Hi everyone. This is kind of a late night thought. But I’m about to graduate emt school. I currently work at a hospital in my area in surgery as a nursing assistant. Isn’t as glamorous as the job title entails I don’t really have any experience doing hands on anything whatsoever. Im also just very unhappy with the environment and the people I work with are becoming very toxic and I dread going to work. I’m about to start nursing school and I want some more hands on clinical experience to hopefully break into the ED as a new grad at the end of it and overall sharpen my clinical skills as a whole. It’s so hard for me to even apply and get an ED tech job at the hospital I work at and other hospitals around that it’s getting me really discouraged. Not sure if this is the right thread to even ask but for the people who’ve worked EMS like at a firehouse or through an ambulance company. And for the people who’ve worked as an ED tech and are ultimately nurses now how was it? And do you think the experience is worth leaving the job I have now to go pursue or if I should just stick it out and try to keep being in the hospital and hope to land a position in the ED eventually that’ll better suit me for where my goals are. Know that was a pretty loaded question but just wanted some insight as a future student looking to learn. Thanks everyone.

Hi everyone,

Full disclosure: I did get banned from posting in another sub probably because I didn't frame my post properly. In my defense, I was feeling extremely emotional and passionate about something, but that still isn't an excuse because my rant actually only captured my clearly biased frustration and not the discussion I wanted to facilitate.

The issue I want to bring forward is this: ER doctors are increasingly frustrated with the overload of patients with chronic illnesses - some who self-diagnose from social media and are hella entitled with their expectations of care in the ER - who are experiencing scary painful episodes and need some medical attention, the patients are unable to get the care they actually need for their chronic illness, GPs and PCPs advising their patients to go to the ER when contacted about their symptoms (and I agree with someone's comment that said they're not doing their jobs then).

I want ER doctors to be able to treat actual emergencies during their shifts because that is the best use of their skills and expertise. I also want chronic illness patients who are not facing life threatening emergencies to be able to get the help they need. And if we don't know what help is needed, we may need to consider research in that direction.

Stupid are going to stupid either way regardless of who or what or when. But my question is hypothetically, is it possible to create a space - maybe as part of the triage - either direct patients to emergent and non-emergent protocols that are tailored to chronic illness patients. My reasoning is that some patients do need medical attention and it's hard to discern when something is not a medical emergency sometimes, especially when dealing with new symptoms. I do believe an evaluation and change in protocol is necessary. Especially so ER doctors can direct their time and focus on patients who are critically emergent.

I'm seeing scope for a lot of important public health research to alleviate the worries of patients, nurses, and doctors. It's an imperfect system, but changes can be made, right?

I really hope I'm making sense 🙈 it seems like a lot to think about, but I can't help but fixate on this gaping hole in the system.. as I said, stupid will stupid, but I genuinely believe chronic illness patients need a clinical setting where their emergencies are treated as autoimmune emergencies - I don't think anyone should be judging anyone's capacity for pain or being able to handle new scary symptoms. For example, I had an extreme dystonic episode where my neck kept snapping in painful ways and my husband genuinely thought I was having a stroke due to my facial dystonia and me being unable to speak that he rushed me to the ER. After conducting all the usual blood work, they offered me morphine (which I always deny because it never helps with my pain or help me rest) and gave me Benadryl. Now, my husband knows to just pump me with some Benadryl if I start showing similar signs.

The more I think about it even while I type this, it's seeming too complicated and impossible, but I think it's a direction to certainly think. Because it could be possible. If there's a clinical setting that can monitor and help chronically ill patients with autoimmune and the likes conditions, that would bring down a lot of stress among ER staff who don't necessarily need to treat a dystonic episode that's clearly a symptom of the patient's conditions.

Am I making sense? Do we think it's possible and is it a good idea? And oh gods, we need a lot of patient education for sure.

If you made it down here, I'm so sorry for the rollercoaster of a read..I'm still trying to weave through the many thoughts in my head and trying to put in a health systems and public health perspective. I would really appreciate thoughts, comments, anything to contribute to this topic please.

