Demigod in white? A clinician tells us

Dr. Mechthild Haake has been working as a trainee internist in the emergency room for a year. Here she explains what this has to do with traffic light colors - and why it is important to listen to the nursing staff

"When working in the emergency room, the noise level is initially troublesome. Phones ring, devices and monitors beep, people talk confused. And as a doctor, you are not only a contact person for patients and relatives, but also for colleagues. I often have two Phones in my pockets - and if I'm unlucky they both ring at the same time.

My tasks are primarily to keep an eye on who needs to be helped first, to examine the patient thoroughly and to carry out a structured anamnesis - i.e. to query all possibly medically important information.

A crisis-proof profession

Then there are the questions about further therapy: Can the patient go home? Does he have to be treated as an inpatient, i.e. stay in the hospital? You can build on a lot that already happened during your studies.

After school, I could not only have imagined medicine, but also teaching, bionics or art. A longer stay abroad in Ghana helped me with my decision. I lived with a host family there and worked in a hospital. It was more of a hospital by German standards, but I was fascinated. About the fact that as a doctor you have to deal with so many people, from toddlers to old men. And how open and positive they are towards you. Doctors are also needed all over the world. At that time I was already thinking about the fact that medical work is a crisis-proof profession.

Back in Germany, I then studied medicine in Lübeck. A good decision. I had a lot of fun and would choose it again and again.

Enthusiasm and respect

Now in my first job, I have a mixture of enthusiasm and respect for responsibility. It's great to be part of a functioning team. For example, I think that we have a good questioning culture in the house. Everyone asks everyone here, after all, nobody can know everything.

We also read up on strange symptoms. When it comes to tropical diseases, sometimes not everything from the textbook comes to mind.

Once we had a patient with itchy rashes, and he also talked about diarrhea, nausea and vomiting. It turned out that he had recently come back from a trip to South America and had eaten an exotic fish there. After that the symptoms started. Unfortunately, he no longer knew what the fish was called. Maybe it was a reaction to the fish's poisons.Of course you are in the dark for a while. In such a case, all we can do is alleviate the symptoms.

Traffic lights in the emergency room

The first come, first served principle does not apply in the emergency room. Medical care is provided according to urgency. When patients come to the emergency room, they are first sighted by trained nursing staff. They are classified according to symptoms and recorded in the system with the traffic light colors red, yellow and green. Red means: acute danger to life! Action must be taken immediately. Problems that can wait for a while, on the other hand, are green.

Another thing some patients should know: There is no food in the emergency room. We only have water and, for diabetics, glucose. So if someone goes to the emergency room themselves, maybe they should pack a bite to eat - I think that would be a good idea. Because waiting a long time and then also being hungry is of course not very pleasant.

I can never say what the day will bring or when it will be particularly stressful. People don't come with an appointment. And they come with everything that is medically available: from heart attacks to suspected tuberculosis. There is also a lot going on at night. Then patients appear who may only be found in the emergency room. People with drug or alcohol problems, for example. Some of them share their whole life story with me - also for the repeated time. That can make you sad. One can imagine that one will probably see them again and again. No matter how often I say: "It would be important that you reduce your alcohol consumption!"

Internist in the job profile

Specialty: Internists are specialists in internal medicine. This makes your tasks very versatile. They diagnose and treat diseases of the internal organs such as the heart, lungs and stomach, but also infections and metabolic disorders.

Training: After completing your studies, you will train as a specialist in a clinic. It usually lasts five years. Up to 18 months can also be completed in a practice.

Job: There are around 53,000 internists in Germany. The majority work in practices, around 24,000 in clinics.

Listen to the carers

If there's one rule every new emergency room doctor should consider, one thing is for sure: Always listen to the nurses! The staff have years of experience in the emergency room. So if a nurse comes to me and says, "You should have a look at this patient quickly," then I'll do it. Right away.
Some people think that patients die every day in the emergency room.

But that happens much less often than you might think. Nevertheless, we experience dramatic situations. For example when an emergency doctor calls us and registers a shock room. Patients who are seriously injured after an accident, for example, are cared for there. Anesthetists, surgeons, internists or doctors from other specialist departments are called together for this.

Some cases leave their mark

Once we had a patient in the emergency room with severe pulmonary embolism. She was about my age. When the ambulance brought her, she felt very bad. After we stabilized her, she went straight to the intensive care unit. Such cases do not leave us without a trace. Discussions in a team, with colleagues from psychosomatic medicine or with emergency chaplains can then help. I can't say what I'll take home with me on days like this.

When I need to speak, my friend listens to me. There are some things I don't want to discuss at all. That’s a good thing. What is very important to me: I want to know what happens to the patients after the emergency room. This is the only chance to find out whether our care was good and whether our diagnoses were correct. That's why we mostly follow up on the ward and are happy when everything went well.

How long I'll work in the emergency room remains to be seen. For the specialist, I have to get to know other stations. All I know right now is that I often go home after the shift and think, that's pretty much why I wanted to be a doctor. "

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