Emergency Room Doctors

There are many components to a hospital or medical facility. All of them are necessary to have a properly functioning environment. The emergency department of a hospital is a fast paced world. You have to be constantly on your toes and prepared for whatever may come through the doors. There are many people that work in an emergency room to make it run smoothly. Techs, nurses, CNA’s, LVN’s, and doctors all work side by side to help those who are critically injured. Without all these people it would be complete chaos.

According to the Society of Emergency Medicine Physician Assistants (Society of Emergency Medicine Physician Assistants, 2013), the role of a physician assistant in the ED is to provide emergency care under the supervision of a licensed physician. The extent of care they provide varies by state law, facility policy, education of the PA, and how much the supervising physician feels comfortable delegating work (Britnell, Dodd, Vella Gray, & Brochu, 2015). For example, at Memorial Regional Hospital, the PAs working in the ED are allowed to perform I&D (incision and drainage of abscesses) and laceration repairs, but they are not allowed to perform intubations or place IVs under ultrasound guidance (Levy, 2016).

You will document the diagnosis and ongoing treatment plan of the patient; as the emergency room doctor that you assist, provides you with orders, tests, and procedures for the patient. Often the emergency room nurse will assist in administrating these procedures as well as provide IV therapy, cleaning and bandaging wounds, administering medications or injections and contacting other staff members when necessary for other procedures.

Family and General Physicians deal with everyday problems such as broken bones, infections or just the common cold on a daily basis. They diagnose and treat patients with illnesses and injuries.They have many responsibilities along with that. Their responsibilities include examining patients, collecting medical information about the patient, family history, and maybe other doctors, immunizing patients. They also run tests and labs, prescribe medications, coming up with a plan on how to treat the injury or illness. Which usually includes sending them to different therapies or specialist or prescribing certain treatments to help them get better.

A call came at 10 saying that there was no need for an additional doctor yet because of how slow the emergency room was that day. We were eventually told to come in at 12:00 though, but the fact that the amount of time you're made to work directly correlates to how busy the E.R. is was a weird concept to me. The way the emergency room is laid out is with a central station of desks with a wall separating the two haves. Surrounding the desks are the patients room. As a doctor, you simply wait until a patient is set up in a room by nurses and then claim the patient in the system. Each patient has a description of their pain complaint in the computer along with a ranked emergency level. After claiming the patient, the doctor go to see them in there room. When a Doctor visits a patients room, they do exactly what one thinks they would do— they ask questions. It was interesting to note how differently my father and Dr. James went about these interviews. Dr. James was more of a talking, “why don't you tell me what the issue is” kind of doctor. She let the patients talk but gently guided the conversations. She was very nice and would explain exactly what she meant in basic, social terms. On the other hand, my father was computer-like efficient in his investigation. He would always ask the same set of specific questions in each case no matter what the problem was. He would always be the one in charge and almost a bit callus in his method. That’s not to say

When I take a step back and look at the endless opportunities I will have as a Physician Assistant (PA) it truly amazes me. There are so many areas of clinical practice to choose from and at this point in my education as a PA student I am still unsure of where I will end up. However, the area of practice that I am currently most drawn to is emergency medicine (EM). What draws me to EM is that it is face-paced and team-oriented. In addition, not only do you get to see a variety of patients, but you also see a variety of diseases and injuries. This being the specialty that is of most interest to me, it is important that I understand what exactly being an EM PA encompasses.

Any patient brought into the Emergency Department, is first signed in at ED receptionist desk and triaged by a triage nurse, prioritized and brought to patient room by a charged nurse either by wheelchair or stretcher or walking by the patient depending on patient’s illness. A nurse is assigned to the patient. Emergency Doctor comes in and if the patient illness is life threatening it is stabilized and the Doctor orders test such as blood work and x-ray if necessary to be conducted. Based on the test result the patient is either discharged or admitted. Certain times the emergency department is filled with a lot of patient that there is no place to sit and patients keep coming in and creating

Assess the current Models of Care in their Emergency Departments using the given criteria It is recognised that not all of the Models of Emergency Care are applicable for all NSW Emergency Departments. Decisions to implement them will be made based on the staff, patient presentations and space available in the ED to operate each model. Assess the potential to introduce models to their hospitals that may improve patient care and flow, the patient experience and clinical outcomes