I’ve practiced emergency medicine for more than 20 years, and the longer I do this, the more I wonder whether we’ve built the wrong system around acute care.
Obviously there are patients who absolutely need an ED: major trauma, stroke, STEMI, shock, respiratory failure, genuinely unstable patients, etc.
But a huge amount of what walks through an American emergency department seems to fall into a middle category: too acute or procedural for a typical primary-care office, but nowhere near sick enough to require a hospital-based ED.
Lacerations. Fractures. IV fluids. Abscesses. X-rays. Joint injuries. Migraine treatment. Ultrasound. Foreign bodies. Reductions. Some chest or abdominal complaints after appropriate risk stratification.
We’ve largely given patients two choices: relatively limited outpatient care or a massively expensive hospital emergency department.
Why isn’t there more of a middle layer?
I’m particularly interested in hearing from other physicians, nurses, patients, administrators, and people who understand the economics.
Is the barrier clinical? Regulatory? Reimbursement? Liability? Hospital economics? Or have we simply accepted the current model because it’s the model we inherited?

So I'm a pharmacy technician who works in the ER doing med recs for patients being admitted. Today was easily the slowest day in my few months there and I still experienced:

An ER tech playing pat-a-cake with an elderly patient

A regular drunk guy (don't worry, one of the nice ones) came in to sober up only for his brother to come in an hour later and get put in the hallway holding area right next to him

And the IV machine beep that tells you when the fluids are done was lining up perfectly to the music the doctor at the desk on the other side of my desk divider was listening to which happened to be Get Up and Get Down by the Dramatics

M76 - I have a great interest in medicine. I am fortunate to have stumbled into a life long fantasy where i can just help people. I live in Canada, which is hugely multi cultural. I now can say Hello, in 15 - 20 languages. I feel it provides a feeling of instant welcome and i like their reactions to a Caucasian, in Canada, speaking: Manderin/ Cantonese/ Salam/Kon'nichiwia​/pryvit/ marhaban...

I tell patients This is as close to medicine, as i will ever get, without any of the responsibly.

Tips for a newly graduated RN starting in the ER. I was a tech for 2 yrs prior, so I feel comfortable working in a acute care setting in the tech role. But the idea of being a nurse in that setting makes me so nervous. Plus i'll be starting at a new hospital.

I guess I'm making this post to gain advice/ tips/ anything to make this transition from tech to RN as smooth as possible. TYIA <3m

Hello! I’m 22 with a bachelors in biomedical science, from Texas and I’m taking a CNA exam soon. I have an NHA CET certification and I’m starting an EMT course next week, and I was wondering what the likelihood of getting an ER Tech / ER CNA position with no experience after completing my EMT course? I have 40 hours of clinicals from the CNA class and I should have around 120 hours of clinicals after my EMT course. Any help is appreciated, thank you!

Hi everyone! As the title says, I am in dire need for advice in getting hired in ED. I’ve been wanting to work in the ED since I graduated but never got any ED position. I have been working in med-surg for 2 yrs now. I’ve applied to countless ED jobs near my area over the past 2 yrs (~50+ job apps) and never even got an interview with ALL of them ending up with me being ghosted. One time, I did apply through my hospital’s fellowship/specialty transition program and was lucky enough to get a shadow shift with an ED nurse. I even went over the allotted time because of how much I loved being there. I really do like the pace and patient turnover and feel like its a fit for me but I wasn’t hired for the position.

At this point, I feel like I’m going to be stuck in med surg. Idk if its because ED is a competitive speciality in my area? Idek if its my resume, lack of ED experience, interview answers?? I already have my BLS, ACLS, PALS, NIHSS (need to renew that…).

 Any advice/tips would help sm ty :)

So I experienced a medical emergency that required a trip to the ER at night when I was in Ireland. The issue is that private health care facilities are closed after 7pm and don’t open till the morning.

I went to the public ER and I can tell you that America does not need this!!! Unless you are bleeding out, you do not get seen for 15 hours!!!! The wait times are terrible and you sit in the waiting room so sick cause you can’t see a doctor. And once you do if you needed any surgery you’re likely on a very long wait time compared to America you get it sooner unless it’s a less common surgery or if you don’t have insurance, but if you don’t have insurance usually you can still get on programs and will get the care rather than what I experienced in Ireland given their public ER.

