Hey guys. I'm Siobhan, a first year medical resident. I just got to the hospital and it's Saturday morning. I'm starting a 24-hour call shift.
So I've been getting questions around who actually pages me,
what is that like, or what they keep paging about. So I'll try to address that
during the day today, when I'm seeing patients. And
then who knows, we'll see what comes up in the evening and I'll bring you along for that too.
So let's start out by wiping the slate clean and deleting all the old messages.
So this morning I'm responsible for seeing nine patients.
And then I'm carrying the pager and fueling any questions for the thirty patients in our team.
It tells me the number I need to call back and it also tells me the location and the time it was sent.
Hi, this is Siobhan from team B medicine.
Oh yeah, team E.
Yeah, you know, I actually haven't been told who I'm carrying but I'm happy to get handover and carry team E if you'd like.
Yeah, yeah, I'm on B3. So yeah, we can come here and we can hand over. Thanks.
Okay, so that was the staff from team E medicine.
So I guess I'll be getting handover and then carrying that team for the rest of the day and night.
So this one doesn't actually say the location.
Still waiting...
Guess cuz people page and sometimes they walk away from the phone, so there's no one there. So still waiting...
Ok, I mean they'll call back if it's urgent. This one's from the emergency department.
Hi, this is Siobhan from team B medicine.
Hi, Erica. Yeah. Oh...
Okay,
fair enough. Okay I'm glad it's taken care of. Great, thanks. Okay, bye.
Ok, so that was just a patient with a high sugar but it turns out they actually are going
to be transferred to the critical care unit right now. So they were sort of paging the wrong team about that.
Ah... Another one while I'm still sitting here, it's so hard to actually write my note
Okay, so when it rains it pours because earlier today I had no calls until about 11:00 a.m.
and now we get all of these.
Okay, you've got the number and the second number after here is just saying the priority, so it's a 1 through 3 scale.
So priority 2 is sort of medium priority.
Hi, this is Siobhan from team B returning a page.
Oh, what does it look like?
Oh okay. Yeah, you know what? That's another name for spironolacton.
Yeah, yeah.
Okay, perfect. Okay. Thanks. That's actually pretty funny. That was a nurse calling to ask,
because they couldn't read the handwriting of
the staff physician who saw the patient.
So luckily I had actually already seen those orders earlier today when I was looking through the chart. So I
knew what it actually said so I could help out, but often I would actually have to go up to the ward and try to
figure it out. And it's kind of like sleuth work.
Not great for patient safety when you can't read handwriting. So we try to be really careful, even though mine still isn't great.
3:00 p.m. Now, I'm just discharging a patient.
I haven't eaten yet today. I do not recommend that, that is not my medical opinion.
So I'm gonna go grab some food very shortly.
So no time to eat yet. I just got paged about a patient who's having extreme amount of abdominal pain.
So I'm gonna go and see them and see what we need to do.
If we need to order an abdominal x-ray, if we need to order any fluids or
medications at this point.
So I think the abdominal pain is more likely something like reflux. So I'm gonna give a medication to help with that.
I don't think it's like a surgical emergency. I don't think it's to do with chest pain or anything,
so I'm a little bit reassured by that.
Anyway, it's coming up on four o'clock now and I still have a couple of notes just to finish up from this morning.
So I'm gonna do that
before I grab food. Mostly because I just don't want to get behind and then I'll bring you along for some food.
All right, so it's just after 5:00 p.m. now.
So we're just entering into the evening time, where it kind of feels like everything changes, anything could happen,
you never know. And I've actually got a medical student on with me tonight.
So I'm just gonna go and find him, his name is Sedad and he's a great medical student. And he's actually gonna be carrying
the team pager tonight, so we'll find him now.
Hey Sedad.
Alright, so tonight we are kind of working as a team and
so we're covering a team of what?! Like thirty patients, maybe even a little bit more. Yeah, so anything that happens...
Sedad is going to be carrying the pager and nurses will get in touch with him.
So this is kind like the moment of truth. Have you carried the pager yet?
Yes, I have once. I was on call two days ago. Man, on your first call shift. They got you to carry it?
Yeah, yeah. Oh this guy's like experienced now.
Okay, so it'll probably be like when you do it last time. Ehm, any kind of pages you get from like from nurses or whatever.
You'll just text me to keep me in the loop. If I get a couple of blissful minutes of sleep,
that may not wake me up. So feel free to page me if I need to call or go up to the ward.
Yeah.
If you're worried about anyone, just like call me right away and I'll meet you to see the patient.
And if you can't get in touch, even page me. Okay, so don't worry, you can always find me. Sounds a good plan.
