Pros and Cons of Becoming an Emergency Room (ER) Doctor: Should You Become an Emergency Room (ER) Doctor?

Globally, there is a shortage of doctors including emergency room (ER) doctors, so the need is there. If you are considering becoming an ER doctor, this kind of career choice offers a unique, professional challenge. A hospital ER is an excellent, learning-teaching environment.

Doctors are acutely aware of the pros and cons of working in hospital emergency room (ER) settings. Many of them enjoy the excitement of the ongoing activity, even though sometimes, it can prove to be quite chaotic. This kind of a setting, invariably gives doctors front-line experience that they may not obtain elsewhere. This is true of ERs in extremely busy, city hospitals, as well as those located in remote regions.

Other pros and cons may include the following, depending upon the country, location and size of the hospital.

Hospital ERs are a place where doctors and nurses continually deal with emergency, medical situations. Here, doctors carry out medical assessments, as well as offer diagnosis and treatment options, in conjunction with nursing care administered with the assistance of registered nurses and other health care professionals and non-professionals.

Hospital ERs serve their communities in other capacities, often functioning as a place where patients can obtain pre-scheduled minor surgery. They can be temporary clinical settings for doctors who are already in or en route to the hospital. In times of community medical crises, they may become a central, designated center for the medical-surgical treatment of large numbers of patients, who need care simultaneously. ER doctors play a major role in organizing this kind of a scenario.

ER doctors may function in other capacities working inside the hospital or in their own practices and clinical settings. At times, there may be only one doctor in a hospital ER, but there may be more than one, depending upon the population in a certain area, the needs of a community or the demands made by a hospital. Other doctors may come and go from ER departments, depending upon patient needs. The patient turnover in ER departments can be extremely high, relatively diverse in terms of race or culture and complex with respect to medical-surgical demands.

ER doctors need to be intuitive and able to assess patients quickly, quietly and accurately. Being well organized is important. They must work well with registered nurses and other health care professionals and non-professionals, on a one-to-one basis or as teams.

ER doctors must be able to act quickly in any kind of an emergency. They need a high level of medical-surgical skills, as well as those related to specialty areas like cardiology, pediatrics, obstetrics, psychiatry, oncology,  and gerontology. ER doctors draw from all of their previous training and experience and should have advanced training in CPR, first aid, intravenous therapy, medication administration, cast care, wound care and sutures.

Hospital ERs demand a great deal of paperwork from ER doctors, depending upon the patient volume and status. ER doctors have to be familiar with hospital procedures and policies.

Previous medical records for patients may not be easily accessible, particularly on evening or night shifts, holidays and weekends, when the ER is busy. Specialists may not be available, so there may be times when an ER doctor has to make a learned, medical decision or a judgment call. It may not always be possible to have the essential lab work, x-rays or other tests done, immediately. Calling technicians at home, may be necessary during off hours.

There may not be sufficient beds to accommodate the patients in need of hospitalization. Transferring patients to other medical facilities may be necessary. The stabilization of patients is an important aspect of their care, prior to transfer via ambulance or air ambulance. For example, a child in medical distress may need transfer to a children's hospital for immediate cardiac surgery.

In the ER, critical medical situations occur without a moment's notice. This can include cardiac or respiratory arrests, hemorrhaging or the unexpected birth of infants. At times, the ER may be been alerted to patients who have suffered trauma from motor vehicle accidents and fires, but not always. Doctors may have to contend with a constant flow of police officers, fire fighters, emergency response team members, ministers and priests, as well as patients, family members, friends and others.

Patients may arrive by ambulance semi-conscious, unconscious or deceased. They may be well oriented or disoriented. Many patients may appear confused because of head injuries, illness like diabetes or psychiatric problems. Patient's complaints may not always appear to be well founded.

Patients may show up alone or accompanied by others. Many ERs function as walk-in clinics and numerous patients arrive, expecting to seen, diagnosed and treated by a doctor, immediately. Many times, they have to wait. Crisis scenarios must be dealt with first. Numerous crises can happen simultaneously, in an ER setting.

Life and death is a daily, ongoing struggle in hospital ERs. Some patients are struggling to stay alive. Others may have attempted suicide or are knowingly or unknowingly hurting, harming or killing themselves and others, through the abuse of tobacco, drugs and alcohol. There may be a high level of knife and gunshot wounds related to violence.

Good patient assessment, diagnosis and treatment skills are vital for ER doctors. Effective communication and conflict management skills, interpersonal relationship and counseling skills are essential.

The ER doctor functions as a teacher for registered nurses and other health care professionals, as well as patients and their families. Each patient must be educated in some way, regarding diagnosis and treatment, as many may not have follow-up care. Often patients require hospital admission by ER doctors.

Doctors must act professionally at all times, while they attempt to meet the mental, emotional, spiritual and physical needs of patients. Integrity is always important, as is strict attention to detail.

Doctors must demonstrate high levels of concern and compassion, as well as insist on high quality patient care, as legal action or malpractice suits can occur, unexpectedly. The doctor assumes the responsibility for patients in the ER, in conjunction with registered nurses involved in patient care.

There is a high level of risk of infection for doctors, registered nurses and others working in hospital ERs, particularly when there is a global concern, like the current spread of the H1N1 virus. Infection control is always an important aspect of any doctor's work.

On a global level, hospital ERs may be short staffed, particularly in busy hospitals or remote areas. This means that the ER doctor may have to work extra hours, particularly on weekends and holidays. It may entail missed meals and breaks. Family and home life may suffer.

Essential medication or medical supplies may not always be immediately available. Doctors often have to make do with what is available at the hospital or try to obtain the needed medicine or medical supplies for patients, through local pharmacies or hospital supply places. Sometimes, an ER doctor may have sample medications, but at other times, patients have to wait.

ER doctors demonstrate a great deal of patience with other health care professionals and non-professionals, as well as patients and their families, who may become frustrated, angry and upset. Many patients and their families, as well as others, do not comprehend the seriousness or the reality of what happens in hospital ER settings and thus, they may become demanding, abusive or aggressive towards the ER doctor and others.

There are many times, when working in the ER can appear to be a thankless job, but ER doctors are instrumental in saving many people's lives. Sometimes, they only treat teens or children with sports injuries, by applying casts or suturing cuts. Sometimes, those who they have to treat are members of their own families.

Should you become an ER doctor?

Ultimately, the decision is going to be yours, but if you are thinking seriously about it, begin to do some online research, visit some hospital ERs and talk with other ER doctors. Inquire about available courses at your local medical school or university.

Do not be surprised if other doctors raise an eyebrow, when you tell them that you want to become an ER doctor, because they know that you will have your work cut out, if you go that route. They may smile as well, because they know you will probably enjoy it, too.