Time and time again, I hear references in our ER about how our crazy, hectic pace is tied to the cycles of the moon. "It must be a full moon," people say, as if every explanation to being overwhelmed and underappreciated in the ER is somehow aligned to that beautiful bright, glowing circle of wonder that hangs over our heads several evenings a month. I remember driving home many a nights, though, from an ER shift where I've gotten a spanking, only to look up and not find the moon guiding my way.
The other reference? Warm, hot weather. "It is so nice outside today," some staff will say, "it's no wonder we're getting slammed." Again, the thought is that warmer weather promotes more outdoor activities and more buzzing humans which, in turn, promote an increase chance of injury or illness. We do live on a lake, yes, but I can't even remember the last trauma I've had that involved a water-sport activity. I do remember, though, the numerous heart attacks that were a result of patients shoveling three-feet of snow during our cold, windy winters.
After four years of being a resident and thirteen years of being an attending, I have learned that there is only one truth about an emergency room's busiest moments.
Are you holding on to your hats? Ready for the big revelation?
The truth is...there is no rhyme or reason to when the ER might be busy.
Most people assume that Fridays, Saturdays, and Sundays are the worst days to visit an emergency department, that we are at our busiest. Honestly, though, in our ER, Mondays are panning out to be impressive for both the long waiting-times and the quantity of patients coming through. And Tuesdays are coming pretty close to Mondays' craziness. The thought that an ER is less busy in the winter months compared to the summer months is just that--a useless thought. And morning times are supposed to be less congested than evening and night times but, again, I wouldn't hang my hat on that. Many times, I've come in for a morning shift only to find the ER clogged with waiting patients.
So, this is the reality. Every time you go to an ER, you just don't know what you are going to find. It may be slow on a Friday night, and it may be crazy at 3:00 a.m. on a Wednesday morning. But another truth? It is what it is, plain and simple, and a patient yelling and carrying-on about his long wait will not get him seen any sooner. Louder does not make you flow through our system any quicker. Nor does it make you any friends. And calling your family doctor, the one who promised that if you went to the ER 'it will be a quick visit', will not push you further ahead in the waiting line, either. Sorry. That is something you'll need to take up with him.
I'm very matter-of-fact about the whole thing. And I'm certainly not complaining. I signed up for this job, as did the rest of my comrades, and we will all continue to do our best and give 110% of ourselves. We always do. Sometimes, though, on some of the worst days, I wish I had a magic wand to wave over our backed-up ER and start anew.
A few shifts ago, I arrived to work my evening shift (from 6 p.m. to 2 a.m.) only to find that there was a four-hour wait to be seen and approximately twenty-five "angry" patients hanging out in the waiting room. Soon after, unfortunately, we got a motor-vehicle accident with four trauma victims brought to our trauma center for life-saving treatment. As you can imagine, this pushed the number of waiting patients and the waiting-times even further back. Add in the occasional stroke patient and cardiac patient, and you can see where this shift was heading. Despite having 36 treatment rooms and a full staff, we were extremely busy. Organized chaos, I always call it.
By midnight, the wait time was almost six hours. Thirty-five people were still waiting to be brought back to a treatment room. I was told the waiting room was becoming a potpourri of angry incidents. People were starting to lash out. Besides getting our security team and the police in place, what else could we do but keep plugging along.
You know how it feels to return to work after a week or two of vacation and see the pile of work awaiting your return? I think I would liken that feeling to how we all feel during a shift like this. The workload was endless. Despite our best efforts, it was simply one step forward and two steps back.
But, as I knew it would, 2 a.m. did arrive. It was my time to go home. But did I? Hell, no! For the overnight, our ER had one of my partners and one PA scheduled. Hardly enough man-power to provide care. I checked out the patient-waiting list. We were now 38 patients behind. UGH!
I stayed for three extra hours. I could never leave a sinking ship no matter how tired I was or how much I had been kicked around already. By 5 a.m., however, our waiting time was down to three hours and there were only 15 people waiting to be seen. The new, fresh morning team would be in at 6 a.m. And I was at a lull between waiting for results to return on my current patients and for the nursing staff to bring back more new patients.
It was the perfect time to escape.
I found my partner and asked him if he was okay...if he needed any help with anything. He didn't. He graciously took my sign-outs and before I knew it, it was 5:15 a.m. and I was driving home.
I opened up all of my windows and my sun roof and enjoyed the brisk nighttime air as I drove along the lake. Minutes later, I drove by a Tim Hortons and did a u-turn. I parked the car and ran in and got a dozen of my kids' favorite doughnuts for when they woke up in an hour to go to school. If I couldn't be a hero to 38 waiting room patients, I would sure be one for my kids.
As I walked out of the doughnut shop, I looked up. And there it was, glaring right at me--the sky's full monty. Suspended in the clear, dark night among some twinkling stars, the moon and its glow hovered over my every step. I was in a short-sleeve shirt and felt the swirling warm breezes of the night immerse me in their embrace.
That quickly, my center was reset.
Okay, I'll give. Maybe there is something to this full moon and warm weather business after all. Yes, it was warm. Yes, there was a full moon. And, finally, yes--the ER was swamped with patients. That was probably the busiest I've seen our ER in a while.
But, at least it wasn't a Friday, Saturday, or Sunday...
Hey all. I'm working a string of six shifts and it has been crazy-busy, so I'm sorry for skipping Wednesday and today's late posting. I'm whooped and go in for the last one tonight. On a good note, I spotted another double-crack last night! Yes, two in that many months!!! But, no pic...no can do...LOL. As always, thanks for reading. I hope your Memorial Day weekend is a safe one spent with those you love. See you next week.