Day in the Life – ICU Doctor


Hey guys! How’s it going? I’m Dr. Amit Pandey. I’m a third year Internal
Medicine Resident at UC San Diego and this is a ‘Day in the Life’. So, I’m on a Intensive Care or ICU rotation. It’s about 6:15 in the morning. I’m headed in for my shift that starts at 6:30 a.m., usually lasts till about 5:00,
sometimes up to 7:00 p.m. And then tomorrow I work a longer day, which starts around 8:00 a.m.,
goes through the night. I’m 24 hours until the next morning,
usually around 10 a.m. We take care of all the ICU patients
and anyone newly admitted to the ICU. [music playing] The way the day usually works is the patients
are all divided up amongst the residents. And we come in
and do what’s called ‘Pre-rounding’, where we look at all the vital signs, all the labs and any overnight events. We examine the patients. See if there’s any new medical issues
that need to be addressed. Then we meet as a team with the ‘attending’, who is the supervising doctor for the whole team, and we discuss the plan of action and go through our plan for the day. [music playing] So, this is a typical ‘call room’
in my hospital, nothing too fancy. We got a bed here as you can see but unfortunately no pillows,
kind of tough times. We’re also lacking a chair. This is a particularly unique call room. But anyways, you got a computer,
you got the bathroom. Basically, you know, just the basics,
in case you need to take a quick nap. Call Nights get quite busy frequently,
especially in ICU, so often we don’t even get to use the room
and sleep, but the space is here if you need it as obviously, we spend long hours. All right, so in the afternoon, we like
to get some procedures done or as patients are acutely ill,
we’ll do them as they are needed throughout the day. And one of the procedures that we do
is a Central Line and this thing is– [Kevin] Hold on, you are internal
medicine, you guys do procedures? – Yeah, unlike surgeons,
we actually use our hands and our brains. [Kevin] Ouch. – No, I’m just kidding, but yeah, this is one
of the procedures that we do, Central Line. So this is one of the old kits
that we have lying around the call room or the workroom to teach the new residents. And so what we do for the central line
is we have this needle that we use to access the vein,
either in the neck or the groin. Next, we put in a wire through that needle and the wire– you make a little nick
with the scalpel after that, and the wire allows you to introduce
this catheter into the vessel and what the catheter does is, it allows us to provide special kinds of
medications and allows it to get to the place where we need and usually that’s really important for
critically ill patients in the ICU. – All right so what’s going on now?
– So, we just finished up our morning. We rounded as a team,
we had a moderately busy day, had about 15 patients in the ICU to see. We go around with the attending
and make a plan. And then I actually had to break off
from the team for a little bit to go see a patient in the emergency room, they needed to be admitted up to the ICU. I took care of that patient, got them up there and then reconvene with the team
to finish up the plan, and now I have a little break. There’s no guarantee that you get
that every day, but have the chance to grab some food,
take a quick lunch break and then we go from there. – So Amit, why internal medicine? – Yeah, good question–
– Versus plastics, which is you know… – Oh, they of course, the natural for sure–
– Yeah, the logical choice. It took me a while to figure out in medical
school exactly what I wanted to do, but I ended up on medicine because
I love how broad it is. It has a really great exposure to really
all the working systems of the body and we learn a lot about Physiology
and Pathophysiology, how the organs work and what diseases
can go wrong with them, and I love that part of medicine. – It’s a very– a kind of cerebral field—
– Intellectually challenging. – Exactly.
Yeah, I love that and I also love specifically Cardiology,
super interesting physiology. I did a research in that as an undergrad
and medical student and that’s one of the subspecialties
of internal medicine, so I pursued medicine for that reason. – I am not surprised that you love
cardiology so much… – Yeah. So, Amit and I, we were classmates
at UC San Diego, we… – Yup.
– We studied together a lot and one of our favorite blocks
was actually Cards, – Oh, yeah. Absolutely. I loved it.
– Cardiology. – Looking back, that was along time ago…
– That was. We worked hard
but it was actually really fun to learn, really get your–
like the nitty-gritty of Physiology and more details than you actually get to really understand in undergrad. – Okay, I’m convinced
that internal medicine… – Respect!
– Oh, yeah. – But why be a doctor in the first place? Why go to medical school?
Why do residency? – It’s a long arduous process.
– Yeah. Oh, definitely and it’s a great point that you bring up,
so I think it’s something that should really be thought about,
to make sure it’s the right thing for you. So it took me some time to figure that out. Kind of started getting interested
later in high school. My dad is a Physician,
so I always had the opportunity to observe him. He’s an internal medicine doctor. And then in college, I realized
that I love learning about biology, organ systems, a couple of classes I took, great. And then I realized
that I didn’t want to be doing a job where I was just sitting at a desk
all day, kind of on my own. I wanted something where I was interacting
with people throughout the day. And honestly, medicine is perfect for that, so there’s not a lot of fields that I can think of, where you have as much
like intellectual stimulation, but also that interpersonal stimulation. I think every patient is different, so every day is different and that’s why
medicine was right for me. [Kevin] What’s going on man?
– What’s up man! How’s it going? [Kevin] How was the day?
– It was good, it’s good. First thing we did in the afternoon
was a couple of procedures, we had a Central Line to do. And then we also did a Paracentesis, which is a procedure where we put a
needle into the abdomen to remove fluid and to check that fluid for infection usually, and that typically happens with liver disease and some other kinds of abdominal
infection and diseases as well. And then after that,
we had a couple more admissions. It was a good busy day. The last one I just did was a patient came
into the emergency room with respiratory failure, requiring
a really high level of oxygen, so much so that they needed to be intubated, which is when we put a tube
down the trachea, hook the patient up to a ventilator
to help them breathe. Luckily the patient’s stable now,
doing much better. Overall all, all in all, pretty good day. [music playing] – Now, ICU is known as being one of the
most challenging rotations in residency. And Amit, I’d like to hear from you, how
does ICU differ from other rotations? The main difference in the ICU is that
you’re taking care of the sickest and the most critically ill patients. And that can be really, really challenging but also really exciting and rewarding. We take care of patients that are as
critically ill as you can possibly be and with the right treatments within, you know, several days, they can be walking out of the hospital healthy, and that is just an awesome
feeling, super rewarding, but at the same time, you know, there are some patients that are so ill
and their disease process is so advanced that no matter what medical treatment we provide, there’s really nothing that we can do; and obviously, those cases are really,
really challenging. Of course, for the patient, for the family
and that’s really crucial, one of our roles is to support the family
through these difficult experiences. And it’s also taxing to the provider. And you know, this is something that I’ve
spoken about recently in a blog post on the medschoolinsiders.com blog. It’s something that’s really taught me a lot and I’ve done a lot of introspection about it and it’s helped me learn a lot
about my interaction with patients and my role as a Physician. All right, just got home from work,
had a good day. Usually when I get home at this point,
I like to have some dinner and then get a workout in, if I can. It’s not always feasible
based on the schedule. After that I usually do a little bit of research. Big part of a resident’s life is often doing a
research project in their area of interest. I’m doing Cardiology research at the moment. And then the last thing I generally do is some of my projects for
medschoolinsiders.com. If you’re interested in becoming a Physician, whether you’re a pre-medical student
or a medical student, Medical School Insiders is here
to help you achieve your goals. Learn more at medschoolinsiders.com. So, that’s a day in the life
of an Internal Medicine Resident. I’ll see you guys next time. [music playing]

