Portland

So I spent the beginning of this week in Portland, ME, looking at a pair of hospitals, and shadowing an Emergency attending (friend of the family) on an evening shift, to get a feel for the department. LOVE their ED. I have a SERIOUS case of emergency department envy. It's brand new, cavernous, but extremely well laid out, with WINDOWS. Doesn't feel claustrophobic at all (thanks to the aforementioned windows and nice high ceilings), and manages traffic very very well.

The attending I followed is wonderful, and has a good relationship with and respect for nurses. She even let me yell at her residents for saying "oh we'll just do this here, and let the nurses clean it up"...including one bright young doctor who said an elderly patient could just defecate in the bed if he didn't get around to telling a tech to bring a bedpan, and that then the nursing staff could "just clean it all up". My response? "Um...do you REALLY want to be the most hated resident in the department? REALLY?" His attending started laughing, and said she'd make HIM clean up, since the nurses had plenty of THEIR OWN WORK to do. (Have I mentioned that she's awesome?)

Saw some really interesting cases, including an exceptionally elderly gentleman who presented with what looked like TERRIBLE pneumonia, like, die in an hour or two pneumonia, resps in the 40s, BP crashing, HR 160s...a mess. And HIS brilliant resident discovered a massive bowel obstruction, that was causing his abdominal contents to compress his lungs, so they DEcompressed him, his abdomen shrank by a good 4 inches, and his vital signs stabilized so that he could wake up and recognize his wife. He may WALK out of the hospital in a few days. How cool is that?

All in all, one of the Portland hospitals and one Vermont hospital are the top of my list.