I am a nurse practitioner committed to expert level end of life care. I a consultant for hospice and palliative care organizations, a clinical educator and a volunteer in my town on the local emergency medical service. My life is paradoxical.
It’s not a happy partnership having a palliative mind and responding to 911 emergency calls to save lives.
There was a time when Herb was living the American dream in the sunny state of California. He was married with 2 children, a big house in the suburbs, a golden Labrador retriever, and a well-paying job as an executive in a book publishing company.
His two sons were stellar athletes and students, both moving on to attend nationally ranked colleges upon graduation from high school. They were the pride and joy …
When I advise students about how to choose a specialty, I suggest that they seek out advice from physicians who are at least 10 years out of residency and leading the type of life they hope to have in the future.
It is difficult, and perhaps impossible, to anticipate in your late 20s or early 30s what practicing a certain specialty will be like when you are 40, 50, or 60.
When it comes to caring for the sick, it’s often assumed that health professionals and their patients usually get along.
But that’s not always true. Sales people call some of their customers difficult. Turns out that doctors do exactly the same thing with theirs. An article in the current issue of the journal Neurology provides a catalog of difficult …
I have a suggestion for all of those federal workers who were concerned about a government shutdown.
To all those who already have better insurance and better benefits than most in the private sector; for all those whose jobs pay more than equivalent private sector jobs for the same activities. Do what hospitals do. ‘Go to your jobs, and do the necessary work anyway.’
I imagine the world as a vast, boundless frontier weathered by our swirling human emotions and complicated energies — hurricanes of intense heartbreak and tornadoes of joyous, unbridled celebrations, with every weather pattern in between. Sunshine and rain included.
If I could gather this world, foolishly believing that I could sweep my arms and hands through the unsuspecting air to collect a smaller, more-contained version of reality, I know with absolute …
It’s no secret that healthcare’s inevitable move toward accountable care organizations (ACOs) has many physicians feeling a bit …nervous. Admittedly, most physicians are creatures of habit who fiercely defend their individual approach to patient care, focus on cures not cost, and dread the concept of “cookbook medicine.”
An international ACEP member has been giving real-time updates to the ACEP Disaster Section about the developing situation in Japan. He agreed to share the information with the emergency medicine community and will try to continue to provide updates when he can.
Here is a letter to the editor in a recent Philadelphia Inquirer:
… In 1986, Congress passed and President Ronald Reagan signed the Emergency Medical Treatment and Active Labor law, which requires hospitals to admit all who arrive at the emergency room and treat them without regard for their ability to pay.
In essence, we had federally mandated national health care – signed …
It is Saturday night at an Emergency Department (ED) in Boston, MA and I am faced with a medical student’s dream dilemma: which one of the many interesting cases should I observe? Should I watch trauma surgeons operate on the 17-year-old gunshot victim or work with the ED docs to assess whether a 59-year-old woman is having an acute stroke?
My partners and I have long struggled with the lack of specialty back-up at our hospital. Semi-rural hospitals, out of the way facilities, just can’t always attract specialists. So, we’re happy to have cardiologists every night, but understand that we only have an ENT every third night. We’re thankful to have neurologists, even if they don’t admit anyone. We’re glad to have radiologists, even if they don’t read plain films …
Informed consent has continued to generate a lot of interest in medicine worldwide.
The reason is because patients in medicine and subjects in clinical trials need protection from the multitude of injuries and harms that have been caused by intentional or accidental actions. The controversies generated by various lapses of informed consent, in my opinion, have not been addressed and more safeguards need to be put in place …
Dr. Erdoc happened to look up when the internist walked into the emergency department.
“Oh no,” he murmured under his breath. The consulting psychiatrist was sitting next to him, typing a note. She looked at him and raised an eyebrow.
“I hoped it wouldn’t be him. Unlike his colleagues, Dr. Internist seems to have a deep loathing for us emergency docs,” Dr. Erdoc explained as he stood up. Dr. Internist was frowning …
As a pediatric emergency physician in Northern Virginia, I have the good fortune to work with an amazing staff in a busy pediatric emergency department (ED) that sees a wide range of patients with both minor and life-threatening illnesses. Of note, we have a wonderful electronic medical record (EMR) that allows us to see past visits, lab tests, and medical problems.
We’ve all had that hysterical patient. The one that comes in during a busy shift. Grabbing at their head, their chest, their abdomen. Yelling out that they are in pain.
You know the one. They makes the nurses’ eyes roll. They add to an already chaotic scene. Other patients stop to watch as the gurney rolls by.
In an essay from TIME, Zachary Meisel discusses why abdominal pain, in his words, is the doctor’s “booby prize.” And when you consider that there are 7 million visits annually by people who report abdominal pain, that’s a …
When I arrived for my shift this am, I was passed off the following patient.
EMS responded to a 50-year old guy laying alongside the Interstate. He had no idea who he was or how he got there. He complained of knee pain and shoulder pain. They were kind enough to tote him to my ER where his evaluation revealed that he had a fracture …
With regard to emergency trauma care, a few minutes can mean the difference between life and death. This first hour of definitive medical care is called the “golden hour.” It is usually this first hour where the patient’s medical fate is sealed. In general, the faster that medical care is rendered, the better the medical outcome will be.
You’ve probably experienced that age-old ritual of cooling your heels in an ER waiting room hoping that it won’t be too many hours before a nurse lets you inside the sliding doors.
Simon Bradley tweeted this to my Twitter Account @WCBADoctorBrian: “My buddy had a deep laceration between the thumb and the index finger – a full layer of skin. Took 10 hours at (name of hospital withheld), fastest in town.”
