Editor's note: "On the Job" examines occupations both common and unique once a month in 2015.
COAL TOWNSHIP - The list of patients on a wall-mounted flat-screen monitor continued to grow.
It rose to 23 people, ranging in age from 3 to 94, either being treated or waiting to be seen at Geisinger-Shamokin Area Community Hospital's (G-SACH) emergency department on a cold Tuesday evening in February.
The ailments covered a wide range: cardiac conditions, respiratory illness, influenza, abdominal pain and an assortment of bodily injuries.
With the ER's 12 patient rooms filled, the staff on duty - five nurses, one technician, a unit desk clerk, a mid-level provider and a physician - used gurneys in the hallway to create makeshift "rooms" 13, 14, and 15 for less critical patients.
A bad night at the ER? More like "par for the course," said Mark Williams, nurse manager for the ER.
"It's becoming more and more the norm here," he said. "We are getting the reputation for the quality urgent care that the area needs."
20,000 seen a year
Back in 1992, 20 years before Shamokin Area Community Hospital merged with the Geisinger Health System, the emergency department was revamped and remodeled to its current state. Back then, Williams said, the department would see about 8,000 patients a year. That number has grown to 20,000.
"A good number of those visits are usually non-emergency, but consist of those patients who do not have access to a primary care physician," Williams said.
It makes the job "busy and chaotic" at times, but satisfying, said nurse Sherry Stankiewicz, of Shamokin.
"We all strive to have to give our patients quality care," she said.
Everyone works together to keep the flow of patients moving to make sure all are seen in a timely manner, or to get to a higher level of treatment if needed.
Doctors and nurses meet at the hub of the department, an area in the center of the room where computers deliver lab results, patient history and digital X-rays for doctors to examine to help with their diagnoses.
"I can remember when we were doing everything with pencil and papers," said Stankiewicz, an 18-year employee of the hospital.
ER diplomacy
As the night continues, Williams watches his staff work with patients and doctors. At one point, he is approached by a patient's relative at the desk.
"We are looking for an update as to what's going on. The doctor told us that my mother is going to be admitted, but that was an hour ago," the woman says.
"I understand that." Williams replies. "Let me check on it."
After looking in the computer and talking with doctors, Williams tells the woman they are awaiting lab results and for a bed to be prepared upstairs.
"I just hope it happens soon because I have to be at work and I don't want her to be alone," the relative explains.
"Don't worry; we will take good care of her and transport as soon as we can," Williams assures.
"There are times that you have to be diplomatic with people, but that's our job," he says afterward about the exchange. "We are seeing people who are at their absolute worst, and family members feel completely helpless. You have to ease their minds."
Like a pit crew
Dr. Michael Fitzpatrick, director of the emergency medicine service line for the Central Region of Geisinger Health System, one of the doctors who takes shifts at G-SACH, says working there is a pleasure because of the staff.
"It is a very functional department," he said. "The word 'team' is often used to the point of being a cliche, but it's really true there. After working there for the past 2 1/2 years, I feel their work together really stands out."
Fitzpatrick said he remembers asking a fellow physician how it went after his first shift in the G-SACH ER.
"He told me it was like watching a NASCAR pit crew seeing how well the staff worked together," Fitzpatrick said.
The core of the staff has been there since before Shamokin and Geisinger merged in 2012, but Fitzpatrick said new employees have blended well with the existing staff.
"This very talented staff was there in the beginning. All we brought was a different method of record-keeping," he said.
"These are people who are treating their neighbors, maybe even family members," he added. "I just hope that the community-at-large realizes what they have there."
At the worst
While the ER has one larger room dedicated to trauma cases, every room is equipped to handle any problem.
"I can remember one time we had three code (emergency response) teams working in the department at three different beds," Williams said.
On this day, a patient in the trauma room was awaiting another team, this one the Life Flight medical helicopter crew that would transport him to Danville for more specialized care.
"On the average, about 13 percent of the patients seen in the emergency department will be admitted," Fitzpatrick said. "That's one of the challenges we face with the low acuity patients, because they can go from being sick to very, very sick quickly, and that consumes a lot of our resources."
Sometimes, all the care in the world doesn't help, and the department is the last place that person will see. Stankiewicz says those times are the toughest, and that's when "the team" becomes something more.
"Every person has the support of the rest of the staff when that happens," she said. "We try to heal each other, because such a situation is not something we can share with our families at home. When that happens, we turn into a second family for each other."
(Next month: On The Job in the office of a magisterial district judge.)