Highland at Night: Reflections from Nocturnist Maria Kellermier, M.D.
Maria Kellermier, M.D., served as nocturnist at Highland for two years. She recently moved to evenings, and Manuel Enecilla, M.D., assumed the role. Dr. Kellermier received many accolades for her work. Youngrin Kim, M.D., Chief Hospitalist, who worked as nocturnist for 11 years, calls her "the personification of excellence.” He adds, “She has done an amazing job keeping Highland Hospital safe, teaching our residents, backing up our APPs, and supporting our nursing staff.” This is an interview with her about what caring for patients at Highland is like during the night.
What appealed to you about being a nocturnist at Highland?
When I accepted the role I had just finished my residency and was the mother of a six month old. I naively thought that being in charge of Highland at night might be a quiet, predictable role. But I found out early on that Highland runs full steam at night and that all the physicians, APPs, nurses, and staff who choose the night shift comprise a dedicated team who face a wide variety of challenges as they work together with a common mission of providing optimum, compassionate care for patients and families. I was inspired by their commitment and loved the atmosphere.
What do you want other physicians to know about Highland at night?
Highland at night is anything but quiet. The majority of patients admitted to the hospital come through after 4 p.m. So we are fielding calls, triaging patient needs, allocating beds, and dictating patient care with a marginal number of physicians, APPs, nurses, and technicians available. It is truly an amazing team effort that keeps your patients safe overnight.
What were your responsibilities during the night?
The nocturnist is responsible for accepting patients to the hospitalist service as well as the geriatric service. We accept transfers from Strong, Strong West ED, and outside hospitals. We are also responsible for all patients in the Emergency Observation Unit, and handle any and all consults from other services (Gyn, Ortho, Surgery, etc.) overnight. On a normal night, I may accept 20 or more patients. Not only do I have to see several of these admissions myself, I am also responsible for the admissions my APPs and residents take care of. I am also their point of contact if/when any previously admitted patient decompensates. I run codes, place emergent lines, and help facilitate transfers to Strong. Outside of bedside patient care, I am also involved in decisions regarding patient flow, especially with so many of our patients boarding in the emergency room and a limited number of beds available. So all-in-all, from 9 p.m. onwards, it’s go, go, go.
What is the night staff like at Highland?
I can’t say enough about Highland’s night staff. It is truly a dedicated, tight knit group of people. They are the reason I was able to do it for two years. And you have to remember that Dr. Kim had the role before me and we called him “the legend,” so those were big shoes to fill! Any success I had in this role was only because of my amazing nurses, techs, APPs, emergency room physicians, and my mentor Dr. Kim.
You have worked at several different hospitals. What is special about Highland?
Every employee at Highland strives to create a family atmosphere. Over the past two years I’ve met so many support staff, technicians, nurses, APPs, and physicians who have helped make my job easier because they understand that ultimately it is not about any of us, it is about the patient. It’s about maintaining integrity and humanity. It’s about serving patients and their families in their hour of need, in the best way we can. Medicine is not a business at Highland. And you don’t have to look far for a helping hand.
How has working nights changed you?
This was a very challenging job. I would not have survived if the people I worked with didn’t keep me going. It was empowering to work alongside fellow mothers who made a conscious decision to take an overnight job just to be able to spend a few more hours with their kids. There is such a camaraderie overnight and I’ve never seen anything like that. I came into this job timid and unsure of myself, and over the years have gained confidence in my skills as a physician. I’ve become more efficient and have learned to effectively care for patients with limited resources. So I have nothing but gratitude for this job and the wonderful people I’ve met along the way.