April 12, 2007, 3:40 pm

Workin’ On the Night Moves


Well, well!

I guess they had concierge medicine in the old days, too!

Can’t imagine they’d advertise on back tires these days.

But…the doctor is making a house call!

$29.00 for deluxe drugs sounds like a deal to me.

“Deluxe” probably meant instead of a basic, generic run-of-the-mill “mustard plaster”, you could get a “Grey Poupon mustard plaster”.

With a pickle.

Blue Cross would only reimburse $3.67 of course, so the rest would be out of pocket.

They don’t cover pickles.


Man, you know you’ve been blogging a long time when you have to google something to see if you’ve used the title before.


Where do you go when you want stimulating, up-to-the minute news on nursing issues and poignant patient care anecdotes that remind you of why you went into nursing?

Not here, that’s for sure.

I’m exhausted.

But, I am also a trooper. I said I’d blog daily and I shall!


Is it just me or has the night shift changed over the last decade?

In the days of yore, the night shift had a certain ambiance.

You would enter the land of bright lights and dive into the full-department chaos of the evening shift.

The goal: clear the department out as fast as possible.

By 0200, the department would be empty. The next patient would come in around 0530 or 0600.

There was time to read all the latest nursing journals, discuss nursing issues with your colleagues, discuss the various ways of improving the unit, updating all policies and procedures, debating the merits of JACHO and conducting staff inservices to keep each other abreast of the latest in nursing research.

Not that we did any of that.

Usually we would just balance our checkbook, read the latest bestseller, crochet (man, I made some killer afghans!), gossiped and ate our way to wakefulness.

If a patient did come in, they needed to be there and we were all over that case as a team until the patient was admitted or discharged.

At which point we would resume our pre-patient activities.


Things have changed.

Someone, somewhere told John Q. Public that we were open 24/7.

The department is still cleaned out by 0200.

But now the hits just keep on comin’!

Slowly they dribble in.

Patients with sore throats for five years. Patients with chronic alterations in their comfort level who have realized that a 0400 visit means no waiting. Patients we see so often we know their medications lists by heart.

Adults who vomited. Once. Ten minutes prior to arrival.

Acute soul-crushing toe trauma.

Extremely high fevers of 101.0 that, doggone it, keep coming back after the Tylenol wears off.

And then there are the really sick, the ones who absolutely needed to come in to the emergency department. For them it is the difference between life and possible death.

The ones who, for some reason, always come by private car when they should have arrived via Code 3 ambulance.

It’s not just my facility. Hospitals all over the area have had to increase their staffing at night due to the increase in census.


I don’t want to come across like I’m griping. I mean, patient care is why we are there. It’s what we do.

I love my job and I like my patients and I do the best I can for all who seek care.

But… every now and then it would be nice to have one of the “old time shifts”.

Especially when one has two papers due by the end of the month.

If you get my drift…..


  • Steve

    April 12, 2007 at 8:34 pm

    Now some people would use this as a claim that the medical system is broken. I ask you IS the medical system broken? Or are people using the system inappropriately? Why should we try to overhaul a system; if the participants are the ones that aren’t using it properly? Shouldn’t we be “fixing” the participants?


  • Cannuck Jo

    April 13, 2007 at 6:35 am

    I remember those days. Where did they go?
    Keep it up. I so enjoy your blogs.

  • Max E Nurse

    April 13, 2007 at 7:58 am

    OOOOOhhhh yes! Ye dayes of olde. I left emergency care just as that transition was occuring. My last night shift in A&E was much busy than they used to be, but none-the-less we had time for a bar-b-q, and I got KY jellied and feathered before going home.

    You said you balanced our checkbook, read the latest bestseller, crochet,gossiped and ate. we were far more resourceful – we used to play cricket with leg splints for a bat and stuffed latex gloves as balls.

    Keep smiling Kim,

  • Kelly

    April 13, 2007 at 11:12 pm

    Extremely high fevers of 101.0 that, doggone it, keep coming back after the Tylenol wears off.

    Ha!! You think any of these people know that Tylenol reduces fever? Yeah right.

    The reason these people dribble in is that it’s free to them, so there’s no incentive for any of these people to use the clinic where they’d have to wait for normal business hours and possibly–gasp–an entire DAY or TWO to be seen. They don’t have jobs to get to in the morning either, so why not show up at 4 am with a tension headache? Of course, an ambulance ride is free as well, so why drop $15 for a cab ride?

    We need a medical assistance co-pay for ER visits and ambulance rides. That alone would save millions of dollars per year. Make it equal to a monthly cell phone bill at least since all these people have cell phones. Certainly, no one would pay the co-pay, but it may dissuade some of them from coming anyway.

    In our hospital, we’ve done a chart review study which said that for frequent flyers (people who use the ER more than 6 times per year), there were only 2 admissions out of the first 600 visits studied. The “frequent flyers” were usually black, young, and on medical assistance. There is no reason that people on medical assistance should be coming to ERs for primary care other than for their personal convenience.

    A simple co-pay is all we need to get back to the days of wheelchair races, craft projects, and eBay surfing.

  • Kerri.

    April 14, 2007 at 3:20 pm

    As a complete sidenote, can I reveal that I once thought “Working on the Night Moves” was instead “Working on the Night Moose?”

    Imagine my shock when I found out I was wrong. 😉

  • geena

    April 14, 2007 at 8:44 pm

    “Man, you know you’ve been blogging a long time when you have to google something to see if you’ve used the title before.”

    HA! That’s nothin… try having to search your own site to see if you’ve blogged about something before. 🙂

  • Chris

    April 15, 2007 at 1:10 pm

    My DH is a cop and when he worked the nightshift I always knew that he would come home in the morning with a piece of killer cheesecake from his ER visit the night before…oh, those were the days 🙂

About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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