Busiest shift I've had

[ChrisPAinED]

I currently work both at a rural ED and at a sister hospitals ICU (way bigger hospital) 

I was working the Rural ED a couple nights ago and had the most hectic night. I want to know about your most hectic day working as a PA. 

 I came in at 1800hrs and we only have 16 beds in the ED. 1 mini trauma, 2 resus, 4 inpatient/supervised rooms, and 9 fast track rooms. Had the trauma and a resus room occupied and all the fast track rooms.

 

Rural hospital again so any really critical patients typically transfer to our sister hospital but even with that being said we had a Vent in resus that was pre hospital arrest with ROSC having some atrial tachycardia and then had a walk in pt with a head trauma and had a very large hematoma on the side of the brain that was having seizures during day shift also waiting to transfer. Several other work ups in fast track and pair it with another Cardiac Arrest that came in later that night. Just 1 MD and I working ED so we even had the 1 hospitalist working the floor come down to help. It was insane total of 19 patients I saw that night. 

My fault for not realizing it was a full moon before scheduling that night shift. What was your busiest shift you remember? 

[EMEDPA]

Busiest? 60 pts in 12 hrs. This was in the days before EMRs with paper notes. Most ever was in Haiti. 100 pts in 6 hrs with charting on 3x5 cards. 

Highest acuity? back to back codes with lifeflight bringing me one who coded enroute to another place(only has happened to me twice in 37 years working in the ED), followed by an uncomplicated delivery at term, followed by a bunch of traumas, one who jumped off a 4th floor building on purpose thinking he could stick the landing. Meth talking. He didn't stick the landing. Also gave TPA to a 40 yr old with a stroke. Ugly. 

[ChrisPAinED]

@EMEDPA

Wow that's insane! 

I've really only worked mostly rural ED and the little I did at university we had patient caps and my ICU position went have patient caps I've never had that many in a shift because of how slow everything is during the night. Order a CXR that's about 30-45min before they even come to do the CXR and about 1.5hrs before a radiologist reads it unless it was Stat. The most patients I've had in a night was 37 in 12hrs but I was only doing fast track that night. 

[KuchiKopi]

I'm pretty new at it and I work in a pretty rural ED but still see about 30 a day with 10 beds. Single provider with a Hospital NP upstairs and only a general surgeon on call if needed. Just going to go with my last shift, and saw 46 last 24 hr shift (really came in from 1000 to 0200). One code, one motocycle accident (bravo that that needed sedated for a couple reductions and then transferred), and a traumatic bilateral brain bleed were the 3 that I really remember. We generally see pretty high acutity and shifts like that are not all that surprising. Centrals and intubations are pretty common. Praying for a smooth 24 tomorrow. 

[DiggySRNA]

On 9/4/2024 at 9:10 PM, KuchiKopi said:

I'm pretty new at it and I work in a pretty rural ED but still see about 30 a day with 10 beds. Single provider with a Hospital NP upstairs and only a general surgeon on call if needed. Just going to go with my last shift, and saw 46 last 24 hr shift (really came in from 1000 to 0200). One code, one motocycle accident (bravo that that needed sedated for a couple reductions and then transferred), and a traumatic bilateral brain bleed were the 3 that I really remember. We generally see pretty high acutity and shifts like that are not all that surprising. Centrals and intubations are pretty common. Praying for a smooth 24 tomorrow. 

I love seeing this because I remember a few years ago you were applying to PA school!!! I don't even know you but just wanted to share my excitement haha.

[ChrisPAinED]

On 9/4/2024 at 9:10 PM, KuchiKopi said:

I'm pretty new at it and I work in a pretty rural ED 

Welcome to the team  

[EMEDPA]

On 9/4/2024 at 6:10 PM, KuchiKopi said:

I'm pretty new at it and I work in a pretty rural ED but still see about 30 a day with 10 beds. Single provider with a Hospital NP upstairs and only a general surgeon on call if needed. Just going to go with my last shift, and saw 46 last 24 hr shift (really came in from 1000 to 0200). One code, one motocycle accident (bravo that that needed sedated for a couple reductions and then transferred), and a traumatic bilateral brain bleed were the 3 that I really remember. We generally see pretty high acutity and shifts like that are not all that surprising. Centrals and intubations are pretty common. Praying for a smooth 24 tomorrow. 

most places with that kind of volume have gone to 12 hrs shifts and/or double coverage.