PtboCanada Exclusive: A Day In The Life Of An ER Doctor at PRHC
Thursday, September 9, 2010 at 3:01PM Recently PtboCanada went behind the scenes at PRHC’s Emergency Department. Most of us have been there at one time or another as patients or to assist sick family members. But what’s it like for the doctors who work there? More importantly, while we wait, what are they doing back there? Turns out, seeing about 200 patients a day and dealing with a myriad of sick people. Thanks to Dr. Tony Jeffery, the ED staff, and his patients for letting PtboCanada photograph him on a shift and for keeping notes on his day for us.
*Notes below by Dr. Tony Jeffery, PRHC Emergency Department Physician
**Photos by PtboCanada's Evan Holt
11:00 h - Arrive and sign in on my personal tracker on the computer. There is only one chart in the rack – a slow start to the day, but I know it will pick up. First patient is an elderly man with chest pain and shortness of breath. I take a complete history and am concerned he may have a blood clot in his lung. Blood is sent to the lab and a chest X-ray ordered.
11:15 h – The rack is filling up with charts. I see two middle aged female patients, both with abdominal pain. I listen carefully to their stories and order appropriate tests. They will take some time working up.
11:45 h - The paramedics bring in a trauma - a man who has been in an accident and sustained a nasty fracture to his right leg, which will require surgery. I splint his leg for comfort while he waits for the orthopedic surgeon.
12:00 h - A late middle-aged man with chest pain arrives drenched in sweat. He has the look of someone having a heart attack, but his EKG doesn't support that diagnosis. We treat his pain and give him oxygen, but I am worried about him and contact the cardiologist on-call.
12:25 h – An elderly man arrives with rapid atrial fibrillation (an irregular heart rhythm) that had been occurring since the night before. He seems a good candidate for cardioversion (using electricity to reset the heart rhythm). I explain the procedure to him and after answering all his questions, he agrees. We sedate him with rapid-acting drugs and give him one shock at 200 Joules, which puts his heart back into a regular sinus rhythm. It is one of the most satisfying things we do in the ED. After he wakes up, he has no memory of being shocked, but he feels a lot better.
13:00 h - I take a break for lunch and then reassess my patients. I am able to discharge one of the women with belly pain and the man who we cardioverted. I order some follow-up investigations for him, including a Holter monitor.
A selection of photos submitted from local photographers that decorate the hallways as part of 'Emerge' project
14:00 h – An elderly woman presents with an episode of visual disturbance. She has had a stroke in the past and she is concerned it's happening again. To me, it sounds more like a migraine as she tells me her story. I take some time reassuring her, but to be safe I order a CT scan of her brain.
14:30 h - I see a very pleasant older woman who has had abdominal pain for several years and has been worked up assiduously by one of the local gastroenterologists. Her pain is worse today, but she looks remarkably well. I can see she is worried and in pain however, and knowing how stressful coming to the ED is for patients I order some pain medication and appropriate blood tests.
14:45 h - A younger man presents with chest pain after feeling like he might pass out. He has had panic attacks in the past and has a young baby at home. I suspect his symptoms are simply due to stress and we discuss this at length. After I am able to reassure him he isn’t having a heart attack, his pain goes away. Sometimes just listening to a patient and treating them with respect can be therapeutic.
17:00 h - I go to help out in Fast track (Ambulatory care) where they have fallen behind due to a surge in patients. I see as many patients as possible before my shift ends at 1900h - lacerations needing suturing, back strains, sore knees, children with coughs, rashes, and people who only need a prescription renewed because they have no family doctor.
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Reader Comments (9)
This was a remarkable and candid look into something that not many of us are privy to on a day to day basis.
I think sometimes, doctors get de-humanized for the inherent perception of their profession, so it's refreshing to see that though his job holds a great importance on our wellbeing and can be literally a life and death situation, that at the end of the day it's a job....if that makes any sense.
Fantastic concept, would love to see more of this happen!
-Ryan
Not sure if every patient Dr. Jeffery seen that day was mentioned, but follow a night shift when there is only 1 MD available. Watch one MD start at midnight see 30+ patients, respond to a code blue and never catch up by 7am. Then feel guilty because they never got caught up and leave 6 or 7 charts in the rack. I am grateful to have a colleague acknowledged in a positive light. Typically the public and media choose to focus on the negative aspects of the doctors, nurses, ward clerks and housekeepers of the Peterborough ER. I have seen a lot more good happen than bad during my employment at PRHC.
I really enjoyed this post and I hope you do more like this. Keep up the good work. Also, thanks to the caring doctors and nurses at the hospital who work so hard to care for Peterborough's citizens.
I liked this blog. Thanks for doing it!
Great blog! I think everyone who works in Emerg that I have worked with is a great team and a good role model as a team for others to follow.I have worked in most areas in the old hospital in the past 24 years.In Emerg I feel everyone treats each other with respect.
housekeeper Dave
Great blog! I think everyone who works in Emerg that I have worked with is a great team and a good role model as a team for others to follow.I have worked in most areas in the old hospital in the past 24 years.In Emerg I feel everyone treats each other with respect.
housekeeper Dave
I like the blog/article but am rather disappointed in the photos.
Not to blow my own horn too loudly, but I would love to provide the photos for any "day in the life" article. I'd like to see one of a Nurse or lab tech, or even a pathologist.
Great job Evan and PTBOCanada, and thanks to Dr. Jeffery for the candid insights. Very much appreciated. It's very comforting to hear how your thoughts are so very much with the patients. Some of us have had bad experiences (for me, elsewhere), and it's good and important to set things right.
I know it is not easy for doctors and hospital staff to frequently miss their meals because of these emergency cases, and I salute them for their dedication and commitment to their jobs. As patients, we sometimes feel bad about waiting in the ER, we should not feel bad, as long as it is not life-threatening and we can still stand the pain, patience, please!