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.
This week I’m doing a Night Float rotation so I get to sleep in. I wake up around 11AM and make some breakfast. I tune in for our noon lecture over Zoom. Most of the residents attend in person, but when I’m working nights I prefer to watch from home. Today’s lecture is an R3 panel discussing how to get involved in research during residency. It’s inspiring to hear how many of our residents are involved in research projects and are successful in publishing. It reminds me of my own research projects, and I look at my To Do list. I decide to upload my poster presentation to Digestive Disease Week (since it’s a virtual conference this year). I also work on writing up a case report from my time on 6RC last month. By the time I finish up my work, it’s mid-afternoon and the sunny 70 degree weather is calling me. I take a break to go for a walk before making dinner and heading to UIHC for my shift.
It’s a quick 12-minute drive from my home to UIHC, and since I’m working nights I get to park in the parking garage for free! I meet the day residents for sign-out at 5PM. On the Night Float rotation, you cover patients on the inpatient Heme-Onc and Med-Psych floors. This is about 30 patients in total. I’m asked to check up on a few labs overnight, and my co-residents prepare me for anticipated events that might occur overnight. After sign-out, the day residents leave for the day and it’s just my night senior resident and me. The great thing about Iowa is that all of my senior residents have been awesome mentors and friends. We hang out in the workroom for a while talking and waiting for an admission.
Some nights are busy and some are quiet. Tonight happens to be a busy night. The night begins with a Code Green being called on a heme-onc patient who becomes agitated and attempts self-harm. Psychiatry residents are paged to Code Greens and they come to give advice. The patient is unable to be redirected and eventually requires Haldol to ensure her safety. We have a bed in Med-Psych available and decide to transfer her there for the night. Later on we get a few more admissions to Heme-Onc. One patient has intractable nausea in the setting of brain cancer. Another patient presents with neutropenic fever. My senior resident helps me create a plan to stabilize them and begin their diagnostic work-up. Our new patients get tucked in and everything is calm around 2AM, so we decide to try to get some rest. I go to my call room and get a couple hours rest before getting my next page. In the early morning I will often get pages about fevers, high blood pressures, and labs abnormalities. By now I am comfortable managing these on my own, but if there is anything I’m uncertain about I know I can call my senior for help.
My daytime colleagues come back for sign-out at 7AM. I’m happy to report that there were very few acute events overnight. I go to the Med-Psych workroom to present their new admissions at 7:30AM, and then head to the Heme-Onc workroom to present their new admissions at 8AM. I always like morning presentations because I get to tell the whole team (staff, residents, and students) all about the patients and discuss what work-up we did overnight. These discussions are great learning opportunities and I feel very comfortable asking questions. After my presentation, the day team discusses what additional steps they plan to take for the patient that day. My daytime colleagues help me make sure consults are called and correct orders are placed, and I am free to leave around 9AM most days.
By morning I’m ready for bed. I head home to sleep and enjoy the rest of my day. I don’t return for my next night shift until the next evening, since I alternate nights with another intern. I get the rest of the evening and next morning to spend resting, pursuing hobbies, and working on scholarly activities before coming back.