Change

Working in an ED is much like that old commercial for Bits and Bites….remember that one? The cartoon dude stick figure with the slightly stoned voice….

“Stickin’ your hand in the bag, and comin’ out with a new handful..3 cheese bits, 4 spiced rings, and 2 pretzel sticks. Next handful, a whole new ballgame…Bits and bites every handful is different! Yeah!”

There is no routine or typical rhythm to our day in the ED. We approach each patient and pass them through a basic process within the dept but even that changes. (see above). It depends on a million variables. Age, predisposing factors, time of day, severity of the actual presenting complaint etc. The list is enormous.

I have often been asked how I would explain the workings of an ED. Two words come to mind. Controlled chaos. Each of the 12 hours of every shift are always different. You need to be prepared mentally for the absolute worst case scenario every second of every hour of every shift. It may not happen today, it may take weeks to materialize but, when it does, we find ‘comfort’ in our meticulous preparation for such events.

I have often told students, and newbies that the moment you become comfortable and ‘off alert’ is the moment you should not work ER anymore.

Even after 30 + years, those 10 minutes before shift (where I look like I’m half asleep) tying up my runners in the staff lounge before my day begins, are my mental strengthening and prep time for what’s to come in the next 12 hours. It may not happen today, but I’m ready. I may have sleepy red eyes and walk a little slower than I used to but I’m ready. The moment that patch phone goes off I still feel my heart rate increase and my mind shift to “what if” mode. I’m ready for come what may.

In a few days I’m changing departments. No more controlled chaos, no more waiting for the worst case scenario to arrive (sometimes unannounced) on the doorstep, no more adrenaline rush with the sound of a phone ring…BUT….I’m ready. I’ll stick my hand in a different bag(see above) and may come up with the same presenting problem repeatedly BUT, the patients themselves will always be different.

Change is as good as a rest. I’m excited for it and I’m ready.

At least I still get to stick needles in people!