The clock reads 4:30 AM, but I barely notice. Time moves strangely during a shift—sometimes dragging unbearably, other times vanishing before I even have a moment to breathe. Right now, I’m somewhere in between, floating in that exhausted haze where every task feels like it’s running into the next.
I pass through the waiting area, scanning the faces I’ve come to know too well tonight. The receptionist is still at her post, her expression unreadable but undoubtedly tired. She catches my eye for just a second, and I offer a small nod. We both understand. It’s been a long night, and it’s far from over.
A woman who has been here for hours is still pacing. Her frustration is visible in every sharp movement of her hands, in the way her foot taps the linoleum floor. I saw her earlier when she had an argument at reception. Her irritation hasn’t faded—if anything, it’s settled deeper into her bones. She’s waiting for someone, and I know exactly who. I glance at the patient board. Her husband is still in the queue, marked as ‘stable.’ It’s not the answer she wants, but it’s the reality. He’s not dying, so he’s waiting. That’s how it works.
I turn back towards the treatment area, where a man on a trolley groans as we wheel him past. He came in with a head injury—ambulance priority. Blood still mats his hair, and I make a mental note to clean it properly once the doctor has finished his assessment. His eyes flutter open, unfocused, but I murmur something reassuring anyway. Not for him, but for me. It’s a habit now. A voice in the chaos.
Stepping into one of the cubicles, I grab a pair of gloves and check the chart. Next patient: suspected appendicitis. I exhale and push back the fatigue.
“Hello,” I say, pulling the curtain aside.
The man in the bed looks up, wincing as he shifts. He’s been waiting for hours. I can tell by the way his shoulders have sunk into the mattress, by the exhaustion on his face.
“I know it’s been a long wait,” I say, even before he has the chance to bring it up. “Let’s see how you’re doing.”
He nods, relief flickering across his face that someone is finally paying attention to him. I start my assessment, asking questions, pressing gently against his abdomen. His wince tells me enough. The telltale tenderness. We’ll need imaging, but I’d bet good money on it being his appendix.
“We’re going to get you seen as soon as possible,” I say, squeezing his hand lightly before stepping out. I can’t promise him anything, but I can at least let him know that someone is listening.
As I step back into the corridor, I see the receptionist rubbing her temples, trying to soothe the tension building between her brows. The woman from earlier has returned to the desk, her arms crossed. I already know the words she’s saying—‘It’s been hours, this is ridiculous, how much longer?’—but I don’t have time to intervene.
The doors swing open again. Another patient arrives. More charts to check, more lives to manage.
By 5:00 AM, I’m running on adrenaline. The exhaustion has settled deep into my bones, but I don’t have the luxury of stopping. The waiting room is quieter, but there are still too many people here. The board is full, the queue is long, and the staff is stretched beyond capacity. I pass by a cubicle where a doctor is explaining a diagnosis to a young woman. Her eyes are red-rimmed, her hands twisting in her lap. I don’t know her story, but I know that look—the mix of relief and worry that so many patients wear.
A patient in the next bed over moans softly, gripping his stomach. I glance at his chart. Suspected gallstones. He’s been waiting for imaging, but the radiology department is backed up. We’re all backed up.
I step out for a brief moment to grab a drink of water, my throat dry from hours of speaking. The staff break room is dimly lit, a single flickering fluorescent light buzzing overhead. There’s an untouched sandwich on the table, left behind by someone too busy to eat. I sigh and take a sip of my water before heading back out.
At 6:00 AM, the night shift is nearing its end, but that doesn’t mean the work stops. The patients keep coming, the demands keep rising. A nurse from the morning shift arrives, her expression one of quiet determination. She greets me with a tired smile, and we exchange a knowing look. The baton is being passed, but the race never ends.
I move towards the reception desk one last time. The receptionist, still standing, still fielding questions, glances up at me. “Long night?” she asks, though she already knows the answer.
I let out a short laugh, more air than sound. “Aren’t they all?”
We share a moment of weary camaraderie before I turn back to my patients. There’s still work to do. There always is.
This is a fictional account intended to provide insight into the perspective of an A&E nurse. While inspired by real-life situations, it is not based on any specific case or individual.