How does a real emergency department compare to ‘The Pitt’?

For Eric Pitt, watching “The Pitt” — the hit medical drama that follows a single shift inside a busy emergency department (ED) — can sometimes feel a little too familiar.

And yes, the name is purely a coincidence.

Pitt manages the ED at Sharp Grossmont Hospital, one of California’s busiest emergency departments. The department sees more than 120,000 patient visits each year — about 335 on an average day — and receives an average of 95 ambulances daily.

With that kind of volume, the crowded waiting rooms, unpredictable emergencies and constant juggling of patients portrayed on “The Pitt” aren't just TV drama.

So how does the TV version compare with the real thing?

"It's pretty accurate," says Pitt. "Every person who comes through the doors is different, and you never know what the day is going to bring. That's part of why I love working in the ED."

The pace is real, with a few TV twists

Like the fictional ED, Sharp Grossmont can go from relatively calm to extraordinarily busy in minutes. A cardiac arrest, stroke and other serious emergencies can all arrive within a short period of time, Pitt says. There's no predicting what will come next or how quickly the pace can change.

Amber Dinh, an advanced clinician in the Sharp Grossmont ED, says that unpredictability is one reason the pace portrayed on “The Pitt” feels familiar. Some shifts are steadier than others, while particularly busy days can bring a seemingly nonstop stream of people seeking care.

Still, the fictional ED and Sharp Grossmont differ. While Pittsburgh Trauma Medical Center, the fictional hospital in “The Pitt,” is a teaching hospital, Sharp Grossmont is not. However, Sharp Grossmont does have residents, new nurses and other clinicians who rotate through or train in the ED, Pitt says.

"You probably don't have the students doing as much physically," Pitt says. "There's a little more oversight than what I think is portrayed."

And then there are the small details that need no Hollywood embellishment. "The turkey sandwiches truly are a thing," says registered nurse Nicole Marshall, laughing.

The emotional side hits close to home

While medical emergencies drive much of “The Pitt's” drama, Dinh says the show also highlights a side of emergency care people may not always see, including workplace violence, burnout and the emotional toll of caring for people on some of the most difficult days of their lives.

"I love that they covered a lot of things that nurses go through," Dinh says. "They were able to really shine a light on that side of it."

But the show's realism can make it especially intense viewing for the people who live that reality every day. "After working 12 hours in the ED, I don't necessarily want to go home and watch it all over again," Marshall jokes. "It feels a lot like work. It's pretty real."

But that realism has also given friends, family members and patients a rare glimpse into what happens behind the doors of a busy ED. When “The Pitt” first aired, Marshall says friends and family began calling her to ask the same question: Is this really what you deal with?

Dinh has heard similar reactions from patients. "'I never realized this stuff actually happens,' is something I hear a lot," she says. "It starts a conversation, which is nice."

There are lessons for patients, too

That window into hospital life can do more than show viewers what it's like to work in an ED.

Dr. Nicki Rao, a palliative care doctor affiliated with Sharp Grossmont, says some of the show's storylines can also get people thinking about their own health care wishes. Rao points to an early episode in which siblings must make decisions for their seriously ill father despite an advance directive outlining his wishes. It's a situation that isn't confined to television.

"It is, sadly, very common that people have not ironed out their wishes for end of life," Rao says. "I probably see this scenario on a weekly basis, if not more often."

For Rao, the storyline reinforces the importance of talking with loved ones about health care wishes, such as advance directives, palliative care, death doulas and end-of-life care, and documenting them before an emergency happens. "I hope there can be more awareness, especially for fields that are not as well known," she says.

For Rao, that's part of the value of a show that gets so much about health care right. Beyond the drama, “The Pitt” gives viewers a glimpse into the realities patients, families and health care workers face every day while starting conversations that might otherwise be difficult to have.

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