The night shift in the emergency room and trauma center is totally different from whatever has shown in the TV shows. It is a very stressful and tactful job. I wish we could have all the fun as shown in the TV shows, but the reality is totally different. I have tried many times to convince my former colleague who is an emergency room physician and as well a famous filmmaker, to make a real emergency room show. Anyway, neither we were able to make a real show, nor we were able to go away from our stressful job. Of course, we don’t have time to eat on time so how we could do the barbeque in the ED helipad area.
The night shift starts at the peak of chaos in the ED. Our night shift starts at 1900. The transition of patient care sometimes becomes impossible. As we arrived in the ED, we try to clean the day shift issues. At this time of the day, the majority of the population is not very sick, but the volume of patients in the ED is pretty high. At the beginning of the shift, we perform a role of a primary care provider, in addition to handling real emergencies which include strokes, endocrine, or neurological, cardio-respiratory or GI. Real emergencies are only 20% of all visits.
The night shift starts at 1900 and the hospital cafeteria closes at 1900 too. Thank God, Dunkin Donut (DD) is inside the hospital vicinity that closes around 8 pm, then reopen at 0400. The night shift staff cannot afford to go to the Starbucks run because it is out of the hospital boundary. The most near SB closes at 10PM. Does anybody have time to get the coffee while everybody is busy? Both DD and SB don’t have the idea how much money they are losing by not serving coffee to the night shift staff. Sometimes, one of us will look at the clock and remind us, “oh my god it’s already midnight”. All of us take this reminder in a positive way, “DD will be open soon”. Aroma smell of coffee and donuts remind us like we have sat in heaven and talk to God. However, nobody has time to get the coffee when DD opens. Of course, this is the prime time for the ED staff handling “The golden hour” of trauma patients. All local clubs and pubs get closed at 0330 AM. so, we are ready to receive all GSW and MVA due to drunk drivers, and of course, overdosed patients. As soon as we have done working with the ‘Golden hour Rule’ patients. We get busy to attend wake-up calls from the nursing homes and homes which includes the stroke patients or broken limbs. Sometimes, we tell the paramedic,” Can you just stop somewhere to get coffee while the siren is still on”.
However, in reality, everybody gets busy. I have seen the staff members working hard as “do and die mission”. It makes me happy to see the staff still has compassion and passion. They still have empathy and sympathy. The night shift staff treat each other as a family. Anything happens in your personal life, your co-workers will know first than your family. During the day shift, our colleagues get hot and grilled food. Of course, the kitchen staff ensures that night docs will be taken care well too. So, they don’t hesitate to fill the fridge with ham and turkey cold sub sandwiches. They never forget leaving us a tray full of fresh baked cookies and chips. The fridge will be overloaded with the coke and Pepsi bottles. However, I hardly notice if there is any cold milk or healthy drinks in the fridge.
Finally, our medical director was able to convince the hospital administration to buy an espresso coffee machine. Instead of keeping the coffee machine in the emergency room, the administration has decided to keep the machine into the main doc Longue which is at least 10 minutes away from the main ED. We are only two at the night time and cannot leave the department. Unfortunately, only two of us have access to the lounge. Giving your badge away to get the cup of coffee is strictly restricted. How important is 10 minutes for one patient, only ED staff could tell that? How many times the primary care doctors come to make the round in the middle of the night, so why coffee machines has kept in the main lounge? Not to mention, sometimes that Nescafe espresso machine is broken itself and sometimes stressful and impatience people have broken the machine. It means next day, there will be no coffee at all. But we will get a nice household education memo. In the memo, all instructions would be written such as “Nobody forgets to mention how expensive is the machine and how much it will cost to repair it, and how it would impact our annual budget”. However, nobody dares to instruct us how we will manage the coffee during night time.
Of course, nobody has time to take a break. We share food with each other. Pizza is very friendly which is also delivered at any time. Fast food is not a problem anymore since Doordash, Uber start delivering the food at low delivery cost and at any time. Who cares about the nutritional value of the food when you are hungry? It often makes me laugh sometimes when after eating a pizza, you go to the patients telling them about the DASH diet. Most of the night staff are a smoker. They need at least 5 minutes breaks which we allow them to take it. Sometimes they don’t want to take a break being busy. of course, charge nurse makes them go. Or, I get out of my chair and yell at the charge nurse to send the staff for their health necessity break. That is very important for the smoker to take the break for the safety of the rest of the staff. I tell everyone the specific person is busy taking their respiratory treatment if someone asks for a specific person. We don’t use the smoking word because our facility is a smoke-free facility.
We don’t get fussy and cranky patients all the time. We do get the patients who come high with an illicit drug overdose, and escorted by at least 15-20 people which includes firefighters, paramedics, and cops. Do we need all additional people in addition to ED staff and our security staff? Definitely yes, we need them. Our ED looks like a war zone more than an emergency room at that time. After securing the patient, Cops also look for a cup of coffee. Sometimes, the local cops come to the ED to use the restroom. We have planned many times to make them pay for using our bathroom. We tried telling them many times, but they will never bring the coffee, instead, they will look around if we have the coffee.
Day shift staff always jealous of us why they don’t get a fun time. By the time the day shift staff reach, our funny patients are already sedated and sleeping soundly or they are already in the withdrawal phase which is not funny at all. So, this is the only time our job is stress-free. Most of our patients are well known to us. They know our names. Their demeanor becomes so nice as intoxication starts to wear off. Believe me, those people respect the ED staff a lot.
My boss starts to hate me exactly at the same time whenever the coffee machine breaks. I am not sure how he knows early in the morning that the coffee machine is broken. Of course, he doesn’t have any problem with the broken machine. Night shifts crew suffers. My boss thinks I always end up breaking the coffee machine. I am failed to make myself understand that why the heck I will break the coffee machine when I am a big-time coffee lover. he will announce to fix the machine as soon as possible before I say something. He knows well the coffee is life for night shift staff and I will continue to remind him until the machine is fixed.
At the end of the long 12 hours shift, most of the staff become grumpy which I have given the title of “homicidal and suicidal thoughts without the food and coffee”. Everybody asks me why I am not being frustrated and why I am making a joke. I always have one response, “I am immune to the stress and frustration because I was born in the emergency room”. Of course, there is no mother at home who would eagerly wait for me with a hot breakfast. So, I end up eating the children’s junk food. Of course, I know their metabolism is totally different than mine. Everything goes down the throat when you are hungry. Who we should blame now? So, working night shifts is not a cup of tea for everybody. It asks a lot of sacrifices. It will be a challenge for me while I will be on the day shift as of mid of July. I will miss all the fun. I have signed my new contract on one condition if I could not function on day shift, I will be transferred back to the night shift.