Hey guys. I'm Siobhan, a second-year medical resident. The first part of my day has been a complete blur.
I started out the day seeing patients in the nephrology clinic.
Then I gave a presentation over the lunch hour about how to treat lupus nephritis.
And then I went back to the clinic to see more patients in the afternoon.
Now my day continues on into the night, I'm on a 26 hour call shift. So here we go,
let's go find a pager.
Alright, time to go and get a call room.
It feels good to change into scrubs.
Basically like getting to wear pajamas at work,
which is pretty nice.
And then I like to have
everything I might need when I'm on call, so I feel prepared. And of course that means the pager.
But this pager, this nephrology pager is completely falling apart. It's like held together with tape,
but it still works. There's no, there's no stopping it.
So did you guys know that we can actually change the ringtone on our pager? I haven't done it in a long time,
but let's see what options there are.
Ok. Beep. Beep and it vibrates.
More beeps.
Okay.
That sounds like a phone basically.
Alright alright, I've definitely heard that one at the hospital.
A little intense, I don't think that you want to be woken up by that. Oh, or that.
This phone is not in service, isn't it the sound it makes on the phone. Okay.
That's horrible, oh my gosh. That lasts so long, that is my least favorite so far.
And then a beep.
Okay, so now we're back at the beginning.
So there actually aren't that many options.
I thought I've heard people with some fun ringtones around the hospital and I don't know how they get it on there.
But maybe people wouldn't take me as seriously if I had like the can can on my pager.
Anyway, I will stick to my beep but at least we know we have some options tonight.
Oh, I must have tempted fate, there's a real page.
Hey, this is Siobhan from nephrology returning a page. Sure, I'll be right there. Thanks. Okay, bye.
I just got a consult for a patient with a diabetic foot infection.
So one of the complications from diabetes is kidney disease.
People can end up on dialysis and
if their diabetes is so bad that they're on dialysis, they are often
predisposed to getting bad ulcerations on their feet. And if they're not taken care of,
they can become so severe that they aren't healing well.
In this case there's a concern that maybe this infection has gone all the way up to the bone of the foot.
Seeing the patient
I learned that he has had diabetes for 30 years and over time the nerves in his feet have become damaged.
So now he's unable to feel his feet and that's why he didn't notice the ulcer that had formed until it was too late.
I'm gonna order some blood work and imaging to see if the infection has gone into the bone or into his blood.
But for now, we'll be admitting him to the hospital and starting antibiotics right away.
One way to assess if the bone is infected is to take a long swab and stick it into the foot ulcer.
You're actually trying to hit bone.
And if you do hit bone, there's a high chance that the bone is infected because there's no skin left to protect it.
We actually call that the probe to bone test.
I just got paged about a patient who passed away on the ward.
It sounds like the patient was at the end of their life and that this was expected,
but I never had a chance to meet this patient.
And I haven't met the family either, but they're at the bedside now, so we'll go and pronounce the patient.
I always keep my pager, my patient list
and some pens by the phone. So that if or when I get paged in the middle of the night,
then I know which patients they are talking about and I can write down notes to hand over to the morning team.
Hi, this is Siobhan from nephrology returning a page.
Sure sure. Yeah, I can put in... Let's do an extra 3 units of insulin. I can just put them in the computer now. Yeah.
Thanks. Okay, bye.
That's a patient who had a really high blood sugar, so we just need to give them a little bit more insulin.
Okay, oh... My least favorite part is that you have to get out of bed, go to the computer, turn it on.
It's so bright and then you've got to crawl back into bed. I shouldn't complain, but
it's the worst.
Hey, let's go to the computer. At least I've got one in the room here.
Insulin. Oh okay.
The patient's blood cultures came back positive, meaning they've got some
bacteria actually in their blood. Which is a really bad sign, so they need to get antibiotics right away.
So we'll
put that into the computer now.
Alright, it is 7:00 a.m.
I just got up and I'm getting ready to look at some blood work from the patients from last night.
And then this morning I actually have to do something called an OSCE.
So as a resident, I'm a doctor, I'm working in the hospital,
but I'm still training to be a specialist. So we still have
educational
stuff that we have to do. And these are like... It's like a formative
exam where you go from station to station and they watch how you interact with their patient.
What physical exam you do, what you're gonna order, what the management is. I need to try to get to the right
diagnosis.
To be honest, that is the last thing I want to do after working for 26 hours.
But it's part of... It's part of our learning process.
So apparently it doesn't count for anything, it's just for our learning. So anyway, I better go to that so I'm not late.
Finally done and heading home on this rainy day.
So if you wanna see more videos like this, find out what's really like in the hospital,
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And otherwise, I will be chatting with you guys next week. So bye for now!