WRIGHT-PATTERSON AIR FORCE BASE, Ohio -- On Wright-Patterson Air Force Base, the national anthem plays at 5 p.m. to mark the end of another workday for the vast majority of personnel here.
However, illness and injury do not always keep to that same schedule and can often show up at the most unexpected times.
The men and women of 88th Medical Group who work the night shift at Wright-Patterson Medical Center must be ready to accept new patients 24/7 all year-round to ensure proper health care is available for those eligible to use their facilities.
“Generally, the normal clinics manned by the day shift depart about 4 or 4:30 at the end of the scheduled patient care or the end of the scheduled appointments,” said Col. Rachelle Hartze, 88 MDG master clinician and evening shift in-house supervisor. “That is typically when we start to see an uptick in our operations.”
Hartze begins getting phone calls for admissions, patient transfers and other notifications through the intake supervisor about 2 o’clock in the afternoon as clinical operations in primary care areas start to wrap up for the day.
“Patients are coming in because they have something that can’t wait to be seen the next day,” she said.
Those qualified to enroll for care and use Wright-Patterson Medical Center include all active-duty personnel and their dependents, as well as retirees in the local area. Civilians who work on base are also eligible for emergency care only.
Units available during evening hours include the Emergency Room, Intensive Care Unit, Maternal Child Care and Medical Surgical Unit, along with the lab and pharmacy. However, that does not mean other facilities are out of reach.
“We have other services that are on call but not necessarily in the building,” Hartze said. “Think in terms of anything that we would need to support our patients. For example, if we need radiology or radiology studies, then we have a radiologist on call or radiology tech that we can call to come in and shoot the films, then take a look at them for us.”
Of the many people who work this often-busy overnight shift is Brenda Fox, a registered nurse with 88 MDG for more than 13 years.
“I’ve worked the overnight shift, which is 6 p.m. to 6 a.m., for most of my career here,” she said. “The biggest challenge is coming back to nights after going on leave, since I’m on a day-shift schedule during that period of time. So there might be a week of struggling, drinking lots of coffee to get back to the night shift.”
While Fox has kept pace on the night shift for a steady amount of time, it is different for the group’s enlisted members, according to Staff Sgt. Austin Joyce, an aerospace medical technician.
“Enlisted members rotate between the day and night shift every three to six months, depending on the needs of the unit,” Joyce said. “They switched me to night shift back in January, and this is my second time on night shift.”
Joyce’s responsibilities include monitoring patient’s inputs and outputs, general patient care and putting in lab orders as needed. Every technician who works in the ICU also has to be telemetry-certified so they are able to monitor the cardiac levels of patients.
“We have a good nursing staff here that often helps me out by watching the telemetry system when I’m not able to due to my floor technician duties,” he said. “During the day, there are more technicians on hand, but at night there are only normally a couple of us on shift, so that’s what I would say is the biggest challenge that most night technicians face.”
As an Airman, Joyce says he is trained in a much broader range of skill sets than what he could do if he worked off base.
“We can do things like give IVs, but in the outside world, nurses and paramedics are the only people that can give IVs,” he added. “The ICU techs are all ACL-certified as well, so we have the ability to help push meds in a code scenario, and we can help with shocks and compressions.”
Fox’s role as a registered nurse involves taking care of up to six patients and doing a wide variety of tasks.
“I’m responsible for monitoring patient vitals, handing out medications, changing dressings, and inserting catheters and tubes and other things like that which the patient may need during the overnight hours,” she said.
For Hartze, as the in-house supervisor, it is a bit different. Her job is not to see patients. She ensures the floors are properly staffed and everyone is being taken care of.
“I round periodically throughout the night to check and see how things are going with everyone,” she said. “Sometimes, I make adjustments to where people are being staffed based on the needs of that night.”
In addition to overseeing patient care, Hartze also uses the night’s slower times to do some professional staff development.
“I’ll go around and have a conversation with the team about leadership and ethics and some of the challenges of being a military leader,” she said. “I believe that it is applicable to everyone in our organization, regardless of your rank or your position, because in the medical profession, in the health care field, we have a concept called trusted care.
“Everyone in this organization is a leader, and everyone has a responsibility to speak up and speak out. Because that’s how we take care of our patients and provide for patient safety.”
Anytime day or night, Wright-Patterson Medical Center staff stand ready to help.
“Some of our patients have been known to bypass other facilities because they want to be seen here,” Hartze said. “So even though they may live on the southside of Dayton, and they have a health care need that they feel is urgent or emergent, they choose to bypass two or three other civilian facilities, because they want to be seen here at Wright-Patt Medical Center.”
Fox agrees, saying the 88th Medical Group is prepared to take care of any patient need.
“It’s totally fine to come in middle of the night,” she said. “If you need to be seen, we’re here and sufficiently staffed so that we can handle whatever comes in.”