Another possible factor could be the fact that doctors tend to make more mistakes during operations on Fridays compared to start of week.
STEMI centers (this is picked up by EMS and these ambulances are redirected to appropriate centers) have 24/7 cath lab coverage and any major one will have an ER bypass even during afterhours to expedite care.
In fact more and more hospitals (and all the major ones) announce a “Code STEMI” overhead either when the ambulance is dispatched or as soon as the ECG showing ST elevations is discovered in triage/ER to activate the team and reduce door-to-balloon time.
Honestly, when I have an ICU nurse providing procedural sedation for me I essentially just defer to their expertise on the rhythms and if they're worried I activate the mobile response team.
That matches with my impression about a lot of things in her job. I'm always a little surprised when she talks about calling the doctor saying I need X, Y and Z and the doctor just being like cool I'll put in the order. Obviously, not all doctors are like that but it seems like the vast majority defer to the nurses in a lot of situations. This is completely different than the conception I had of healthcare before I met her.
> I'm always a little surprised when she talks about calling the doctor saying I need X, Y and Z and the doctor just being like cool I'll put in the order.
This is the best part. A lot of decisions like sleeping aids, antipsychotics, antiemetics don't have evidence to choose from the various options so it's a bit of trial and error. An ICU nurse typically covers 1-2 patients and knows them very well, so if the recommend/ask for something it's usually the right decision and reduces the cognitive burden on the physician. We obviously still do a safety/sanity check but ballpark estimate I'd say I disagree or order something else < 5% of the time.
Similarly I'd say the proportion of bullshit overnight pages (e.g. I fondly remember a 4am call that a patient has leg cramps) I've received from ICU nurses are even less than that.
General ward nurses on the other hand... A very heterogeneous bunch with high turnover (worse in academia, at my last hospital average career length was ~2 years before they leave for greener pastures) so the relationship is very different.
Not that I don't appreciate them or their work, but far less trust in decision making and they need more oversight.