Visit to USA hospital emergency room

This is very interesting about the environment of American emergency room and the third world country like Pakistan.
I was trained in Pakistan as physician. We used to have emergency duty. We used to have frequent admission of the patients with emergency. Their relatives was worried about the welfare of the patient.
But we as doctors , nurses and paramedical staff were always making noise and cutting jokes.
I was always upset by the attitude of our staff. Perhaps they were used to and immune to the worries of the emergency patients.
Recently I went to one of the American hospital emergency and I was just surprised that there was similar noise and atmosphere
So I believe that emergency room whether is USA or in Pakistan , there is no difference , perhaps that is normal for emergency room..
I can presume that in emergency always there is tension and people dealing with were always in tense situation by making noise and jokes they try to relieve their tension.
I can advocate that people should not mind noise in the emergency room.
Prof.Riaz Bhutta