At work we had a labor crisis--one of the PA's quit. Just quit. No 2 weeks notice, nothing. She had just started with us and she felt "overwhelmed" and "anxious before every shift". No shit? Really? Welcome to the game, idiot. This isn't a Derm clinic where you get $150 an hour to decide which pimple to pop first. It's the real fucking deal and if you don't feel overwhelmed you're not working hard enough and if you don't feel anxious before every shift you're deluding yourself about what the day holds in store for you. So because she quit we were down a PA in ED2. But that's no problem. 12 beds and moderate acuity--it meant more work for me, but it also meant that I could see a shitload of patients and inflate my patients-per-hour stats. Fine. Then one of my first patients of the shift was our other PA--out with a bad malady. Uh-oh.....that's a problem; nobody up front to do the rapid exam and dispo. Definite system failure time! The department director came in (on a Sunday evening) to work the PA shift. Strong. That's leadership! Alas, because he came in he was on hand to witness another miserable U-561 reduction. Embarassingly bad. My ortho training was just not adequate (largely my fault....but not entirely...) and I'm bad at ortho. I'm bad at ortho. What a miserable thing to have to acknowledge. Must improve. Where could I go to just reduce fractures for a week?--just reduce forty fractures a day for five days? That's what residency is for....and I blew it. Have been dismayed recently. The long work hours, the few days off, the studying, the crash, the possible lawsuit, the seasonal affective disorder, etc....I just have been dissatisfied with what I'm making of my days and weeks. But feel better now. In large part because of the Biscuit. She's wonderful. U-561