Today I’m sharing another post in my A Day in the Life Series. In the past, I shared A Day in the Life of Psychiatry and A Day in the Life of Internal Medicine so if you missed those, definitely check those out (don’t worry I’ll wait here).
I’m currently wrapping up my surgery rotation (hallelujah *insert praise hands emoji here*) and recently I completed two of my required overnight trauma calls. For those of you not in the medical field, taking call/ being on call is when you stay in the hospital and evaluate the patients that come to the emergency department and bring them into the hospital (or sometimes you discharge them). Overnight call, is basically the same thing as regular call except you stay in the hospital overnight.
On my surgery rotation, students are required to take 2 overnight calls with the trauma team. On my overnight call days, I start my day at 4am, work all day with my regular surgery team and then around 6, I switch and join the night trauma team and then I don’t get to leave until 8am the next morning. It’s a LONG shift, especially when there are lots of traumas overnight but it is a good learning experience and today I’m giving you a sneak peek into what it’s like as a medical student on trauma.
This is when alarm #1 goes off. I’m usually tired (not from studying but from BSing and scrolling through Instagram in bed or something equally foolish) so I really struggle with waking up.
4:30am: I actually wakeup
I actually get out of bed now. I sluggishly turn off my alarm and get ready for my day. I usually take a quick shower, brush my teeth and do my hair. On call days, I skip my usual 5 minute hospital makeup routine and I wear my glasses because it will be a long day and I don’t care about how cute I’ll look after working for 24+ hours.
5:00am: Out the door
Ideally, I leave by 5am and get to the hospital around 5:30am. On a good day, I am in the hospital by 5:15am but most days are not good days. When I get there, I print the list for my team, check on i’s and o’s (in’s and out’s) for each patient and prepare for the day.
My current surgery team rounds around 6:15am. Rounds is when you go door to door to each patient’s room and check on them. We discuss their labs, overnight events, anything that is pending, and the plan for the day.
6:45am: Pre-Op & Breakfast
What I love most about surgery is that the rounds are VERY short. What I disliked the most about Internal Medicine were the long rounds so I really appreciate the quick pace of surgery. After rounds, we head to the pre-op area and consent our patients. From there we grab a quick breakfast in the cafeteria with my team.
7:30am – mid afternoon: Surgeries
First cases in my hospital start at 7:30am but by the time we intubate and prep the patient for surgery, its already 8/8:30am. Currently I’m on Vascular Surgery and I see a lot of AV fistulas, angiograms, venograms, aortic repair, amputations, and other vascular related diseases.
So at some point after the first case I will grab lunch. Meals have varied from team to team for me. On one of my surgery rotations, the chiefs would tell students when to eat. But on this rotation no one really does that. Occasionally I may get a “this is a good time to grab lunch” but for the most part I use my own discretion as to when is a good time to slip away and go to the cafeteria. I typically leave immediately after the first case, or immediately after we visit patient #2 in pre-op.
Usually at some point in the afternoon, the med students on the surgery rotation have a lecture. This really varies by hospital site and location but usually we have about 1-2 hour sessions 3-4 times per week. Our lectures are designed to reinforce what we see clinically and help us prepare for our shelf exam.
4:00pm: Return to the OR
After lecture, there’s usually a case still going on. If I skipped lunch, I usually use this time to grab something from the cafeteria. From there, I’ll head to the OR and see the rest of the case that was going on during my lecture.
6:00pm: Switch Teams
Usually I get to leave around 6/6:30pm. However, sometimes I stay overnight since my school makes us do 2 overnight calls with the trauma surgery team. On my first day of trauma we got a major accident at 6:00pm followed by back to back surgeries all through the night. I didn’t close my eyes once and was so exhausted when I got home. On my second trauma night, things were a bit more chill and I actually got a second to breathe and rest.
Overnight: Consults & Redlined Cases
Overnight the trauma team gets paged for a lot of the surgical emergencies in the hospital. A lot of time they are also covering for other teams so if something doesn’t require emergent surgery, they can pass the patient to the respective surgical subspecialty in the morning. When major cases come in (motor vehicle accidents, gunshot wounds, stabbings, etc) these patients get redlined to the OR. At some point in the night, the trauma team orders takeout to the hospital. That way in between cases we can grab a slice of pizza or some wings, but honestly, I’ve found that there’s rarely time to have a proper sit down meal. Here are some of the things I’ve seen during my overnight calls:
- Stab injuries – One time I had to stick my hands into someone’s neck to keep them from bleeding out (don’t worry I wore sterile gloves to protect me and the patient). It was really gross but kinda cool.
- Butt abscesses – Not my fave but still kind of interesting.
- Diaphragmatic Hernias – after major trauma like a car accident, your abdomen contents can break through your diaphragm and enter your chest. For you medical students out there, contrary to what UWorld says, I didn’t actually hear bowel sounds in the patient’s chest but I guess I’ll take their word for it that you can
- Motorcycle and Car Accident Related Traumas – Lots of broken ribs, broken limbs, pneumothoraxes (collapsed lungs), and other major injuries
8am: Go Home
By 8am the next day I am ready to collapse. I always think I’m gonna be so productive the next day but honestly I spend half of it sleeping. I typically drive straight home but if I’m tired enough I may take a power nap in the student call rooms before heading home.
Overnight calls are exhausting. At my current hospital, the trauma surgery residents do it every 3 days. I don’t know how they do it, but it takes a lot to take call AND operate on a 28 hour shift.