Morning guys. I'm Siobhan, a 3rd-year medical resident. I just got to the hospital,
it's New Years Eve and I'm starting a 26 hour call shift.
So...
Last week I was on vacation. I had 5 days off over Christmas, which is why now
I work 5 days over New Year's.
So you kind of get to choose: Christmas or New Year's off. And it was so nice to be able to spend time with family.
Usually New Year's Day gets I think a little bit busier, because people often come home over Christmas and
they realize like '''Grandma or grandpa are not really doing as well as they were last year.'
I haven't seen them in a year.'' So they bring them to the hospital.
So we'll probably be seeing quite a lot of that.
Uhm, but you know... I actually kinda like it. It's a good team spirit over the holidays.
The first thing we do is meet with the resident who was on call overnight, so they can actually get home and go to sleep.
And then we divide up the work for the day.
Deciding who's gonna see which patients and just sort of make a general plan for each of them.
But the day never really seems to go exactly as planned,
especially when you're carrying the team pager.
Hi, this is Siobhan from team A returning a page.
Okay. Yeah yeah. I'll pass along to the team and we might change up the antibiotic actually.
Yeah, okay. Thanks for letting me know.
Okay, bye.
Okay, so uhm, I was just called letting me know that
one of the patient's blood cultures came back showing that there is a bacteria in the patient's blood that we actually didn't expect.
So we're gonna be starting an extra antibiotic to cover that and I'm also going to tell the team, just so that
they're aware, because I wasn't seeing the patient today.
Hi, this is Siobhan from team A returning a page.
Oh that's great. Yes, oh thank you for letting me know. You know, I've been trying to catch them now for
a couple of days now, so that's incredibly helpful. Yeah, I'll just be right over in a couple minutes. Yeah, great. Awesome!
Okay, this is so helpful.
We got a patient that we've been seeing now for a couple of days who doesn't speak English. And so I have been trying to call the family and
couldn't reach them, so it's been such a struggle.
And apparently the family is by the bedside,
so I want to chat with them and actually get to the bottom of some of the symptoms now.
I still have some notes to do, but I wanna quickly run downstairs and get a call room key to get like one of the good rooms.
It's become competitive to get one of the good call rooms.
An excellent room: computer,
bed, light and
most importantly... Washroom! Personally I think the biggest concern is that some of the rooms don't have good like heat
regulation and so some of them are
freezing or super hot. And the ones on these floors tend to be a bit better,
so I'm very pleased with this and I'm optimistic
that I'm gonna get a little bit sleep tonight. I think this is the exact same call room that I filmed my early vlogs and
it makes me really happy to see this. It's kind of like full circle after a couple of years, it's kind of cool.
For safekeeping,
so I don't lose my call room key.
Next I need to pick up the team G pager. That's another team of patients that I'm covering tonight
now that the daytime team has left.
And now I'm really hungry. This is like one of these moments, I gotta refuel.
Residency has been a disaster for cooking, so I'm trying to make an effort.
It's actually going to be my New Year's resolution is to cook more and have like meals prepared for work.
I did that to start the year right.
Hi, this is Siobhan from team A returning a page.
Oh great! Yeah, I didn't even expect that until tomorrow. So that's a bonus.
Sure. Yeah, I'll take a look at the electrolytes. And do you want some tomorrow morning too?
Okay, sounds good. Thanks. Okay, bye.
Okay, so that was the dietitian who just has some TPN. So it's like
nutrition that comes in a bag that can go into a patient's IV.
It's not like a long-term solution
if someone's not eating, but it helps to get nutrition to people who can't eat for a little while while they're really sick anyway.
Some people use it long term, but it's not... It's not the best solution.
Oh hi, this is Siobhan from team A medicine. Yeah, yeah no problem. I'll be right down. Yeah, I'm not busy.
Okay, see you soon. Okay, bye.
Okay, so it looks like we've got a whole bunch of consults coming in from the emergency department now.
But before going down to actually see the patient, I just want to look them up on the computer.
Look at their blood work, see what's going on. Just so I have a bit of background information.
Okay, so from what I can see here. This is a patient with diabetes,
who is coming in with a really painful leg and it looks like a skin infection, a cellulitis.
So the emergency department is giving them some IV fluids and starts some antibiotics, which is very reasonable.
And yeah, it seems pretty straightforward. So we'll go down and probably need to admit them.
Especially if they can't walk or if they're looking pretty sick.
