First Shift

So, I had my first shift as an "offical" ER doctor last night. Let's just say, if I wasn't used to people calling me "Dr. Hamburg" before, I am now! However, I still feel like a total fraud. Walking into the busy ER at noon to start my 12 hours, I made the conscious decision to go slow, be thorough and not make mistakes. It didn't matter how full the rack of patients to be seen got, I wasn't going to let it pressure me.

Fortunately for me, it was a relatively calm day for Columbia Presbyterian (meaning that, instead of patients lining every inch of space inside the curtains and stretchers end to end along every single wall and solid structure, there were two patients to a curtain and stretchers occupying every other hallway space).

My "welcome to a new world" wake-up call came about 5 minutes into my shift after I had seen my first patient. I wanted to order Morphine to help her with her pain, but I know that I'm not allowed to prescribe medications... or so I thought. I asked my attending to sign off on my Morphine order and he said, "You're a doctor now. This is the LAST order I will ever sign for you." whoa. (Turns out that in the ER, I am writing med orders under the auspices of the hospital and therefore am allowed to prescribe medications.)

I made it through the shift without too much stress, managed to see 4 patients (I was reassured that this was normal for a first shift), got mistaken for a nurse about a hundred times (the ER was literally 79 degrees and therefore the white coat got ditched in about 30 seconds), learned the names of 4 nurses and one unit clerk (I feel that is an accomplishment), managed one barely stable patient who continuously threatened to tank on me (just to keep the adrenaline level up), signed about 100 orders "Dr. Hamburg" and prescribed narcotics to my pain patient like nobody's business all the while desperately trying to not chew my nails with nervousness that I would overdose her.

Damn I love my job.