Hi all! Coming in today/tonight with a little late night post because I'm still working nights and (getting ready to say what one should never speak out loud...) it has been a relatively quiet night for the first time since I started! And just like magic, *my pager just went off*... brb!
For one - I have awesome co-interns. I purposefully chose a hospital that was the closest commute from home (nothing beats a quick 10 minute drive home), but I've never worked or rotated here before so I wasn't quite sure what I was getting into when it came down to the house staff. Thankfully I couldn't have gotten a more fun and down-to-earth group of docs to celebrate and commiserate with - we had some great bonding during orientation and I know we will continue to grow closer as we rotate through together!
What I was most worried about? Liv of course. But having my MIL living with us (you can read more about that here) is really worth its weight in gold, and I never leave the house feeling guilty or worried about how she'll do - they absolutely adore each other. And with this night float schedule (roughly 9pm-7am), I actually get to see her first thing in the morning as she's waking up, then I lock myself in my room and sleep for a couple of hours (thank goodness for my eye mask and ear plugs - sleeping during the day is just not normal for me), and then get to hang out with her all late afternoon and evening - playing with her, getting dinner ready, and some days even squeezing a bath in all before I leave again around 8:30. It's been pretty sweet. The one thing that has been the most rough is spending time with N. He's on a normal day shift, so most days he's out of the house before I get in in the morning and sometimes isn't back until after I leave. But communicating throughout the day definitely helps big time, and the best part of night float of course, is that I work Sunday night-Thursday night, so I actually get my weekends off (for this rotation at least). And he does too. So weekends are our time and we make the most of them!
Ok, back to the hospital. As night float intern I'm basically covering for 6 different teams' patients - some days I can be lucky and it means only 25 patients, but most days it's been averaging around 45, sometimes even more. That means should anything come up with any one of those patients I get a page about it, whether a patient wants something to help her sleep or a patient has a change in mental status or new chest pain, really you name it and I'll get paged about it. I work with another resident (someone at least a year my senior), but they are responsible for dealing with the new admissions that come in, while I handle all the inpatients. They are certainly there as extra back up should I need it, but I'm the front line. Which was terrifying at first (and still is especially when I'm dealing with something new), but it's amazing how quickly you learn and figure out things. At this point in our training we're not expected to know much, but we are expected to know what we don't know and call for help when it's needed. Just two nights ago I had a patient who I had seen just an hour earlier now desatting to the low 80s, using her accessory muscles to breathe, and really not looking good (she was sweaty and really struggling). I started with basic quick fixes - bumping up her oxygen, switching to a nonrebreather, getting an ABG and stat portable chest x ray (and paged my resident of course), paged respiratory, but when they didn't come and my resident arrived I gave him the quick rundown of the situation and told him I think we should call a rapid response. At the end of the day it comes down to what the nurses on the floor can handle and our nurses were doing all they could and this woman was still going down. We called the rapid response, and we ended up transferring her to the ICU where she eventually had to be intubated. At the end of all that, my resident and the ICU resident both came up to me later and said "good call." Moments like these are the times it 1) just feels good to hear since in medicine we so rarely get positive feedback, and 2) you actually start developing your own clinical intuition and feeling like you may actually be able to do this after all. The moments like these make the endless pages and order-writing and busy work worth it.
Alright, enough late-night rambling from me. Time to have a snack and feed this growing belly! (Which I also forgot to mention, but thankfully incubating baby does not seem too upset by this new insane schedule mama is working as long as I eat plenty of snacks throughout the night and stay hydrated. Best of all he or she has already started moving around and kicking in there, which is the best feeling - puts a smile on my face every time).
I hope you all have a wonderful 4th of July weekend and enjoyed this post!! xoxo