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Tips for New Grad starting in EM


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If you have time and resources do an er bootcamp class.

 

Watch complaints come in and read the charts when another provider sees them. It will help your documentation and thought process.

 

If you need help with a orient ask educated questions don't just present the problem to your supervising MD. As in, don't ask what do I do but come up with your own tentative plan and ask if that sounds appropriate. Good luck!!!

 

 

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I second the EM Bootcamp idea. I was sent by my employer and found it very helpful.

 

Here's my two cents about working in the ED that come to mind after a year.

 

When all else fails and you don't know what to do, get a history and do a good physical exam. I used to fret when I saw a CC, especially something vague, and didn't know where to go with it. Most of the time, once the patient tells their story and you do your PE, you'll have a good answer. If you don't, it's okay to say, "This is obviously bothering you a lot, and I want to take a second to take a look at the best way to help you," and look it up.

 

I still struggle when there is nothing that can be done to help a patient. Remember, these people often want someone to listen to them, actually do a PE, and offer your best suggestions. Don't give into running tests, just to run a test that wouldn't be useful in finding an emergent condition, be polite, yet firm when saying no to unreasonable requests and explain why, and be empathetic as you can, while explaining that the ED is not the appropriate place for their problem. I've been surprised at how open people are to just getting some help finding resources, etc.

 

Finally, anger is your enemy. People are people, and you will often see people at their worst. Find the humor, embrace the crazy, meet people where they are, and realize you can only do so much.

 

Enjoy the adventure!

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Just an update after my first shift. 

 

I felt like I knew some stuff, but there was a 5 month gap from the last time I saw a patient and presented it to an attending to now. I felt like I forgot a lot what I learned from school/rotations, but I hope to recall most of it back as I see more patients. I'm doing the EM boot camp, but I don't know how much it's really helping.

 

I'm struggling on EKGs (wasn't a strong point in school) so I'm trying to look things up, and I'm guessing it'll get better with experience.

 

I saw about 5-6 patients in a 12 hour period on my first shift, just to get use to the computer system and all. Typically the PAs see 18-24 patients, so hopefully I'll get to that number. 

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Good for you! I saw five patients during my first couple of shifts myself. Then 7... Then 10... Now I have seen up to 20 in ten hours. Totally normal and you'll get up to speed.

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