A Day At the ER

During my physical therapy clinical affiliations, I got to see a lot of different diagnosis and people from many walks in life. I was still in school and always felt confident because I had a clinical instructor around me to help during the "crisis" moment. Like the time my patient coded and my CI ran into the room, grabbed my lab coat, and proceeded to wipe things up while the nurses pushed me out of the way to work on the patient. Then there was the aggressive head injury patient that screamed obscenities every time I walked by, but I felt confident he would never lunge at me because my trusty CI was right around the corner. Then I graduated.

I got my first job and I realized that though I had great therapists all around me to help, these patients were my responsibility and under my license. That first three months were humbling and hard. I lacked confidence, constantly stumbled over my words, and made many mistakes. To this day I wake up sweating and pray for my patients that I had my first year out of school. What I discovered this week is that sometimes doctors lack confidence right after they graduate.

Tuesday, I took my son to the ER because he was having trouble breathing. His oxygen levels were low at the doctor's office and they told me to drive immediately to Children's Hospital. I drove quickly and within minutes they had us checked in and back in a room. As soon as we were placed in a room the nurse and respiratory therapist confidently walked in, checked my son, and immediately put him on some breathing treatments. The physician that oversees the residents came in, checked my son, and with a very calm demeanor, ordered treatments. Our nurse explained the whole treatment process in great detail. This nurse had a great bedside manner, was good with the boy, and really calmed me down.

During the breathing treatment the resident in charge of our room shuffled in to greet us. She was trying so hard to talk calmly and softly, but frankly I couldn't understand her over the screams from my boy and asked her to please speak up (he really hates his breathing treatments.) She continued to talk quietly, but she wasn't really making much sense to me. I finally caught that she wanted to look at my son and needed my permission. I pointed to the boy who sitting on my husband's lap, squirming, being held down by the respiratory therapist, and screaming at the top of his lungs and said, "Be my guest." She looked at me with what now I think was almost terror and said, "I'll just come back." I shrugged, "Okay."

I wasn't really concerned if this particular resident did a thorough evaluation because I was confident that the nurse and respiratory therapist knew exactly what they were doing. Later that afternoon the same resident came in and asked how the boy was. I looked at her and said, "Um, fine I think. I feel like his breathing is better." What I thought was, "I don't know. Why don't you check his lungs and tell me what you think?" (I was tired and cranky at this point so I need some credit for not saying this out loud.) She then tried to check the boy's lungs, but was unsuccessful due to his constant screaming. She finally left and went to talk with the boy's nurse.

After a day of treatments, suction, singing show tunes to our boy, waiting, and watching cartoons and a re-run of Gilmore Girls, we were sent home.

That evening as I was describing the day to my sister she laughed and said, "My friend just started her residency yesterday. The quiet resident was probably on her second day out from medical school." "Ah, that would explain a lot" I said.

Poor thing. I hope we didn't traumatize her for life, but at least she'll remember us.