Whether it is a quiet morning or a quiet night, there is such a place: inside the door, there are fighters who do not give up easily, and outside the door, waiting for anxiously waiting for relatives and friends. This place is the emergency room.
Although the space is small, it is a microcosm of reality, although the time is short, it is full of joys and sorrows, the efforts and perseverance of the angels in white, and the prayers and expectations of the families of the patients. Although there is a barrier from the door, it is a common guard of life.
It has been said that emergency doctors are doctors who have "no specialty" and have no future "without specialty". Many doctors are reluctant to engage in emergency work, tired, hard, risky, low income, and more importantly, "everything is possible" in the emergency department.
However, it is precisely because of the tension and unpredictable emergencies that forge the courage of emergency doctors to be independent and independent.
In our minds, there are often thrilling rescue scenes in the emergency department, ECG monitoring oxygen inhalation, bandaging hemostasis, opening the airway, tracheal intubation, electric defibrillation, gastric lavage, hemodialysis, etc., every first aid operation is particularly important here; here, the medical staff unite as one, race against time, division of labor and cooperation, in order to pull the patient back from the death line, they do their best to escort the life of every patient; here, will be for the "three nos" Patients open the green channel and respect every life, because they are duty-bound to shoulder the mission and responsibility, and here, there will still be a tense doctor-patient relationship, but it will not affect the medical staff's treatment of patients, because although the medical staff are not the ones who create myths, they will definitely give all their efforts to defend it.
Emergency physicians need to have the following abilities:
◆ Ability to control complex situations: The condition of emergency patients may be simple, complex, mild, or critical, but they are all "urgent", especially the urgency of the patient's relatives and friends. Emergency physicians should be able to control complex things in a variety of complicated situations, and be able to solve the main problems or main aspects of the patient first under the guidance of the important principle of "life-saving treatment", actively deal with the pathophysiological conditions that are life-threatening or may be life-threatening, and analyze and discuss the diagnosis of the disease and complete the follow-up treatment from the main symptoms or signs under the premise of stabilizing various vital signs.
◆ Friendly communication ability: Due to the special timeliness of emergency work, doctors are not only required to communicate well with senior and subordinate doctors and nursing staff in their work, but also require doctors to continuously improve their conversation and response ability in the current medical service when there is indeed poor communication between doctors and patients, and optimize the communication effect with the humanistic care attitude of "being anxious about what patients are anxious about and thinking about what patients think". If there is a lack of thoughts and emotions in language communication, ignoring the artistic, normative and scientific nature of language communication, and ignoring the information conveyed in the patient's language, it may become the direct cause of doctor-patient tension or even medical disputes.
◆ Ability of unity and cooperation: "Three points of medicine, seven points of maintenance (nursing)" has fully revealed the integrity of medical care work, any medical behavior is difficult for individuals to complete, team spirit and cooperation ability is one of the basic requirements of emergency doctors.
◆ Emergency doctors should also have a sense of service, law and innovation: medical treatment and service itself are inseparable, only by correcting the service attitude, changing the service style, and standardizing the service behavior can there be satisfactory medical treatment, and the purpose of medical service is "patient-centered" to satisfy patients. Practicing medicine in accordance with the law is not only one of the basic guidelines for safeguarding the best interests of patients, but also a necessary means to ensure the smooth progress of medical care and protect the legitimate rights and interests of medical personnel. As a science, medicine has gone through the foundation stage of ancient empirical medicine and the initial development stage of experimental medicine, and has begun to enter the development stage of modern medicine since the 20th century. The medical model has shifted from traditional disease observation to rational thinking and judgment, from perceptual understanding to rational understanding, and from experience to scientific practice. Nevertheless, many mysteries of life have yet to be revealed, and many questions of disease have yet to be clarified, which requires us to have the spirit of innovation and the ability to innovate and create the future.
