Comments on: Declining generalists and job security in the ER http://www.kevinmd.com/blog/2007/06/declining-generalists-and-job-security.html Tue, 14 Feb 2012 22:04:00 +0000 hourly 1 By: Anonymoushttp://www.kevinmd.com/blog/2007/06/declining-generalists-and-job-security.html#comment-88655 Anonymous Mon, 15 Dec 2008 06:49:00 +0000 http://clients.emmense.com/kevinmd/2007/06/declining-generalists-and-job-security-in-the-er.html#comment-88655 Not to be a slam on hospitalists and internists, but I believe they have forgotten that the ER is controlled chaos. Its as if you are a waiter on a 8, 10, or 12 hour shift that does not end, only lives are at risk. when we make a disposition whether it be to the floor or the unit, we are turning over the care of that patient to you. We may have two or three other "critical" patients we are caring for. your timely action is expected..... Now I am not saying that we should stop providing time sensitive, directed care for the septic patient, But I do believe that once disposition is made, those accepting admission should stop rounding, eating, watching television....Just long enough to tuck in your patient. My hats off to those of you that understand the importance of moving patients out of the ER in a safe, time effective way so that we may provide care for the next arriving batch of patients Not to be a slam on hospitalists and internists, but I believe they have forgotten that the ER is controlled chaos. Its as if you are a waiter on a 8, 10, or 12 hour shift that does not end, only lives are at risk. when we make a disposition whether it be to the floor or the unit, we are turning over the care of that patient to you. We may have two or three other “critical” patients we are caring for. your timely action is expected….. Now I am not saying that we should stop providing time sensitive, directed care for the septic patient, But I do believe that once disposition is made, those accepting admission should stop rounding, eating, watching television….Just long enough to tuck in your patient. My hats off to those of you that understand the importance of moving patients out of the ER in a safe, time effective way so that we may provide care for the next arriving batch of patients

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/06/declining-generalists-and-job-security.html#comment-76719 Anonymous Wed, 27 Jun 2007 04:39:00 +0000 http://clients.emmense.com/kevinmd/2007/06/declining-generalists-and-job-security-in-the-er.html#comment-76719 I moved 3 "stablized, completely worked up" patients from the floor to the ICU today.<br/><br/>It's not so much we want the workup done, it's that we want to know a doctor did something medical after calling us to admit.<br/><br/>Our view from the wards (and the ICUs) is simply that once the ER has a disposition, they quit doing anything. <br/><br/>Sometimes we have to remind them the morgue is also a disposition. I moved 3 “stablized, completely worked up” patients from the floor to the ICU today.

It’s not so much we want the workup done, it’s that we want to know a doctor did something medical after calling us to admit.

Our view from the wards (and the ICUs) is simply that once the ER has a disposition, they quit doing anything.

Sometimes we have to remind them the morgue is also a disposition.

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