There are many key components in approaching access to health care: coverage, services, timeliness and workforce (Healthy People 2020, 2015). Patients who have a positive and consistent source of care will ultimately have better end results, minor discrepancies and fewer costs (Healthy People 2020, 2015). Timeliness is the health system’s capability to optimize services in a convenient manner, whether it embraces the time spent either waiting in a doctor’s office or an emergency department. At the same time for many patients it encompasses the time between analyzing the need for tests or treatment and obtaining those results. Working as an ER nurse there has been incredible long waiting times in emergency rooms secondary to the fact that people are using the ER for care and more notably as their primary care physician. Likewise prolonged Emergency department wait times can decrease patient satisfaction and notably people leave without been seen. Finally the different element of workforce is vital in contributing access to health services. Primary Care Physicians (PCPs) play an important role in providing access to health services and it has been noted that many medical students are leaning away from working in primary care (Healthy People 2020, 2015). Our ultimate goal is to direct them towards that needed profession.

What I saw was phenomenal! Everyone working the emergency department seemed to flow together as they worked as a team to improve the condition of patients and discharge them after their chief complaint was relieved. The PA helped increased the efficiency and outcome of the health services provided by the department. Another thing that I noticed was the PA spent a much more significant amount of time with her patients then the attending physician. With treating a patient, the PA made sure that the patient was getting the treatment that they needed and deserved, even if it was a simple reassurance that medical staff was doing everything they could to keep the patient

“Hospitals are not only required to care for emergency patients, but they also are required to do so in a timely fashion” (Pozgar, 2010, p. 272). “Hospitals are expected to notify specialty on-call physicians when their particular skills are required in the emergency department. An on-call physician who fails to respond to a request to attend a patient can be liable for injuries suffered by the patient because of his or her failure to respond” (Pozgar, 2010, p. 271). Under the doctrine of Respondeat Superior, hospitals are also liable for the actions of physicians working or on-call in their emergency department.

I found both my interest in medicine as well as my desire to help others perfectly align within emergency medicine. The intensity, the shifting dynamics, and the comradery I experienced working on a large team to provide the best available care to our patients provided a satisfaction like no other. My other rotations further revealed the importance of the emergency medicine PA. When anything became potentially life threatening the patient was sent to the ED; thus, it requires the EMPA to carry the responsibility of being part of the last line of defense regardless of what comes through that door. This challenge is part of what I love about emergency medicine. Being able to have the knowledge and clinical skills to evaluate patients from start to finish, and confidently ruling out life threatening conditions to provide patients with peace of mind is extremely gratifying. This is why I find the opportunity to have three-week specialty rotations

The Emergency Medical Service(EMS) are the people who will usually respond to a 911 call relating to medical emergency.

Thus, emergency physicians cannot rely on earned trust or on prior knowledge of the patient's condition, values, or wishes regarding medical treatment. The patient's willingness to seek emergency care and to trust the physician is based on institutional and professional assurances rather than on an established personal relationship. Fourth, emergency physicians practice in an institutional setting, the hospital emergency department, and in close working relationships with other physicians, nurses, emergency medical technicians, and other health care professionals. Thus, emergency physicians must understand and respect institutional regulations and inter-professional norms of conduct. Fifth, in the United States, emergency physicians have been given a unique social role and responsibility to act as health care providers of last resort for many patients who have no other feasible access to care. Sixth, emergency physicians have a societal duty to render emergency aid outside their normal health care setting when such intervention may save life or limb. Finally, by virtue of their broad expertise and training, emergency physicians are expected to be a resource for the community in pre-hospital care, disaster management, toxicology, cardiopulmonary resuscitation, public health, injury control, and related areas. All of these special circumstances shape the

　　　Paramedics are experienced medical practitioners, who carry out roles done by physicians and also observe, asses and treat patients using the equipment found in the emergency department. During an emergency, the paramedics are the first health care professionals that are contacted and they then asses the patient’s condition and treat if possible. When Edith’s husband, Roland, called for emergency, the ambulance arrived