Introductions

Well I feel a bit bad for not introducing you avid readers to the family of people who work in Emergency. They're an eclectic bunch with their own idiosyncrasies... but they're not too bad.

1. The triage nurse
Job description: to ask people what's wrong with them and make sure that the people with gunshot wounds or heart attacks get seen before the people with a sore toenail that's been there for 5 months.
Personality type: usually very task orientated and abrupt, knows the 'frequent flyers' to ED and warns you of them, often provide valuable advice about the patient's social situation before you see them (such as "the guy who dropped her off was carrying a great big knife" - always helpful to know!)

2. Ambulance officer
Job description: They are the delivery boys of our pizza shop. Except instead of getting rid of our products, they bring us more work. Thanks! Supposedly have some kind of training in first aid and some basic medical stuff, they love to run around with their sirens blazing and picking up the old ladies who 'had a bit of tummy pain'
Personality type: although they see a lot of action, they love to laze around after they've dropped off their customer and flirt with triage nurses or admin staff. Nige-phobes in that they often travel in packs and all arrive at the ED at once so they can hang out together, but having the undesired effect of making the doctors inside panic when they see 4 ambulances pulling up at once.

3. Comms clerk
Job description: To do all the dirty work of phoning up and getting a hold of extremely difficult people to contact. Whereas on the ward you would spend hours wasting time chasing down surgical registrars who refused to answer their page, these lovely people get them waiting on the line for you then announce over the intercom "Dr J to the bridge, surgical registrar on the line" thereby saving you the pain of having to find them.
Personality type: Anyone who can hunt down a surgical registrar must have a fair bit of tenacity and perseverance. They are generally very friendly for people who probably cop abuse all day from disgruntled doctors and are much more efficient than the switchboard.

4. The radiographers
Job description: To Xray anything that hurts in the Emergency Department because we are too precious to go across the hallway to the 'real' radiology departmant. They are a highly organised SWAT team of imaging and are veiled behind their magic lead-coated curtain.
Personality type: Reclusive. They rarely venutre out except to grab the next patient and then hide back in their little room devoid of sunlight or human touch. They make Quasimodo of Notre Dame look like a social butterfly.

5. The ED nurses
Job description: Never (I repeat NEVER) to be confused with their less evolved cousins the 'ward nurses', the ED nurses pride themselves on getting to wear blue scrubs like the doctors and being able to [gasp] insert IV cannulaes and take blood. Their job is to constantly hassle the doctors to find out what the management plan is so that they can enter their 'times' into the data collection system to make the State government look good for the upcoming election. They are also prone to the vice of the ward nurses known as the 'tea-break' which means that although you are not allowed to even relieve yourself, they may take all day to administer those medications if it even looks like interfering with their mandatory union-provided tea-break.
Personality type: generally less amoebic in intellect than the wards, they have let this confidence brew into disdain and can be more aggressive with interns who they don't trust* however provide a refreshing change because most of them 'want' to be in ED.

6. ED consultants/staff specialists
Job description: to run the department and direct medical care whilst keeping an eye on those dodgy young junior medical officers to prevent any mishaps and bad media coverage for the hospital.
Personality type: anyone who chooses to work shift work beyond the age of 35 is generally highly driven and does not want to 'settle' into the mundane life of general medicine. Often like to balance their career with extreme sports or vehicles and believe that every other department in the hospital revolves around them. Often willing to abuse ward registrars for not seeing the ED patients and will gloat about it afterwards.

7. ED registrars
Job descritption: To help run the ED whilst studying intensely every aspect of medicine so they can become like the above-mentioned consultants. Also run the entire ED on their own between the hours of 11pm and 8am when they have cortisol induced hypotension which they relieve by carrying around a large bottle of caffeine such as a 2L bottle of Coke Zero or the like.
Personality type: Not quite a boss and no longer a scut-monkey** they still have some humane aspects but enough cynicism to help them get through each day. Usually complaining non-stop about how overworked they are (which is true) they spend their spare time either doing extreme sports again or writing letters to our boss asking for more fellow registrars to be employed to share the load.

8. ED Interns and Residents
Job description: To see patients in the ED and then not really think too much about them because they have to present them to the boss anyway. Pretend to know something whilst really knowing they know less than they should. Try not to kill too many people*** and not pick up any gomers (old people) within the last hour before they leave. Have a glazed look after night shift which indicates their apathy and incompetence by the end.
Personality type: Over achievers who start to panic when they realise they may be out of their depth sometimes. Often seek outlets for their crazy wokring life, like drugs or chatting up allied health staff in early hours of the night shift.

And so here we have our wonderful world where we all run around in a noisy fast paced frenzy. This last week I have been doing night shift was has been a blast. Eating junk food with nice nurses (including a girl I used to know in high school) and having 'intern teaching' from a bleary eyed registrar at 5am. I've seen all sorts of diverse things such as a newly-diagnosed-brain tumour, a completely dislocated wrist with no sensation or pulse, a security guard who was beat up, chronic 'period pain', hyperventilation syndrome, someone with a lack-of-direction in his life (very urgent thing at 5am in the morning!) and am never ceasing to be amazed at what things people classify as an 'Emergency' in the wee hours of the night.

Can't you people read the sign? It says E-M-E-R-G-E-N-C-Y!


* one notable example was when I was told at handover round that a patient was to be admitted to the psychiatric ward once a bed was available. I was pestered non-stop by a senior ED nurse because it wasn't documented in the notes. I looked through the notes and found a clear entry from the ED consultant saying "Patient discussed with psychiatry registrar and for admission under the psychiatrists" Apparently that was not good enough and I was forced to 'reaffirm' this directive with a rather irate psych registrar at 5am in the morning.
** "Scut-monkey" is a term used to describe me and other junior med officers cos we end up doing all the crappy jobs that other doctors dont wanna do cos we are the bottom of the food chain.
***One shift started with a new registrar introducing himself to me and saying "I don't care how many of these patients you kill, as long as you don't link them to me in any way" - I hope he was kidding?