{"id":141350,"date":"2025-09-13T16:09:21","date_gmt":"2025-09-13T16:09:21","guid":{"rendered":"https:\/\/www.newsbeep.com\/ca\/141350\/"},"modified":"2025-09-13T16:09:21","modified_gmt":"2025-09-13T16:09:21","slug":"seven-things-the-pitt-gets-right-about-teaching-hospitals-and-a-few-it-doesnt","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/ca\/141350\/","title":{"rendered":"Seven things The Pitt gets right about teaching hospitals \u2014 and a few it doesn\u2019t"},"content":{"rendered":"

There\u2019s a tragicomic moment in the hit TV series The Pitt<\/a> when attending emergency physician Michael “Robby” Robinavitch almost gets a moment of relief, but he\u2019s interrupted when yet another trauma case is wheeled onto the ward.<\/p>\n

\u201cIt’s just so true to life,\u201d says Samina Ali<\/a>, who knows from her work as a practising pediatric emergency physician at the Stollery Children\u2019s Hospital<\/a>, professor of pediatrics and adjunct professor of emergency medicine. She\u2019s also married to an emergency doc who had a much different reaction to the show.<\/p>\n

\u201cSometimes you literally can\u2019t heed your bodily functions \u2014 like, \u201cI\u2019m thirsty\u201d and \u201cI need to pee\u201d \u2014 because you\u2019re on your way to the bathroom and someone calls a critical patient to the resuscitation room. Your body shuts it all down and just keeps going.\u201d<\/p>\n

The Crave series depicts a 15-hour shift at a Pittsburgh emergency department, following Robby and a cast of nurses, residents and medical students as they handle the chaos of cases ranging from life-threatening (heart attacks, overdoses, stab wounds and acute diseases) to absurd (an angry girlfriend glues a dog collar to her boyfriend\u2019s neck as he sleeps).\u00a0<\/p>\n

The show scores 95 per cent on the Tomatometer<\/a> and has 13 nominations for Emmy Awards<\/a>, to be handed out in Los Angeles this weekend.\u00a0<\/p>\n

The show is already a winner among those who actually work in Canadian emergency rooms and teaching hospitals<\/a>.\u00a0<\/p>\n

\u201cIt got so much buzz about how realistic it was purported to be that it really made me want to watch it,\u201d says Nicole Harley<\/a>, an award-winning clinical nursing professor who used to work in local emergency departments and just finished binge-watching the show.<\/p>\n

After giving The Pitt a reality check, here\u2019s what these two University of Alberta experts have to say about which parts of the show truly reflect a day in the life of a teaching and trauma hospital \u2014 and which ones are just a little too Hollywood for real life.\u00a0<\/p>\n

The pace is fast and the trauma is real \u2026 but there\u2019s also a lot more paperwork.<\/p>\n

Actor Noah Wyle, who plays Robby, had previous \u201cmedical\u201d experience as a rookie on TV\u2019s ER<\/a> 30 years ago, but he told the Canadian podcast The Skeptics’ Guide to Emergency Medicine<\/a> that The Pitt gets the details right more often than the \u201990s show did.\u00a0<\/p>\n

The Pitt producers consulted with medical expert Mel Herbert<\/a>, creator of EM:RAP<\/a> (Emergency Medicine Reviews and Perspectives), and it even won the seal of approval from Wyle\u2019s mom, who worked as an ER nurse.\u00a0<\/p>\n

More than 100 patients are treated during the course of the show. And though the balance of trauma to non-acute cases is higher than in a real emergency department, says Ali, the volume and intensity are realistic.<\/p>\n

\u201cFrom the patient perspective, nobody wakes up in the morning expecting to go to the ER, so they are having one of the toughest days of their lives, whether the problem is little or big, and we have to be present for it all,\u201d says Ali, research director and principal investigator for the Pediatric Emergency: Advancing Knowledge (PEAK) Research Team<\/a> and chair of Pediatric Emergency Research Canada<\/a>.<\/p>\n

One thing Ali is firm on is that there\u2019s a lot more (digital) paperwork to be done than is depicted on the show.\u00a0<\/p>\n

\u201cThat waiting room doesn’t look much different from our waiting rooms at the Stollery these days, and when it\u2019s backed up like that we often push our documentation until after hours, because it would paralyze the department if we did it any other way,\u201d she says.<\/p>\n