Okay, awesome. Are you good with it? Yeah. Yeah. Yeah moment of truth. Okay, the pager is being passed.
Now it is your responsibility.
So much responsibility.
Well the first page already, two seconds after I give it to him. Poor guy.
Okay, so now I'm heading to go and get a call room and be able to have some food, relax for a little bit before
I get my first consult.
So when I'm in a call room, I typically just kind of want to rearrange it a little bit. So I grab the phone,
that's hard with one hand. So I grab the phone and I basically take it and
put it beside the bed here. You can imagine that in the middle of the night,
it's a lot easier when the phone rings to just be able to pick it up like this.
So I'm finally in my call room, gonna be able to settle in and have some food. So I'll show you what I packed.
So I've bought some black bean soup. It's just actually pre-made from a jar, but I think is really tasty.
I've got my cucumbers and I also got myself some kombucha. I've already had some of it today and I love that stuff.
Oh my gosh, I'm not sure if you guys can hear that, but I can hear another pager from the other room.
It just reminds me that mine is about to go off. You just know it.
So now I actually have a rare moment where I could just put my feet up, take my shoes off and
just kind of just relax as if I were at home. So I'm gonna watch some Netflix of course.
I do have my pager right beside me,
so it doesn't really feel as relaxing, but it's still a nice way to break up the Saturday call shift.
Just a test code blue, so they tested just to make sure that it's working on all the different pagers.
So I just need a call back and let them know that I did receive the test. You don't have to go running.
Alright, yeah, thanks for calling me. So what's up?
So basically this patient is like super short of breath, lots of edema.
Maybe you might need to give her some Lasix. So I think if we can go up and take a look at her together.
Yeah, yeah, it sounds like a good plan.
When we arrived our patient was sitting up in bed feeling very short of breath.
We could hear crackles at the bases of her lungs and her legs were very swollen.
I completely agreed with Sedad's impression and we gave her IV diuretics. So a water pill to help her pee out the extra fluid.
So it's about 1 a.m. now. A lot has actually happened since I
chatted with you guys. So it's really hard to vlog when you're in the emergency department and stuff is going on.
So kind of have to catch you up.
So I did a consult on a patient who had
seizures
and
I actually did a lumbar puncture, which means that I stuck a needle into the person's back and then took out
spinal fluid and we're going to be testing for bacteria,
viruses, anything that could be causing these seizures.
So we'll be waiting and we'll get some of those results back tonight, which will be pretty interesting to see.
So now
finally heading back up to the emergency department. I mean back up to my call room, you can tell
already getting confused.
Okay, not even ten minutes later. I'm getting that page. I kind of knew it was coming. Not a consult, but actually
a patient in the emergency department's condition has changed really rapidly and they're apparently
looking very unwell, they can't get a blood pressure on him. So I'm heading down right now.
Okay, did not end up being that urgent in the end. Turns out the patient was having rigor.
So they were shaking so much from a fever. So looks like more of an infectious picture.
And so... you know, dealt with that. Sent off blood culture, gave some antibiotics and
some tylenol and it looks like they're doing a lot better. So back up to bed.
I think that's the emergency department.
So it's now 4:45 in the morning, and I just got called for another consult
for a patient with a really really low heart rate. Oh, I'm just trying to wake up right now,
It's always the toughest time for me, when I find like the 4 a.m. 5 a.m. time to wake up.
So alright, head down to the emerge.
So as I'm heading to the emerge, I'm just thinking about what could cause such a low heart rate. So this
patient has a heart rate of 30. You can imagine,
normal heart rate is between sixty and a hundred. So that's a pretty significant.
So kind of racking my brain, make sure I got a plan by the time I get down there. It would be a little bit more efficient.
Alright so it's now the morning.
I handed over my patients to the different teams. This most recent consult that I had in the emergency department,
so this patient had such a low heart rate that we're certainly going to be referring to cardiology to look at getting a pacemaker, but
yeah... it was an interesting consult.
Anyway, I'm meeting up with a couple of the other residents who were on call and we're gonna grab breakfast together before going home.
Hey guys!
Post call
Party breakfast. This is the best part. Oh yeah, totally agree. This is my choice here.
Oh yeah, breakfast with
the best team. Team best. Team breakfast.
Thanks so much for watching guys.
I also want to say thanks to Sedad for being an awesome medical student and for being part of the video.
So by the time you guys are watching this, I'm actually gonna be on vacation in Greece and heading to Norway.
So I've got two weeks off and I'm so excited for it. The week after
I may or may not be able to post a video. But either way I look forward to hearing from your comments.
I hope you subscribe if you like the channel. And otherwise, I'll be chatting with you guys soon. So bye for now!