Sunday, April 17, 2005

heart of darkness

Hey, that sleep mask really works! I didn't sleep quite as much as I would have liked (which, these days, is about 10 hours straight, though I can rarely swing that)--but still, 5 hours is an admirable block of sleep for the middle of the day. Never mind that Joe walked into the bedroom and started laughing at the sight of me with my giant 100% light blocking apparatus on my face. Though I don't know what's so funny, the kind of stuff that they make their patients wear over their eyes is far more embarrassing.

And so I have begun another week of working the night shift in the ER. There's a definite rhythm to the night shift, and it's broken up into discreet, predictable blocks.

8pm - 11pm: The After Dinner Specials
"Hey kids, we've all had dinner, we're all still awake, what say you we take a big family trip down to the emergency room for no sound medical reason whatsoever?" "Yeah! Great idea, dad!"

11pm - 2am: Baby Mama Trauma Drama
Now that the weather is starting to get warmer and people are starting to get a little more...rambunctious...every single chart that lands in the box between this time period is some sort of trauma. Lac repairs, car accidents, and my personal favorite, kids falling off of things. Last night, I think every single kid in the neighborhood under the age of three fell off of something high. Fell down the stairs, fell off the bed, fell off the bed at the top of the stairs. Which teaches me an important lesson about parenthood: keep your kids strapped down to the floor with heavy nylon cords at all times.

2am - 6am: The Auto-Triage Zone
I don't know if this is as true for the adult ER, since it always feels like a zoo in there, but in the Peds ER during the non-winter months, this is a relatively quiet stretch of the night. Basically, the early hour weeds out all the actual healthy patients (which for us, feels like about 75% of the patients we usually see), and those kids who actually do make it in to see us are usually legitimately sick. Unfortunately, it's kind of hard to evaluate these kids sometimes, because when the parents tell you at 4am that the kid is "acting sleepy," you can't tell if he's septic or just normal.

6am - 8am: The End-of-Shift Gold Rush
They're somewhat sicker than the After Dinner Specials, but weller than the kids who come in during the Auto-Triage Zone. Maybe their parents want to squeeze in a quick visit to the ER before work, or they have a fetish about coming to the ER in their pajamas. Equally frequently, they're also the frequent flyer/chronically ill patients that know enough of what to do for their kids overnight, but also know that they will have the shortest wait time if they come into the ER before 8am. Unfortunately, this is also the point of lowest work motivation for overnight ER staff. Couldn't you have waited 45 minutes more before coming in, AFTER my shift ended?

(When I was working the day shifts, I also noted a block prior to The After Dinner Special that I call The After School Melee. This is when we see all the neighborhood teens come in with all bruised and bloodied because they got jumped after school. And not just guys, either. I've had more than a few girls coming in after getting mauled by what sounds like some roving all-girl gang, like something out of "Faster, Pussycat! Kill! Kill!")

Well, that was fun. Gotta go get ready for work now.

Currently craving: This is a real Chinese People thing, but I can't get enough of those Ching Kee Cookie Rolls. They're like these eggy, flaky, tube-shaped tea cookies, and they make more crumbs than any other cookie on the planet.

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