My work anniversary was earlier this week. My 14-year work anniversary. That’s a long time for a military kid who moved every three to four years growing up; I’m used to changing things up. So what is it about DoveLewis that made me stay for this long? Why, when on my very first shift in emergency, I was completely overwhelmed and stuck with 11 patients behind a glass wall where I only did half of their treatments because I didn’t understand how the treatment sheets worked (true story – it’s no wonder why I’m so enthusiastic about training). WHY am I still here?
It’s not that I’m seeking thrills. At all. I broke my wrist on roller skates when I was 16 and have refused to do anything even remotely exciting since then. I’m terrified of heights, don’t like to go fast, yell at people who think spinning donuts in the icy parking lot is fun, run away from danger, and I wear sunscreen. Maybe that’s why I gravitate towards emergency… I have no other source of adrenaline in my life.
It’s not the hours. While I am never happier than when I am sleeping in and swing shifts are the BEST, working 14 hour shifts, getting called in to run anesthesia at 3am, and staying late ‘just to help them get caught up’ can really get old. Quickly. It’s rare that you’ll find a person working emergency that doesn’t currently work overnight shifts or who hasn’t had to put in their time on the graveyard shift. Those can be killer. Even for a night person like me, working an overnight shift throws me off for a week. And the work never ends. We’ve all had those shifts where the patients just keep coming in, the procedures keep stacking up, the diarrhea keeps flowing, and the thought of abandoning your fellow workers is awful enough to keep you there well after your shift ended.
It’s not even the money. While I made more as a graveyard emergency tech, is the extra couple of bucks an hour worth the physical and mental effects? How much caffeine can one person take? I know plenty of techs who slave on the overnight because it offers more money but we’re still just barely making a living. So what is it about emergency medicine that has such a hold on me?
I’m making a difference. I worked GP for about two years, and while I appreciate the opportunity to lay a good foundation, I was never happier then when I was treating an emergency. The occasional HBC, the pyometra surgery, the dog maul that we had to refer to the emergency hospital for further care; yes, I understand the importance of preventive medicine and educating clients and I am in no way belittling all of you who do that so well, but I struggled to feel like I was really helping those patients. And I HATE dentals, so that ‘making a difference’ feeling is out on those cases. With emergent patients and their owners I feel like I did some good, some tangible good, and I like that.
I also like the medical puzzle presented with emergency cases. We only have what’s in front of us and a little bit of history to try and figure out where to go. At DoveLewis I am a part of the medical team where we discuss our ideas for what to do next. That’s very important to my job satisfaction and one of the reasons I’m still here 14 years later.
It’s EXCITING. Being the person that places that arterial line, putting in a quad lumen central line, or sometimes even that peripheral catheter in the cachectic cat gets the blood flowing. Running a rocky anesthesia from induction to recovery, sweating the entire time, that’s a good night for me. While in general practice I saw some emergencies, but never enough to keep me interested. I want to stand and stare at the ECG and think about why and what to do next. I want to frantically search about rare toxicities and learn something new about cardiac meds. I want to lug giant textbooks to and from work so I can read about ventilator waveforms and try to figure them out. Nerdy is exciting!
So yes, I will volunteer to be on-call for another Christmas day. I will come in at 10pm to run through the anesthesia ventilator with a new overnight tech. I will be jealous that I missed the thoracotomy when the surgeon sends me pictures of the diseased lung lobe she just removed. I will get excited when I learn an easier way of interpreting acid/base status. I love triage. I love the ventilator. I love sending that formerly critical patient home with grateful parents. I love making a difference every shift I work.
I love emergency and critical care. I'm looking forward to the next 14 years, but I hope they include more sleep.