Moderator EMEDPA Posted December 25, 2016 Author Moderator Share Posted December 25, 2016 started with a stemi, finished with a stroke . total count 19 in 24 hrs. my busiest shift here ever. busiest on record for this facility is 22 in 24 hrs. 1 Quote Link to comment Share on other sites More sharing options...
sk732 Posted December 26, 2016 Share Posted December 26, 2016 My day was much more relaxing today :-D. SK 1 Quote Link to comment Share on other sites More sharing options...
Boatswain2PA Posted December 27, 2016 Share Posted December 27, 2016 Made almost $5K covering a sleepy little ED for 48 hours over Christmass eve and Christmass where I saw 10 patients total, admitted 2, and shipped 1. Had plenty of time for reading. I love rural EM. BTW - Dec 16 Annals of EM has a great summary of current status of cardio-pulmonary arrest. 1 Quote Link to comment Share on other sites More sharing options...
FriarMedic Posted January 2, 2017 Share Posted January 2, 2017 How far would you/ do you commute for a rural solo gig? I'm in New England in an area with no local rural options. There are a couple around 2 hours one way but I'm not sure they do longer shifts. For 24s or longer that seems feasible. Quote Link to comment Share on other sites More sharing options...
Boatswain2PA Posted January 4, 2017 Share Posted January 4, 2017 Depends on pay, average patints per day, length of shift, and then quality of hospital (ie: nursing staff, policies, etc). My primary contract is 4.5 hour drive. Pays great, averages 8 ppd, I do 72 hour shifts (almost exclusively during week), and they pretty much let me pick what days I want first. There are major nursing problems there. These things all vary. Just depends on what you are willing to accept. Quote Link to comment Share on other sites More sharing options...
FiremedicMike Posted January 4, 2017 Share Posted January 4, 2017 What kind of private sleeping space do you have during these 72 hour shifts? Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted January 4, 2017 Author Moderator Share Posted January 4, 2017 I commute 35 miles to one, 63 miles to one, and 115 miles to one. have call rooms for all 3 with shower, microwave, etc Quote Link to comment Share on other sites More sharing options...
Boatswain2PA Posted January 4, 2017 Share Posted January 4, 2017 Depends. Sometimes sleep in call room at hospital, sometimes stay at a house or apartment near the hospital. Quote Link to comment Share on other sites More sharing options...
FiremedicMike Posted January 4, 2017 Share Posted January 4, 2017 I mean, it's great that you have a private space to unwind/sleep between patients, but 72 hours is 72 hours, and this is coming from someone who's spent the last 18 years working 24 hour shifts.. That's gotta be mentally exhausting.. Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted January 4, 2017 Author Moderator Share Posted January 4, 2017 I mean, it's great that you have a private space to unwind/sleep between patients, but 72 hours is 72 hours, and this is coming from someone who's spent the last 18 years working 24 hour shifts.. That's gotta be mentally exhausting.. not if you see 3-5 pts/day, work out, watch movies, eat free food, etc. I did some 72s as a medic. it's doable in a low volume scenario. 1 Quote Link to comment Share on other sites More sharing options...
Boatswain2PA Posted January 5, 2017 Share Posted January 5, 2017 What Emed said. I am able to do 72 hr shifts at a place that sees an average of 8 pts/day. Sometimes it SUCKS...saw 15 yesterday, including admitting 5 between 2300-0400 this morning, then a psych walked in just as I was done. I was tired... But then slept in till 1130 this am, and I've only seen 4 all day so far. This place also pays very well.I sometimes will work at places that see 3-5 pts/day, but they don't pay as well as this place. If I can do this for another 4-5 years I will be able to retire again, this time relatively comfortably. Of course, I'll probably continue working, but will just cut wayyyyyyy back. 2 Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted January 5, 2017 Author Moderator Share Posted January 5, 2017 I'm looking at 6 24s/mo in a few years at a very slow place with very high acuity and 1 weekend/mo at my fun coastal job (to be social and because I bought a condo there near the beach). so 8-9 days/mo. I'm only doing 12 now, but there is some unpleasant driving involved. 1 Quote Link to comment Share on other sites More sharing options...
FiremedicMike Posted January 5, 2017 Share Posted January 5, 2017 Well that certainly seems doable. If your facility were closer to home, could your wife come have a meal with you? Quote Link to comment Share on other sites More sharing options...
Boatswain2PA Posted January 5, 2017 Share Posted January 5, 2017 Not sure who your question is to. No, generally way to far for lunch. She has done some weekends with me at different places though! Quote Link to comment Share on other sites More sharing options...
