Abe recently told me, "I have no idea what you do at work all day." This inspired today's post. I warn you it it long and detailed (a busy day!) but if you are curious, here you go.
A Day in the Life on Midface Trauma Call:
Background: "midface" is when all facial trauma (minus noses or just mandibles) comes to you. This gets split between oral surgery and ears, nose, throat. When we are on "midface" we are required to live at the hospital. Other weeks, we get to take call from home.
7:45 am: change into scrubs. "I hope I get a nap in soon. I am tired."
8:00 am: rounds. Check on patients currently in-house (staying in the hospital). Gather information on their care for the day.
8:45 am: Emergency room. Mandible (lower jaw) fracture. Evaluate patient and get ready for surgery. Assaulted after returning home from bars 3 am.
9:45 am: Emergency room. Mandible fracture #2. Evaluate patient and add on to surgery schedule. Assaulted at/after(?) bars 1 am. Place orders (instructions for nurses, medications, etc) for both patients and prepare thorough history for surgery, prepare for admission to hospital. This takes some time...
11:00 am: Rush to catch up to chief (resident in charge) in OR. "Time for a cookie? Oh, lunch on-call money hasn't started yet. Better get going, anyway. Bathroom? Time to get my goggles in the resident room? No, better get there."
11:15 place orders for surgery, assist in surgery. 11:45 "Ouch, headache! It is very hot in here. I hope I don't pass out again." Continue to receive pages throughout surgery. EEK.
1:00 "Dr.'s, your next surgery is ready. You can go straight from here to the next one." ...no ibuprofen for my splitting headache, still no cookie.
1:15-5:00 surgery on jaw fracture #2.
5:30: Catch up on missed pages while in the OR.
6:00: evaluated patient in ER for being pushed down stairs during fight.
6:30 Wait in line at lame-o off hours cafeteria. Grab fries and soup. Eat fast, just in case. Finally some down time.
7:30: Round on patients for the night.
7:45: Free time. Yay! Try to sleep. Room is way too hot! Headache is horrible (where is an open pharmacy?), bed is like a board. Finally get ibuprofen at pharmacy and try to sleep. TRY being key.
3:00am: BEEP, BEEP, BEEEEEEP! "Pager. Ugh. Try to sound awake on the phone." Emergency room (one of Abe's doctor friends) calling about facial laceration with arterial bleeding they cannot stop. Can you come quick? "Uh oh! What am I going to do?" Page chief to come in ASAP.
3:05 am: scalp bleeding, put pressure on for 2 minutes, it stops. "Wahoo, I am awesome!--whatever. Oops, wish I wouldn't have told chief to come in." Page him again. He calls and says sorry for missing page. I am glad this time. Embarrassing to have him come in for THAT. By the way, patient was very rude, esp with me saving his life from bleeding to death and all. Kid got bit by sign in the head while "not drinking."
3:15am: While in the ER, another laceration. "He wants plastics closure with NO SCARS." ..."Great, do I tell him I have done this maybe 2 other times?" Struggled with very small laceration for too long, maybe an hour! Deep stitches and glue. Hope it works! While suturing, ER again, "Consult for 3 more patients."
4:00am: 6 kids in car accident on way home from haunted house. I get consulted on three of them. 1 has 2 big lacerations on forehead, one girl as jaw fracture with tongue laceration and loose teeth, 1 intubated and in intensive care for facial crunch.
6:00am: sewing up forehead lacs.
7:30: Finish one laceration (lac) and have to pre-round (check on patients before the boss comes).
8:00 "No longer on call"
8:00 re-round on all patients. Finally make it to intensive care to evaluated the facial crunch from earlier.
10:00: work on discharging two patients. Run to grab donut and chocolate milk (no time and few options in cafeteria closing for morning)
11:00: Finish suturing other forehead lac. (other resident does farcial crunch lac, thank you!) Chief does most of it, thankfully. It would have taken me much longer.
11:45 Time for 7 notes...Lots of paperwork
1:00: Home. Yawn!