Thread by @RuralEDPA, In my next life, I’m going to work in a place where [...]

In my next life, I’m going to work in a place where I’m not alone and trying to solve all the community’s problems with zero resources.

I love my community and I love problem solving, but holy hell I am tired of trying solve unsolvable chronic problems. At 4 pm Friday. Always.

Going to disjointedly complain for a bit, so here does

Scroll by if not In the mood.

I am tired of being dumped on because it’s 4pm Friday.

I man tired of being dumped on because you can’t make a decision and do the right thing for your patient.

“Sure. Send it in and I will sort it out” is always my pleasant canned answer. Every time.

I am NOT talking about any specialty/profession in particular, I’m just an exhausted ED PA who has been killing herself to help her community despite the never ending uphill battle

We are short staffed. Some with very limited hours. I am the scheduler so (feel) it’s my problem

We are covering a 24/7 ED with 3 people. One full time and does 48 hrs/week with us in addition to 40/week in primary care (yikes)

A second won’t work more than 36/wk because he doesn’t want to (mad kudos to him for sticking to his guns)

I’m flexible to a fault (my fault 100%)

I’m tired of making patients wait in the waiting room because I don’t have a place to put patients. Often because we only have 3 private rooms, each with 3 hour clean time after any possible COVID.

I’m tired if making patients sit in the dirty waiting room because my very few rooms are full of possible COVID. Or because I have more than one patient who had died and I’m waiting on transport from ONE local funeral home with limited staff

I’m tired of telling families their loved one isn’t coming home and died a horrible death. Alone.

I’m tired of fighting corona conspiracy

I’m tired of patients being put in harms way because some conspiracy theorists don’t feel like dealing with things. (Not in general, just one PCP locally)

I’m tired of working insane hours (because I can’t willfully refuse to work and abandon my community)

[ I am not bashing/comparing myself to residents, on-call docs—don’t @ me. I respect the HELL out of you all. More than words can explain]

I’m tired of being the only space in this community that people can depend on, without fail.

It shouldn’t be this way.

Patients should be able to depend on their PCP’s to take care of their chronic and mild acute symptoms.

I get the necessary ED referrals. 100%. Happy to help in any way possible. This is what I’m here for. I’m honored to be the person you trust when you can’t figure it out.

But don’t be a condescending prick about it.

I’m tired of getting Monday morning quarterbacked after an impossible situation. I am tired of hearing ridiculous criticisms from a brand new nurse who is afraid to talk to the physicians, so harasses me instead.

I love my nurses. They have saved me no less than 49848977 times in my career

I’m not taking about helpful input (99.9% if the time nurses are correct and I am off)

I’m talking about being a condescending prick (no matter your credentials)

We haven’t been hit that hard, but I’m tired of being blamed for everything. Im tired of trying to sort out high vs low risk in a pandemic where we don’t even know what “normal” is.

In a hospital that has minimized EVERYTHING about this pandemic

I’m tired.

No, I’m exhausted.

I’m not comparing my fatigue to anyone or any other situation. Only my own.

Can we please do better?

Can we support each other and our common goal?

Can we recognize that “go to the ED” isn’t always the right answer, particularly during a pandemic.

*Can we also fiercely encourage people who we have always suggested go to the ED for stroke/MI, etc, continue to do so promptly

Can we call and talk with someone in the ED—before sending something nebulous in—to discuss concerns (I recognize this is incredibly painful sometime and that many are not receptive)

Can we please just help each other.

Anyway. Thanks for reading my rambling gripe fest.

I’m fine, just tired and over it.

3 more weeks until I get more than 1 day off in months.

So, yeah.

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