Hey guys. I'm Siobhan, a second-year medical resident.
You have joined me on so many different call shifts in the hospital. And today
I'm answering some of the most common questions that I get.
Things like: What happens if I get multiple pages at once? Or even worse: If there are multiple
code blue emergencies that go off at the same time.
So I first just really want to thank you all for
sending in questions and sending in videos, because I love getting to know you guys this way.
Alright, let's dive right into the first question.
Hi Siobhan.
My name is Angelina and I am a phlebotomist and an aspiring doctor. And I was wondering: If you get multiple pages,
how do you know which one to respond to first? And how do you decide which one's the most important?
That's a great question. So we actually have a priority system on our pagers.
Ah, there we go. You can see... Okay, that's annoying. So you can see it's calling back at 43856.
I know that I need to call back and that's this exact phone number.
So you can put in your page number and then the priority either 1, 2 or 3.
Priority 1 means: It doesn't matter what you're doing, you go to the phone and
you answer it right away. Some emergency is happening in the hospital, so you don't waste time.
Priority 2 is
routine, so maybe you answer it within 10 to 20 minutes.
If I'm in a patient's room and I get a page and I see it's priority 2,
I might finish up getting their history, hearing what they have to say before
I excuse myself, answer the page and come back to do my physical exam. So I'm not running out of the room.
I can finish up my thoughts.
Priority 3 is really non urgent.
It might be something like you know a diet change or
medication question, but the person isn't receiving their medication for 5 hours, so it's not urgent. In those cases
I will see that patient that I was seeing, I'll do their history,
I'll do their physical and I'll leave and at that point finish my thoughts and then I'll answer the page.
In general though if I'm not in the middle of patient care,
I'll just answer all pages as soon as I get them, so that you know we can get on with things and you don't forget
it later.
One thing that's a little bit tricky is when you are wearing your sterile gloves and you're doing a procedure. So I can't touch anything,
I can't touch my pager, I can't answer the phone. At that point
maybe I'll be busy for 30 or 40 minutes on that procedure,
so I'll actually ask somebody else in the room to answer my page just to let them know that I'm busy and not ignoring them.
Sometimes that's a nurse, a med student, one of my junior residents, whoever's around.
Alright, next one.
What would happen if the code blue pager went off whilst you're already dealing with a cardiac arrest?
Uh-huh. Yes!
Good question.
That has never happened to me. Knock on wood. I hope that it doesn't.
Most hospitals have a particular procedure for this and it sort of depends
on what doctors are in the hospital overnight.
So some hospitals will have
ICU,
cardiology, anesthesia in addition to internal medicine.
And there might already be a procedure, so that if people are at one code
ICU responds to the second one.
It just depends on the hospital, but what's important to remember is that lots of people show up to codes.
There's a ton of redundancy in the hospital. Lots of doctors
are there, lots of nurses are there. So we have the manpower to run multiple codes at the same time.
It's just about organizing people to go to the right place.
Hey Siobhan.
My name is Hannah and I was wondering: How you get everything done that needs to get done after a
24 hour or 26 hour shift? I'm sure you have to do things like study and I don't know... Other chores around the house.
I know I'm exhausted after my shifts and so I was curious if you had any
rituals or things that you would do to get motivated and have the energy to get everything done. Alright, thanks.
Aha, yes.
So in medical school and residency we get post call days. So after you've been up all night,
the next day you get off and it's designed to sleep or whatever you want to do.
So I used to have lofty goals when I first started out. I would be like: '' Yes, I'm gonna study and clean.
You know, go to the gym and get all these things done on my post call day.''
So I would set an alarm and wake up and I would feel awful.
And then I would feel exhausted for a couple of days
after and I was just feeling really drained.
So with time I've become wiser, I think. And I now don't even set an alarm post call.
And I just sleep as long as I can,
because I never have trouble going back to sleep again at night.
My one and only goal when I'm post call is to go to the gym.
That is the one thing. And I try to go and maybe pick up some healthy food,
but otherwise I've realized that if I can just get myself to sleep, gym, eat well, it kind of resets things.
So the next day I'm no longer exhausted and the rest of my week isn't kind of ruined by this call shift.
It's really about stamina and I no longer am playing the short game, it's all about the long game.
Let's see what's next.
Hey girl, thank you so much for all your videos and your positivity is just so contagious all the time.
I'm wondering about how you feel like your 26 hour
shifts are going now that you've done them for a while as compared to when you first started doing them?!
Aha.
Yeah, that's a good question. I mean a lot of things are very similar,
but the biggest difference I think is the amount of responsibility that you have.
In the 1st year when you go and see a new patient in the emergency
department, you make a plan and then you run it by the senior resident that's on call with you. So they're helping you through it.
Now in second year I am the senior resident, so I'm helping the clerks, reviewing with the junior residents,
you're dealing with any sick patients up on the ward and on top of that you're running the code blue emergencies.
So it's a lot.
But you are ready for it, because you put in so much work and did so many call shifts in
your first year of residency. And even though you have lots of responsibilities,
you always have help.
So if I ever feel unsure,
I just call my staff physician who's responsible for me at home, run something by them and we figure it out.
So it's a difference in terms of responsibility, but there's always people to help you.
Alright, last question.
Hi Siobhan, my name is Lauren and I'm a veterinarian in the States.
My question for you is: In your 3rd year of residency, will you have fewer 26 our on-call shifts?
Will you have more? Will they stay about the same?
Thanks, I love your YouTube channel.
3rd year, wow! I cannot believe that that's just around the corner. It seems too fast.
3rd year is a huge year for us.
It's the year that we apply for sub-specialties within internal medicine and in addition to that, it's our
massive exam that we write. So people actually study for an entire year
leading up to the Royal College exam.
So they try to make it so that we do less call in the 3rd year, so we have more time to study.
But I'll still be doing those 26 hour call shifts when I'm on
my ICU rotation, when I'm doing the CCU,
so the cardiac care unit, as well as of course internal medicine. So still lots next year.
So I want to thank you guys for watching and for all of those who participated by sending in questions.
I try to read as many comments as possible, because I value
what you guys have to say, because it shapes the community and it really does shape the type of content that I'm creating.
So let me know in the comments below: What kind of content do you like? Are there certain questions
you want me to answer in future 26 hour call shifts?
And then don't forget to subscribe, because you don't want to miss any of those videos.
Anyway, I'll be chatting with you guys next week. So bye for now!