Thursday, July 28, 2011

Day in the Life of a Pediatric Intern

In an effort to decrease the number of "Is it like Grey's Anatomy" questions I receive (no, we don't shack up in the call room after every patient), I will share what different days as a Pediatric intern have been like for me. I can't say there is a "typical" day because every day brings unique issues, families and new diseases. Plus, every 4 weeks we switch to a different "service" so we are always moving. So I invite you to sit back, relax, and enjoy vicariously the adventure that is Residency!

A Day in the Life...on Night Float

Arrival Time: 630pm Sign out
Departure Time: Depends on how long sign-out takes, but usually by 7 or 730am

When we first arrive, we go to "Sign-out" room and receive sign-out from day team. This is where the Docs from the day shift present every patient on the Peds service to us, the night shift team. Once a patient is signed-out to us, the day Doctor is no longer responsible for the decisions we make as the night team. During the Day shift, there is a separate Doctor who covers the Newborn service, 5-Central and ER Admits (the Peds floor at CRMC downtown; can be 2 residents if we have a guest from Family Practice), and Neonatal ICU (actually 2 residents, sometimes 3 if we have a FP guest).

At night, there are only two of us - the Senior Resident and the Intern Resident - to cover all the above areas. Since we are "only" covering and not responsible for necessarily moving care forward, it isn't as bad as it seems. However, there are times when you have two babies born simultaneously, each requiring resuscitation, an ER admit and a regular newborn who needs screening and it all happens at the same time. That can be pretty hectic.

As the night Intern, I am primarily responsible for all Newborns who join our world at night and for any ER Admits and/or Consults that occur during the night. On some nights, this can consume all 12 hours. On other nights, not a single baby will be born, in which case we either read, sleep, snack, or round with the Senior resident on NICU. It must be noted that every senior resident I have worked with so far has been incredible. Patient, guiding, kind and smart. And every single nurse is always willing to help and offer advice or just a joke to help you smile and make it through the night. The NICU nurses especially are most kind and really know their stuff.

On my busiest night so far, I received 4 pages for newborns (yes, we still use pagers), one of my mommy's needed resuscitation and I handled a consult - all within the hours of 2am and 630am. It went from being a quiet night to suddenly non-stop action. And of course, two of my babies were from mom's who either a) didn't know they were pregnant until last week or b) knew they were pregnant, had good prenatal care, but had fevers going into delivery - something called "Chorioamnionitis", which requires that I treat the baby with antibiotics after delivery and observe for at least 48 hours to ensure that baby won't become septic. The clock ticks pretty doggone fast when you have to make lots of decisions quickly.

And then, after a night of carrying 2 pagers (my own and the Newborn one) and a "Vocera" (the NICU in-house walkie-talkie-ish phone), I get to hand over all but my own pager, sign-out all the patients to Day team, and go home and rest for a bit before coming back and doing it all again.

Stay Tuned for More "Day in the Life..."

1 comment:

  1. So glad I checked the blog tonight! Very interesting and looking forward to the next post!