We asked a number of our residents to describe what a typical day looks like. We are grateful to share their stories in this series of diaries.
Each day at University of Iowa Hospitals & Clinics has a different flavor, rhythm, and pace that offers its unique learning opportunity. While slower-paced days offer time for ‘chalk-talks’ and discussions, busier days provide the opportunity to learn directly from patient care. Regardless of the pace, the team always works together to provide great patient care while still smiling and laughing. While each day may have its unique touch, my rough daily blueprint makes sure I have a work-life balance.
5:45 am – 6:30 am: The first of many back-up alarms sirens and it’s time to start the day. Shower. Scrubs. Coffee. And I am out the door. My traffic-free drive to work usually consists of calling one of my parents or my best friend. If I did not have time for home-made coffee, I visit Bread Garden on my way in for a refreshing Espresso Cooler, which is probably too much sugar for the morning but we all deserve to indulge in life’s simple sweets.
6:45 am – 9:00 am: I get to the 4RC work room, the Inpatient Cardiology headquarters. Soon after, my interns are walking in with the night hand-off from the CVICU senior resident. We take a few minutes to talk about major events that occurred overnight and big plans for the day: who is getting a procedure and who is discharging. Now, it is time for chart reviewing. Looking at the daily BMP, ins-outs, Echo, recent coronary angiograms have meaning when you are the resident taking lead on the patient’s care. The morning is a time to reflect on the patient’s hospital course and formulate a plan that will bring that patient one step closer to feeling better. Daily plans include anything from today’s diuretic dose to physical therapy planning to deciding between a stress test or a more invasive catherization. After chart reviewing, I review each patient’s telemetry, looking for any arrythmias or rhythm changes overnight. I like to mark down any unusual strips because I know they will make for good discussion and learning points later on rounds. The rest of the time is allocated to pre-rounding on patients and social rounds. Social rounds are a multi-disciplinary team meeting with social workers, nurse navigators, and me. This is one of the new responsibilities I have as a senior resident and it really helps me refine my skills as a leader. Social rounds are a great tool that bridge inpatient treatment with outpatient care.
9:00 am- 12:00 pm: It is time for the main event – Team Rounds! Our attending comes in and honestly it starts off with a couple of personal social news and maybe a joke a or two. We then go ahead and conduct table rounds, discussing each patient’s newest objective data and plan for the day. Morning rounds are one of my favorite learning opportunities because it allows me to connect a general topic to a specific patient. Our attendings are wonderful and are always teaching when the opportunity arises. After table rounds, it’s time to see the patients. Our hospital is quite large but it is not difficult to maneuver around. One of the best perks to Inpatient Cardiology is that all the patients are on the same unit, maximizing efficiency! When rounds are over, the whole team heads back to the work-room and we “run the board.” This is a great way to make sure the whole team is on the same page. Now it’s time to make the plans happen! Discharges, orders, consults, and medication changes are then placed by the team members.
12:00 pm – 1:00 pm: Lunch with a side of learning! We all head to noon conference for the lunch hour to enjoy a meal provided by the program while engaging in interactive and comprehensive lectures. Aside from all that, noon conference is great time to see all your friends who are on other services.
1:00 pm – 5:30 pm: After noon-conference, we check-in with all our patients and consults we have made. This is a chance to see if our earlier plans were effective. Alongside of this, we usually get 1 or 2 admits. An admit is a team effort with the attending or myself doing the triage and the intern placing skeleton orders to get the ball rolling. After seeing the patient, usually as a team, we often head back to the workroom to discuss and finalize a plan. This is another great learning opportunity that facilitates great discussion between the team members that I really enjoy. The rest of the day is allocated to adjusting each patient’s plan and making any necessary changes. The afternoons can get busy but they are enjoyable because of the friendly, encouraging, and engaging team dynamic we have at Iowa! The final moments are used to formulate a sign-out for the night team. The interns and myself attempt to create a comprehensive game plan for the night resident if things were to turn south.
6:00 pm – 10:00 pm: I usually arrive home anywhere from 6 to 6:30 pm. Just like my drive to work, my drive home is usually spent on the phone with family or friends. My wife and I have a hearty warm meal while catching up on our days. Having a support system during residency is crucial and my wife has been my rock during this time. A TV show of some sort, usually FRIENDS, is involved in our nights at some point. Then it is off to bed to unwind while I watch YouTube videos. It has been a long day but one filled with jokes, learning, and family time so I cannot complain!