I wonder sometimes if I really do in fact like rural emergency. I always thought I did, and always thought I would go into emergency medicine when I finished MD school.
But these last few months I have been questioning that decision. I really like actual emergencies...codes, acutely ill patients, problem solving the mysteries that collapse on the triage desk. But what I don't like is the mundane, CTAS 4 and 5's that come into emergency departments on a regular basis. The worst part about the sore throats and narcotic seekers that come to emergency is that they have to wait a long time because they are NOT EMERGENCIES. So by the time you assess them in the department they are hissy and pissy because they have had to wait. And rightly so (the waiting part, not the cranky part).
So the cranky jerks who are abusing the system are the ones that I have to listen to whine all night.
I just don't know if I want to do this as a career anymore.
In this place I am currently working, several docs have just left town, thus leaving hundreds of orphan patients. There is no one in town accepting new patients and no walk-in clinic. Hence my current contract not in ER but in a glorified clinic. I can't blame people for having to access health care in the ER because there is no where else for them to go, in fact I feel really badly for people who have to wait ages to have something like a Rx refill (like the 78 year old gentleman who sat quietly for almost 5 hours to get his furosemide refill). But this is not why I am an ER nurse. And yes, I know it comes with the territory. But I guess I need to get back to major tertiary centers before I forget how to run nitro, insulin, integrelin, and blood at the same time.
But now I feel at a bit of a loss. I don't think I know what I want to be when I grow up anymore!
On the upside I've met and worked with great people so far here, and have just agreed to come back for 5 weeks in July/Aug. Not so much for the ER side of things but because I love being on the ocean, having access to organic food and a decent gym (two things that most northern communities cannot boast).
Now on to more soul searching...
(People checking in at the triage tent this fall, somewhere near Chansal Pass...)