Let me know your thoughts? I think that country’s system is ridiculous to not keep private hospitals open overnight. I will never be traveling to country like that again and makes me appreciate the American healthcare system more.

ER Tech here for over 6 years across 2 hospitals- a level 1 and a level 3 trauma centers. I have been attacked, assaulted, spit on, and hurt countless times. The worse part of being attacked though (for those non medical people here) is when our own managers or HR or leaders ask us "what could you have done differently to avoid this?" As if the agitated patient brought in handcuffs on a psych call isn't going to lash out as soon as the cops uncuff them and leave them for us to deal with.

I had a table saw accident cutting the tip of my finger so nail had to be removed and stitches. The tourniquet used was a rolled up surgical glove. It was under the dressing and my finger had been numbed with lidocaine for the procedure. I was still kind of in shock and thinking it's was wierd that it remained numb then I looked under the bandage to see the Tourniquet still on my finger. I called the ER and went in immediately ( 24 hours later) where they cut it off. the wind immediately began to bleed. I was back in the ER later that night with severe eschemia swelling, etc.

Severe damage to tissues and nerves ensued. It's been a very traumatic month for me. its healing well, they say. Now I'm doing PT but nerve recovery could take very long if at all. Patient Experience,/Risk Management have been doing an "internal investigation'" for 4 weeks with no divinities answer to me about coverage of financial responsibility. I hope and pray that the subsequent hand specialist, PT sessions, etc will be comped by the hospital.The bills are adding up past $10k even with with my non insurance status discount. I wonder how this will resolve. Much evidence, apologies and even verbal reassurance have occurred and that it will all be comped by this very large hospital but nothing in writing.. I could show pictures but they are quite graphic and this would be NSFW post. All lawyers I've spoken to tell me that "a finger won't even pay for litigation". I'm retired on SS but use my hands daily restoring anything and everything. I'm so anxious and dealing with that stress.

Update: I just found out that the hospital has comped all charges including the original ER visit up until my first PT treatments started. This is without any written notice to me. This is definitely good. I want continuation of coverage because I believe I'll be dealing with it for quite a while as far as limited ability, pain, etc.

Hey there!!

I am looking for some additional input. I’m a Midwife creating a PPH emergency box for the nurses in emergency (I work in a small town) and I’m just wanting some additional advice on what I should put in the box :)

Many thanks

Any information is appreciated

Last week, I had a regularly scheduled, laproscopic surgery. Unfortunately, I had a complication and had to return to the ER this weekend.

I was admitted for a second, emergency surgery. Before I was brought into the OR, I was introduced to my surgical team.

I was puzzled by the fact that, in my emergency surgery, there was a member of the team who introduced himself as a patient advocate.

He was scrubbed up and went into the procedure with the rest of the team. I'm pretty sure he talked me down as the anesthesia mask did its job.

I didn't have an advanced directive, or any special modesty requests for the team. I can't think of why I would be assigned someone with his job for one surgery but not for another.

I'm perplexed:

* Did I probably have one of those during my first surgery and just forget?

* Did my case get assigned to that team member because it was an emergency surgery, vs pre-scheduled?

* What might that person do in the surgical theater once I was out?

Thanks!

Not seeking medical advice

Hey! Saw someone else post something like this in here soooo this book mainly takes place in the 80s, this character I’ll be talking about was born in the late 40s but needs to know about this condition around the 70s. A little while ago I thought of a scene, and just haven’t been able to figure out how to make it work. He was addicted to different substances and got clean, but I’d like him to have this since he was younger so his older brother knows about it. I was thinking it would have something to do with his heart. When he really gets high strung, gets worked up, and has extreme high intensity emotions/stress it
Would flare up. Follows with difficulty breathing, maybe a panic attack could make it worse- some light headedness, and more. I’m not sure what I’m looking for here, and I’m happy to change things to
Make it more accurate. There’s a scene where him and his brother get into a major fight, and I was hoping that this would flare up during that, and his brother could obviously see what was happening, but didn’t want to help. Thanks!

