How Much Can Emergency Departments Handle?

[@EBMisKing]

Not even finished watching this video, but as a Paramedic and current nursing student, emergency medicine is an absolute mess. EM and EMS has fully absorbed the issues of society and is completely carrying the burden of our political leaders who are simply FAILING. On a typical 24 hour shift, I may run 15-20 patients. Of those 15-20 patients, MAYBE one of these patients actually needs emergency medical care. The absolute abuse of EMS/ED is abhorrent. Assault and battery is just another layer to the issue.

[@user-eo1nt2xs6b]

why dont yall speak up then or do something about it

[@Epokman88]

How? ​@@user-eo1nt2xs6b

[@DFOlover1]

@@user-eo1nt2xs6b EMT-Bs and paramedics are underpaid and have little say in general. They will get rid of you quickly for speaking up or prompt you to leave.

[@EBMisKing]

@@user-eo1nt2xs6b and whom exactly should I tell?

[@yusufabulouz7525]

@@user-eo1nt2xs6b holy dense bro HAHAH we have been but no one gives a fuck

[@jt6685]

If you are calling the ER to ask for wait times, go to an urgent care or see your PCP.

[@seankelley9710]

I’m a radiologist and even I switched jobs just to not read studies from the ER. The poor crew in the ER man I feel for them

[@shakenbacon-vm4eu]

I’m rads too. Just took a job with the VA. Pay cut, health gain. Sick people, but volume is so low! I’m glad I went balls to the wall right after fellowship so that we could erase loans and build a base. But we don’t need that anymore.

[@Drewbeedoobedo]

As an ER nurse on his lunch break(I know, a rarity here) watching this video, I vouch for the amount of people coming in with problems we can't fix. Something that isn't talked about as much about the ER is how other specialties and even urgent cares will inappropriately send patients that should not be sent. Be it chronic illness requiring chronic solutions (i.e. BP problems) or issues that could be treated elsewhere (i.e. sending over a kid with arm pain that had nothing broken but needed a spica splint)

[@jeffreyswenson8487]

When you said wired to EM=ADHD and Love the Outdoors, I think you defined me in one description.

[@jonathanjack1000]

Right like I had to pause the video and I’m a ER nurse

[@KenmanG1982]

In Canada- ER is one of the most desirable jobs. Highly competitive. There are problems but the shift work and lack of follow-up are huge advantages. Most people love it.

[@TubeSquanch]

🇺🇸 🚫 switching sides 🍁 🇨🇦 🗣️

[@samuel_heinz2649]

EM resident here, this may be different where he worked, but at my residency we see mostly acute, rapid, and fixable/triage admission worthy complaints in the ED. The rest is usually seen by mid level providers. If it's not urgent, the MD is likely not seeing you. I don't usually like mid-level creep, but in this case for triaging patients it makes our jobs as EM physicians amazing and what we signed up for. I am at a larger, academic institution, so I realize this may not be possible at every hospital. Also I personally am close with family, like super close as in lived at home during medical school --- so the way I see it with holidays/birthdays/weekends is that I spend so exceedingly much time with my family outside of that, that the ones I don't make or am not there for don't hurt quite as bad. Now I don't have a wife/kids, but I have my parents -- feel this has worked for me thus far and will continue to.

[@Mayor-q6b]

Hope you say nice things about APPs and they thank for their job since they make your job easier but since you’re bringing up mid-level creep in a context that doesn’t make sense (taking care of lower acuity patients) sounds like they make ur job easier and you bad mouth them.

[@samuel_heinz2649]

@@Mayor-q6b Nothing but respect for them, not sure where I am bad mouthing them? Yes scope creep is a real thing. Have a great working relationship with some of our PAs here in the ER.

[@derekscott3523]

The issue is those people are still coming to the ED and being seen in the ED reinforcing their behavior. You are being shielded from it now during training but will basically be running a urgent care + as an attending

[@mustang8206]

In my last year of undergrad and I am just starting to appreciate how nice weekends are. Its when my friends and family are off, its when church and sporting events happen, and its nice being able to go hard for 5 days then getting 2 days to recover. I don't think I would enjoy a specialty where I would regularly be sacrificing those things

[@Erinflave]

Where I live Tampa General had a billboard that said “from broken bones to boo boos, Tampa General has you covered”. This is teaching people to go to the ER for wrong reasons. Yet our urgent cares are mostly wide open. The nurses are stressed and overwhelmed. The administration needs to turn people away and direct them to the urgent care.

[@prestonb4295]

Especially for Tampa general over half the people who walk in there don’t need that’s hospitals capabilities. And on the ems side we can only recommend somewhere to transport, can’t force them not to go to TGH. Wait times are hours long and the ER looks like a war hospital with no regard to how many patients the nurses have to take care of.

[@bettysmith4527]

You cannot turn people away from an emergency room, it is illegal in the USA and carries very heavy fines! EMTALA!

[@rikmcdik6662]

@@bettysmith4527beat me to it. Even if the chief complaint is “wants socks”

[@dtae7855]

I was TODAY years old when i found out you had a car channel. Instant sub!

[@kevinjubbalmd]

Welcome! 🏎️

[@susanchristineknisely3546]

Well done guys!

