Hey guys. I’m Siobhan, a second-year medical resident. Over the past two years you guys have joined me on countless call shifts. You’ve seen me responding to emergencies. Code blue, level 1. I just got paged about a patient who’s got a heartrate of about 30. Seeing patients at crazy times at night. Oh man. I just got paged after 30 minutes. So it’s now 4:45 in the morning. So it’s now 3:38 in the morning. 4 a.m. now. 6:00 a.m. And soooo many pages. Just got a page from the emergency department. Alright. So today I’ll be answering some of the common questions that I get. Things like: What if I get multiple pages at the same time? Or what if I fall asleep and forget to answer a page? And I want to thank all the people who sent in questions here on YouTube and over on Instagram. It is such a cool way to get to know you guys and it reminds me of what an incredible community this is. People who are motivated, intelligent, curious and yeah… You guys are, you guys are the best! Alright, let’s dive right into the first question. Hey Siobhan, I’m at work. I’m a kindergarten teacher and I’m just enjoying my morning coffee. I’m just wondering: Do you ever get nervous when you get a page, anticipating what that call might be? Thanks, I love watching your videos. That’s a great question. The short answer is no. I don’t get scared anymore, because I’ve had so much practice. In medical school we actually carry the pager overnight on internal medicine, so you learn to get used to getting pages. So by the time I got to residency all the nervousness and excitement had sort of worn off, which is nice. At this point I mostly get nervous when it goes off at 4 in the morning right as I’m getting into bed, because I’m scared that it’s gonna be a consult in the emergency department, which always takes at least an hour and probably longer. Alright. Hey Siobhan, so I’m wondering: Out of all the pages that you get, do you ever forget to call back someone? Aha, that’s a good question. Ah… I will admit this has happened to me and I think this has probably happened to any doctor out there. Even with your best intentions, sometimes things fall through the cracks. And nursing understands, whoever is paging you understands that this can happen. So if you miss a page, they will likely just page you back realizing that it was not intentional. And in the worst case scenario that it’s an emergency and someone needs to reach someone right away, then they were just gonna call someone else. So a nurse might say: Okay, you called the medical student, they didn’t answer. Well, I’m calling the junior resident. Then I’m calling the senior resident, they’re not answering. Okay well, I’m calling the staff physician at home, waking them up. You will just keep calling someone until you hear back. So there’s a lot of redundancy for safety sake in the hospital. A similar question that I get a lot is: What happens if you sleep through a page? So I can’t imagine that happening, it is such a loud obnoxious sound. It’s right near you! And I think there’s something about when you’re in the hospital and you know you’re on call. Your body is sort of ready at all times, ready to be paged. It’s not like when you go to sleep at home, for me anyway. But I do have residents who are friends that are really worried about this and they say they are such a deep sleeper, that they will clip the pager to them, have it vibrate and then turn up the sound to as loud as possible. So I… I would jump out of my skin if I did that, but there are ways to make sure it doesn’t happen to you. Okay, so my question is: How do you remain energetic when on call? Because I know that internal medicine calls are rough. So how do you manage? Okay, that is a great question. You must really know kind of the hospital system and know what internal medicine is like. How do I stay energetic? So okay, I’m not energetic all the time and I’m not positive all the time on call. I don’t think that it’s possible, it is normal for it to fluctuate. It’s not like I get paged at 4:00 in the morning and I’m like ‘Yahoo, I’m so happy that I’m waking up at 4:00 in the morning!’ That would just be a little bit odd. So instead I kind of see myself like pac-man or something, like you’re going along and I’m gathering energy as I go. So when I get woken up, maybe my energy is low. Then I go down and I see a patient and that’s where I just gather a ton of energy. Because all of a sudden it doesn’t matter if my feet hurt, I’m hungry, I’m tired. Like none of that really matters, because when you start to connect with a patient, listen to their story, hear about their personal suffering and what brought them into the hospital. While I’m connecting with them as the person, I’m trying to think. That doctor side is coming out, I’m working to try to figure out what’s going on. I can’t be focusing on my low energy or the fact that it sucks that it’s 4:00 in the morning, because you’re there to help someone. So my energy starts to rise and I maybe leave the patient room and I see a nurse that I know and we chat for a bit and then I see a fellow resident and we kind of console each other that it’s the middle of the night and we’re both up. And then I’ll get some water or a snack and… And all of that kind of builds your energy. So you’ve got to figure out for you what builds energy and to know and expect that your energy is gonna fluctuate and that’s normal. That’s okay. Okay, next one. How do you unwind after a long shift on call and what do you do to maintain your mental health? This is an important topic that I haven’t talked about as much on this channel as as I want to going forward. Residency, medical school, it’s tough! People hit the wall, they feel burnt out. It’s a challenging journey. I have had those times where I just feel completely exhausted and you’re like, you’re up at night or sleeping during the day. There’s so much pressure, you’re supposed to be doing research or getting emails about more obligations. And then you go onto Facebook or Instagram and you see that your friends just seem to be like having all this fun, traveling around and I’m like: What am I doing with my life? Why am I working so hard? Those are the moments that I know that I’m starting to feel maxed out and I really have to listen to that and take care of myself. Sometimes that just means like having an afternoon with my friends and laughing and just fueling up myself. And other times that means that I need to really just kind of step back, play some violin, read, write, do something for me. I have gone on like yoga retreats for a week, which was so grounding. Or going back home, spending time with my parents, kind of eat all their food, be taken care of. All that stuff really helps. And what I found over time, I would say what keeps me from getting to that point where I’m feeling so exhausted, is often building in exercise and time with my friends regularly. I actually try to combine them, I usually like to go to the gym with one of my close friends and then we’ll go out and eat after and hangout. And so all of a sudden I don’t feel like my whole life is just medicine. I feel like there’s Siobhan who has always been there, who gets nurtured as well and that really helps me. But sometimes gym and good food is not enough and sometimes residents and med students really get into a place of crisis. And we’re seeing this all too often. So if you see a friend in a place where they’re kind of in a mental health place of crisis or if you find yourself in that place: I want you to know that you’re not alone and I want you to reach out to someone. Usually there is a program called a physician health program, there may be hospital programs or through the university. People want to help you and you just need to reach out and find the best resources. And I truly believe that asking for help is not a sign of weakness, but it’s a sign of knowing yourself and being strong enough to ask for help. So I just don’t want to see more tragedies in medicine, we’ve got to stick together. Hi Siobhan, this is Anila from the Netherlands. I was curious: How do you manage to have a proper diet during the 26 hours of your shifts? Thank you so much and have a great day. By the way I really like your videos. Yes, this is a challenge. Something I don’t always succeed at, but I would say the key thing to do is to be prepared. So in the hospital at the middle of the night, there’s always like snacks and goodies at the nursing stations and it’s really hard not to be tempted by that. So I would say bring snacks of your own. So I always like to have nuts in my bag. I’m always wanting something sweet around 3 or 4 in the morning, so I have fruit with me and then choose things that are like satisfying for you. So I would way rather eat a warm stir-fry than a cold salad. So that’s what I’ll pack for myself at night. So you guys asked so many amazing questions that I recorded way too many and this video became incredibly long. So we’re gonna cut it here and create a second follow-up video with lots more questions, so I can take the time to answer them. So your job is to click the notification bell so that you can actually watch that second video when it comes out. Did that plug work? Let me know in the comments below. Anyway, I’ll be chatting with you guys next week. Bye for now!