Shadowing In The Emergency Room - 45 Hours

I've finally completed my final shift at St. Francis yesterday evening. This completes a 45 hour internship in the Emergency Room (and just in time to make the deadlines to turn in all the paperwork for my school).

Going into my final visit, I saw some of the usual suspects: A few more lacerations, a few more people who symptoms really don't warrant a trip to the emergency room, and a few more homeless. (The homeless is a subject that frustrates much of the hospital staff, whether they say it aloud or not, and a subject I won't go into again. You can read more about it HERE.)


I did see a pretty good second degree burn (oil burn), which was interesting. He was a nice man to talk to, he had a good sense of humor about it all, and he also he a daughter who was a medical student at UC San Francisco. It's kind of amazing how easily the skin of the burned area just peels right off. Pull of the skin with some tweezers, give him some light pain medication in the moment, give him some prescription pain medication to go home with, inform him what type of prescription cream to apply to the burned area for the next few weeks, and done.

An interesting case to see for the first time, but like I said, everything else was pretty standard. My 45 hours was up and it felt like it. It was getting to the point where the cases of "something new" were getting fewer and farther between. It was getting to the point where I was running out of questions to ask, to the point where the doctor was finding less and less to say (about the same cases), and where I was probably getting in the way of some of the other staff.

The last thing I wanted to do as a wide-eyed observer was to get in the other nurses' way, lowering the level of care some of the patients would receive. That sounds like a very technical phrase, but it's true.

Still, it was a great experience. I've said this before (and I've said this in the presentation I had to give to my school on this subject), "If there was one thing I would have wanted to accomplish before I sent my applications, it's this." And I mean that not just in a "check list" kind of way to look good on a resume, but in a way that I really learned something from this experience and it will show in my writing, speaking, and interviewing with any potential medical schools.

One final thought: It's funny how lacerations and physical injuries, in some ways, are the easiest cases to deal with. Sure, there may be blood, there may be pain, and there may be very concerned friends & relatives not too far away... but they're healthy. For the most part, the rest of their entire body is healthy -- there are no surprises.

"What are the signs & symptoms?"

"Let's have a look."

You can point to and see clearly where the damage is done. Through all of your medical training over however many years you've studied, you can assume that everything else (that you can't point to and see) is for the most part, exactly described in your text books and labs. It's clean and in some ways, it's refreshingly easy. There is a confidence when dealing and treating those injuries.

It's the sick that are the tricky ones.

"What are the signs & symptoms?"

"Well... I feel cold, nauseous and I've been throwing up... it hurts in my abdomen a little. How much does it hurt? I'd say a 7 or 8 on a scale from one to 10, but it's been getting worse. It started two days ago."

It's not so easy to point to. It's not so easy to access. It could be anything and it's time for the process of elimination.

With medical emergencies, you start with everything and begin to narrow it down. With trauma emergencies, you start with what you have in front of you and it's time to get to work.

Maybe that's part of my narrow view with limited exposure, but it's interesting.

I'm glad I did this and I think it will be a great help in the years to come.

I asked for a letter of recommendation as I left and told him, "Hey, if I ever make it, I'll look you up."

"Please, do." is all he said.

I hope I get that chance.

By: Jonathan A. Abesamis

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