Good morning guys, I'm Siobhan a first-year medical resident. It's Saturday morning, and I just got to the hospital and today
I'm gonna be bringing you on a call shift
So we'll be staying with me all day while I'm seeing patients on the ward and all night long seeing patients in the emergency department
Every day has its own adventure, so let's go and let's see what today brings
All right, so we just divided up the list I've got
13 patients to see and different prior to the hospital
So first thing I do is I sort of look at the list figure out where the patients are and then after that
I sort of prioritize things based on if anyone's sick, so if anyone's not doing well
I'll go and see them first then second priority is anyone who needs to get discharged so at this time
No one's particularly ill people are all stable knocking wood. Hopefully it stays that way so first thing
I'm gonna do is go and see if a patient can get discharged it all depends whether her hemoglobins were a red blood cell count
Has stayed stable.
Making sure she hasn't been bleeding for a couple of days, and then she can she can get going
Oh man, discharge is always take way longer than you expect
So I'm just gonna be making some follow-up appointments for this patient, and then dictating a discharge summary
Which goes to the family doctor.
And she's got a scene infectious disease doctor and northpia surgeons so making sure everyone knows. What's been going on
Wow this day is going by so quickly
so of those
13 patients I had to see I
still have
like four of them left, so
Gotta head downstairs
See some more
Wow, this is truly the most busy day. I've had. I think ever this is pretty crazy I
It's now uh
5:15 and I'm being called down to go to the emergency department actually called me about 30 minutes ago
And I still have to finish up seen patients
so I'm finally done seeing my 13 patients and dealing with all the stuff that came up during the day and
Apparently they've already been 9 consults down in the emergency department
that's nine people came in that internal medicine had had to go and already see and bring it to hospital today, so
Now let's see see how many are waiting when I get down there now
5:30 and I've already had 19 pages crazy, maybe that means that all the pages will be done for the night
So I was just at a code blue, we're doing CPR and it was a patient that was in droplet precautions
so it was a really really tight mask and you can see how red my
Face is and that's actually from the pressure of the mask and it's really hard work, so I really worked up a sweat anyway
amazingly the patient pulled through and
To be honest most codes that I think to where patients heart stopped or they stopped breathing most of them
Don't come back. So this was a really amazing thing to see and to be a part of so now
I've got to head back down to the emergency department because that code blue sort of interrupted the consult
So I've got to get back down there see this patient admit them
That's me okay water break time.
I always manage to get super dehydrated by the time i'm post-call
So anyway one consult done, and I think I'm just gonna see if there's another one pending before I go upstairs. Oh
Man guys I'm getting really tired you can always tell I'm getting tired because there's no more stairs. It's all about the elevators
I've done the second consult
And actually able to just grab some sleep right now
Before get paged about the next one
So this is the key box where we get our call room keys basically just swipe our badges here
And then it asked me to remove key, and I get to put in the key number that I want
What no more keys allowed, okay wait let me just try a different one ah
No more keys allowed
Okay, that doesn't bode well for tonight. What's so fast security
just came and hopefully fixed it, so let's try it now right machine. It's just you and me grant me some access
Okay
Ah amazing
Target acquired.
Let's check it out
So 125
Okay, so pretty classic room
Chair, bed
Desk
Coat hanger all you really need
4:30 a.m.. Heading down for consult number 3 just trying to try to wake up right now
Feel like I could just lie down on one of these
So far I've had 29 pages
It's 6:15 now I just had the second code blue of the night, so there's a second patient whose heart stopped
And she's heading down to the ICU, and it's very strange because now that job is done
And I'm just heading back to the emergency department
Can hear my pager going so?
Gotta go
It's now 10am I just met up with all the different teams that I was covering tonight and where I admitted patients
And now I'm gonna go back to my call room grab my stuff and then freedom!
I'm gonna go home and have a really long nap
So in minutes, and we do a lot of debriefing so let's debrief so during the day I saw 13 patients
busy
And then overnight
admitted three patients
One of them came in and had was really decreased level of consciousness
Wasn't waking up turns out a bad infection
So we're treating that the second one ended up having a pulmonary embolism
Nothing when a clot travels and gets stuck in their lung
And then you can develop a lot of shortness of breath
As a result which is what brought this patient in and then the third patient that I saw
Had a stroke and came in with a lot of weakness on one side of their body
And then as you know there were two code blues overnight
I will definitely be telling you guys lots more about these types of emergencies in the next
Month or two because I'll be doing rotations in the intensive care unit and dealing with this all the time
So I'll tell you more about it later
But before going home. We've got the featured question of the day, and we're gonna be answering Daniella's question
And she's asking about getting paged at home as a doctor
So I would say there's sort of three main reasons that you might get paged at home
First is if you're on home call which basically you're on home
You're supposed to be at home, and if you're needed in the hospital. You'll get paid you'll come in the second reason would be if
Say you discharge a patient
And one of the community pharmacists this might have a question about the dough so the medication change that you've done
So I'll page you and maybe you're at home at that time
Maybe it's a Saturday morning who knows then you just call the pharmacist back and make a clarification
it's pretty simple the third reason that could happen sometimes happens to me and that's when I just happened to leave my pager on and
some from the hospital might think that I'm still in the hospital or
They don't realize that I've gone home because I was on call the day before and I get paid sort of by accident
I know some of my friends actually turn off the pager
But I'm too scared that I'm gonna forget to turn it back on so I just leave it on all the time
Anyway, I hope that answering this question didn't just jinx things because I'm gonna go home now
And I hope that my pager does not go off so knock on wood