To follow on from the RCEMLearning blogs on Bullying in the ED and Undermining in the ED, we will move on to an unwanted behaviour that is less subtle.
A 44-year-old male collapses and is subsequently brought into Resus. He presents with sudden-onset chest tightness and sweating, preceded by progressive shortness of breath over the past 24 hours.
A 50-year-old male presents with painful Horner's syndrome. The initial CT scan is reported as normal, and stroke consultant suggests discharge, creating a challenge in clinical reasoning and professional advocacy.
Bullying is something that an unacceptably high number of healthcare workers will experience. Despite priding itself in being a friendly specialty with a flattened hierarchy, those working in emergency medicine, too, report experiencing bullying.
A 60-year-old patient presents to the ED with a leaking ambulatory chemotherapy pump. The chemotherapy helpline is unreachable, and staff must manage a potential cytotoxic spill safely.
A 34-year-old man presents to the ED with a red and painful left eye that is worsening over the past two days. He reports photophobia, blurred vision but no discharge.
The idea of “normalisation of deviance” is the brainchild of an American sociologist, Diane Vaughan, who thought that essentially people become used to accepting deviant behaviour as normal practice, the more it occurs.
It’s Friday evening and you’re at work in the ED (where else would you rather be??). Jack is a 15-year-old boy who has taken an overdose of paracetamol a couple of hours ago. He texted his girlfriend soon after and she called an ambulance.
The baby looks well at first, nothing really worrying - but he has been crying for last 2 days, which is unusual for him. His mother`s concern leads us to a serious diagnosis.
It is Monday morning 09.00hrs and you are checking your email inbox. You have received the following email from the StR who has just finished weekend nights.
A motorcyclist presents after a high speed collision, appearing stable with minor signs. But is everything as it seems? Would you trust the vitals or investigate further?
Do you know what is going on with you, and around you? Have you been in a situation where there are nine poorly patients in the resuscitation room, and you are the only clinician looking after them?
As two producers of FOAMed, we would forgive you for expecting us to tell you about what a wonderful place the internet is. Indeed, without it, we may not be here talking/writing to you.
In an era of increasing bureaucracy, never ending targets, and spiralling demand on a background of chronic underfunding, the prevailing cynicism of the medical profession might be understood.
Alcohol withdrawal is a common presentation to UK EDs and patients can present significant management challenges to clinicians.
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Incivility in the Emergency Department