Hey guys. I'm Siobhan, first year medical resident. It's Saturday, I'm just arriving at the hospital and starting a 24-hour
ICU shift.
Today is gonna be fun, because I'm on with my friend Carol. So she's a second year internal medicine resident, so you'll get to see what
someone who is a year ahead of me in the program is like.
So this is where we meet in the morning. We'll get handover, it's sort of our doctors' room in the middle of the ICU. Oh, here's Carol.
So this is Carol that I was talking about.
She is a second year internal medicine resident, in the same program as me.
So it's kind of fun that we get to see what's coming next year, and she's my backup tonight.
So she knows way more than me. No.
No, she does. She is being humble.
But so like, she's gonna help out in terms of like admitting cases and you can imagine two heads are better than one, so...
But we always have our staff who's at home, who is willing to come in.
Yeah, we are never alone.
It's funny, cuz I was in Siobhan's place last year. As an R1 you're just starting
ICU and as an R2 you're actually one of the seniors on call overnight.
So yeah... Big transition, big transition, like I'm pretty scared for that.
Anyway, so people from last night still aren't here. They should be getting here any minute, but we're gonna print out patient lists for now.
So we start each day with morning rounds.
Which means the whole medical team and the allied health professionals go from room to room
seeing each patient and making a plan for the day. Well, it's
9:50, just literally 10 minutes into rounds and we already got a consult going to the emergency department.
So I'm gonna head there now, see if we need to admit this patient.
It sounds like they're having some trouble breathing and then I'll report back to the team
what needs to be done.
Alright, it's 11:15 now. Just finished seeing the patient.
It was nice, because I got to see some of my other internal medicine residents, who had already seen this patient overnight.
It's always kind of nice when you see your friends in the hospital. So my staff just came and reviewed this patient.
He agrees with the plan, so now we're just gonna finish up and go rounding.
But as I'm walking by I just saw this sign and the emerge is super busy, so maybe it applies.
Okay, we're heading for a team lunch now. So this is team. The weekend team is a little bit shorter than the rest of the time.
Yeah, so we're done rounding on the patients and then we'll see what the afternoon brings.
Carol is getting...
Trying to get a sandwich.
You actually feel comfortable doing like lines and everything overnight?
So you feel better as a second year. Like in first year
I was
scared all the time and would always ask for supervision. And even by the end of your first year
you're supposed to kind of be able to do it without supervision.
Because when you go on to be a senior, you won't always have that there. Yeah.
Yeah.
But as a senior, like you start feeling a lot more comfortable as the year goes on. And
in the beginning of my ICU rotation in second year, I would like ask for supervision for
the first line, just so I can remember.
Because sometimes you haven't done one in a while.
But now I'm feeling a lot more comfortable doing them and supervising them.
Anyway, what do we have to do this afternoon? We have another patient coming that we still have to admit. Yeah. And
up in the ward someone needs a high ventilatory support.
Something called BiPAP, where you put high flow oxygen,
big mask on their face. You put very high flow oxygen, they stay on it for a bit and then
you try to get them off.
Yeah, so one thing is that I really like is that you run into people in the hospital
and they kind of give you a heads up about who may be coming into ICU. So
the word on the street when I was in the emerge, is that there are two that may be coming our way.
So in the meantime we are gonna sign out a
patient that can go to the ward, so basically that just means that we get them ready to go up to the wards. So that there will
be room for a new patient to come into the ICU who may be sicker. Also I just noticed this sign behind me
Wait are you calling us fat?
That's funny, I wonder who wrote that.
So it's now 4:15, I'm actually in the emergency department
internal medicine consult room area, it just has more computers down here. And
we're admitting the fourth patient or is it the fifth?! Honestly I'm losing track, this has been a busy day. So
maybe that means that we're admitting all the patients during the day and then it won't be as bad.
We will see.
We've gotta go with one of the patients down to the CT scan, because we think she may have a clot
in her leg that may have traveled to her lungs, called pulmonary
embolism, PE.
So that can be pretty dangerous, so we're keeping close eye on her. So
typically we don't go to the CT scan with patients, but in this case our patient is really unstable.
So we'll be there in case she gets worse while she's in the scanner.
Sorry to pause it here guys. Part two is gonna come out next Saturday, so don't forget to subscribe and click the
notifications button. So that you can find out what happened to the patient who went to CT scan and
what happened the rest of our night. Spoiler alert: I did not get to sleep all night.
Thanks for watching guys and see you next Saturday.