A day in the life of an Intern – Yana Zemkova, MD

Last year, we asked two interns in the Internal Medicine Residency Program to each provide an account of what a typical day looks like. Over the next couple weeks, we will post diaries from second- and third-year residents as well. We are grateful for their participation. 

As the month of April comes to a close, I am faced with the fact that we are winding down our 10th month of residency, and soon the entirety of intern year will be a memory that we glimpse in the rearview mirror. It’s a strenuous journey to embark upon, but Iowa has become my home and my routine, and the people my family. So what are the days like?

On 6RC ~
The morning alarm goes off a touch earlier than preferred but at least now the sun is (almost) up and the birds are chirping to welcome the day. Getting ready on inpatient is a luxury since the stress of putting together a sensible and fashionable outfit is eliminated by the ease of the GREEN SCRUBS.

Although sign-out is at 7am, I typically arrive by 6:30 for quiet time to establish my space – you know, where I have to place my pager, Voalte phone, stethoscope, pens, papers (and of course, coffee #1) in just the right arrangement to ensure an organized start to the day. Then it’s on to the overnight team. There is always a moment to relate to their overnight experiences and hope it was more calm than not and that some sleep was possible. Getting the scoop on my patients, I mentally keep my fingers crossed in hopes that everything was tucked in enough yesterday without major issues.

Pre-rounds on EPIC: just your standard run of the mill – COLLECT ALL THE DATA (and keep it all straight). Time to see some patients! There is always a momentary hint of guilt waking them up early in the morning – this is a place for healing, right? Can’t we let them rest? “But I still need to ask you how you are feeling even though you have only been up for about a millisecond.” If I’m at all concerned, I race back up to the team room to update my senior so we can come up with an immediate intervention. At first coming up with a plan as an intern was intimidating, there was so much I didn’t know! And what if I was wrong! And now…now there is still so much that I don’t know! And I am still wrong a lot! But that’s what the seniors and staff are for – I come up with my plan and we talk it through together.

The time to round with the whole team rolls around and we are off! Walking through the halls in just enough of a rush to facilitate efficiency. If we’re lucky, most of the patients will be located in the same general area of the hospital. Other times, we get “lucky” if the goal is steps on the FitBit, because then we get to spend the morning wandering across all areas of the hospital.

Rounds are complete by late morning – notes updated in stolen moments between patients, orders placed, consults called. We have made it to lunch time! Noon conference is our dedicated time – pagers are held, lunch is provided (Hy-Chi, anyone?), and a lecture for education. Sometimes it’s a game of Jeopardy or even social hour. It’s a great moment to see our colleagues, friends, and program leadership for a break in the day and glimpses into our work lives on other services.

After lunch is a perfect time for coffee #2. If there’s more energy (or a need for coffee #3), holding out until 4pm would be the way to go in order to get the Bread Garden Happy Hour – coffee and free pastry! In the afternoons, we run the list with the seniors and we work – entering more orders, labs, discharging patients, talking to families, following up with nurses. There is built-in time for a teaching session with other teams, and if we’re on call, then waiting for that heart-stopping page indicating a code or rapid is on the radar as well.

Somehow the end of the day has arrived. After a quick check (by referring to my color-coded, now-battered-from-being-folded-one-too-many-times paper), and a final running of the list with my team, I’m ready to go! Sometimes it’s at 4, other times at 6 . . . and occasionally later than that. Sign out to the night team, plug my pager in (I don’t want my pager waking me up overnight!) and that wraps it up. Rinse and repeat for an additional “X” amount of days until the next day off!

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