26 HOUR CALL SHIFT with EMERGENCY CODE BLUE: Day in the Life of a Doctor

Morning guys. I’m Siobhan, a second year medical resident. I just got to the hospital. It’s a good old Saturday and I’m starting a 26-hour call shift. So honestly, I’m gonna be spending most of the day in this room. As a senior resident I’ll be doing all the consults coming from the emergency department getting admitted to the internal medicine service. So at this point it’s a waiting game. Whenever the emergency department calls, I’ll go see their patients. So it’s 10:30, I’ve been here for an hour and a half and I’ve had no pages from the emergency department. None. So I feel like this is the calm before the storm. I feel nervous. Something big is coming, I’m sure of it. Anyway, in the meantime I’ve had a chance to look at patients’ blood work and just catch up on what’s going on upstairs in the ward. So for now I guess I’m gonna go up and see if the medical student and the junior resident upstairs need any help and just kind of wait. It makes me uncomfortable, aaaah. Hey guys. How’s it going? Good, how are things up here? Not too bad. Yeah, we’ve just seen all our patients for the day. Are you ready to review? Yeah, man, you guys were efficient. That’s awesome. Yeah, let’s review it. How is the emerge? Actually, not that bad. I’ve had no new consults, which is really bizarre. And so I figured I come up here to try to help. So I saw six patients today. First one was in the critical care unit, so she’s a sicker patient. Yeah, yeah. And as you know main thing for her has been the volume status. What do you want to do for her today? So I think for her today, we’ll keep her at the same dose of her diuretic. Because she is improving and we don’t want to go up too high on that medication, because then some of her kidney markers will go up. Yeah, sounds very good. I’ll be popping in on her later, so I’ll text you if there’s anything to change. I have just haven’t seen her yet today. Okay. So it’s 11:30 now, still no page. I’m legitimately wondering if my pager is broken. So I’m gonna go down to the emergency department and just make sure that nobody’s looking for me. And then otherwise, I don’t know, maybe I’ll study. What do I do? Get lunch? This so bizarre, this has never happened before. Hey, this is Siobhan, the SMR, returning a page. No, no, no. Actually that patient is admitted under nephrology. So you’re actually gonna need to call nephrology. Yeah, sorry. Okay, thanks. Okay, bye. So to put this in context: Last weekend from 9:00 a.m until 5:00 p.m I had 12 consults to do on my own. So 12 sick patients in the emergency department to see, it was crazy. This is why I am so confused by the situation. Anyway, I’m gonna enjoy it. Let’s see what happens. Do you guys think it’s gonna be a consult? I do, I kind of recognize the emerge number. Hey, this is Siobhan, the SMR, returning a page. Sure. Holding, they’re getting the emerge doc. Hey yeah, it’s Siobhan, the SMR, returning a page. Thanks, okay. Bye. So we’ve been consulted by the emergency physicians to come and see a patient from a nursing home who has a pneumonia. Just looking at the blood work here. It looks like this patient may be already a bit dehydrated. Sodium is elevated, their creatinine and the urea are elevated, so markers of kidney function. So we’ll go and do a physical exam and make a decision about antibiotics and fluids. Sounds like this patient needs to be admitted to the hospital though. So unfortunately this patient isn’t able to give me much of a history herself. I was able to find out that there’s been a big change in her behavior in the last three days or so and certainly been coughing more. But I definitely need to be calling the nursing home to be able to get the full details and the medical side of things. Hi, I’m hoping to speak with one of the nurses. One of your residents just came into the emergency department and I’d like to get a little bit more information about how they’ve been recently. So that was very helpful. It sounds like this patient has been often coughing when they’re eating and has had multiple pneumonias in the past couple of years, so I’m gonna go online and try to find previous x-rays and be able to see if it looks similar. Maybe there’s a pattern here. Hey, this is Siobhan the SMR, returning a page. Sure. Yeah, yeah. Ehm, have you guys already had a chance to call psychiatry? Great. Yeah, I’ll come and see in like 10 minutes or so. Perfect. Thank you, bye. So this is a consult for a patient who’s had an overdose and it sounds like overdose only on tylenol. Psychiatry has been consulted to help determine: Was this on purpose or not? And to help do a risk assessment to make sure the patient will be safe in hospital. And then also when they leave. From our side, we need to help manage the medical part. So tylenol is very toxic to the liver at high doses and the antidote is called NAC, so N-acetylcysteine and the patient is already getting that right now. Whenever there’s an overdose I always want to make sure that we’re not missing anything else that person could have taken that we can help reverse. So anything like aspirin, heart medications, alcohols, homemade alcohols and we’ll do a bunch of blood work to make sure there’s nothing else that we can help reverse to make them feel better. Hey, I can take your pager. Oh wow, it’s 5 o’clock already! You know, honestly it has not been bad. I just got one consult just now, so I’m working on it. Amazing. Yeah. Well, hopefully that’s how the night is. I agree, yeah. Amazing. This is amazing, I can smell it. This is a spread of feast for a Saturday night. Hey. Hey, thanks for coming up. What’s up? We have a lady with severe abdominal pain. I’ve ordered some labs. Do you mind if we take a look at them together? Yeah. I’m worried about how she’s doing. Absolutely, let’s do it. Great, thank you. Okay, so let’s take a look at what we’ve got here. So we’ve got our VBG, the lactate is a little bit up, white blood cell count is a bit up. So you’re kind of worried about infection at this point? Yeah, I think so. Yeah and is this patient on antibiotics already? She is, she’s on antibiotics already. Okay, alright. Okay, so why don’t we go and take a look and feel their belly and decide what we think. And you can tell me what you want to do and we can decide together. Sounds great. Awesome. Thank you. Okay, so I think we’ve got a plan. We’re concerned about an obstruction. So that may be the bowels aren’t actually passing, which can be an emergency. I don’t think in this case it is, but let’s get an x-ray to start. Let’s follow up on it like next 30 minutes. It should get done and then you want to let me know? Yeah, that sounds great. I think that’s great. Yeah, okay. So the patient had lost a pulse, but the nurse was right there when it happened. And so CPR started right away and we were actually able to get the patient back, get a pulse back. And so they’ve now been transferred down to the ICU to continue their care there. So the ICU physicians take over at this point, but I’m really really glad that that worked out well. Okay, so that code was on the other side of the hospital, really far. But luckily when I got there, there were tons of people already there. And in this case it was a pre-code, a code blue was called to get resources, get people to this patient, because it looked like their blood pressure was going down, heart rate was going down and looked like they were very very sick. Luckily we were able to sort of fix up the situation and get the patient to a more monitored setting and the patient is doing much better now, but we’re gonna have to watch closely. But before heading back to sleep I just want to check on the blood work for a couple of the patients. All right got my stuff from the call room and now I’m heading down to meet up with the staff physicians who come in the morning. We tell all about the patients that we admitted, tell them about anything that happened on the ward and that’s effectively our handover to prep the morning team for their day. Hi, just to return the… Thank you. Thanks. Good morning, guys. How was the night? I haven’t seen you in a while. Pretty good. Yeah, did you guys all get to sleep? A little bit. That’s amazing. Good call karma is at the best team. Done for the day. Ah, I always love that feeling when you come outside, you haven’t actually had fresh air in 24 hours. Feels good! Successful night, not busy on the consult front, but quite a bit of acuity with both those codes. Anyway, you can never predict the night. So if you want to see lots more videos like this, don’t forget to subscribe and then comment, because I actually love hearing from you guys. Otherwise, I’ll be chatting with you next week. So bye for now!

