Williamsport Regional Merdical Center Emergency Department (part of Susquehanna Health Systems) (current status: This is available for 2010. Contact Prof. Milofsky if this opportunity particularly interests you.)

Williamsport Hospital and Medical Center in Williamsport (about 30 miles north of Lewisburg) is willing to host students from our class for up to an eight hour experience in their emergency room.

Students who participate in this setting must watch a video and take a short quiz on HIPAA regulations before they will be allowed to visit the ER.   This is in addition to the security clearances and CITI protection of human subjects certification that are required for the course.

The directions in the next paragraph give you contact information for our contact person, Sherry Hyland. However, in many ways it works best if we get a list of interested students during class and set up a schedule for visits and for going through the HIPAA training. Contact Milofsky so he can plan the group experience.

Once you let your instructor know this is a placement you want, scheduling is your responsibility. To schedule a visit, conrtact Sherry Hyland, Clinical Nurse Educator of the Emergency Department. of the Williamsport Hospital and Medical Center. Her office phone number is: 321-2250 and her email is: shyland@susquehannahealth.org.  

Williamsport Hospital is what we call a "secondary" medical care facility, which means that although it is a most specialized and high technology center, the most extreme medical cases will be transferred elsewhere, probably to Geisinger Medical Center in Danville. Their emergency room is the primary facility for the largest metropolitan area near here and so it is quite busy—some years it has more cases than does Geisinger Medical Center.

In past years we have had students serve as interns at the Williamsport Hospital ER as well as at other hospitals in the area like the Geisinger Medical Center and Shamokin Hospital and students have had very meaningful experiences.

What we've arranged is for one of the nurses in the ED to act as your host and guide.  This means that you’ll have a contact person you always can check in with when you are on the unit and if, perhaps you got involved in some other activity and want to reconnect with a supervisor who can give you new directions.  Usually the nurse host will give you a tour of the facility and also will make a point of introducing you to new activities or settings. 

Understand, however, that while your nurse supervisor will help you out an emergency room is a busy place and your nurse contact has a job to do.  She or he may have to quickly become intensely involved in the case of a patient.  Your responsibility then is to find a place that is out of the way and observe what is going on.  You may ask where to stand and in some cases you may be asked to wait outside of the booth, room, or treatment area since issues of privacy and confidentiality may come up.

Your time in the ED will be more interesting and more socially comfortable if you offer to help out with simple tasks.  Your nurse supervisor may give you some tasks to carry out and you should be grateful when that happens.  It takes work for the staff to have you present and it is a good thing when we as observers can be outgoing about volunteering to help.

That said, Bucknell does not want you to be involved in medical procedures where you may make physical contact with patients, come in contact with bodily fluids, or where you give out information you are not competent to provide.  Be aware that you must minimize risk to yourself.  Understand, however, that your host nurse and the medical staff also are keenly aware of what would be risky for you or for patients.  If medical staff asks you to complete a task (perhaps removing paper waste from the setting where a medical procedure is going on) or asks for help that involves contact with a patient (perhaps holding a child’s hand steady while a doctor sutures a wound) follow their guidance and your own good judgment.

Most of the time emergency rooms are quiet places despite expectations to the contrary.  We have images of ERs being places with lots of drama and of wounds and medical procedures that can be upsetting to a newcomer.  Be prepared for such events to happen.  If you feel light-headed SIT DOWN!  If things happening in a treatment space upset you, leave the room!

You are more likely to be surprised and puzzled that staff members will treat you as a colleague and as such will take you “back stage” so that you learn about the contents of medical records, you are included in patient interviews that include confidential material, and people take time even when busy to explain physiological signs and symptoms to you.  Do not question the professional competence of staff members when they do this.  They treat your presence as part of the medical education responsibilities of the hospital and as such staff will treat you as medical professionals in training.  Everyone must start their education somewhere and direct experience is an extremely important part of learning to be a health practitioner.  Be very aware that your visit is a privilege and that it carries with it responsibilities to follow the HIPAA and IRB rules.

You may carry out this experience either as one eight-hour day or as two four-hour visits. Emergency rooms are most active on Sunday through Tuesday nights and so you might want to set up two of them. However, the emergency department is a busy, active, and interesting place and you will find plenty to see if you visit during the week. At night and on weekends things are slower because the rest of the hospital is closed. One of the reasons the emergency department is interesting is because about 1/3 of all hospital admissions originate there. Working in the ED allows you to see other parts of the hospital as well, especially if you're there during the regular workweek.

I will post two reading assignments on Blackboard.  One is titled "The Sociology of Emergency Medicine" written by Dr. Arno Vosk and myself based on our observations in the Williamsport Hospital Emergency Department in the early 1990s.  The second is an article by Erving Goffman titled, “  “. 

There are many directions to go in terms of an observation and writing assignment, since the experiences of sick people and those involved in serious accidents (organ transplantations usually start in the emergency room) offer much to think about. However, the most important thing for you to see and learn about is the variety of people and roles in action in the ER and the way the division of labor of that setting functions and how coordination is achieved both inside the ER and with professionals and departments elsewhere in the medical system. That is the focus of the article Vosk and I wrote.