Students get to try everything.<\/p>\n

Nicole Harley regularly takes groups of nursing students onto medicine, surgery and mental health wards at local hospitals, and some may also get practical experience in emergency departments later in their training.\u00a0<\/p>\n

These clinical placements are the students\u2019 chance to practise all the things they\u2019ve learned in lectures and labs, and they take full advantage, whether it\u2019s putting in a catheter, starting an IV or giving narcotic medications.\u00a0<\/p>\n

\u201cWe really do try to support students in working to their full scope at whatever level they\u2019re at, and that changes weekly,\u201d Harley says. \u201cIt\u2019s the best way for them to develop and grow. And we make sure they do it safely.\u201d<\/p>\n

Same goes for medical students, says Ali, who may have up to three learners working with her on any given shift in emergency.\u00a0<\/p>\n

But they never do anything without supervision. \u201cIt\u2019s unrealistic in the show when Dr. Robby pops his head in and says, \u2018You’re doing well with that chest tube, carry on.\u2019 There’s no world in which I would walk out of a room where a critical procedure was being done,\u201d says Ali.<\/p>\n

\u201cIt would probably be a pretty boring show if we just watched Dr. Robby supervising everybody all day long, but the reality is we stay in the room. We don\u2019t send in residents to tell someone a patient has died or has cancer,\u201d Ali adds. \u201cThose are really critical moments that need to be handled with empathy and love, given how difficult it will be for the family.\u201d<\/p>\n

Post-COVID PTSD is still with us.<\/p>\n

Ali says it\u2019s no coincidence that a hit show about the strain faced by health-care workers would come out right after the COVID pandemic put their work under a spotlight.\u00a0<\/p>\n

\u201cA show that demonstrates the humanity of health-care providers and their intent to try to do their best with whatever limited resources they have, it\u2019s pretty close to home for us and many of our colleagues,\u201d Ali states.<\/p>\n

Both Harley and Ali find Dr. Robby\u2019s COVID flashbacks realistic, although they say not everyone has anxiety attacks, and different things trigger it in different health-care workers. For Harley, it\u2019s seeing violence against her colleagues \u2014 including verbal abuse, punches and other assaults \u2014 which she says is under-recognized in health care.\u00a0<\/p>\n

For Ali, it\u2019s putting on an N95 mask. \u201cEvery so often it just hits you and your voice hitches and you feel all that stress, that fear you had in 2021 when I thought \u2014 and I don’t think I was alone \u2014 that I was going to die caring for somebody else\u2019s child while my children were alone at home.\u201d<\/p>\n

It\u2019s especially hard when a patient or parent challenges her on why the mask is needed. \u201cThis is what keeps people safe from infectious disease, because the child in the next room has cancer and your child\u2019s flu or measles could kill them,\u201d she responds.<\/p>\n

Part of the stress comes from being ready to switch gears on a dime.<\/p>\n

Ali says the biggest challenge on the job in emergency is having to be ready for anything at any hour. Most emergency department patients aren\u2019t critically ill all the time, but staff are always prepared to switch gears and deal with the chaos of a mass casualty event or a highly violent or critically ill patient.\u00a0<\/p>\n

\u201cUnlike in The Pitt, we\u2019re not doing it every hour, but we\u2019re always ready to respond in the way they do on that show.\u201d<\/p>\n

That\u2019s why it takes a team, including people like the uber-competent charge nurse on the show, who constantly walks a fine line between kindness and tough-mindedness, but also the respiratory therapists and lab technicians and residents.\u00a0<\/p>\n

Ironically, their biggest enemy is the thing that drives them to try to do everything right \u2014 perfectionism.<\/p>\n

\u201cWe\u2019re dealing with human lives, so we want zero mistakes. But what that model fails to acknowledge is that we are human beings providing health care and mistakes will happen,\u201d Ali points out. \u201cWhen mistakes happen, you internalize it and think you\u2019ve failed. And it\u2019s not just med students. It can happen in residents, in staff. We saw a lot of that through COVID when so many adults were dying that health-care providers started to feel like their efforts were futile.\u201d<\/p>\n