100 thoughts on “26 HOUR CALL SHIFT with EMERGENCY CODE BLUE: Day in the Life of a Doctor

  1. For when you say cold blue also the dr doesn't grab that cart that's the job of a tech or a nurse to grab the crash cart. You really never see the doc to grab shit.

  2. Hi, I’m a retail pharmacist and I wonder if you ever have to return calls to pharmacies about discharge prescriptions? Or do you not handle that part? Thanks I really like your videos!

  3. Wow, I really liked the level of assistance they provide in the hospital, from nurses to the team in the pre-code situation. I loved this video and your personality. I wish you the best. Greetings from a Guatemalan 🇬🇹 medical student (here we have a crazy emergency !!)

  4. Did you know if you don't sleep for 20 hours is the same as being drunk? You will have episodes of small microsleep which you will not know.
    Did you know that you will make more mistakes in surgery if you don't get at least 7 hours of sleep in one day and your lvl of mistakes will rise to %170 to damage a different organ during the surgery?
    This has been proven by researchers in London by DR. Matthew Walker. he is an asleep doctor.
    Did you know the reason that you have this long of an hour of doing residency been placed because of one person that did cocaine all day and he wanted all student of medicine to follow the same path ???
    All of this has been proven by researchers all over the world.
    Not attacking. Just information. 🙂 <3 your videos

  5. I've never heard a medical student speak like Jewel haha. I'm assuming you guys told her what to say and to be as non-specific as possible.

