I can’t say I’d want to go to any hospital that performed surgery and X-rays in the waiting room… but hey, this is a game, right? Hospital Hustle, which we previewed a while back when it was called Sarah’s Emergency Room, is a hectic time management game that has you playing an extremely overworked nurse, sorting your way through seven medical centers around the USA.

These medical centers aren’t your typical clinics – they offer everything from dentistry to opthamology to obstetrics. And, did I mention there’s only one nurse?  

The protagonist, Sarah, just graduated from the University of California. After a stint of unemployment, she comes across a help wanted ad for Maryville Medical Center. They hire her on the spot, over the telephone, because she sounds "sweet and gentle" (and also because the nurse who answers wants to retire). Thus begins a brilliant nursing career.  

Much like other time management games, the goal is to service your patients before they lose patience. When you first begin, this is pretty easy. Sarah walks a bit slowly, but most customers are pretty relaxed, so it isn’t too hard to meet your goal.  

Customers have hearts over their head, which indicates their health. If they lose all hearts, they will leave the hospital. Some decorative upgrades will slow their decline in health, like television, plants, water, and food stations. As in real life, some people have more patience than others, so you’ll have to keep an eye on things. If a patient is low on health, you’ll see his/her face pop up in the corner of the screen as a warning.

To begin a patient’s treatment, you need to take them to the diagnostics counter. Once diagnosed, the patient will have an indication of the next treatment above their head. This involves visiting one or more medical stations. You also need to bring the patient’s chart to the station before they can begin treatment. All treatments take time, and some require additional input, like cleaning up beds, or bringing medication.

Treatment stations can break down and require repairs, which Sarah does by using the wrench. It’s a bit hard to figure out precisely what is broken, but some random clicking ought to solve the problem.  

A nice, original addition is the ability to refer patients to other medical centers. There’s an ambulance parked outside, so you can send patients to other hospitals if you are unable to care for them. This is helpful if you don’t have the type of medical station they need, but also if you are too busy to handle everyone. You’ll still get some cash for patients that are taken elsewhere.

At the beginning of each level, you’ll have the opportunity to buy, sell, and position equipment. In the expenses tab, you can also adjust the amount of money allocated to special costs like salaries. Increasing salaries speeds up doctors, and increasing pharmacy costs speeds up the delivery of prescriptions and charts. The coffee bar increases the coffee power up, which speeds up Sarah greatly. Increasing the maintenance bar decreases the frequency of mechanical break downs.  You can even change the color of Sarah’s uniform, which has no real purpose but is fun anyway.  

Once you’ve reached the third hospital, you’ll have to manage two floors. This really changes the game pace and dynamic, but not necessarily for the better. It reminds me of Jane’s Hotel, when all of the sudden you needed to scroll around to meet customer’s needs. In Hospital Hustle, you basically have to send patients up and down on the elevator, and then follow them up and down to serve them. It takes time to travel between floors, and it often feels like Sarah is painfully slow. Coffee helps a lot, but it’s not consistently available.  

If you’re looking for new additions to the genre, you can find a few. In addition to referring customers to other hospitals, there are lots of different medical stations you can use, including CAT scans, baby scans, X-rays, cardiology, ultrascan, dentist, ophthalmology, psychiatry, physiotherapy, surgery, and resting stations. Many have amusing animations, such as electrocuted skeletons for the X-rays, and a psychiatrist who occasionally goes loopy.   

The graphics are done mostly in polished 3D, with the exception of some well drawn comic book style cutscenes. The music is also well done, and blends suitably in the background. All in all, everything is really smooth. The challenge level is moderate, and it certainly gets tough about half way through. With over 6 hours of game play, there’s enough length to satisfy most players.  

On the downside, the pace is a bit slow to start, mostly due to Sarah’s slow walking speed. I wish there was a more permanent upgrade to hurry her up. That girl definitely needs more coffee. Also, clicks need to be accurate, or else they don’t take. This can be a bit frustrating when you’re under pressure. Also, I noticed that the doctors are mostly just men, which seemed a bit funny.  

Moving from floor to floor is a real pain. It’s hard to keep an eye on what’s happening. While this does make things more challenging, which is obviously the idea, it adds more “work” to the process, which can slow down the overall pace. I sometimes referred patients out simply because I was too lazy to want to click between floors.  

Still, despite some minor issues, Hospital Hustle is an interesting time management game that brings plenty of new ideas to the table. While it’s not the first hospital-themed time management game to be made (Carrie the Caregiver and Fever Frenzy both come to mind), it’s still less common than the glut of restaurant and fashion themed titles available. It’s a nice one to check out if you’re a fan of the genre.