Hey guys, before the video actually starts I have some really exciting news. So yesterday some of you might have seen that I was featured as creator on the rise by YouTube. And I just want to say: Oh my gosh, like what?! I’m so excited by it. I never expected something like this and I can only say that this is all because of you guys. Thank you so much for helping to create such an incredible community with all the comments and support and I just… I’m blown away. For those of you who are new, we’ve had lots of new subscribers. The community is just growing and I want to say welcome and I’m really happy to have you here. I’m looking forward to your comments and to hearing from you guys. So thank you. Thank you. Thank you so much! Anyway, on to the actual video. Hey guys. I’m Siobhan, a first year medical resident. Today is Sunday. Another day, another morning, another call shift and I’m bringing you guys along for another 24 hours in the hospital. So today I’m sort of like a substitute teacher. So you can imagine that doctors can’t be in the hospital all day all night every day. So my job is to go in and to cover a team of patients for the day. So I’ll tell you more about it when I get there. It’s just coming up on 8:40 now and I’ve gotta get there by 9 o’clock, so I’m gonna call an uber and hurry to the hospital. Hey, so I just got into the uber. So there are kind of different parts to the day, so I’ll give you a rundown. So first in the morning, we do handover and then after that during the day, my main job is seeing patients on the ward that are already been admitted. And then starting around 5 o’clock, so at night, that’s when we start doing admissions in the emergency department. So I’ll still be answering pages and dealing with things on the ward if they come up, but my main job is admitting new people who were sick in the hospital. And then the morning that’s the fourth and maybe even the most important part. And that’s when you go and meet the morning team and tell them about the new patients you’ve admitted overnight or about any issues that came up on the ward at night. So that’s the plan for today. Alright, so it’s just coming up on 10 o’clock. Just finished handover, so I heard about all the issues. We’ve got about 20 patients on the team, but luckily I’ve got a med student with me today. So really I divided up the list and all I need to do is see about eight patients this morning and then I will talk to our attending staff about any issues that came up. So it’s about 2 p.m. now, I just have one patient left to see. I like to take a hydration break, so I like to actually go and get water, otherwise I get super dehydrated during the day. Anyway, so then I’m gonna be meeting up with the medical student who’s working with me and we’ll go over the patients that he’s seen and see if there’s anything I need order, I need to do or if there’s any of the patients I need to go and check on. So that’s the plan now. Alright, so I can give you a bit of a sense of what our notes typically look like when we’re seeing a patient. So first I go and see them, see how they’re doing and then I write a note in their chart. So this would be a typical note, you know, you put your title, so who you are. Date and time, you put the patient’s identification. It’s usually their age and what brought them in. Then this is your subjective section, so you talk about what the patient told you, what the nurses told you, then you move on to… This is your objective sections, so you go through their vital signs. So blood pressure, heart rate, what their oxygen is like, their temperature. You document their physical exam findings, talk about their lab results. So maybe their blood counts or they had a chest x-ray, write all that down here. And the last part is maybe the most important thing and that’s when you talk about all the issues that the patient has. So you talk about the first issue and then you write the plan and then the second issue. And for some people there may be four or five different issues. Oh, there goes my pager. So here we go, okay. Oh, which one is it? This one. Sorry about the page, that was about it actually for the note-taking. And you have to make sure that there’s a note each day for each patient. And the reason is that if someone else came along and wanted to look at the chart to figure out what’s going on with the patient, say they got very sick, they want to have the most updated version and to know what you were thinking and how you’ve been treating that patient. So it’s the best way of communicating is documenting everything in that chart. 2:30 Now and I’m done seeing my patients, the ones that were assigned to me. So now I’m just going to go and find the medical student and chat with him about his patients. Now we’re entering into phase three of the evening. So that’s basically when we’re done seeing all the patients and now it’s all about the patients who are going to be coming into the emergency department and who need to be seen and assessed to determine if they need to get admitted to the hospital overnight. So now I’m gonna go and try to snag myself a call room before the busyness of the evening starts. So it’s 5:15 now. I just went to the consult room to check and see if there were any new patients that we have to see. And luckily there’s no one to see right now, so I just snuck off to my call room. And the thing that I haven’t really been able to show you guys yet that is so amazing about being on call, if there’s something that’s so amazing, is sort of the camaraderie and you really feel like it’s a group of you that are get through the night together. And you make good friends and you get to chat in the hallways and you know, people buy food together and they laugh and you make jokes and, I don’t know, I guess people commiserate a little bit and it’s a bit of a bonding experience. So it’s not like you’re at alone right now. We’ve got a senior medical resident here, you’ve got other internal medicine residents and medical students and then you have other friends that you’ve got in the hospital. So if you run into some of the nurses that you know or maybe you consult like cardiology or a different service and they come into the room and say hi to you and say: ”Oh, yeah… Like I heard you wanted me to see this patient. What’s up?” And then you talk a little bit. So there’s this sort of nice vibe. Not to say that sometimes you don’t have experiences with people that are less pleasant, but for the most part it’s actually a really nice experience and it helps you get through these nights. 7 p.m. Just got paged to go to the emergency department and see a consult. So I guess it’s a good way to start the night getting some sleep, but it was pretty disorienting. I think I sort of forgot that I was on call and actually I fell right asleep, which is nice. It’s 10:30 now, I actually finished the consult pretty quickly. It’s a patient who had a fall and had a fracture, so it’s a break and been admitted into hospital. But after that I was called up to the ward, because there’s a patient whose heart rate is going really fast and blood pressure is quite low. So patient seems pretty sick and so we started some medications and someone I’m gonna have to keep a close eye on tonight. So for now as the medication starting to work, I’m actually going to have some dinner and I’m gonna go check back up on her after that. Just heading back up to check on that patient, so let’s see how she’s doing. I actually just went and spoke to my senior medical resident, just to get a second opinion to make sure they agreed with what I was doing and the consensus we’re doing the right thing, but you know, we’ll see once I get up there. Alright, so the patient is looking a bit better, which is good. It’s going in the right direction, but I’m gonna check in on her another half an hour and see how things are going. It’s 1am now. Patient is doing way better, blood pressure is coming up, heart rate is coming down. So we’re looking much better at this point. And I’ve just been called to go and see a new patient in the emergency department, so here we go. I remember when I first started medical school I thought it was really funny that we would talk about like sick patients, because you think everyone in hospital is sick, but it’s sort of a way of saying who is really sick, like who is life-threateningly sick. And that’s the difference between having a cold and when we say we’re sick. I have a cold, I’m gonna stay home from work versus when a doctor says this patient is sick, it has a very different meaning. So when I’m saying I’m worried about this patient tonight and I’m saying they’re sick, that means that they could potentially be life-threateningly sick. So I left the hospital at 9 o’clock. The rest of the night was such a blur. I always love to share with you guys, but honestly I just… I didn’t have it in me to be vlogging. And I think it’s because I was trying to go between looking at this patient and I was starting to get really tired. So in the end, I’m really happy to say she did not need to go to the ICU. She ended up doing well in the end. And then I was actually able to get a solid two hours of sleep at the end of the night. So I sort of slept from 5:30 to 7:30 in the morning and now it’s freedom for me. I just went to the grocery store, got myself some breakfast and now I’m gonna be heading off to sleep. Thanks for watching guys. It is such a pleasure to see all of your comments. I read them all and I love to hear from you. So don’t forget to subscribe if you haven’t already, if you want to see more vlogs like this and I will be chatting with you guys soon. So bye for now!