ER Nurse Talks About Her Code Black Hospital Experience


McKay-Dee Hospital nurse Irma Hinkle grew up in Los Angeles and briefly worked at the LA County-USC Medical Center in her early days as an agency nurse. The hospital’s ER is featured in the Netflix documentary Code Black and is the inspiration for the TV medical drama.

Code Black is a concept to describe an emergency department that is overcrowded and lacking resources, explains Irma. While Code Black isn’t an actual medical term, the resources at the former LA County hospital ER were sparse in one of the busiest ERs in the country. A new renovated building opened in 2008.

In Irma’s own words regarding her experience

Being an ER nurse at the hospital

When I worked there, the average wait time was 12 hours for patients who arrived at the front door. Patients were treated in the hallways most times or in small rooms separated only by curtains. Often there were multiple patients coming in with traumatic injuries caused by gang violence, car accidents, and other traumatic events.

Working in the trauma bay “C-Booth”

The most critical, traumatic injured patients arrived in the trauma bay, called C-Booth, where “more people have died and more people have been saved than in any other square footage in the United States,” according to physician and director Dr. Ryan McGarry.

I know certain scenes in the documentary look like chaos. There’s an enormous amount of people surrounding a trauma patient, however, every single person has a specific job. Everything moves fast, you get caught up in the flow, and somehow it works.

LA County hospital is a Level I Trauma Center which means, aside from other criteria, it is also a teaching facility, so you’d be working alongside interns, residents, and other medical students. Above C-Booth was a balcony where people could see what was happening below and learn from it.

On her first patient at the hospital

My first patient was a pediatric traumatic full arrest who’d been in a car accident. His heart was not beating, he wasn’t breathing and within seconds the ER doctor had his chest cracked open and was manually pumping his heart.

Some traumatic injuries are unimaginable; you literally have seconds to perform interventions that can save a life.

On the differences and similarities with Intermountain

We’re very lucky at Intermountain. McKay-Dee is one of the best emergency room’s I’ve worked in — and I’ve worked in almost 20 as a former agency nurse. It makes me appreciate Intermountain and everything we have here.

Many of the processes are the same at Intermountain, although we do have more resources such as social work, pharmacist, and other ancillary support.

On learning from the documentary

I’ve never seen the TV show, but I’ve watched the Code Black documentary multiple times. Each time I watch it I still find something I missed.

Some reasons, I believe, why the film was produced was to give a physician’s perspective on the realities of providing adequate care despite the limited resources, and to document the occurrences that took place in C-Booth as they moved to the new state-of-th-art LA County-USC Medical Center. Patient care has changed so much with technology and it’s good to remember where we’ve been as we move forward.