Morning guys. I'm Siobhan, a second-year medical resident. I just got to the hospital.
I'm on internal medicine right now and I'm starting a 24-hour call shift.
Alright, so heading up to meet the team in just a couple of minutes. Grab all my stuff that I need: stethoscope,
lanyard, pager, so everyone can get in touch with me whenever they want. And
of course pen.
Okay, let's go.
Okay, so we just met as a team. We have five residents on today, which is
incredible because often in the holidays, we're not that well stocked with doctors.
Today we will divide up the 30-ish patients that we've got on the team. We each see them, write a note,
you know follow up, update families, talk to different services that are involved, typical patient care stuff.
This morning I'm going with the staff physician to see the three new patients who got admitted to our team.
So we're heading down to the emergency department to catch up, get to know them and see what
care we have given to them last night.
All right, just back from the emergency department. I saw those three patients, one of them was having persistent falls,
another one came in with COPD exacerbation.
So their underlying lung disease
which is from smoking too much, got really bad because of the flu. And
the third person actually came in with the flu as well. So we're getting into that kind of flu season.
Make sure you guys get your flu shots. It can be pretty bad for some people.
Okay, so this first patient is coming in actually has heart failure is one of their issues.
And a pneumonia, so I'm looking to find out their weight,
reviewing their medications,
taking a look at their blood work from today.
And I'm seeing a note from our dietitian to see what they're suggesting,
some nursing notes.
That at least gives me a little bit of a primer. I know what's been going on, I'm gonna go see the patient now.
Hi, this is Siobhan from Team C returning a page. Mm-hmm
Okay
Oh
I didn't realize that. Okay, you know what?! Let me check it then and I'll give you a call back. Okay? Okay. Bye.
Ehmm.. Some mix-up with the patient's home medication. It's not exactly what's been ordered and
the patient has a question about that. So I need to look it up and then we'll give them a call back.
Thank you so much for bringing that to my attention.
Yeah, so I've just made the change in the computer. It should be up now.
Thanks, sure sure. Yeah. Okay. Bye.
Aahhh another page already. Hi, this is Siobhan from Team C returning a page.
Yeah, oh one second. Let me just grab my list, my patient list.
All right, finally getting back to this first patient's note.
You know when you start getting paged all the time and your attention is getting pulled from
place to place, a little task like writing a note can take so long.
Okay, that one done. Next on to seeing this patient.
You can tell there's a lot of documentation. You see a patient, you document. You have a conversation, you document. You check their medication,
you document. You talk about risk, you document. You do a procedure, you document. The whole idea
is that so everyone in medical team,
even if they haven't spoken to you in person, can read your note and know what the plan is.
But sometimes it feels tedious, so it's not all running around the hospital all the time,
full of action. There is some of that absolutely, but then you gotta document after the action.
Oh, 1:45 guys. The exhaustion is setting in. Definitely time for a tea break and some food. Tea and food.
You know since I'm down in the first floor, I might as well just pick up my call room key now.
Hey, can I get a call room key? Oh, that would be great. Do they have computers?
Because I forgot my computer in a different city. Excellent! Got the call room key, now to heat up my lunch.
All right, let's get to the call room for lunch. I'm just gonna put my feet up for a minute.
Oh
man, aahh!
The bed is not made, uh, at least I figured this out now and not like 3:00 in the morning.
Otherwise, I'd be so sad at that point.
Okay, bed is made for future me to enjoy.
Just having some salmon now, some left over from Christmas festivities. And just looking over blood work.
So some blood work on a patient that I really thought just didn't look like herself,
so..
Just seemed a bit off,
and so I've sent off some lactate, vbg, some CBC and just to see what's going on, if anything has changed.
Anything that... I'm just worried about an infection that's brewing.
So I'm gonna look at that and then I'm gonna head back up to the ward and go and see a bunch more patients.
Or maybe I'm dealing with this. Hey, this is Siobhan from team C returning a page.
Oh perfect! Yes. Yes. I did know they were coming.
Oh, you can just let them know I'll be there and... I don't know, 10 minutes or so.
Perfect. Thank you very much. Okay. Bye.
Okay, there's a family that I need to chat with, in terms of the goals of care of this patient.
So I just really wanted to catch them in person. So the nurses just let me know they're here. I need to go upstairs,
sign that discharge prescription and then head over there. All right.
Let's go.
It's 5:30 p.m
I just got paged from one of my colleagues, one of the other residents down in the emergency department.
They just got three new consults to internal medicine from the emerge.
Meaning there are three patients in the emerge who need to be assessed and likely admitted to the internal medicine service.
So I'm heading down to go and do one of those consults now.
Round two, the glowing sign.
Oh man... It's 2:30 in the morning right now,
I'm so tired. I've been
in the emergency department since 5:30 pm.
I admitted four patients and then in that time just kind of been up and down, back to patients on the ward who had
different issues that I need to address. I didn't have time to vlog to tell you guys about the consults, because it's just been
go-go-go and feeling pretty exhausted. And I realized I haven't eaten dinner and
I'm freezing and I didn't have my sweater.
So I'm just back at my call room, getting my sweater, getting some food and then back to the emergency department.
Okay,
feeling warm makes such a big difference.
Food is heated up
and I'm gonna eat while I'm
looking up this patient's blood work and and x-rays and stuff and ehh...
Try to keep moving. Just keep moving.
Okay consult number five, I'm feeling a second wave of energy, now that I've had some food.
So this is the patient who continues to fall,
multiple times over the last couple of days.
So there's a huge list of what could cause this. So I'm gonna dig into the blood work,
then go have a long conversation with the patient.
It's 3:50,
I'm just finishing up this patient's note and I know there are still three patients that
we haven't seen yet, that are just waiting in line for us to see.
We are counting down the hours now.
Okay, 5:00 a.m. Just finished that sixth consult and
Dare I say it? I actually... I'm gonna try to go to my call room for the first time to sleep.
Let's even do it.
Oh man I just got paged after 30 minutes. I actually thought I was dreaming, I didn't really understand where the page was at first.
Okay.
I've got a patient whose
heart rate is going very fast. I need to go and assess them.
See, eh, what I can do to help
and
get going. Okay.
Oh my gosh, I'm so tired
Got this awkward 30 minutes before I go meet up with the team.
I'm scared if I go back to my room, I'm gonna fall asleep.
Finally done, heading home.
It was a busy night. That was steady, that was really steady and I cannot wait for my head to hit the pillow.
Anyway, if you guys want to see more videos like this
and see what it's like overnight on call, check out these videos up here.
And of course if you like videos like this,
don't forget to subscribe, comment because I love to hear from you guys. And otherwise, I'll be chatting with you next week,
Bye for now!