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How many of you are working in solo coverage EDs?


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Do you all find that you enjoy these positions more than your typical ED gigs? I'm only 2 years removed from my EM residency and am already feeling the burnout creep in, and actually have been for a while. I mean, I still love the pathology, but it's the patients who are whittling away at me (with some blame also assigned to the obligatory fast track shifts i have to do each month, but those two often go hand in hand). I'm trying to get out of the field, but only for the right jobs in my local area for now. But if these critical access/rural solo or 2 provider EDs might be a solution maybe I'll just pack up and move to do it in several years. These jobs sound fascinating in the typewritten word on these forums. 

Edited by dphy83
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Sometimes I look back at residency and think I miss it, but then I go back for a lecture and remember the dread from the endless patient onslaught. I never even did fast track. While I see fewer critically ill, I see enough. When I transfer them I have to have them a lot more stable to drive an hour versus going upstairs. I feel I have to be even more on my game. I think and mentally rehearse about resuscitative hysterotomies, trephinations, canthotomy, things that can’t wait for transfer, all the time. Plus I own every patient. Much fewer notes and admin burden. Getting paid to sleep is pretty awesome too 🙂

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I agree with the other info posted above. Working solo in the ED is rewarding and keeps me thinking and on my game. Beware though, burnout happens everywhere. You need to develop a way to process it and deal with it now. Some jobs are toxic and you have to leave quick, but you still need to figure out some coping mechanisms. Moving to rural, solo coverage EM will fix a lot of it, but you'll still get flashes. I saw 18 folks in 4 hrs the other day at my one job. Nobody sick, just colds, flu, stomach bug stuff. Not a common occurrence, but enough to stress you and can bring back some fast track flashbacks for ya. 

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On 12/28/2019 at 8:41 AM, dphy83 said:

Do you all find that you enjoy these positions more than your typical ED gigs? I'm only 2 years removed from my EM residency and am already feeling the burnout creep in, and actually have been for a while. I mean, I still love the pathology, but it's the patients who are whittling away at me (with some blame also assigned to the obligatory fast track shifts i have to do each month, but those two often go hand in hand). I'm trying to get out of the field, but only for the right jobs in my local area for now. But if these critical access/rural solo or 2 provider EDs might be a solution maybe I'll just pack up and move to do it in several years. These jobs sound fascinating in the typewritten word on these forums. 

I have found that contacting hospitals directly can be helpful. The other option is to use a recruiter that specializes in critical access hospital jobs. If you don't mind western Minnesota or somewhere in North Dakota, hospitals are always hiring. At this moment, I know of numerous places looking for people in this region. I personally prefer the quieter places. Mine averages about 4-5 pts a day which means even a busy day is manageable. Some hospitals have doc back-up which is really nice but a bit harder to find. The ones with doc back-up will sometimes take someone with less experience like myself. Of course the downside is that you are in the middle of nowhere. My nearest stoplight is 75 miles away. Nearest fastfood is the same distance. 

Edited by Twinpines
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17 hours ago, JMann said:

I agree with the other info posted above. Working solo in the ED is rewarding and keeps me thinking and on my game. Beware though, burnout happens everywhere. You need to develop a way to process it and deal with it now. Some jobs are toxic and you have to leave quick, but you still need to figure out some coping mechanisms. Moving to rural, solo coverage EM will fix a lot of it, but you'll still get flashes. I saw 18 folks in 4 hrs the other day at my one job. Nobody sick, just colds, flu, stomach bug stuff. Not a common occurrence, but enough to stress you and can bring back some fast track flashbacks for ya. 

Agreed, seems like sometimes everybody comes at once. The other day,  had a really busy day with 10 pts. 8 of them came within a 3hr time period and several were admits or transfers. On the otherhand, currently 22hrs into my shift with only 3 pts so far and 2 of them were urgent care stuff. 

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6 hours ago, Twinpines said:

Agreed, seems like sometimes everybody comes at once. The other day,  had a really busy day with 10 pts. 8 of them came within a 3hr time period and several were admits or transfers. On the otherhand, currently 22hrs into my shift with only 3 pts so far and 2 of them were urgent care stuff. 

working 4 24s this week. acuity and volume is all over the place. did nothing for the first 24, saw 17 in the first 12 hrs of the 2nd, including delivering a baby and a pt with cauda equina, and the last 2 have been fairly busy as well. usually don't do more than 2/week, but folks are on vacation and they offered me doc pay to cover the shifts. how could I say no?

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  • 2 years later...

Hi - We are looking for PA's who are able to work solo in the ED from 7pm-7a in Alabama. Must know how to do procedures. Traveling to Alabama is fine. Would you or anyone you know be interested? 12/1/22 start date. please email me at lynn.osborne@neshealth-care.com or call me at 859-327-2663 if you would like more information.

Thank you!

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