  6. I’m such a deep sleeper.. I woulda slept through both of those codes 😭😭😭 Idk how I expect to be a doctor

  7. Im guessing you do all the recording short compilations of medical equipment when the actual emergency isn't going on. I think this is confusing some people though.

  8. Have you ever had to treat or otherwise deal with someone who is an anti-vaxer? How would you try to convince someone of the benefits of vaccination?

  9. I really want to go into the medical field and this is pretty cool except the fact that she is vloging a cardiac arrest. Besides there are teams for that and she wouldn't be allowed to have a camera during a code

  10. Love watching these, nurse here and such good refreshers since my specialty is hospice ❤️🙏🏻you are so great at your job!

  11. I don't know how you do it, stay so positive, happy and smiling, but I really enjoy watching your videos. Very informative too. Keep it up!

  12. Guess my town is garbage nurses and doctors are fat woman or old people never hot ones i hate got to doctors its lamm and lifeless

  13. Something about this makes me feel uncomfortable… the clip while running for a code blue, and even just speaking so openly about a patients condition. I realize you don’t use any identifying pieces of information, but it still feels invasive.

  14. I wish I could restart my life and pursue a medical career. Somehow I feel like my pursuit for a 3d modeling career seems insignificant by comparison :'D

  15. I overdosed on Tylenol before. was in the hospital for three days. had IV's and meds pushed down an NG tube every three hours. I nearly killed my liver.

  16. imagine how many morons actually think she filmed everything about the emergency blue code, imagine yourself reading this and thinking the same thing, imagine how much of a dumbass you are. one more thing, her always being positive is actually really good, it lessens the worry her patients and their guardians are feeling. imagine how many people didn't get any of what i said, there are so many idiots around in the comment section.

  17. She's obviously not filming during a code blue,she's not violating anything,not putting patients face in the vid,names,or appearance described, and not putting anyone's life in danger,I'm pretty sure she's fine guys

  18. you treat a bowl obstruction with morphine to relax the intestines, IV, and something for nausea such as zofran, if it the obstruction still remain's after a couple of day's then they need a NG tube. if that doesn't work the it's off to surgery.

  19. I will never understand what is the necessity for 24 hours shifts in the hospital. Why can't they just do normal shifts? 3 shifts of 8 hours or 2 of 12 hours? Wouldn't it make more sense?.

  20. Oh to be young. I didn't do medical, but also had a pretty stressful job. As you get older it starts to wear on you. So while young, save your money and maybe you can retire early when you get older. I know it seems like so far away, but I've woken up today and realized my daughter will soon be graduating high school, it seems like yesterday she was in kindergarten.

  21. I hate to hear a Code Blue go off when im in the hospital. It makes me sad, because i know what it is and i know what can happen…. ive been in the hospital way too many times in my life time….

  22. Is a pre-code a Rapid Response? I've never heard of a pre-code. Love your vidoes.

    RRT with several years of experience

  23. She seems like a really nice Resident. I just think.its odd vlogging a code Blue. Its nice to see the action in the er, but understand permission has to be asked before with film crews or individuals with cameras. Hippa rules can't be ignored. 26 hours was a long shift. But interesting anyway.

  24. Loved this video so exciting to see what a typical day might look like for you where is this hospital I was trying to figure out the location if you are able to tell me that wouI'd be great,all the best to you keep up the good work.

  25. Massive respect to you, your a hero along with all of your fellow doctors and nurses, and to do 26hour shifts on a regular basis is amazing 😉

  26. I feel bad for doctors who are on 26 hours shifts… I was born 25 weeks early and had bronchitis twice and open heart surgery and major things like that etc…. and was an out patient from six years old and had chronic constipation but was referred back at 11 years old and my doctor had stayed 2 hours after his 26 hour shift just to see me since he’s been my doctor since I was born…. so me and my grandma bought him some chocolates on my next visit 😁

  27. Maam I am a medical student from India. Could please tell me if gynecologist working abroad get enough sleep most nights

  28. So exciting!!! Abdominal pain… wuz thinking… appendicitis, gastric, swallowed something??? ….The tension is REAL!!!

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