Emergency life has also forged a special way of thinking and behaving for emergency doctors:
1. Save your life first, then see a doctor
For emergency physicians, it may not be so important to have a clear diagnosis, the key is the vital signs. Fluctuations in heart rate, blood pressure, and blood oxygen will stimulate the nerves of emergency doctors, bringing a series of differential diagnoses, such as whether the capacity is enough, whether the heart function is good or not, and whether there is a problem with the respiratory function. As for what the disease is, don't worry, just wait. Perhaps the emergency doctor's treatment plan is not comprehensive, but the assessment of the condition and the control of the risk must be relatively comprehensive.
2. Always wonder if there are other possibilities
Some people say that the specialist sees everything like tuberculosis, the oncologist looks like cancer, and the cardiovascular specialist looks at everything like heart disease. Although the evaluation is not objective, it reflects the tendency to limit thinking and unreasonable tendency to judge diseases when dealing with a type of disease for a long time.
Emergency physicians are often faced with an unknown world, with new symptoms, new signs, and no clear medical history, and there are many possibilities that can be misdiagnosed at the slightest thought. Although emergency doctors do not have a deep understanding of diseases, they are involved in a wide range of specialties and have seen a lot of diseases. Often, after experiencing many missed diagnoses and misdiagnoses, I feel sad and frustrated to doubt my life, and then I encounter patients who will come up with infinite possibilities, which keep flashing in my mind, identifying and distinguishing again.
3. Observe closely and pay attention to changes in your condition
Emergency physicians place more emphasis on observing changes in the condition than specialists. A long time in the emergency room can make people feel that nothing is impossible, only the unexpected. Perhaps you can judge the development and changes of the disease 99% of the time of the disease, but there is still 1% of accidents that can occur at any time. Closely observing the changes in the condition is not an empty word, it takes time, energy, personal visits, and careful examination to find clues and make up for possible mistakes and omissions.
4. Move quickly and be polite
In contrast to specialists, who are held high by patients and their families, emergency physicians are faced with emergency patients and family members who are impatient, demanding, and ready to intervene. Disagreement can lead to bad consequences, so it is important to be decisive and quick in dealing with the patient, and at the same time to communicate well with the patient and build a sense of trust within a few minutes. Work efficiently to triage patients, reduce waiting time, and deal with problems with empathy, so that patients can accept them better.
5. Communication and informed consent are also indispensable
Compared with specialists, emergency physicians can quickly identify various problem patients, problem families, and at-risk conditions, so that patients can understand the condition and make decisions about observation, hospitalization, transfer, and abandonment of treatment, which requires a certain level of communication skills. If the explanation is critical, the family will say that they were frightened and beat the doctor (the real incident in the department);
The specialist doctor explains the condition in the ward, and if the family does not sign, he can not have surgery or special treatment, and the emergency patient may be entangled in lawsuits if he or not signs or does not do treatment. In the face of an emergency, how to let the patient know in a short period of time, and to be able to agree and sign as evidence, indeed requires a certain amount of skills, and it takes a certain amount of experience to explain the condition without being beaten.
6. The core system is in the heart, serious and responsible
Emergency doctors will do it, and under no circumstances can they pass the buck to the patient, and they are serious and responsible. All departments consult, all departments do not want, emergency departments also have to be needed, and the emergency doctor who is responsible for the first diagnosis does the best. It's not because I'm willing to be responsible, it's because I can't afford to take it. Once an accident occurs, the first emergency diagnosis is inseparable (often blamed by specialists and forced to take the blame), so it can only "not abandon and not give up".
……
Emergency medicine is like a microcosm of society, and you can see the world in a small space, so emergency doctors may be more open-minded about the concept of life and death. The longer I stay in the emergency department, the more I seem to feel the feeling of "life and death". Every time we are rescued, we will constantly say to ourselves, "We must do our best"; every parting is very uncomfortable! Emergency also makes us know how to cherish everyone at the moment.
Source: Medical Eye Views