Whaaa?

Day shift and night shift in an ER are vastly different in many ways. Both have their pros and cons, although obviously I'm a little biased towards nights. I think the night shift staff rocks so hard it's like a hurricane, and I've got no plans to abandon them for days any time soon.

But there are some times where I go, "holy crap, this would never happen on nights!" and get a little jealous.

I recently worked a night shift and agreed to stay over for a few hours since the day shift was shortstaffed. My first patient at 0700 was a gastric band patient who was having some trouble. Apparently, he had called the surgeons office to seek advice. The surgeon happened to be there, and told him to go to the ER and he would meet the patient there.

Now see, this happens often on nights. Except the doctors office says, "go to the ER, the doctor will see you there." And it's 5 pm on Friday. The patient shows up at triage, gets a number, and sits for three hours in the waiting room. They get back to my treatment room, irritated to the max. They tell me the doctor told them to come here and they'll get admitted. I look at them and sigh, because I know this story all too well.

But back on day shift, I'm standing in the patients room at 0703 getting his history. He tells me the surgeon told him to meet him there, and I don't even have time to think about raising my eyebrows before the surgeon walks into the room with an admission order sheet and tells the patient he'll be admitted and going to surgery that day.

I had to scrape my jaw off the floor. I hadn't even drawn labs. Hell, I hadn't even charted anything on this patient yet. If it hadn't been a lapband patient, I think the surgeon might even have brought him a cup of coffee. This never happens on nights. Ever. We get to fight for two hours to get a consult, then the doc comes in all bleary eyed and cranky and then complains that we're admitting someone. No, my friend, not on day shift.

Triage to surgeon consult to admission time? 17 minutes.