How ‘The Pitt’ lands with a Penn emergency department nurse

Season two of the HBO Max medical drama “The Pitt” finds the emergency department at the fictional Pittsburgh Trauma Medical Center working a Fourth of July shift.

Penn Today spoke with emergency department nurse Bobbie Poller, 41, who has worked at Penn Presbyterian Medical Center for about 12 years, including three as an RN in the ED, about how the show squares with reality.

It captures the pace

In a recent episode, health care providers treat a man with a skull fracture from a fall and a severely asthmatic teenager, solve the medical mystery of a jaundiced woman with liver inflammation, learn of a patient’s death in surgery, and grapple with their own interpersonal issues.

Poller says “The Pitt” accurately shows how the emergency department staff rapidly transition between different types of cases, “how you can go from someone actively dying in front of you to someone saying, ‘Can you heat up my food because it’s too cold?’ to another person who’s withdrawing really severely to another patient that has sickle cell.”

While Presby sees a wide array of cases, the nature of dramatizing for television means “The Pitt” overstates the variety of cases ED teams see in one day.

Clinicians do spend a lot of time charting

Season two shows second-year resident Trinity Santos struggling to keep up with charting as her patient load increases. Attending physician Baran Al-Hashimi makes the case for using AI to speed up the process, which leads to an error and debates over the use of AI in medicine.

Poller says doctors at Presby have to chart while they may be intubating several patients and seeing many more in a single shift. Following their shifts, doctors will sometimes stay “for a half hour or an hour after, doing some of their notes,” Poller says.

It gives nurses their due

“The Pitt” does not make it look like doctors and residents do everything: It shows senior attending physician Michael “Robby” Robinavitch repeatedly pressing the hospital’s chief medical officer to hire more nurses, and depicts the critical role of the tough but empathetic charge nurse Dana Evans in assigning staff to patients and looking out for other nurses.

Poller says charge nurses do things differently, but they all assess who gets to be seen next and who might need to wait for care.

“I feel like they’re a parent, but they’re also like a best friend,” he says. “They’re constantly walking around, trying to get an idea of what’s going on and knowing what nurse is getting slammed.”

It captures how language barriers are handled

The show features doctors setting up a video call with an interpreter for a deaf patient and trying to figure out what language a patient speaks; Poller has encountered both situations.

Presby staff use an iPhone app to connect to medical translation services, but in identifying the language, “you get really savvy,” Poller says. “We’ve gone as far as trying to Google someone’s name and find them on Facebook and try to see what they speak, and because the ED staff is so diverse, you do have people that speak Spanish, that speak Tagalog.”

It does not highlight the hard work done by the techs

Before finishing nursing school, Poller worked as a patient care observer and then a nurse technician. “It’s a role that made it easier for me to transition to a nurse, knowing where everything is, what equipment was what, how it functioned, how to fix stuff, and to find my way around the building,” he says.

As a tech, Poller did chest compressions, moved patients, helped deescalate violence against health care workers, and more, while “The Pitt” shows doctors, medical students, and nurses performing these tasks.

It depicts the challenge of leaving your personal life at home

In “The Pitt,” a doctor has a panic attack during her shift due to issues with her mother—leading Robinavitch to mock her and Al-Hashimi to criticize his lack of empathy.

So, how does Poller keep his personal life out of the workplace? “For me, it’s putting on a uniform sometimes and then taking it off,” he says, comparing it to serving in the Marine Corps Reserve—an experience that taught him how to compartmentalize.

But some patients remind Poller of a family member who struggled with alcoholism and died two years ago. “It can be a very visceral feeling, but that’s when I have to step away and take a deep breath and reset myself,” he says, “because it’s not about me, it’s about taking care of the patient.”