The overnight shift in the cardiac ICU at Children's National Medical Center requires great communication and concentration.
With the proliferation of hospital dramas on primetime television, it's very easy to forget just how quiet the night shift in a hospital can be.
But inside the Cardiac ICU at Children's National Medical Center--the only ICU in the D.C. area that focuses specifically on cardiac patients--it's often quiet and harrowing at the same time.
On this particular night, Dr. Craig Futterman is in charge. He's making rounds, getting and giving updates on the 16 children in the unit.
He says two or three children are still unstable, requiring interventions every 20 minutes or so, but he thinks all are headed in the right direction. However, he also says things can change very quickly.
"What I've decided over the years is that I'm not going to be surprised by anything that can happen," he says. "I have to be ready to say, 'All right, I could be awake all night, and I can do it.'"
Tonight, one child that doctors and nurses are watching closely is 2-week-old Zachary Wancjer, born 5 weeks premature with a congenital defect known as Tetralogy of Fallot, which affects the way blood mixes and flows in his heart.
He's a day removed from corrective surgery, and his tiny body seems lost amidst all the tubes and sensors surrounding him.
Zachary's father Hershel says even though he and his wife Dana knew about their son's condition before he was born, the emotional peaks and valleys of the past couple of weeks have been extreme.
"It's a rollercoaster," Wancjer says." We're on sort of an uptick. Last night was sort of a downtick. He had a rough first night adapting to all of the changes they made in his heart."
Dr. Futterman says all it takes for the doctors and nurses here to shift into high gear is a patient who needs help, even after 25 years, and even though he's sworn off ever being surprised, a busy ICU is enough to make him a little nervous, and he says that's a good thing.
"Sometimes, if it's a very busy unit with a lot of unstable patients, I'll have a little bit of angst going into it," Futterman says. "But I'll tell you, if it's a very busy night and I've done my job well, it's a rush. Everybody's still alive, a bunch of them could have died, but didn't because of the great work that you did... it's a great feeling."
And make no mistake, even on a quiet night like this one, lives have been changed and saved in the Cardiac ICU.
[Music: "Night Scene" by Jonathan Larson from You're a Good Man, Charlie Brown (instrumental)]