They can\u2019t fix everyone \u2014 but almost.<\/p>\n

Harley confesses it took her a long time to accept that sometimes patients will die despite the staff\u2019s best efforts.\u00a0<\/p>\n

\u201cSometimes you can do all the right things and it still happens, and that\u2019s really hard,\u201d Harley says.\u00a0<\/p>\n

Dealing with grief is a daily reality in emergency departments.<\/p>\n

\u201cWhat I try to remember is that 99 per cent of the time the patients I treat get better and go home, whether it’s the same day or a few days later,\u201d Ali says. \u201cUnfortunately, the losses cut so deep that they stay with us and we sometimes can forget the wins. I try to remind myself that for every one child we lose, there were hundreds if not thousands of kids we supported and they went home. But every loss still hurts, and we grieve alongside the family.\u201d<\/p>\n

Group debriefs are essential when something goes wrong.<\/p>\n

The Pitt team goes through several formal debriefs immediately following a loss, to examine what happened, what they learned and how to cope.\u00a0<\/p>\n

\u201cThere’s ample evidence that group debriefing is essential and effective,\u201d says Ali. \u201cYou should debrief as a group, and very close to the event, which is why many of our teams in Alberta now do it on the spot, same day. It\u2019s a huge improvement for the well-being of our teams.\u201d<\/p>\n

It\u2019s also about self-care, whether that\u2019s finding support from colleagues or seeking out stress-busting activities after work. Harley won a 2023 Teaching Innovation Award for her self-care program for nursing students \u2014 a response to the pandemic, workforce shortages and burnout.<\/p>\n

\u201cFor me, I have really strong support systems outside of work. I try to go to the gym and work out,\u201d Harley says. \u201cAnd since the pandemic, I\u2019ve really noticed the importance of connection with others and being outside in nature. It\u2019s little things and habits you need to do every day. It\u2019s not about that one big self-care moment.\u201d\u00a0<\/p>\n

Patient satisfaction surveys are real, but\u2026<\/p>\n

There are a few notable differences between the American health-care system depicted in The Pitt and the hospitals where the U of A trains future medical professionals. Every hospital here is a teaching hospital, including in rural Alberta<\/a>. Canadian patients don\u2019t get to pick which hospital an ambulance will take them to in an emergency, and finance managers don\u2019t usually show up during a shift, but they do take patient satisfaction very seriously.<\/p>\n

\u201cIn the show you really see that it\u2019s hard to satisfy everybody in the emergency department,\u201d says Harley. \u201cYou go from spending two hours doing CPR and coding to keep a patient alive, then someone else is yelling at you because they had to wait. We often see people at their worst.\u201d\u00a0<\/p>\n

In fact, for some health-care workers, The Pitt gets it all a little too right.\u00a0<\/p>\n

\u201cMy husband (also an emergency doc) walked out of the show,\u201d says Ali. \u201cHe said, \u2018This is too close to reality. I don\u2019t need more of this. I do this at work already.\u2019 So he left.\u201d<\/p>\n

But for Ali, watching the show is affirming.\u00a0<\/p>\n

\u201cI found some solace and comfort and felt seen watching the show, seeing the empathetic lens with which people who do the work I do are being presented on TV,\u201d she says.\u00a0<\/p>\n

\u201cIt\u2019s not exactly like our daily lives, but it\u2019s probably the most realistic portrayal of emergency I’ve ever seen.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"There\u2019s a tragicomic moment in the hit TV series The Pitt when attending emergency physician Michael “Robby” Robinavitch…\n","protected":false},"author":2,"featured_media":141351,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[49,48,75939,75941,58118,15065,84,392,46996,75938,2371,11074,75937,75940,38553],"class_list":["post-141350","post","type-post","status-publish","format-standard","has-post-thumbnail","category-healthcare","tag-ca","tag-canada","tag-clinical-teaching","tag-emrap","tag-emergency-medicine","tag-emmy-awards","tag-health","tag-healthcare","tag-medical-education","tag-nicole-harley","tag-nursing","tag-pediatrics","tag-samina-ali","tag-stollery-childrens-hospital","tag-the-pitt"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts\/141350","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/comments?post=141350"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts\/141350\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/media\/141351"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/media?parent=141350"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/categories?post=141350"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/tags?post=141350"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}