD

More in Physician

  • Why the heart of medicine is more than science

    Ryan Nadelson, MD
  • How Ukrainian doctors kept diabetes care alive during the war

    Dr. Daryna Bahriy
  • How women physicians can go from burnout to thriving

    Diane W. Shannon, MD, MPH
  • Why more doctors are choosing direct care over traditional health care

    Grace Torres-Hodges, DPM, MBA
  • How to handle chronically late patients in your medical practice

    Neil Baum, MD
  • How early meetings and after-hours events penalize physician-mothers

    Samira Jeimy, MD, PhD and Menaka Pai, MD
  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
  • Recent Posts

    • Why the heart of medicine is more than science

      Ryan Nadelson, MD | Physician
    • How Ukrainian doctors kept diabetes care alive during the war

      Dr. Daryna Bahriy | Physician
    • Why Grok 4 could be the next leap for HIPAA-compliant clinical AI

      Harvey Castro, MD, MBA | Tech
    • How women physicians can go from burnout to thriving

      Diane W. Shannon, MD, MPH | Physician
    • What a childhood stroke taught me about the future of neurosurgery and the promise of vagus nerve stimulation

      William J. Bannon IV | Conditions
    • Beyond burnout: Understanding the triangle of exhaustion [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 1 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
  • Recent Posts

    • Why the heart of medicine is more than science

      Ryan Nadelson, MD | Physician
    • How Ukrainian doctors kept diabetes care alive during the war

      Dr. Daryna Bahriy | Physician
    • Why Grok 4 could be the next leap for HIPAA-compliant clinical AI

      Harvey Castro, MD, MBA | Tech
    • How women physicians can go from burnout to thriving

      Diane W. Shannon, MD, MPH | Physician
    • What a childhood stroke taught me about the future of neurosurgery and the promise of vagus nerve stimulation

      William J. Bannon IV | Conditions
    • Beyond burnout: Understanding the triangle of exhaustion [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Exceeding the stool limit in the emergency department
1 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...