In larger ERs, the need for speed takes on a life of its own. In the American system, it’s all about how many people are admitted. In ours, it’s about how many people we push through. I was once told about an ER in Toronto, where rookies were expected to push through at least seven patients an hour. If they failed to make this tally after a couple of shifts, they weren’t hired on because they were deemed to be too slow. And if a trauma, cardiac arrest or another patient requiring a long period of care came in and monopolized an hour or two or their time? Too bad.
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