69 thoughts on “Day in the Life – ICU Doctor

  1. Dr. Jubbal, how much overlap is there between what you do in plastic surgery and the other specialties that you've been exploring (such as internal medicine and psych)? I would love to get a closer look at what you do as a plastics resident. Great work as always!

  2. Have you ever seen someone troubled with Levaquin tendonitis in the Intensive Care Unit?
    Lots of people were hurt by the antibiotic Levaquin unfortunately a now popular antibiotic…. This antibiotic causes really nasty side effects to people and should have never been put on the market.

    there are lots of people who are helpless and hopeless and riddled with pain and also even misdiagnosed with fibromyalgia .

    because the side effects are not rare over 1 billion dollars was rewarded in 2016 from lawsuits.

    Tell me , do you know how to repair someone damaged by the side effects of Levaquin.

    Thanks so much for your help

  3. I find it very concerning that doctors are working overnight, doing procedures on patients and not getting any rest.
    Then they wonder why they are burnt out ๐Ÿ˜’

  4. Being an ICU nurse, you can feel the happiness when patient youre taking care off trans out and recover but also, the sadness when some of them expires. Its really hard because they are mostly dependent but you need to be tough enough.

  5. What types of central lines can be inserted? Whatโ€™s the difference between single lumen double lumen triple lumen practically speaking?

  6. What is the difference between central lines and pic lines (Iโ€™m 13 and Iโ€™ve been in hospitals since Iโ€™ve been 8)

  7. Thank you for this video, this is my dream I want to be an intensivist. And you know what? He is right when he says that they need to know about physiology, pathophysiology and of course pharmacology, and those are my favorites fields in medicine.

  8. I have a couple of questions. First one about medical pants. Is it normal in your clinic in emergency room with sterile conditions use the same pants that you are wearing in car and street. Why in your blogs you can't show us emergency room and patients. I wanna see how you set a central lines with comments. You can blur a faces. Isn't it?

  9. My dream is to become a doctor. Save lives, help people, and make my life worth it all. Itโ€™s going to be a tough path, expensive, stressful, and requires a lot of diligence. I hope to one day have my name, DR. Sally Zhou

  10. Our break rooms were really gorgeous. Problem was that we NEVER got to use them! Actually I got to use the shower once and that was it.

  11. Every time I hear a medical student/resident/physician answer the question why they wanted to be a doctor, they bring up points that one could say about being a nurse too (learning about the body, interpersonal relations, helping people, etc.) – what should one consider if trying to decide between becoming a physician or nurse? Thank you!

  12. You should look up Dr Dhir. You two sound exactly the same way and tbh, I see a slight resemblance visually. ๐Ÿ™‚

  13. Love the videos! just took my MCAT and am looking for Lecture videos for Internal Medicine. I was wondering if you had any suggestions/links for free med school youtube lectures @MedSchoolInsiders

  14. One day hoping to be pulmonologist I would love the feeling of helping someone in need and making someone healthier

  15. Love these videos, can not stand those centra lines ๐Ÿ˜” my son had one in the PICU, I could never do it, i tried to volunteer at ICU and I broke down just thinking about it my PTSD still hasn't went away. Well done to anybody who is able to do that job

  16. Great vids, thanks, I'm an IMG who practiced Pediatrics in my home country. can you make one Day in the Life of a Pediatrician..
    I'm not sure if there's already one that you made.

  17. My oldest brother is having alot of medical issues now. He had triple bypass at 37 and has been taking 9 different medications since then. He suffers from fuild buld up in the legs, liver problems and kidneys. Who knows how much longer he has. I'm just preparing for when "that day" comes. He has 4 daughters and a grand daughter.

  18. We use the Internal medicine doctors as a monitor for surgical patient – internal medicine do nothing and just talking a lot .. ๐Ÿ˜‚

  19. My moms an ICU nurse, she always has great jokes about the internal med residents. All in good fun of course ๐Ÿ˜‚๐Ÿ˜‚

Leave a Reply

Your email address will not be published. Required fields are marked *