Sunday, September 25, 2011
I know you've all been dying to hear about being on call for medicine.  Or at least dying to hear what exactly being "on call" means.  Since yesterday was my first call day of the second block of medicine, I figured I'd use it as an example of what a typical call day looks like. 

This is the meat and potatoes of intern year.  We do five rotations on the medicine service during intern year.  If you're admitted to the hospital, and you don't have a doctor (or your doctor doesn't come to the hospital, or you don't remember who your doctor is, or if we are your doctor...) we will take care of you on staff medicine.  In addition to taking care of my patients, when I'm on call I'm responsible for admitting any new patients coming to our service, running code blues, RAT (rapid assessment team) calls, seeing patients who fall while in the hospital, and pronouncing patients who were DNR and died. 

So, yesterday looked a little like this...

6:30 - Get to hospital and preround on my patients (we just started this rotation so they were all new to me)
7:00 - Breakfast rounds.  This is a Saturday only special.  But I like it.
8:30 - Finish rounds and start seeing patients and writing notes.
9:15 - Rapid Assessment Team call.  A patient on one of the floors is having acute shortness of breath.  We go get him taken care off, transferred to where he needs to go, then get back to regularly scheduled programming
10:30 - I do a circumcision on a baby who was delivered by the OB fellow yesterday.
11:30 - Finish writing notes and seeing patients.
12:30 - I grab a sandwich
12:31 - I do a pronouncement of a patient who just died.
1:00 - Talk to a patient about going home.
2:00 - Go see a patient who developed chest pain.
4:00 - Talk to radiology about test results for a patient.
4:30 - Everyone is tucked in... so I just wait to get called by the ER about an admission
7:00 - Night call person comes in.
7:15 - I go home.

Lucky for me, I didn't have any admissions ALL day, which is unusual.  On my first night call the first month I was on medicine, it looked something like this.
7:00 - Arrive at hospital and get checkout for medicine day team.
7:30 - Go to ED to see first admission.
8:00 - Told I have two more admissions to do.
9:00 - CODE BLUE
10:30 - Head back to ED to work on admissions.
12:00 - I've now been told about 7 people to admit.  That's our cap, so I lined the charts up and just started plowing through them.
1:00 - While staffing a patient with our attending, the CODE BLUE siren goes off again.
2:00 - Call attending back to finish staffing.
3:00 - Go to talk to family of patient who died in second code.
4:00 - Go to ICU to pronounce a patient
4:30 - Go back to ED
6:45 - Finished admitting patients.  Go to Cafeteriahhhh to get coffee.
7:00 - Rounds.  I present my 7 new patients.
8:45 - Go to aspirate knee of patient
9:30 - Try to convince patient to have important procedure, which he refuses.
10:30 - Go home.

Typical call days are somewhere between those two...

Now you know. 

Phew, I'm sure you feel better. 

Peace out.
Kari

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About Me

I am a Family Medicine intern at a community hospital in Indiana, navigating the new world of being a physician. I am privileged to work in a field I love, where every day is a new and unpredictable challenge.
I am not only a doctor, but also a cyclist, runner, DIYer in the making, lover of the outdoors, traveler, and human.
Human, MD is a glimpse into the world of a young doctor who is just trying to stay true to herself through the grueling whirlwind of residency.

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