A Typical Day in the ED

Ok, let’s start with the most important thing. There is no ‘typical day’.

There are certain tasks that are typically done every day, but every day is unique. This really struck home over the weekend where I ended up working 4-12 hour shifts over 4 days.

Day 1 doesn’t really stand out in my mind. I started in C-zone (where things are relatively quiet) and acutally had time to take some notes and work on some other items. I was eventually moved to B-zone for the final 8 hours. Here I was definitely busier.

Day 2 was both easy and hard. It was easy because my tasks were fairly well defined. It was hard because it’s both physically demanding as well as requiring one to juggle a lot of requests all going on at once.

I was tasked with “55 Phone”. This means I have to carry a phone (you can guess the last two digits of the phone number) and my job is to transport patients to/from various parts of the hospital. For example, it may be taking a patient from an ED room to the CT scanner (a short trip) or to MRI about 1/5 of a mile round trip. Or, for the first time for me, take someone to Nuclear Medicine, which is about as far away as one can get in the hospital without going outside. That trip is about 1/3rd of a mile round trip (and I did it twice, once to drop them off and once to later pick them up.)

I’m one of the strange techs who actually doesn’t overly mind doing 55 Phone. I did it for my entire 12 hour shift (which is really uncommon, most techs will do it for 8 hours or less). First 4 hours however was slow and I had a lot of fellow techs offering to help. But there weren’t many requests to move folks. Then the second 4, there were fewer techs on duty and the number of requests started to back up. Inevitably the phone won’t ring until you’re half-way down the main hallway with a patient. Now you’re trying to move the patient while answering the phone and then writing down whatever the request is (one of the top rules, write everything down, you’ll forget otherwise!). Sometimes while you’re on the phone another call will come in! So there was about a 1 hour period where I simply couldn’t catch up and I had no available help. Then my third 4 hour stretch started and I noticed things started to improve. Well unbeknownst to me, a “transporter” had arrived on his shift. Their job is to help transport patients. While in general we appreciate the transporters, this guy really works at it. He had already done three ‘upgrades’ (moving a patient from the ED up to their room elsewhere in the hospital) before I even knew he was there. So the final 4 hours was relatively easy.

Day 3 I started in B-zone for the first 4 hour. At the start of the 5th hour, one of my fellow techs who I started with orientation with (we did our classroom work together, so I got to know him then) and who is, mostly due to scheduling, technically still on orientation was assigned 55 Phone. So I was asked to sort of shadow/back him up. After the first hour it was obvious he had the hang of it, so we basically would tag-team each other. I ended up putting another 8 hours in for 55 Phone. So in two days I had down 20 hours of 55 Phone! I certainly burned my calories those days. This day we had 12 techs on duty for a period. (Ideal staffing is 11, we rarely if ever actually achieve that!)

Day 4 was the most atypical. I started in A-zone backing up another tech. A-zone as I’ve mentioned is where the traumas come on. This means that at least one “red-badged” tech has to be on duty. Red-badged techs have gone through training and been checked off to help on traumas. I’m not one yet (though went through the training yesterday and have just a few things to check off on to get tehre). Sure enough we had two patients come into the trauma bays. Since they weren’t technically Level 1 or Level 2 traumas, I was doing a lot with them. But the work was relatively easy and at one point consisted entirely of simply sitting with one of the patients, talking. Finally I got swapped into B-zone so the red-badged tech there could take over for the one going off-duty in A-zone. Unlike the previous day where we had plenty of techs, now we were down to 4 for most of the day. I was at this point the only tech in B-zone. I had literally just logged into my workstation to see what needed to be done when I got called into 3 “Code Browns”, one after another. For the day I ended up at total of 5 or 6 (I literally lost track) and helped nurses with two Foley catheter placements. Note that prior to then if I had done a single code brown a week, that was busy and I’ve only helped with a total of two Foley catheter placements up to that point. So to say that Sunday was unusual would be an understatement. It was literally 4 plus hours into my stint in B-zone before I was able to sit down at my workstation and see what other stuff had to be done.

Most of the rest of the shift was relatively “normal”, or as normal as anything can be. That said, shortly before I left, the attending asked me to help transport a pregnant woman up to Labor and Delivery with the L&D nurse. Typically this would be a 55 job (see above) but 55 was busy and they really wanted to get her up there right away. It was, thankfully uneventful and even in a sense sort of an uplifting way to end the day that way.

Oh did I mentioned 4 12s in a row? Well on Day 5 I went in for Red Badge training and since I was there, figured I’d pick up another 4 hour shift from 3:00 PM – 7:00 PM. This was again in the A-zone. For the first 2 hours there was literally nothing to do. Then the last 2 hours was extremely busy taking in patients, doing EKGs and more. In fact about 5 minutes before I was ready to check out, I saw that the patient in the hallway I had just done a repeat EKG on and that the attending had remarked the EKG looked unusual had been moved into a room where he could be better monitored, so of course I went in and helped the nurse get him setup in there.

So, there you have it, 5 shifts in the ED, all very different from each other. So no, no typical day.

1 thought on “A Typical Day in the ED

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