The overnight shifts in the emergency department.

I would have to say that I like the overnight shifts. There are many reasons why I like these shifts. The administrators are missing in action, they only work from 9:00 - 5:00.  It is a "when the cat is away" situation. Also the patients that come in to the ED are often interesting individuals. You still get all the life threatening illnesses but sprinkled in with the real emergencies are these fantastic characters that come out of the woodwork. You really can't make up these stories. It is a "real life is stranger than fiction" situation.

The other night I had an interesting patient. She drove herself to the ED on her hovearound scooter that was paid for by her public aid money, also known as tax dollars. This was a lady in her late 40's that weighed about 380 - 400 lbs and had been smoking since she was 9 years old. She was on disability and received disability funds. She assured me that she in fact had her last cigarette on her 3:00am scooter ride into the emergency department. Never mind that she asked if she could go out for a smoke 30 minutes later.

I asked the patient what her life threatening emergency was and she explained that she "felt winded"and could not fall asleep. She did not have any immediate life threatening emergencies but because she came to the ED we had to work her up and make sure there was nothing acutely going on. She demanded meals, drinks, warm blankets and something for her pain. I explained that chain smoking for 40 years can make anyone winded and that large consumption of nicotine and red bull will make it difficult to fall asleep. After running some tests and lab work and making sure she was not having an emergency I discharged her and she reluctantly went back to her scooter chained to a tree in the parking lot and rode home.

Although this case is pretty sad on so many levels, it makes the night shift a little more interesting.