It’s almost 11 p.m. on Monday in the University Hospital waiting room, and things seem to be quieting down. Suddenly, a woman who was wheeled into to the waiting area starts to have a seizure.
Staff members put down what they are doing and urgently rush to assist her. She is immediately wheeled into the emergency room.
Casey Jowers, a third-year resident from Jackson, Wyo., is graduating from his residency and is on his last night shift in the emergency room. He has seen patients with seizures before and knows what to do.
In addition to seizures and crisis patients, the E.R. sees more alcohol-and drug-related accidents and gunshot and stab wounds at night, said Rachel Burgio, a nurse who has worked in the U Hospital emergency room for six years.
Every year, there are two peak trauma seasons — one when ski season starts and another when the weather warms up and people are using off-road vehicles.
The busiest times in the emergency room are generally between 10 a.m. and 10 p.m., although the night shift has been busy lately, Burgio said.
Instead of spending his last night in the E.R. quietly, Jowers is cautiously watching his back. Not only does he have to make sure patients are given the best care, but he is also keeping an eye on fellow E.R. night staff members because he suspects the night staff will play a prank on him.
“It’s my last night, and I’m paranoid that they’re going to do something to me,” Jowers said, laughing. “They’re just like your family. They will sneak up on you and get you.”
Jowers, whose favorite hospital show is the comedy “Scrubs,” said a real-life E.R. is similar. Pranks and jokes are sometimes common among staff.
“(The E.R.) is difficult,” Jowers said. “We deal with unexpected deaths and patients falling through the health care system. We try to keep our spirits up because it is sad.”
An occasional joke or prank helps staff get through those hard times, and after being together for so long, they develop close relationships, he said.
Burgio, who is often teased for being a “hardass” by fellow staff members, said the staff has saved countless lives because they are so team-oriented.
“This is a big deal because we all get close like family. This is his last day,” Burgio said of Jowers. “We brought him up since he was a fetal resident and brought him up on our own.”
Burgio’s goal was to make it through the night without crying.
Occasional disturbances or tense moments can test the staff’s close-knit team.
Just before midnight, more than a dozen staff members hear a crash and a patient is heard yelling down the hall. Security officers and hospital police rush down the hall, and minutes later, the patient is escorted out of the facility in handcuffs.
The patient, a middle-aged woman, was being treated in one of the three designated rooms that monitor patients who could have psychological problems. As she was being evaluated, the patient became restless and suddenly hit one of the nurses on staff.
Rob Andreason, a public safety officer, is one of a number of security officers in the E.R. These officers work in the E.R. to protect staff, but they also want to prevent violent or suicidal patients from hurting themselves.
“We work with police to try and keep a safe and peaceful environment here for both staff and patients,” he said.
Anna Heaps, a clinical social worker in the E.R., said many of the patients coming in at night are homeless, especially in the winter. Some patients are mentally ill and need assistance while others might just want a comfortable place to stay for the night, she said.
“I have to judge who is valid and who is just looking for a place to stay,” said Heaps, who has worked in the E.R. for more than two years.
Language barriers can be another hurdle for Heaps and other E.R. staff members. Heaps does not speak a foreign language, which is a big challenge for a social worker who has to make critical evaluations, she said.
Using an interpreter is helpful, but that also has complications because a social worker must try to determine if someone is telling the truth or are not being completely honest because they do not want to be forced to stay, Heaps said.
“Asking questions like ‘Are you suicidal?’ or ‘Are you going to act on that if you leave here?’ are difficult with an interpreter because reading body language is important,” she said.
Burgio said there is no typical night in the E.R., and she could not think of a specific case or incident that was particularly memorable.
“Every night we do something memorable,” Burgio said. “When we have a sick patient, we all come together, and we’ve saved countless lives as a result. We work as a team, not as individuals.”
Carlos MayorgaCasey Jowers, a third year resident in emergency medicine, and Monique Roper, a registered nurse on the night staff at the University Hospital emergency room, check over a patient’s records Monday night.