> Isn't it interesting to hear what motivated us to get involved in the
> specialty.
> I was attracted by the variety of the work and
> particularly enjoy
> being involved in a number of cases at once.
> > I always felt more
> comfortable
> > dealing with one problem at a time, no matter how complex
> that problem
> > was, to the exclusion of all else until that problem was
> sorted out.
I reckon I was attracted because of having a short attention span. By definition once a case gets boring it's not an emergency.
I agree with Sue more than Adrian about multitasking in EDs. I find it's pretty common- quite often got a couple of patients having investigations and a patient with a nerve block waiting to work while I see another patient. I also personally like the way of working as a consultant (or middle grade) where you get a quick feel of every patient and someone else does more of a work up then reports back to you (I'm not saying it's necessarily the best way of doing things, just it's a way I like).
Personally I'm not sure about the idea of 48 hour wards: strikes me there's a risk of being stuck with physiologically stable patients possibly with multiple pathologies; and of becoming "observationalists"- patients come under us as long as there's nothing wrong with them, but if we find anything wrong we refer them to someone who knows how to treat them. This is an important role, but I'm not sure that it is necessarily suited to the same sort of person who suits making rapid decisions on sick patients, so potentially the speciality could attract the wrong sort of people.
The debate about what attracts people to EM is an interesting one. I get the feeling that EM has a lot of very different personalities in it, and people who like different ways of working- more so than most other specialities. This could become an issue as the way departments are run is likely to become more standardised. At the moment we are recruiting higher specialist trainees to EM without knowing what sort of job will be available when they finish their training- which makes it difficult to select the right personalities.
Matt Dunn
Warwick
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