Lessons from the Emergency Department

Dr. Paul Hannam

Dr. Paul Hannam, Chief of Emergency Medicine

The Emergency Department is often the first point of contact for patients as they rush to receive treatment for an illness or injury. It’s a place that never sleeps  open 24 hours a day, 7 days a week, 365 days a year  with volumes sometimes peaking when many are relaxing over the holidays. The Pulse sat down with Dr. Paul Hannam, North York General Hospital’s Chief of Emergency Medicine, to discuss what it’s like to serve in this fast-paced environment.

Working in the Emergency Department is both challenging and immensely rewarding. The community places a high amount of trust in us and it’s a responsibility we don’t take lightly.”

When asked to describe what draws him to work in a hectic place like the Charlotte & Lewis Steinberg Emergency at North York General Hospital (NYGH), Dr. Paul Hannam pauses briefly to reflect. “It’s a unique environment, to be sure,” says Dr. Hannam. “Working in the Emergency Department is both challenging and immensely rewarding. The community places a high amount of trust in us and it’s a responsibility we don’t take lightly.”

As Chief of the Emergency Department (ED), Dr. Hannam is responsible for overseeing a team of professionals that range from nurse to social worker, physician to respiratory therapist. “Emergency medicine requires a high-functioning team,” he says. “Regardless of title, every person who works here has an important role in making sure we deliver safe, high-quality care. Part of my job is to maintain this team and ensure we are here when our community needs us.” These times also include the holiday season or statutory holidays when patient volumes can peak. “It is true that when we are at our busiest, many people are off work,” he smiles and concedes, Flexibility is definitely a trait we cultivate.

“I find that approaching people in a non-judgmental way makes it much easier to have an authentic conversation about what’s happening and what we can do for them today.”

Another important element of the job is communication. “In the ED, we need to gather information and make decisions quickly and efficiently,” Dr. Hannam says. “Listening carefully in a conversation can save time in the end.” By listening intently, health professionals are often able to uncover a secondary diagnosis or key mitigating factor that may be impacting on a person’s health, such as stress or addiction. “If we’re lucky, a patient will trust us enough to open up and share these factors,” he says. “I find that approaching people in a non-judgmental way makes it much easier to have an authentic conversation about what’s happening and what we can do for them today.

This emphasis on non-judgment extends to all visits to the ED. “If we can’t fix the underlying issue or disease, we can rule out the most acute problems, help with symptoms, and outline a plan for what happens next. Strong relationships with providers in the hospital and the community help us prevent the second or third visit to the ED. This is what we focus on.”

“Helping others to develop skills pushes me to keep looking for ways to improve.”

One particularly rewarding aspect of working in the ED is teaching the next generation of health care professionals. Each year, learners from across the health care disciplines choose North York General’s Charlotte & Lewis Steinberg Emergency to hone their skills and experience. At times, Dr. Hannam himself gains valuable insight through teaching students. “It’s one of the best parts of my profession,” he says. “Helping others to develop skills pushes me to keep looking for ways to improve.”

Similar to other areas of the hospital, high-quality care in the Emergency Department incorporates the best available evidence, the experience of the health care provider and the values of the patient, according to Dr. Hannam. “We are always looking for ways to make this care as efficient and effective as possible because in true emergencies we need to be decisive and act fast,” he says. “This is what we train for, practise, and teach others to do. Obviously, the fast pace is not for everyone, but for many of us here in emergency medicine, it is is more a way of life than a career." 

This article first appeared in the September 2019 issue of The Pulse.

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