[@orangeblossom1712]

As a social worker in NYC hospital so much of the ED is homelessness complications or elderly with dementia and can’t live alone

[@Hudson4426]

As a RN in the ER for the past 14 years I can confirm this videos truth. We are over ran with patients who never leave because the hospital is full, so the ER get to bare the burden of an overflowing hospital all while not being able to refuse care to anyone coming in. It makes a bottle neck that gets people killed because they cannot get care fast enough. also, our “leaders” have informed us that we need to prioritize people’s feelings above all else so half of our rooms are taken up with people who can’t sort out their life problems and are now “suicidal”. Which further complicates the problem as those people now require 1:1 sitter, further decreasing our already short staffed unit.

[@bettysmith4527]

Worked as an ED RN for the first 7 years of my nursing career.... No thanks, never again... between the psychiatric patients (my ER would have 12 plus EVERY DAY taking up 12 beds!) overwhelming the department and patients yelling and screaming because they have been waiting 8 hours to have their rash seen, meanwhile we have a bad trauma patient and code we are trying to save in the back! A fair majority of patients in the ED do not need to be there, and they tend to be the most ungrateful and entitled! I do vascular access nursing now, max of an hour with each patient, it's perfect! Day shifts only and only 8 hour shifts on holidays, yes please, I make 55.00 an hour to put in USGIVs and PICCS! We also get a breakfast and lunch break EVERY SHIFT, it's amazing! Truth be told, if solid opportunity came up to go back into EMS as a medic, I would be there and out of the hospital in a heartbeat!!

[@mindsetaspiration5013]

Hey Jubbal I really want you to cover what made you choose contacts over usual lenses. You always cover why you choose some med decision and this is really important to me. I have been thinking about doing a Lasik and I want to know from your perspective

[@kevinjubbalmd]

I already recorded my next AMA (coming out soon) but I'll try to get to this question for the next one.

[@slothassasin1055]

Current USMD M1... was in-between Ortho, EM or anesthesia. How feasible is it to go from EM to pain medicine? That way you can eventually transition to private practice when you are burnt out

[@johnpepper-d6d]

Wow, working out 2 times a day, would love to see your advice for recovery

[@mustang8206]

Watch the Renaissance Periodization video on cardio

[@kevinjubbalmd]

Strength + low intensity cardio

[@johnpepper-d6d]

@@mustang8206 do you think that split is good? 6 days a week strength training with low intensity cardio?

[@dronesandstuff61]

40 years as an airline pilot. What's a holiday? LOL Just celebrate when you can. Wouldn't trade a minute of it loving what I did my entire career.

[@Noseqquiero]

This is why I left premed. I realized I love tech and wanna work remotely for myself and medicine is just so corrupt that I can’t possibly sign my family up for that! We’re coming up to a dr shortage and our system is j worsening that disaster with every passing day.

[@mustang8206]

We're already in a dr shortage, its just going to get a lot worse in the future

[@aviannablair9663]

Lmao why is this my exact life I literally am a senior at a top pre med public school who switched to tech recently 😂

[@kahrenheit3961]

It’s unfortunate that urgent cares don’t treat unless payed immediately. The lower class people with no funds are forced to get care at the ED because they’re the only accessible providers to them. Our government sucks.

[@Rainbowofthefallen]

Just commenting for the algorithm 🖤🤎

[@andrew8658]

Still gonna apply EM

[@NEPtune-fy1ug]

how are ya dealing with the time away during holidays, weekends, etc? because thats the only thing im worried about before applyig em

[@samuel_heinz2649]

@@NEPtune-fy1ug at my residency you get half of the holidays off, like for example I don't like Thanksgiving so I chose to work it, I get both Christmas and New years off. And I don't really care about weekends, my hobbies revolve around weather conditions, so I love getting random Tues and Weds that most other people don't off.

[@samuel_heinz2649]

do it bro it's the besttt

[@NEPtune-fy1ug]

@@samuel_heinz2649 thanks man that sounds amazing

[@JT-tx2ns]

Right. These folks ain’t never been underpaid and overworked. Warehouse work was the fucking worst

[@smivlibee5936]

Good video to react to

[@royalpitamamma]

I would have been perfect for EM. I work nights, weekends, and holidays and all I am is a psychic reader. I love medicine too. EDIT: Oh and I am 44.

[@naveedrehman2987]

I’m no expert here but what I can tell you where I live in the united states I frequent emergency departments fairly often and from my experience as a patient i don’t see a provider for hours. EMERGENCY DEPARTMENTS HAVE LONG WAIT TIMES BEFORE SOMEONE SEES YOU!!!!!

[@luciedonajova1518]

I hate the way he uses ADHD as a quirky personality trait, it is not, it's a disorder. I've heard him say it multiple times now.

[@justahugenerd1278]

Yeah I don't think it's wrong to say that emergency medicine is a field that might particularly attract people with ADHD, but those are people who actually have ADHD, not having the "ADHD personality trait" as it's commonly depicted in media

[@user.AsianRicenoodles]

OMG Americans just complain on everything

[@ChandlerBecker]

It can be both

[@MedicineRunner]

Yes medicine is increasingly getting difficult to work in but also, modern society is becoming soft, which isn’t helping. I see providers complain about typing a note or even seeing a patient when it’s literally the first one of the week. Older generation clinicians don’t want to lift a finger to learn technology (I’m looking at you Gen X, even some of the boomers are taking initiative here). People going into medicine for money now instead of wanting to help. It’s multifactorial.

[@thaqifk]

AI art for your thumbnail? wack