FiremedicMike Posted January 5, 2017 Share Posted January 5, 2017 Not sure who your question is to. No, generally way to far for lunch. She has done some weekends with me at different places though! The question was to either of you, since you both do the long shifts.. Thanks :) Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted January 5, 2017 Author Moderator Share Posted January 5, 2017 my wife has been to 2 of the 3 towns I work shifts in. they are too far away for a lunch date. we occasionally work out a stay at a local bed/breakfast before or after a run of shifts. Quote Link to comment Share on other sites More sharing options...
AssistantDoctor Posted January 8, 2017 Share Posted January 8, 2017 Boatswain2PA or anyone else, Tell me more about rural medicine. I am a new grad. I did 3 emergency medicine rotations and I live in Ohio. Do you knoe anyone hiring around this area? Quote Link to comment Share on other sites More sharing options...
sk732 Posted January 13, 2017 Share Posted January 13, 2017 We had a pt with a massive PE yesterday - 4 hour code before the helicopter could get in to extract...was like being in a final exam of an old school ACLS course, since we must have gone through pretty much all the algorhythms and then some.. Of course we had a blizzard going at the time, so all highways leading in or out were closed due to blowing snow and the bird couldn't fly until mid afternoon. We actually could watch the improvements in JVD in person and RV function by ultrasound as the tPA infusion kicked in. Was really hard to go pick up the next case - teenager that ingested a lethal dose of tylenol...will see how the N-AC goes I guess (very positive APAP level at 5 hours post, about the time they were brought in). Answer your question there AD? SK Quote Link to comment Share on other sites More sharing options...
Reality Check 2 Posted January 13, 2017 Share Posted January 13, 2017 Death by tylenol is HORRIBLE. Watched a remorseful teenage girl die 20 years ago after the ingestion caused liver failure and she lived - for a while - miserably in failure and not a transplant candidate due to suicide. Rotten way to die. I am not rural and in FP not ER but running specials on snow shoveling chest pain and heart arrythmias today. Plus the lady who started having TIA number 7 in 5 days right in front of me in the room - never told anyone about the first 6 episodes...... She got a chariot ride downtown. Doesn't have to be rural to be weird but I envy the rural stuff. Today's high temp was 9 by the way with over 20 inches of snow on the ground. Quote Link to comment Share on other sites More sharing options...
sk732 Posted January 14, 2017 Share Posted January 14, 2017 Today's high temp was 9 by the way with over 20 inches of snow on the ground. I wish our high was in single digits...-29C this morning with windchill down to around -40 odd. Not good dog walking weather...it warmed up to -20 and still had frozen body bits and major league shrinkage. Dogs were happy though. Incidentally, found out PE patient died at ICU. Tylenol patient had normal LFT's today - scanned them going to visit dad today. SK 3 Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted January 15, 2017 Author Moderator Share Posted January 15, 2017 60 yr old guy brought in my ems with dka and altered loc responding to narcan. best ER quote ever in response to the question" can you explain this to me sir?' pt: "dude, I mixed up my heroin and my insulin". 11 Quote Link to comment Share on other sites More sharing options...
sk732 Posted January 15, 2017 Share Posted January 15, 2017 60 yr old guy brought in my ems with dka and altered loc responding to narcan. best ER quote ever in response to the question" can you explain this to me sir?' pt: "dude, I mixed up my heroin and my insulin". At least they were honest about it ;-). SK Quote Link to comment Share on other sites More sharing options...
Evolute Posted January 20, 2017 Share Posted January 20, 2017 60 yr old guy brought in my ems with dka and altered loc responding to narcan. best ER quote ever in response to the question" can you explain this to me sir?' pt: "dude, I mixed up my heroin and my insulin". common mistake i'm sure Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted January 22, 2017 Author Moderator Share Posted January 22, 2017 nice experience at the rural job yesterday. was pretty busy at the beginning of the shift with 3 sick pts at once so I missed lunch in the hospital cafeteria. lady who runs the cafeteria comes over right after they close, hands me a plate of lasagna, and says" I didn't see you over there so thought you might be busy and need this". bless you. this is just reason #10 of 5 million that I no longer work at a busy inner city trauma ctr where no one knew my name after 15 years there or would notice if I missed a meal or worked sick as a dog as long as I showed up. 9 Quote Link to comment Share on other sites More sharing options...
sk732 Posted February 6, 2017 Share Posted February 6, 2017 I mentioned this in another thread, but had a 40 yo female yesterday, C/C of "my legs hurt for 5 days after working out for 15 minutes on an elliptical. I just joined the gym that day". I must admit to rolling my eyes when I read that (hadn't had enough coffee yet and my first case of the day with a full dept handover)...my eyes went from rolling to bugging out when her CK came back after 3 dilutions at 40,783. My first case became my first admit of the day, lol. SK 5 Quote Link to comment Share on other sites More sharing options...
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