A funny email is making the rounds of some EM residency programs, advertising a “new fellowship opportunity” in Waiting Room Medicine. The tongue-in-cheek ad is excerpted below:
“The Department of Emergency Medicine at Any Canadian Hospital (ACH) is actively seeking qualified applicants for a 6 month fellowship position in the emerging Emergency Medicine (EM) subspecialty of Waiting Room (WR) Medicine…
…Emergency Physicians (EPs) have little formal training in providing medical care outside of the usual confines of an actual bed with a nurse available to provide care. Clearly, this training deficit leaves most EPs behind the times.
Rotations Include:
* Unmonitored Cardiology – Make decisions about which of the 6 patients with crushing chest pain should get the next available bed when it opens up in the morning.
* WR Surgery — You’d be surprised how many things you can sew, lance, drain and wrap in a simple WR chair
* Communication Skills — Key objectives for the communication skills module include learning how to ask embarrassing questions in front of a crowd, learning to say “I’m sorry for the care you’re receiving” in a manner that doesn’t lead to your being assaulted by angry family members, and learning to say “these curtains are soundproof” with a straight face.
* Lab & Radiology — learn to make judicious use of investigations based on a triage note and/or EMS report; no need to bother yourself with talking to or examining the patient until all the labs are back
* Triage in the Real World – practice reverse triage, where CTAS 4s and 5s are seen expeditiously, because they are ‘quick and easy’, and CTAS 2s and 3s are left to languish for hours
* WR patients as monitors — learning to use other WR patients for the reassessment of critically ill patients (with a focus on teaching lay people about the recognition of seizures, initial management of cardiac arrest, and guidelines for involving the triage nurse in WR care).
Actually, every hospital we’ve trained in offers some informal education in this new and depressing specialty…
More from the Waiting Room Fellowship at ACH (with concerned correspondence)
