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Emergency Relief

Emergency Relief: Dancing EPs, Illegible Handwriting, and Pocket Protectors in the ED

Scheck, Anne

doi: 10.1097/01.EEM.0000459535.31475.a9

    You Knew It All Along: Burnout is Normal

    First, the good news. There is an actual scientific journal to address the problem of overwork and job stress among physicians, as well as among other health care providers. Now, the bad news. One of the first articles in Burnout Research — ominously titled, “The inevitability of physician burnout: Implications for interventions” — notes that burnout is an “obvious outcome” of a medical career. In fact, researchers should regard it as a byproduct of the system starting in medical school. Sadly, no evidence shows that great coping skills are preventive. And no cure is in sight. The conclusion, by way of broad paraphrase: It's terrible. There's no escaping it. (Burnout Research 2014;1[1]:50; http://bit.ly/1w12qBe.)

    The Dancing Was a Dead Giveaway

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    It sounds too good to be true — and it is. A New York hospital was reported to have returned to paper charting after a frustratingly long and unsuccessful implementation of the electronic medical record (EMR). The idea of adding traditional charts in lieu of the EMR sounded convincing until certain questionable details emerged, like emergency physicians hoisting computer terminals into corridors and dancing around the halls from happiness. As one reader observed: These doctors, in general, only pound and curse their computers, rather than toss them. Also, they largely limit their dancing to hospital parking lots at the end of shifts. (Gomer Blog; http://bit.ly/12l7HFT.)

    Truth is Stranger than Fiction

    And now for a report that doesn't sound true, but is: Scholars debating the rights of robots. After all, someone has to look out for the wellness of highly intelligent computers who will help run emergency medicine and other parts of the hospital. Who will decide best practices as machines become more humanoid in health care and in other fields? The answer remains elusive, but the event actually took place at The New School in New York City. Attendees included artificial beings, robots, and “telepresences.” No, really. They were all there, along with the humans who debated their fate. (The New School; http://bit.ly/1rrRWlY.)

    The Prep is the Worst Part

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    Apparently to offset growing skepticism about invasive screening tests, Travis Stork, MD, an emergency physician, underwent a colonoscopy during a segment of his television show, “The Doctors.” His co-host, Jim Sears, MD, joined him in the procedure, calling it “no worse than a trip to the dentist” and likening it to “a cleanse.” Not to be outdone in entertainment-style support of colonoscopy, a pair of Canadian singers wrote a duet about it that became a finalist in the International Songwriting Competition with lyrics lauding the surgeon's tunneling work “in the heart of darkness, where the sun don't shine.” No word yet on whether Dr. Stork's on-air surgery — or the popular song — has meant an uptick in colonoscopies. (Sing along with the Colorectal Surgeon Song at http://bit.ly/1wgxdJB.)

    Transport that Makes Patients Scream

    Speaking of Canadian vocalists.... Some Canadian citizens are finding good reason to wail on ambulance rides. Cold winters in the maple leaf nation have left a lot of potholes on streets, according to those who practice emergency medicine north of the U.S. border. In fact, one highway to a Winnipeg hospital earned the dubious distinction of second place in a “Top 10” list of bad Canadian roads. The bumpy ride has caused acute discomfort to some patients, and the country has now poured funds into upgrading the thoroughfares. “We know Winnipeggers like the smell of coffee. We're asking them to get used to smelling the smell of asphalt,” one official said. Local paramedics call these concrete cavities a real emergency. (“Paramedics Protest Potholes,” Brandon Sun, April 9, 2014; http://bit.ly/1yJlQcN.)

    The Destruction of Legible Handwriting

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    Reddit.com asked physicians to describe why their handwriting was so bad, and the cited reasons ranged from an abundance of doctors whose education began in public schools — where there were no nuns to enforce proper cursive — to endless paperwork causing ordinary alphabetic letters to devolve into wavy lines and doodles over the course of a typical day. (http://bit.ly/1yfBGx9.) Other health care professionals who weighed in attributed it to “200-year-old” physicians who never retired and passed down their bad habits, as well as an attitude by younger doctors who expect pharmacists to decipher loops, sticks, and dots. One physician, however, blamed it all on medical school. “You had to write notes ridiculously fast. Your handwriting would decay weekly. What was left died a tortured death during internship.” So there you have it: Penmanship is murdered early in medical training.

    Who Put that Trash Can There?

    What is sending an increasing number of people to the emergency department? (Hint: It often happens on a sidewalk, and the collision is usually with a stationary object, like a light pole or mailbox.) Yes, that's right. It is not just drivers texting who put themselves at risk; it's also pedestrians. Now, thanks to a team of Australian researchers, we know why. Texters tend to swerve while casting their eyes downward, making a trash can, park bench, or flower pot, well, not deadly but definitely hurtful. The investigators found that this happens to anyone with two feet in motion who is typing messages. It's been known to occur in hospital corridors, too, but so far no data on that. (Plos One; http://bit.ly/1BaGapN.)

    Back by Popular Demand

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    What trend did doctors start, engineers perpetuate, and cool college kids drive into extinction? Why, the pocket protector, of course. Only a short time ago, it seemed as archaic as a slide rule. But now that plastic encasement is back, in vintage form, often bearing the seals of science departments and lab facilities. Academics can actually rely on the Pocket Protector Preservation Society to keep the trend moving forward. The plastic sheath is now seen as a personal symbol of the very task it performs on a lab coat: Doing a job “quietly, efficiently, and often anonymously.” (American Scientist 2014;102[3]:182; http://bit.ly/12lfHH5.)

    © 2014 by Lippincott Williams & Wilkins