Inside the ER: First Week at EMRAP

When I first received my acceptance to the Emergency Medicine Research Associates Program at St. Joseph Mercy Hospital, I was very ecstatic! But, I was also scared. I didn't know what to expect: what would I be seeing, who would I encounter, and how would I manage?

Though, after completing my first week at the hospital, I am no longer scared. In fact, I am very excited for the rest of my journey! I am so excited to learn more about the medical field, clinical research, and patient interaction! Bring it on :D!

Here's a quick look at my first week:

My first class was on Friday, May 16 in a little classroom in SJMHS-Ann Arbor. When I sat in the room and looked around, I felt as if I was thrusted into a new environment. There were unfamiliar faces (except for the research associates and the programs directors who interviewed me) of students from Eastern Michigan University and the University of Michigan. As per usual with any event, there were ice breakers involved! The first one was "two truths and a lie", and from this, I learned that several of my new colleagues knew how to juggle. (I made sure to take note of this because I have always wanted to learn how to juggle; I think I'll be learning more than the medical field this summer. Yay for meeting new people with amazing talents!) The second icebreaker involved a beach ball, and whichever question your index finger lands on when catching the ball, you must answer it. The questions were hilarious, and helped me learn a little more about each person in the room. These icebreakers helped me become a little bit familiar with everyone. I'm really grateful that I am surrounded by smart, talented, and funny people during this year-long internship. (I even made a new friend! Her name is Christina, and we're carpooling together for our shadowing shifts!)

On Tuesday, May 20 and Thursday, May 22, I had my first exposures to the Emergency Department:

On Tuesday, I shadowed a nurse who was working in the triage. The triage is where patients are evaluated for their symptoms and ailments. I saw patients ranging from young to old! Also, during my experience at the triage, I noticed how quickly the nurse worked just to see as many patients as soon as possible. Every time a patient checks in to the ER, their details, chief complaints, and identification stickers would print out and would be lined up on clipboards. The nurse would try to clear as many of these as soon as possible, but the moment he gets a break, another patient checks in. I felt so bad for the nurse because he was not able to take a break until 1:30 PM for lunch, and he had been working non-stop since 9 AM. At the same time, I was in awe of how the nurse thoroughly documented each case into the online system. The nurse determined the acuity of each case; he needed to note how severe the case was to determine what type of care the patient needs. I know that everyone complains of the waiting time at the ER, but I now know that the doctors and nurses are all swamped with several patients. They do as much as they can and they need to prioritize (ie. they need to give immediate care to a person with symptoms of stroke versus a patient who has a sprained wrist). 

On Thursday, I shadowed a supervising doctor, his residents, and a medical student. Their roles are somewhat different from the nurse who I shadowed on Tuesday. They followed-up with the patients' chief complaints to determine the best way to help the patients. They continuously checked vital signs and lab results to rule out which medicines to prescribe and to determine what exactly was going on with the patient. From shadowing the physicians, I learned how important it is to communicate with the patient. The physicians have to talk loudly and directly look at seniors, and they will talk softly and reassuringly around stressed patients. I also witnessed how impressive it was for the physicians to pull information from their past knowledge to diagnose the patient to the best of their ability. The doctors were talking to each other about every possible diagnosis if it was a difficult case, but sometimes they can quickly diagnose in a heartbeat. Moreover, I learned how important it was for the doctors to engage with the patient. The more the doctor sees a patient, the more the patient opens up about his or her medical history. I feel that the job of a doctor in the ER is to determine how sick one is and what is the best action to help you.

Apart from learning more about the physician's role, I also saw an interesting case. There was a patient who claimed to still have periods, but usually women of her age are experiencing menopause. The physicians thought that she might have a metastasis, but when they performed a pelvic exam, they didn't feel any growth. They decided to perform an ultrasound on her, but I was not able to stay long enough to see the results. There were also several cases of infections, abdominal pains, and diarrhea. It was a pretty slow day, but I still learned so much!

I am extremely grateful for this opportunity, and I hope that I continue to learn more things as I go through this internship. I cannot wait for what is in store next week!