Walking into the room I see a middle-aged man lying in bed clearly in pain. His left shin is really red
and when I look closer, I can see that there's a black line drawn midway up his shin by the
emergency doctors to demarcate where the redness stopped when they saw him.
Now the redness has spread up to his knee and as I examine his leg,
he jumps in pain with even just the slightest touch and I can feel that there's crepitus. So there's air under the skin, which is
extremely concerning for a rapidly spreading infection like necrotizing fasciitis or what people call
flesh-eating disease. I'm really worried about this infection.
I'm actually gonna give orthopedic surgery a call right now. Oh hi, this is Siobhan, one of the internal medicine residents.
Thanks for getting back to me. I'm hoping to talk to you about a patient that I have seen in the emergency department and
I'm very concerned that this could be necrotizing fasciitis and I'm hoping you guys can come to a consult. In the meantime
I'm gonna broaden his antibiotic coverage,
give them more IV fluids and call my attending physician at home to discuss the case. If I'm right about this, the infection can move
extremely quickly and he could lose his leg, if not worse.
I'm heading back to check on him again.
His heart rate is still up, he's still in a lot of pain.
But his nurse tells me that the orthopedic surgeons just scheduled him for the OR as a priority 1 emergency
surgery to try to remove the infected tissue.
I'm actually so relieved to hear this, because this is really the only defensive treatment.
Aha....
The dream team right here!
Okay, excellent. The new year's team.
We've got like what?! 3 Seniors and a junior. We're all medicine residents, that can be pretty sweet.
It's gonna be a good night. Is it gonna be busy? What do you guys think?
We'll see, we'll see. I don't even think about giving my opinion.
Good point, good point. I've made that critical mistake before.
So just got a text from one of my friends, apparently the food has arrived.
Oh wait, we've got 20 minutes to midnight. I'm gonna head upstairs about to check up on 1 patient really quickly and
then I actually bought some like hats and fun things to surprise the other resident, so we can have like a
mini celebration even though we were in the hospital. I better get down in time though.
Earlier one of the residents like jokingly said like ''Oh, I hope there's no code blue right at midnight.''
I really hope that they haven't jinxed us.
Like as soon as she said it I'm like ''Oh my gosh!'' Okay, so this is the assortment and
depending what a given person chooses, this is gonna represent
their new year.
But I don't know what that means...
Okay, it's 4 minutes.
Are we gonna like put on a channel? Is there gonna be like a countdown? What's happening? The room is like completely quiet.
We need some hype here!
Yeah, youtube. Why didn't we think of Youtube?!
Okay, we found our hype. Is this hype enough? Does the hat choose the man or does the man choose the hat?!
Hahahahahaha
Okay, this is great. Just the 4 of us.
5, 4, 3, 2, 1, woohoooooo.
There we go. This is the new luck. Yes, the class of medicine, we need to have coffee represented.
Happy 2020
Okay, mildly
like anti-climactic. Literally these guys are immediately talking about patient care again. These are the doctors that you want, this is good.
Lots of patients already to see in 2020. A young person with a drug overdose, a middle-aged person with pancreatitis
from heavy alcohol use over the holidays,
a man with cardiac chest pain. Then a woman with cardiac chest pain and a few people with pneumonia. Oh and I just found out that the patient with the leg infection just
came out of the operating room is now in the ICU and is doing a lot better.
I think I've hit the wall. I've hit the wall of fatigue. I'm so tired right now.
I mean, I know we just have so much more work to do.
Okay, and there's no like coffee shops or anything open in the hospital right now.
So I think I'm just gonna go for like some cold water. I know that does help.
Just gotta get myself up and do that.
What a crazy night. So much for having a good call room, I never actually made it there.
Oh man, I'm gonna be tired.
I cannot believe that I didn't get any sleep. Not even a minute, not even putting my head down.
You know, I had this weird expectation that
because it was New Year's that we were gonna like celebrate at midnight and then I was gonna sleep the rest of the night.
Foolish, but I like to still keep hope in my days.
Anyways... Okay, I'm gonna pack up my stuff and then hand over to the team in the morning. Tell them everything that happened,
tell them about the new patients and then I get to go home.
Wow, what a night!
Kind of a mix between
excitement, fun, stress. Maybe that's like a sign of what's to come for 2020?! I don't know.
But I'm looking forward to sharing those videos with you.
So if you have any questions, make sure you leave it in the comments below. And otherwise,
I'll be seeing you in the next video. So bye for now!