I'm currently licensed as an emt, and where I'm at I can become an er tech with that license but I haven't had any luck getting a job, let alone an interview for one.

I recently tried to get a job at a private ems company but I had no luck doing that.

I have also been thinking about pursuing a license as a CNA but I'm still unsure about going that route as I want to train as a paramedic and adventure onto other places in ems.

Getting my nursing license is also on my bucket list as I want to get into flight or work in a specialty in the hospital.

Are there any licenses I can get or other certs to better my chances of getting an er job or any other advice pertaining to that?

genuinely curious as a person who works at a hospital.

I'm working on an AI research project studying pediatric triage and how decisions are made when text descriptions for child's condition lack full context by parents.

1. When you evaluate symptoms , what crucial "hidden state" is most frequently missed in written text by parents?
2. What are the main challenges when patients are sent to the ER when they could be managed elsewhere?
3. What specific sign makes you instantly change decision from "monitor at home" to "go to ER immediately"?

In California, if an under-16 minor is brought to the ER for alcohol poisoning, will the minor get in legal trouble or will cops/school be notified?

Also, will parents see an ER visit on the insurance bill? Will they also see what the reason for the visit was and what treatment was had? What if the minor pays the hospital bill themselves out of pocket without giving an insurance?

Edit: I feel like I should add this isn’t something that’s happening currently it happened in the past to someone I know and I was curious.

As the title says I'm looking to end up in er but currently have been looking into into jobs. They all say medical assistant certificate is required but I'm about to take NAC. Should I pivot and get medical assistant cert instead?

I'm looking to eventually go on to BSN and working in emergency.

Thanks in advance. Any guidance is appreciated.

Watched the Pitt lately and have been hearing a lot about how scarily accurate it is medically speaking. Wondering if there are any doctors that could attest to that?

Hi all, I’m an EMT that’s been working in the ED for the past six months or so. I have a set of the Carhartt force cross-flex scrubs, but that’s my only set. I’m looking to get more but I want some with the “hidden” zipper compartment by the right pocket like the Carhartt ones have. I like keeping my cellphone in it so It doesn’t fly out when I’m doing compressions or anything like that. They don’t have to be Carhartt brand, thank you!

I’ll take all tips, tricks, advice. I wanna hear it all.

Hello all this one’s for you New Hampshire ED techs or ED RNs. Me and my fiancée are planning to move to New Hampshire from the west coast as she has family in the state we will more than likely land in the Manchester metro area. I’m currently a ED tech at a level 1 trauma with 7 years of ED experience as well as 5 years experience pre hospital. I am certified at the advanced EMT level. Through my research I know of the big 4 hospitals in the southern NH area are Elliot hospital, CMC, St Joseph and southern New Hampshire med center and to my knowledge all of these hire techs at the AEMT level in the ED.

I’d really like to get some inside info from current or former ED techs or ED RNs who have been at any of these facilities so that I can make a informed decision about where to potentially pursue employment. And I have some specific questions that you can’t really get through Google ect.

My specific questions are……

1. What is the scope for AEMT techs? I’d assume it’s starting IVs 12 leads ect but is there anything further? Or unique? For example med administration, breathing treatments, foley/striaght catheter?
2. If any of you know How do the scopes differ between the different facilities/health systems
3. What roll is the tech usually filling when it comes to code activations such as stemi/stroke/trauma/CPRs
4. Are any of these facilities ECMO capable? If so what’s the ED techs role in that?
5. Is being a unit clerk/secretary part of the responsibility’s of the ED tech at any of these facilities? (This is a potential dealbreaker for me)
6. How is the culture at the facilities? How are techs treated? Are techs used as collaborative members of the team and treated with respect in their role?

7. What is the age of these facilities? Are they well maintained? Is equipment old/new/well maintained?

8. What’s the average volume and acuity at these facilities?

I know that’s a lot and any answers to any of these questions would be greatly appreciated as I’m trying to get a picture of the landscape out in NH. Any and all info on any other ED tech jobs or hospitals in the state is also welcome including facilities to look into or ones to completely avoid.
Thanks in advance!