Morning guys. I'm Siobhan, a first year medicine resident. Today is Saturday morning
and I just got back from a wonderful vacation in San Francisco.
Today of course I'm on call, so I'm gonna be bringing you guys along
to see a full day and night in hospital with me. And I figured we could do something a little bit different today
and I'm gonna try my best to give you the chance to see what it's like answering pages
what kind of issues we get called about
and maybe I can even give you some insight into the types of patients we see overnight.
My first and number-one priority has to be patient confidentiality, so there may be some choppy editing and
you know, I won't be able to give a lot of details, but let's see how it goes.
It'll be an experiment and let me know below in the comments what you think and if it's something that you like.
Alright, so it's 8:50 now. So we got here right on time and now I'm just about to start my Saturday call shift.
So I just finished getting
handover on the list of patients and because I've been away on vacation for a week, there are a lot of people
I don't know. It's a little bit stressful, because I've got to see just about half or more of the patients today.
Because it's the weekend we don't have as big of a team, so here we go.
Hi, this is Siobhan from team A, returning a page. I'm sorry, where is he located?
Alright, well you can let them know that someone will be coming by in a little bit to talk with them. Okay, thank you. Bye.
So it's a family that just came to hospital and is looking for an update.
Weekends are such a challenge. You just have so many patients to see, you don't have as many staff, medical students, doctors here. So
right now, it's
12:30 or so, I actually haven't eaten breakfast or lunch. I just got back from vacation
yesterday and so there was no food in the fridge.
I thought I would get to work and be able to get a breakfast sandwich or something,
but there's just been so much to do that
I haven't had a chance. And I've got two patients who can go home once I get their paperwork done,
so I just don't want to keep them waiting while I go and eat,
I just feel too guilty about that. This morning has just been pretty crazy,
I've only seen maybe four patients this entire morning, but the issue is that one of the patients was getting really sick.
And we found free air
underneath the diaphragm and that's a big sign if you've got air in your abdomen, you start to worry:
Where is the air coming from? So we had to get general surgery involved,
which takes up a lot of time
to consult different teams and hear back from them, getting tests and then checking on the same patient over and over just to make sure
they're not getting sicker as we go along.
Hi, this is Siobhan from team A.
Okay. Sorry, how high was the sugar?
Okay, and how much insulin is she normally on at home?
Oh I see, and she's been getting it today? Okay. Well you know what, I'm heading up.
Yeah, I'm heading up just to see another patient anyway, so I'll stop by and we can give her some more insulin. Okay, great.
Thanks, bye.
12:53, my stomach is growling. It never happens to me where I'm so unprepared.
I always have snacks and granola bars and stuff in my bag, but because I've been on vacation
I haven't been grocery shopping. Anyway,
so one more patient to discharge and then I'm gonna go get some really good food, or at least at Tim Hortons.
I just ran into my senior medical resident and he's so nice.
He saw that I had so much on my plate and actually just decided to do this
discharge, a dictation for me. So I'm gonna quickly run and grab a bit of food. It's 1 p.m.
now, so I can't wait. And then I still have another...
Actually I'm not sure, maybe 3 or 4 patients to go.
So yeah, alright. It's doable.
I've got a one-track mind right now, all my updates are about food. So
the latest is the Tim Hortons line was so long, I just couldn't do it.
So I decided to go and see another couple patients. I went and found this little convenience store inside hospital and
I got a banana, so this will help me. And I will go see a couple.
Alright, now it's 2:30 p.m.,
one patient left to see.
Still haven't had my lunch,
but I figured I might as well just finish off everything and then to go have a proper meal, like a big meal.
And I just got handover from a different team, so now I've got all three pagers as
you can see, now things are stacked.
Stacked for tonight.
So hopefully everyone will be nice, hopefully nice teams. But anyway, so now I'll have extra patients.
Oh and in case it wasn't clear,
different teams have different pagers. So
patients are organized into groups, so that we can figure out which
doctor is covering that team and nursing and anyone else who needs to get in touch can do so. So
now I'm covering teams A and
B,
As well as my personal pager, so that's where the three pagers come from. Okay it's happening,
I'm going to buy some real food now before I get the next page. And I'm just gonna run and get as much food as I can.
A very very happy me gets to actually eat some food.
Hmm... I feel so much better now. Okay, I
just got a message that I need to go and meet my senior medical resident,
but luckily I can keep eating while I'm chatting with him.
So it's 4:15 now and honestly the day has just flown by. I don't understand
how the time went by so quickly, I feel like I haven't had any time to rest and it's almost 5:00 p.m.,
when we start getting called to do consults in the emergency department. Usually I like to take a little bit of time
just to relax a bit,
maybe even put your feet up in a call room before the night starts.
So it doesn't look like I'm gonna have that luxury today, but
we'll see... Maybe it'll happen.
It's 7:45 p.m. and I just got called downstairs by my senior medical resident for a consult,
so I did have a bit of a chance to hang out in my call room. So here I go, we'll see what consult is waiting for me.
So it's 9:30 p.m. right now.
I was just in the middle of doing a consult, I was actually just in the middle of talking to a patient.
And all of a sudden
there's a code blue that was called up ahead and we
respond to that. So internal medicine, our team, we go running throughout the hospital
to a patient. And a code blue means that
someone's heart has stopped, they've stopped breathing or they've gotten really sick really quickly and
someone wants back up.
So
I just went to that.
Unfortunately it was actually a patient who had passed away and after
people got there, we realized that she had never wanted to have CPR and luckily that was not started. So
it was something where we pronounced her and
then we go on with our night, which is
sad, strange.
So it's now 12:48, just got back to my call room.
It feels nice to sit down and
basically, it's been
one sort of sick patient after another right now and
more like just really complicated people. This one consult that I saw in the emergency department,
I think almost every single organ system for this guy had something wrong with it.
He came in because of a stroke, but then when you look back in his notes, he's got so many different things going on that...
That's really the job of internal medicine, it's to try and dig through that and
figure what's going on, put all the pieces together.
So it takes a long time, it takes a lot of thinking
and I'm just grateful that I got this consult earlier in the night and not at 4:00 or 5:00 in the morning.
So yeah, it's one of these guys that I'm gonna be going in, popping down to check on, frequently calling down to talk to the nurses.
Just to make sure we're watching him closely, because he could potentially get quite sick. So now
I'm gonna actually take this moment to try to get a little bit of a nap before I get paged again or before I get
another consult.
It's 4:00 a.m. now, I just got paged to go down to the emergency department and do another consult.
And then just the way it worked out. I've got another page right after that from the ward about
another patient who is not doing as well
and so I'm gonna pop down on one patient while I'm heading down to the emergency department.
Man, but honestly when that pager went off, my body just wanted to push snooze. Like I felt so asleep
that I think I was just like: ''Oh, I don't want to get up. I don't want to deal with this.''
But
now I'm up and
let's see, let's see what happens.
Just that moment from going from
that sleeping to awake is still tough. Like I feel like my eyes are like cotton balls, but
I think I'll feel just better once I start walking downstairs. Six and a half hours later. so it's now
10:45, so way later than I usually actually get out post call, but fair enough.
I'm just happy to be outside and heading home now to get some rest. So hope you enjoyed following me
around for the day.
It's actually nice reflecting on what's going on and being able to take a moment to chat with you guys.
So yeah... Subscribe if you haven't already, comment below,
let me know what you're thinking and I'm gonna go to sleep, but I'll chat with you guys later.