Emergency medicine: what keeps me, what might lose me?

EDs are currently under intense pressure due to increased patient demand. There are major issues with retention of senior personnel, making the specialty a less attractive choice for junior doctors | Emergency Medicine Journal

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This study aims to explore what attracted EM consultants to their career and keeps them there. It is hoped this can inform recruitment strategies to increase the popularity of EM to medical students and junior doctors, many of whom have very limited EM exposure.

Methods: Semistructured interviews were conducted with 10 consultants from Welsh EDs using a narrative approach.

Results: Three main themes emerged that influenced the career choice of the consultants interviewed: (1) early exposure to positive EM role models; (2) non-hierarchical team structure; (3) suitability of EM for flexible working. The main reason for consultants leaving was the pressure of work impacting on patient care.

Conclusion: The study findings suggest that EM consultants in post are positive about their careers despite the high volume of consultant attrition. This study reinforces the need for dedicated undergraduate EM placements to stimulate interest and encourage medical student EM aspirations. Consultants identified that improving the physical working environment, including organisation, would increase their effectiveness and the attractiveness of EM as a long-term career.

Full reference: James, F. & Gerrard, F. (2017) Emergency medicine: what keeps me, what might lose me? A narrative study of consultant views in Wales. Emergency Medicine Journal. 34:436-440

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What do emergency physicians in charge do? A qualitative observational study

Hosking, I. et al. Emerg Med J Published Online First: 10 March 2017

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Introduction: The emergency physician in charge role has developed in many large EDs to assist with patient flow. We aimed to describe and classify the problem-solving actions that this role requires.

 

Conclusions: Emergency physicians in charge have a number of problem-solving approaches that can be readily defined. We have described and categorised these. These results are potentially useful for developing decision support software.

Read the full article here

A joint report between the RCN and the Royal College of Emergency Medicine (RCEM) makes recommendations for meeting increased demand.

RCN & RCEM. The Medicine Needed for the Emergency Care Service. Published online: 18 August 2016

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Image source: RCEM/RCN

The Royal College of Emergency Medicine and the Royal College of Nursing today launch their report: The Medicine needed for the Emergency Care Service.

The pressure on the Emergency Care Service continues unabated and the service is at a crisis point. Growth in patient numbers is outpacing growth in the workforce and so the system has insufficient emergency physicians and emergency nurses. Crowded and chaotic departments are dangerous for patients and demoralising for staff.

A crisis summit was held between the Royal College of Emergency Medicine and the Royal College of Nursing to work together to develop some key recommendations to tackle the situation facing emergency medicine. These recommendations comprise ‘the medicine’ needed for emergency care:

  1. Education and Training: there needs to be (i) a commitment for both educational funding and provision of training time and (ii) an effective and realistic workforce planning strategy.
  2. The A&E hub: A&E should become a hub not a department. Within this hub the emergency department would be one, albeit key component.
  3. A new culture needs to accompany the Five year Forward View: the wider hospital system and the professionals working within it need to collaborate more deeply to support their patients.

Read the full report here