Tips/Tricks to Making a Well Shift in the ED

Authors: Frosso Adamakos, MD and Abbas Husain, MD from Staten Island University Hospital on behalf of the CORD Resilience Committee

Half way through the shift in your busy, overcrowded emergency department, you catch yourself cursing under your breath. I can guarantee that we have all been here in some respects. You are frustrated, hungry, and tired. You have five people trying to talk to you at once, two patients who need to simultaneously be intubated, and your computer just froze for the third time this shift.

While some days at work are just plain worse than others, if this scenario seems to be occurring on a weekly or even daily basis for you, I am hoping to provide you with some insight and some tools to make your shifts more enjoyable, and overall more “well.” Different things work for everyone so try to find what works for you.



One of the most important pieces of advice I have received is to make yourself a priority. You are no good to your family and your patients if you are a burnt out curmudgeon. Schedule time each week for yourself. It can be time to read a book, go to your favorite workout class, or grab a drink with some friends or play with your kids. Do whatever it is that you need to stay happy.

Remind yourself that even if you have a bad shift, it is temporary. Unlike your sick patients, you get to go home at the end of the day and put this all behind you.

Sometimes it helps to “fake it ’till you make it.” Walk into shift and start off with a positive attitude and the day will more likely run smoothly



Be rested. Shut the TV off a little earlier to get a good night’s sleep. Invest in blackout blinds, eye covers, a good mattress and get a good night’s sleep.

Start your shift with a full stomach and empty bladder (who knows when you’ll eat again) and pack food for the day. Even if you don’t have time to cook, order food ahead of time so when it gets busy you have something good to eat.

Take 5-10 minutes before your shift and clear your head. Eat a snack, listen to your favorite song, practice mindful breathing.



Take a break every 2-3 hours. Step out of the ED to use the bathroom. Go stand outside even if it is for 10 seconds to grab some fresh air.

Practice compassion. Talk to your patients like your friends and family and not just a diagnosis. When you put yourself in their shoes even the most minor complaint seems more meaningful and less annoying.

Do something fun each shift. Make bets with your residents, practice a skill you have become rusty on. Bring up with the other faculty a new EBM topic to debate.


Frosso Adamakos, MD

Attending Physician, Staten Island University Hospital

Wellness and Resiliency Curriculum Director

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