A Day in the Life of a Physician in the Emergency Department

10:00 AM - ACUTE
My first course of action is to start the triage process, which is when I analyze a stack of charts to determine who the sickest patients are so they can be treated first. You can compare a day in the hot seat to playing a deck of cards - you lay out everything then decide what to do. Quick, calculated judgments are crucial as time is of the essence for all patients in the emergency department. Working my way through the sickest patients, I scan charts and quickly order blood tests, X-rays, and other pertinent lab tests.
10:30 AM - ACUTE
I then make my rounds to physically examine and discuss symptoms and findings with patients or family members, a process sometimes interrupted by emergencies like cardiac arrests that require all hands on deck. Our number one priority is always to stabilize patients, which involves regulating the heart rate and breathing, then diagnosing the problem. Once a patient is stabilized, we determine whether they need to be transferred to the intensive care unit or internal medicine, a department specializing in less acute conditions relating to the internal organs of the body.
12:00 PM - ACUTE
A family comes in with limited English. I grab the department’s Interpreter on Wheels, a mobile digital translator, to help facilitate communication and understanding. The nurses call for me as the laboratory pathologist wants to discuss an earlier patient’s test results.
12:30 PM - ACUTE
At this point, more patients have lined up with urgent needs. As more continue to arrive, I juggle between triaging, examining patient vitals and symptoms, and ordering tests. Doctors and nurses briskly zip past each other to attend to distressed patients, crying children, and concerned family members.
1:30 PM
A new doctor comes in to take my position in the acute section and I move into the secondary seat. This is when I get some time to wrap up my cases from the morning and make more calls to families of patients. I return to some of my previous patients for the third or fourth time with updates from laboratory tests and decide if they can be safely discharged or admitted to one of the medical specialities such as internal medicine, family practice, and elderly acute care, or admitted under one of the surgical specialties. The department is full with muffled conversations and occupied beds.
2:30 PM - INTAKE / FAST TRACK
We don’t have set breaks due to the nature of the Emergency department, but I make sure to replenish myself with food and beverage before continuing on. I move to a less acute side for the rest of my shift which could be intake, involving those with abdominal pain and non-life-threatening ailments, or treatment where I see patients that require medical attention for injuries related to sprains, broken bones, cuts, and mental health concerns, to name a few.
3:00 PM - INTAKE / FAST TRACK
I spend time with patients to go over test results, medications, and treatments in detail. It’s important every patient fully understands what is necessary for their recovery. It can take up to an hour with each patient to discuss their detailed treatment and recovery plan.
4:00 PM - INTAKE / FAST TRACK
I hear an announcement overhead, “code blue, Emergency, code blue”, and drop everything to attend to the new, critical case being wheeled in by the paramedics. All our beds are still occupied.
6:00 PM
I make sure I have wrapped up all the cases I could for the day and make a final round to see any of my remaining patients before signing over to the next Emergency physician.
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Ever since I was a child, I have always been interested in helping people from different walks of life. I went on to become a doctor because I saw medicine as a valuable profession that serves a basic human need for everyone, across cultures and no matter their situation.

After practicing family medicine, I decided to specialize in the Emergency Department. I liked the idea of problem solving in an acute team environment where investigation is required to figure out if you are dealing with a minor health problem or something major.

My name is Dr. Eliza Chan; I am the Co-Department Head for Richmond Hospital’s emergency department and I have been an emergency physician for 17 years. I have been working at Richmond Hospital since 2018, where I love getting to know people from the community and experiencing the different cultures and needs of our patients. As a bilingual person who is passionate about diversity, equity, and inclusion, I feel I have something to contribute to this wonderful community.

I am also proud to work with a team of health professionals who provide the best care for our patients even when they’re at their most vulnerable. That’s incredibly meaningful. And the fact is, we couldn’t do that without your support, because your donations help all of our health care teams provide timely and efficient care during these challenging times.

Every dollar you give allows health care teams at Richmond Hospital to continue delivering tireless care for you and your loved ones despite the extra strains of the pandemic. That’s why I hope you will consider a generous donation towards the gift of health for your family, friends, and neighbours.

At Richmond Hospital, we have close to 40 Emergency Department (ED) physicians who work varied shifts. We take turns filling different roles within the department—from Acute, where patients may need resuscitation, to Intake, where patients are quite sick, to Fast Track, where we take care of simpler problems like cuts or broken bones.

Every day in the ED is different. Every day is a challenge. With an aging population in Richmond, patient visits to the ED are high. Early days of the pandemic saw patients avoiding the ED, but we are now back to pre-COVID numbers. The combination of the pandemic and other life challenges has created a new ED reality for staff and patients. Patients are arriving in poor condition with longer stays required to recover, along with a significant rise in mental health and drug addiction visits. These circumstances are then further exacerbated by staffing shortages due to pandemic related burnout.

However, even with the current challenges, I can’t begin to tell you how gratifying my job is. Working at a community hospital like ours, you develop a relationship with your colleagues, your patients, and their families.

At Richmond Hospital, we want to see all of our patients live their healthiest lives, and your help makes that possible. Thank you for giving the gift of health and supporting the health of your community.

Sincerely,

Dr. Eliza Chan
Emergency Department

P.S. Now is the time to show your support for your community heroes who are committed to caring for you and your loved ones!

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