26 HOUR CALL SHIFT on NEW YEARS EVE: Day in the Life of a DOCTOR

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!

100 thoughts on “26 HOUR CALL SHIFT on NEW YEARS EVE: Day in the Life of a DOCTOR

  1. As a person with juvenile rheumatoid arthritis witnessing the blossoming of someone who I know will soon be an AMAZING doctor is so exciting!

  2. Hi! Absolutely love your videos.
    Random question…what dictates when you wear scrubs vs when you don’t? Just curious.

  3. Love your vlogs, as a curious student I learn alot watching your video.

    But can you please please please cut down some of your plastic usage. In this vlog I saw so much plastic that it triggered me.
    1) Caring own coffee, water container/bottle
    2) Not promoting plastic packing of food outlets.. i mean if you let them know they become consciously aware of it.
    3) Bamboo/Metal straw

    I’m so sorry, I love your channel but i had to point this out. 🙇🏻‍♀️

  4. Hi doc. Can you please walk us through the USMLE steps and how to ace it and how to aquire a rheumatology residency thereafter like you did?

  5. We had a dump and roll on new years day, apparently he OD and his buddys literally dropped his body outside the ER and rolled away! Please be careful everyone!

  6. Ahh I love this video. It aspires me to work harder to becone an RN.
    Q: Does your work get "looked" over by an attending? Like every patient you see?

  7. Im a nurse at your Hospital, and a bunch of us on my floor watch your videos and we all joke that we wouldn't even know what to do if you're the one to ever page back hahaha.

  8. that hanging more than 1 pager on a dr like this no wander we have so much being told we have something a when it is really something b that we have dont get me wrong here i am standing behind you drs that read this i am taking your side when saying this

  9. I’m sure this question has been asked before, but since I can’t easily locate it, I’m going to ask it again. Does the Hospital administration review and approve your videos before you can post them? Have they ever had you cut out segments or veto an entire video?

  10. I'm lying on my couch with a cold watching your video and now I'm wondering – what happens when you are sick? Do you have to stay away from the hospital and patients? Do others take over your shift at the last minute? Do you go see your own doctor? I think that'd be an interesting video!

  11. I did nights over the Christmas week (and managed to vlog it too). Working over the holiday period can be rubbish but glad you had some time off before working new years 🙂

  12. I feel like you came to my restaurant (it is a vegan restaurant near the hospital) but I didn't want to say "hey is that you?"

  13. I’ve been in the hospital a few times this year and I don’t think I’ve ever had doctors so polite and say thank you on the phone. Like ever. I appreciate your manners so much.

  14. I’ve wanted to be a surgeon for so long… your positive attitude makes me truly believe that even the hardest shifts are manageable and reassures you’ll always be able to get time of for family around the holidays ❤️

  15. i'm a nurse in London, ON and love watching your videos! your patients are very lucky to have such a nice and smart resident taking care of them!!

  16. I’m a first year critical care and anesthesiology resident in Georgia. I’m in love with you and your videos! <3

  17. My mom had flesh eating bacteria in 2003 and almost lost her life. The infection spread from her armpit to the surrounding area, and would have spread to her heart very quickly. Luckily, my dad brought her to the ER just in time for her to get surgery before it was too late. The doctors told him that one more hour would have been fatal. Thank you so much for treating that patient quickly!

  18. Hi, junior doctor here. I just wanna say I've very appreciative of the way you talk to other doctors on the phone! It's a sign of the great household you grew up in. You're walking the fine line between being friendly and warm and being professional and that sort of attitude is not only rare but also hard to maintain. Your parents should be proud of how well they raised you. Lots of love from Egypt.

  19. Happy New Years to you 🙂 I turn 29 this month and I’m wondering if there’s any Advice you could give me for the depression I’m suffering, my fiancée kate passed away suddenly back in July after 7 years together And times gone by so fast yet also so slow it still feels like yesterday we where cuddled up in bed watching family guy… but she’s gone…. I know it’s a case of it’s maybe just to soon but why do I also feel compelled to meet somebody knew and try to move
    On But I just can’t I’ve tried I can’t bring myself to form a “bond” with any girl I do actually very much like, should I speak to a dr and maybe seek some medication?

  20. Why is it, that York Region used the blue/yellow, Toronto the blue on white, yet most of the rest of the province uses the orange on white?

    Also, just found a news article from March 2019, about how Ottawa (the countries capital, for non Canadians), changed their ambulance flashing lights from white/red to blue red.

  21. Love how you brought some party supplies to have a mini celebration at work ! Even if it was only for a short time , I’m sure you made everyone’s day a little brighter ! ❤️

  22. I always wondered if the extra nudge by one's family over the holidays had an impact on whether or not grandma and grandpa went in to the hospital. Sounds like it's actually a thing!

  23. Bring 2 chocolate to keep u up once I ate candy past midnight I end up not sleeping til 5am so or bring a small coffee bag that u can make in break room just a suggestion or tea bag either way 🙂

  24. I‘m a german student heading towards A-Levels rn. I wanna study medicine here in Germany but also wanna be able to work/move to the USA later. I have to take the USMLE exams and do residency in the USA to get the approbation for both countries. Sometimes I‘m so anxious I won‘t make it. You are one of the main persons that encouraged me to pursue medicine after school. I just wanted to say thank you!

  25. Siobhan- "I have a great feeling about tonight, I'mma gonna get some sleep and it'll be quiet!"
    2020- 'I'm about to end this girls career…."

    I would have been AMAZED if you did get sleep that night Siobhan, in Australia we party like crazy & ER's are usually under the pump 🙁 !

  26. I'm curious if they had to remove the whole leg or just an infected area? I've always been fascinated by flesh eating bacteria. Hope the patient recovers well.

  27. i love how positive you always are! even when you are so so tired. that is so impressive! i wish i had a doctor like that

  28. Great video as usual … At one point in 2020 can you please please please please please collab with Dr. Mike ??!!

  29. After you finish residency and you want to continue working in a hospital, do you have to be an attending physician?

  30. Happy new year!!!! Looking forward to all your new adventures and vlogs in the new year. Thank you so much for sharing 💖

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