Emergency Department Elective, Batemans Bay, NSW

I decided to undertake my medical elective at the Batemans Bay Emergency Department. I had completed my year of placement in the Eurobodalla shire that year as part of rural stream. As such I was familiar with the structure of the hospital and how emergency worked in the area as well as the staff. I organised my own accommodation for the duration of my elective, however there is plenty of accommodation nearby and the rural clinical staff are very friendly and offered ANU accommodation in case I needed it.

Structure of my 4 weeks

All weekdays except for Thursday I attended the Emergency Department and Batemans Bay Hospital. My hours varied, often beginning at 7am for a tutorial with Dr Kersty Dunn, the FACEM who was sometimes around. I spent Thursdays assisting surgery with Dr Holland (obstetrics & gynaecology) at Moruya District Hospital. This was an arrangement that I made with him personally. It broke up my week as well as provided him with an assistant (which he struggles to achieve on Thursdays as the surgical registrar is in clinic).
Thursdays would typically run from 8am start until 2pm or so.

What I learned

I enjoyed improving my interpersonal and clinical skills during my time in emergency. Every day I performed basic tasks such as venupuncture, cannulation and also had the opportunity to practice catheterisation as well as more advanced examinations such as the HINTS exam. The doctors on would usually treat me like an intern, having me see patients on my own and take their history, perform physical examinations before presenting the case to the doctor with my proposed investigations, differentials and any concurrent management. 
I then got to see the patients follow through these steps and either be discharged, transferred to the ward or (as is quite common in rural areas) be transferred to a tertiary centre such as Canberra. When more complex or emergent cases came in I was able to observe and the doctors on would always share their thinking with me. I never felt in the way or like I couldn’t be useful in some way or another, even if it was communicating with the medical/nursing/admin team or the patient’s family.

Rural issues highlighted to me included the lack of specialty services available, especially in the area of mental health. If patients were admitted for mental health reasons they would often wait as long as 12 hours in a bed in the department before a mental health worker would come to see them. There were also no psychiatrists in the area. Batemans bay hospital also lacks a CT scanner, so anyone needing a CT had to be transferred by ambulance to Moruya District hospital, a 30 minute drive away. This made wait times even longer and prolonged diagnosis hence treatment options in many cases. On the other hand it did make us more judicious in our use of the CT scanner and only patients who truly needed CTs were sent for one.

Recommendations for anyone wishing to undertake an elective in Batemans Bay/Moruya area

I would suggest getting in contact with the rural clinical school at Batemans Bay, they will do their best to help arrange a placement for you as well as accommodation. Their email is rcs.eurobodalla@anu.edu.au
Other than that, enjoy the beautiful coastal location and make sure you explore the area on weekends and evenings!