Night-time in the Emergency Department.

Last night I shadowed an Emergency Department (ED) nurse at the Brigham and Women’s Hospital in Boston and learned that a sense of humor goes a long way.

The Emergency Department (ED) of the Brigham and Women’s Hospital is slow tonight. The ambulance bay is empty and inside the hospital all you can hear are the beeps of the machines and the coughs of a patient in her curtained off room.

That, and the sounds of the night-shift doctors and nurses teasing each other shamelessly.

“I’m getting looks because I have a cute girl following me around,” says Brad Boehringer, a 33-year-old nurse who works in the ED. He looks across the room, over the bank of hospital staff work stations, to a few female nurses giggling in his direction. “I don’t mind,” he says smiling at me.

I met Boehringer in the ED waiting room at 8:30 pm. Though he’d already been working for two and a half hours, he was enthusiastic and upbeat, his dark brown curls falling down around his bearded face. The key is to find humor and co-worker teasing opportunities everywhere, not just in female journalist-shaped shadows.

Is one of the assistant nurses spending too much time next to the juice fridge? Call him out. Notice someone lounging back in a chair with dark circles under her eyes? Start the endless stream of WHAT-were-you-doing-last-night?-type questions. How else to stay entertained when there are no patients to look after?

Well, not no patients. Boehringer discharged three patients right before I arrived (a happy coincidence) and the next two he received were pleasantly low maintenance– a woman with nausea and a young man whose foot was still sore from the half-marathon he ran over the weekend. Exciting stuff.

After hanging an IV for the nausea patient, Boehringer walks down to the automated drug dispensing machine to get her medication. The machine, a giant fridge with a computer screen and keyboard on the front, looks like it has a high potential for error. Type in the name of the patient, the name of the drug and presto! It appears behind the fridge door. Type in or select the wrong drug on the touch screen and the wrong drug appears behind the fridge door. I ask Boehringer if he’s ever messed up before.

“Pff, course,” he says, scrunching up his face with a snort. “Daily. Wait. Messed up like given the wrong drug?” Yes. “Hmm . . . maybe,” he says, pensive and sedate.

It’s an interesting dichotomy. Everything outside of the patient’s rooms is so hilarious because what goes on inside the rooms can be truly, deeply unfunny. Of course, the line between funny and unfunny is in a slightly different place for people who work with trauma every day.

Later on in the night, the quiet in the ED is temporarily broken when a patient suffering a through-and-through gun shot wound is wheeled in by the paramedics; police, detectives and various specialists trailing behind her.

Two female doctors from orthopedics, waiting to see if they’re needed, giggle to each other outside the curtained off room, and though slightly disappointed that no bones were hit, they laugh their way back out of the ED.

A second trauma victim comes in after midnight, this time an old man with several broken ribs poking into the purple tissue-thin skin around his chest. As the nurses review their notes, they laugh amongst themselves about the doctor who asked the patient “what the hell were you thinking?” when he found out the man was behind the wheel when he suffered his injuries. He collided with a bus.

It may seem almost morbid to keep laughing amidst trauma, but it keeps the ED from feeling like the gloomy, cave-like place it is. And upbeat staff surely leads to better patient care. It means that after seven hours on the floor and seven more to go, Boehringer still has a smile for the patients that come through the door.

Just before I leave at around 1 am, the paramedics wheel in an old woman from a nursing home. She fell and broke her hip, and as the paramedics relay her history, it comes out that she previously broke the other hip.

“So she’s trying to even things out?” says Boehringer to laughter from the paramedics as they all grab corners of the blanket under the patient and hoist her into the hospital bed.

Luckily for everyone, even when it’s late and slow, Boehringer et al.’s good sense of funny keeps the ED from feeling so dead.

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5 thoughts on “Night-time in the Emergency Department.

  1. Pingback: Life-Affirming S*#t. « The Human Side of Hospitals.

  2. Pingback: S#*t That Backs Up The ED. « The Human Side of Hospitals.

  3. Pingback: A Non-Emergent Case. | HealthcareLiterate

  4. I totally agree! It really helps to have humour to lighten stressful situations. It is interesting to read about the blogger’s experiences following the nurse….

  5. Pingback: A Watched ED Never Boils. | HealthcareLiterate

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