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Working In A Rural Emergency Department During The Pandemic

Discussion in 'Hospital' started by The Good Doctor, Oct 4, 2021.

  1. The Good Doctor

    The Good Doctor Golden Member

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    I finished residency in 2020, during the height of the pandemic. We had a ceremony limited to just the graduating class; no family or friends could attend. Then my four other colleagues of the past three years and I embarked on our next steps as physicians.

    Family medicine is my passion – I went to medical school loving the idea of caring for a whole family, from pregnancy through birth to the end of life. This is the job I took – a full spectrum family physician in rural Minnesota. I have clinic, work in the emergency room, round in the hospital, and deliver babies. When signing up for the job, I’m not sure I fully understood the workload and responsibility. However, adding the COVID-19 pandemic makes the burden so much heavier than I ever could have imagined.

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    Emergency department work was always the situation I worried about. Would I know what a patient needed? Could I provide the care necessary, especially if a procedure or emergent transfer was needed? Would I know when a patient could go home versus needing a hospital stay? I am there as the only physician or provider at that time – it’s on my shoulders to make these decisions. I never imagined my job as it is right now.

    The pandemic has been present for over a year. In my rural community, outside of the clinic, there are barely any signs of it. There are no masks, Friday night football games, and other events are packed shoulder to shoulder. We alone are still showing signs that the times are not normal in the clinic, garbed for the day in masks and goggles.

    When I work in the emergency department, my patient with a heart attack may not have a bed to see a cardiologist and receive life-saving treatment. My patient who needs dialysis may die before a hospital can accept him and complete his dialysis session. My patient dying of respiratory failure might not have an ICU bed or ventilator which is necessary to save their life. I never imagined the helpless feeling of having someone in my care, dying, in a situation I never dreamed of. The motto of a rural emergency department is “stabilize and ship” – get them to the specialists and bigger hospitals they need. What happens now when there are no hospital or ICU beds in the state to accept? I bring those patients home. These tragedies could have been prevented.

    At the end of the day, many of my patients still will not vaccinate. And our clinic staff would rather quit their job than roll up their sleeves. The feeling of helplessness is not a feeling I thought I’d be experiencing so, often so soon in my career.

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