When I was applying to medical school I spent a year working in the pediatric emergency room. This was while I was deciding to become a parent, so I saw things both as a future mom and as a future doctor. Here are a few of the surprising things I learned:
1. Pediatric Emergency Rooms take referrals from local pediatricians/practices.
Many ERs know the local pediatricians well and can even receive direct electronic referrals from them containing pertinent information for your child’s care. It can include information like their medical opinions/concerns, previous vaccinations, allergies, and physical exam and test results. This improves and expedites your child’s care in the ER. It means the ER physicians already have things laid out for them by another doctor advocating for your care in their ‘language’. You may also avoid repeating uncomfortable or lengthy tests or procedures. In general, having a direct referral will prove to the triage nurse and ER doctors that your care in the ER is truly necessary and that a pediatrician could not meet your needs. This often gives your child priority over other patients. Likewise, if your pediatrician cannot provide a direct referral, you should try to bring as much information as possible in-hand for the ER physicians. It may not be as ideal as a direct electronic referral and record, but it still helps dramatically. Of course, if there is any concern your child may need immediate care, there won’t be time to call the pediatrician and get them to refer you. Don’t hesitate to call 911 or go directly to the ER yourselves if there is any potentially urgent need for your child’s health. Like they say, it’s better to be safe than sorry.
2. Being treated by resident physicians and medical students can lead to higher-quality care.
Sure, I’m biased on this, and you can feel free to disagree, but I find that students and residents are much more likely to have time to get a thorough interview, cover their bases, and really get to know you as a patient. They might not have the same diagnostic reasoning as a seasoned physician, but they have been trained in the most up-to-date and empathy-centered interviewing skills (and some physicians say the interview is 90% of the diagnosis). Even still, when you have a resident/student work with you, it means you will always have the attending (experienced) physician’s attention and interview too. Together they will have a discussion and teaching session for each patient, meaning that everyone is double-checking themselves and thinking a little harder than they normally would. Generally speaking, these ‘teaching hospitals’ also employ higher-quality attending physicians who are required to stay up-to-date on current research and procedures.
3. The hardest part of caring for pediatric patients in the ER is dealing with the parents.
I hate to say it, but sometimes difficult parents can really sabotage their child’s care. Often parents are simply impatient because of a long and awful experience in the waiting room. Most are just scared for their child’s health. Some are naturally high-strung and hard to work with. Whatever the case, pediatricians are often just as human as the rest of us when it comes to dealing with difficult people. Whether consciously or subconsciously, they tend to spend more time and use clearer judgment with a patient who has a pleasant parent. So even though it might be hard, try not to offend or snap at your child’s ER physician. That certainly doesn’t mean you need to be completely submissive. Pediatricians like to see that you are asking questions, showing concern, and taking an active role in the care of your child.
4. Don’t be surprised if your ER physician spends more time on the computer than with your child.
In our current medical world, keeping thorough and detailed electronic medical records is absolutely necessary. The latest medical dramas tend to be pretty deceptive about this, but in reality, the ER is a pretty calm place 95% of the time. ER physicians aren’t actually running around resuscitating patients left and right. Much of their day is spent at the computer, carefully detailing patient interviews, explaining their diagnostic impressions, requesting consultations from specialists, and ordering or reviewing things like lab work and MRIs. You may be tempted to think that they don’t understand the urgency of your situation or that they are just sitting around ignoring your distress, but they are being thorough and doing their best to coordinate your care within a much larger hospital system. I won’t lie and say I haven’t seen ER physicians take a break to check their personal email or book an upcoming vacation, but even still, they are often filling in some spare time while they wait for test results or a consultation.
*Rebecca Hughes and A Child Grows would like to add the disclaimer to this piece that it isn’t official medical advice.
Rebecca Hughes has a background in biomedical engineering and is now attending medical school. She lives with her husband and two young children in Brooklyn.