Hey guys, I'm Siobhan, a second year internal medicine resident. I just got to the hospital. It's 5:00 p.m. And I'm starting a
Night shift you can tell I'm just getting over a cold. Sorry my voice might be a little bit different today
Anyway, we'll see what the night brings
So this is Nahel.
She is the awesome resident who's gonna be on with me tonight
And so nice because we get to split some of the responsibility and chat together about patients. So better patient care, I think
Anyway, so we've met with the team. We've sort of fixed up our board with everyone's name. So, you know how to contact them
What else? We got the SMR pager. You've got it? Yeah, you got it. Okay good. And so the night will begin
I think we just got our first consult and we'll take you through and show you what happens.
Yeah, let's go and see.
Just got paged about a patient whose heart rate's around 180
So I'm just heading upstairs now to go and take a look at it
Luckily the heart rhythm is normal and I think this is all related to being dehydrated. So we're giving some IV fluids now
So now I'm heading back to the emergency department to wait for the next consult the next new patient to see
Hi, this is Siobhan the SMR.
Yep. Consult
So this is how it works
the emergency physician sees the patient if they
Decide that internal medicine needs to see them the patient needs to get admitted
They call me and while I'm on the phone with them, they're giving me information and I write it down here so the patient's name,
important things about their past medical history, what happened to bring them in, their vitals, any important lab values and
That's how I keep track of things
Okay, so it sounds like patient with pneumonia who
Is still requiring oxygen so obviously can't go home. I'm going to call one of our medical students to come down into that patient. Oh
My gosh, look at this thing. Oh hi, can you please page three-six-two-five to this number, please?
Thank you
Okay now we just wait for the medical student to call back and I'll just get her to come down for this consult
So I was just in the emergency department and we got a consult patient who just had a stroke
so, unfortunately, what happened is the patient woke up and
Wasn't able to drink their coffee
Normally, so they noticed that they were kind of like dribbling out of the side of their mouth and at that point they went to look at them
in the mirror and saw that it was a bit of a droop and then immediately came to the to the hospital.
If you're ever concerned that there's symptoms of a stroke
first thing is just to get to the hospital and you should get some either to drive you or call an ambulance because because you
really shouldn't be driving
so the goal is to figure out why the patient had a stroke so that we can prevent another one. What we found is an
irregular heartbeat called atrial fibrillation and because the heart isn't contracting in an organized way a clot can form
Which can then get loose and it can fly up to the brain and block the blood flow which is an ischemic stroke
So now we have a likely cause so we can talk to the patient about how to prevent a future stroke
This time it's a consult for a patient with a headache and a fever and honestly
I'm worried enough about meningitis that we're gonna do a lumbar puncture and actually get some spinal fluid to test
next consult very swollen legs
another consult chest pain
Not a consult, but still super important part of the evening. Okay, we've got a coffee run before it closed; lots of Tim Hortons
So far, we've already had thirteen consults. So Nahel and I have just been kind of run off our feet trying to see people
But I think we've got a moment to slow down here and and just sort of catch up on some notes. Oh
My gosh, what is that sound? So annoying!
This is terrible how's anyone gonna work?
*CODE RED* That is far away from us, there's nothing we can do about it right now, but if we were upstairs we'd be closing doors
It's 4:00 a.m guys. We're seriously struggling. Are you guys struggling? Is the struggle real? Yeah
It's real it's happening. This is the truth. We're kind of like, you know, barely hanging on
I've got to go see a patient
Apparently they have a very interesting rash
Which I am actually I'm genuinely interested to see it. I'm just gonna ramp myself up
I've got some tea that I brought some a caffeinate and
power-on
Okay, thank you so much for your hard work
Okay, it's 5:30 now we're getting closer to the morning I guess it is the morning but closer to the end of it I guess
So now I'm catching up on notes. I'm making myself determined that I will finish up with my documentation
That is something I did not know about in medicine. There's a lot of documentation
So just going back on the procedures we did and that lumbar puncture just writing a note
We're looking at this rash. I went back and looked it again. So now I'm writing a note on how it evolved
And then I've got a poor um lady who was quite confused and I hadn't had a chance to write a note of her she is admitted though
So I'm gonna go back and do that now
It's 6:30. I just saw the emergency physician. We're having a nice chat
And then he says oh, by the way, I think there may be a patient coming to you
Potassium is low sodium's low patient can't really walk. It's probably coming to us
It's so we're so close, but I think we're gonna get one more
Oh boy. *ONE ETERNITY LATER*
Wow, okay
It's just after ten o'clock. The rest of the night was a total blur. I just got home
I meant to show you guys a whole lot more but you just feel so much responsibility as a senior resident
It just it's it's a lot harder to vlog. I'll tell you that
So I hope you guys got a sense of what my day was like
Let me know if you have any questions
I'm actually hoping to do a Q&A next week or the week after I'm not totally sure yet. So comment
Let me know I would love to hear what you have to say and I'm looking for to chatting to you next week. So bye for now
Boy what a crazy night