wolfpac88

Please forgive me - I did not know there was such strong animosity towards the term "midlevel." You do bring up a good point though about practicing "mid"-medicine. STILL - I've had 2 responses about how I shouldn't use the term midlevel, and only 3 responses to my actual questions, which is unfortunate in my opinion.

My apologies, I should clarify. We are expected to see about 2 patients per hour during a clinical shift, and 2.5-3 patients/hour during a fast track shift. I don't pick up any patients during the last hour, so this averages about 14 patients per clinical shift and more per fast track shift, all of which are 8-hour shifts. It is not unusual to have seen 22+ patients in a single fast tract shift. As far as managing up to 9 patients at a time, this is not always the norm. This only occurs on days where we have very high volumes and during peak hours. At my facility we use Cerner firstnet, so keeping track of patients and pending studies are not as difficult as it would be compared to paper charting. But the sheer volume and higher acuity of patients at a given time is what's most challenging to me, especially when the attending physician has his/her own 8-9 patients to look after and may take any priority 1 traffic that comes through. So, I was just curious how midlevels are utilized in other EDs.

Midlevel provider, i.e. physician assistant or nurse practitioner.

Hey all - I was wondering what the work dynamic between you and your attending physicians is? For instance, do the attendings see all the patients you see? Are some places more autonomous and the attendings will only see the really sick patients? How many patients are you expected to see in a shift? How many patients are you expected to manage at a given time? I have been doing EM for about 18 months and had one month of orientation. This is my first job out of school. During a fast track shift, the attending will not see any of my patients unless I have a question or concern about a particular patient. The clinical shifts vary - there is a supervisory shift where the attending will see all your patients. Whereas some of the other shifts are set up more like a fast track shift, that is the attending will only see the really sick ones or a patient I may have a significant concern about. We work 8 hour shifts and are expected to see at least 13 patients per clinical shift, more for fast track. At times one midlevel may be managing up to 9 clinical patients, many of which could be high acuity cases. Furthermore, during a fast track shift we are managing 9 rooms and at times this may include multiple lacerations, I&Ds, and other types of similar procedures. Sometimes I feel like I'm being stretched too thin, but that may also be because I only have 18 months of experience. I'm just curious how other EDs compare...thanks in advance.