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 fun as shown in the TV shows, but the reality is totally different. I have tried many times 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 become impossible. As we arrived in the ED, we try to clean the day shift issues. This time the majority of the population is not very sick, but the volume of the ED is pretty high. At the beginning of the shift, we end up doing a primary care providers job 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 hospital cafeteria also closed at 1900 exactly at the same time when the night shift starts. Thank God, Dunkin Donut (DD) inside the hospital close at 2000, then reopen at 0400. The night shift staff cannot afford making the Starbucks run because it is not in the hospital boundary, but nearby SB also closes at 2200. Who has time going to get the coffee while busy in the ED? Both DD and SB don’t know how much money they are losing by not serving 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 that reminder as a positive way, “DD will be open soon”. Aroma smell of coffee and donuts remind us just as sitting in heaven and talking to the God kind of thing. However, nobody has time to get the coffee when DD opens. Of course, this is the prime time for the ED handling “The golden hour” of trauma patients. All local clubs and pubs close at 0330 AM, so we are ready to get all GSWs, MVAs due to drunk drivers, and of course, overdosed patients. As we have done with the Golden hours, we get busy with wake-up calls from the nursing homes and homes which includes the stroke patients or broken limbs. Sometimes, we tell the paramedic,” don’t you guys just stop somewhere to get some coffee while the siren 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 and they still have empathy and sympathy. The night shift staff treat each other as a family compares to the day shift. Anything happens in your personal life, your co-workers will know first before your family.
During the day shift, our colleges get hot and grilled food. Of course, the kitchen staff will make sure that night docs are taken care as well. So, they won’t hesitate to fill the fridge with ham and turkey cold sub sandwiches. They won’t forget leaving fresh baked cookies and chips. The fridge will be overloaded with the coke and Pepsi bottles. However, I hardly notice if 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. However, the machine is kept away in the main doctor’s lounge instead of the ED doc lounge which is at least 10 minutes away from the main ED. We are only two at the night time and cannot leave the department and 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 doctors came to make the round in the middle of the night, so why coffee machine in the main lounge? Not to mention, sometimes that Nescafe espresso machine is broken itself and sometimes stressful and impatience people has broken the machine. Next day no coffee at all but we will get a nice household education memo. In the memo, all instruction 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 times. 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 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 is a smoker. They need at least 5 minutes breaks which we allow them to take it. Sometimes they don’t want to go being busy of course charge nurse makes them to go. Or, I get out of the 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, 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 to 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 shifts always jealous of why they don’t get the 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 comes to know 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 understand that why the heck I will break the coffee machine when I am a big-time coffee lover. Before I say something, he will announce to fix the machine as soon as possible. He knows well the coffee is life for night shift staff and I will continue to remind him.
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 frustrated and still making a joke. I always have one response, “I am immune to the stress and frustration because I was born in the emergency room”.
As I reach home. 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 from me. Everything goes down the throat when you are hungry. Who we should blame now?
So, working night shift 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 to the night shift.