Day in the Life of a Doctor: NIGHT SHIFT

Hey guys. I’m Siobhan, a second year medical resident. I’m just starting a night shift, so tonight I am the senior resident in charge of a team of junior first year medical residents as well as medical students. So let’s see what the night is gonna bring. Hey. Oooh, take it! Oh my gosh, hahaha. Okay, was the day that bad? Was it busy? Okay, oh no. I can’t. Hi, this is Siobhan the SMR returning a page. Ah yeah. How low is the sodium? Okay, yeah. Do you mind just sending off urine lytes and then we’ll be there in the next 30 minutes or so. Perfect, great. Thanks so much. Okay, bye. When the emergency physician consults internal medicine to see a patient, it’s usually because they feel the patient needs to be admitted to the hospital. So I’ll go and see the patient first and depending how sick they are or how complicated the case is, I’ll assign either a medical student or a first year resident to do the consult. Then when they’re done, they’ll come and review their work with me. Hypertension and dyslipidemia, 2 prior strokes with similar episodes. She’s being treated with apixaban reduced dose 2.5 milligrams via IV. Hello. Hey. How is it going? Good, how are you? Good, is everything okay? Yeah, it’s not too bad yet. I have a consult for you. Okay. So I have a 75 year old lady and with no past medical history who came in tonight with chest pain. The chest pain has been retrosternal. It’s been on and off for about the past seven to ten days. It gets worse with exertion, associated with shortness of breath, nausea, radiates a bit to her back, vitals are all fine, ECG is unremarkable. The reason she came in today is that when it initially started, it was only happening 2 to 3 times a day, it’s now happening about 7 to 8 times a day. And with even fairly limited exertion, like going up the stairs or just doing something like light housework. ECG is normal, tropes are negative times two, but certainly concerning for angina. I hope you can see her. Absolutely no problem, thanks very much. Angina is chest pain caused by narrowing in the blood vessels of the heart. Based on the patients age and symptoms, it sounds like unstable angina and she’s at increased risk of having a heart attack. So we’re admitting her to the hospital, starting blood thinners and asking cardiology to see her in the morning to consider an angiogram. That’s when they actually go into the blood vessels of the heart and look for a blockage. Hi, this is Siobhan the SMR returning a page. Yep sure, no problem. Okay. We’ll be there to see her soon. Thanks, bye. The emergency physician has asked us to see an elderly patient who fainted. Lots of things can cause fainting, but my first concern is whether it’s related to the heart, like an abnormal heart rhythm or a problem with the valve. Although in this case I think it’s more related to the patient being dehydrated, which we can easily fix with IV fluids. Hey Lana. Hello. You’re ready to review? For sure. Okay, so guys, this is Lana. She’s a PA student. So physician assistant, a student and is finishing up in a couple of months. So very exciting. Yeah, for sure. And you saw our patient with syncope, right? Right. Yeah. So we have a 75 year old male who presented with syncope and he has a history of heart failure as well as dyslipidemia, hypertension. Oh 12:30, I’m so hungry. I feel like my brain can’t function, my breath is definitely bad. Too much information! Ok, let’s go to the cafeteria. Okay, mission accomplished. And I got snacks for the whole team here too. Gotta get some encouragement for all the new consults coming in. Okay, well keep me updated and let me know how she’s doing. Hey Siobhan. Is everything okay? I mean right now we have a… There’s a lady on the floor that’s not doing too well. And if you have a moment, that’s something I want to review with you. Yeah yeah, tell me about her. Well, over the course of the day she’s needed more and more oxygen. I’m worried that she’s heading in the direction of needing to go to the ICU. Okay. I was hoping that you could come with me and we can take a look at this patient. Actually yeah, why don’t we just go do that now? Do you want to do that? We can just see her and figure out… Walking into the patient’s room it’s clear she’s working hard to breathe, as if she’s just been sprinting but really she’s just been lying in bed. Despite all the medications we’re giving her, she’s actually getting worse and needs more help breathing. So the next step is to call ICU and move her to a more monitored environment, which is designed for sicker patients. Okay, so this is Sonya. She has actually matched to emergency medicine. So you are gonna be an emergency physician? I am! That’s awesome, congratulations. Thank you. And now we’ve got a consult for you here in the emergency department. A patient coming in with very very short of breath, requiring a whole lot of oxygen. So right now they’re already on five liters of oxygen, which is a lot. So take a look, see everything that’s going on and then we can chat about it after. Sounds good. Reasonable? Yeah. If you’re worried, come and get me. For sure. Okay, thanks. And it’s been three days since the bowel movement. For a suppository? In terms of her social history, she’s actually quite independent. She’s from a retirement home. She’s functioning quite well prior to coming in hospital, non drinker, nonsmoker. Hey, do you like my dog on the patient board? Mmm, is this 4 am brain? Oh, this?! What is happening? Is this like our 6 am anthem? We’re done with our consults, I think. Don’t jinx it! Did I just jinx it? Nooooo. Don’t say things like that, oh my goodness. Oh my gosh, I’m so sorry. You should know better by now. Hahahaha. I apologize. 6:30 a.m. Just got a page from the emergency department. This is truly the most dreaded time, because oh it’s the last-minute consult. I shouldn’t jump the gun, maybe it’s not a consult. We’ll find out. So it’s confirmed a last-minute consult. Patient had a fall and has a bleed in their brain. So you know what? I think I’m just gonna try and see it myself rather than getting one of the juniors to do it and hopefully just try to finish it off quickly. Finally done, this was a steady night. Honestly I’m so exhausted after doing this every other night for two weeks. Completely done at this point. But I had such a wonderful team and I want to thank them all for being a part of this video. So if you want to see more videos like this, don’t forget to subscribe and comment below if you have any questions, if you just want to say hi. Otherwise, I’ll be chatting with you guys next weeks. So bye for now!

100 comments

  1. It's nice to see shift like this, in my place, we have to work like 36 hours. After a night shift we have to attend the next day. It so tiring..

  2. I was admitted to the hospital last weekend and had consults with internal med (hypertension wooooo) and it just reminded me of your videos lol

  3. this is definitely violating PHI
    not to offend u or anything but, u work in a hospital, shouldn't you know this?

  4. Hey I am a student that is in high school and was wondering if there was any way I can contact you personally so I may ask you if you were able to do an interview for my school project where I find a leader I look up to and see if you had any wisdom you could give to me to help me create my career path. Kimberly Duong please respond back. Feel free to reach through this comment

  5. You are such a wonderful, kind, supportive leader. You inspire me to be a better employer, colleague, friend. I'm on my way to being a criminal defence lawyer, and while the work is dry different, it shares some important similarities: seeing people at their lowest points, highly demanding workload, pressure, and the limited ability of your friends and family the relate to or understand what you actually do for a living. As a result, it's so important that as co-workers we learn to hold each other up well. And I like watching you do that so skillfully. 🙂

  6. You're videos have ignited my love for medicine again and i cant thank you enough! Because of you I will be going back to school in the summer! <3 Thank you so much for being so inspiring.

  7. Hi Siobhan! I was wondering if you could do a video on working together with nurses? I’m a third year nursing student, and when I’m at the hospital I see the doctors brush us off as well as the RNs. It’s really frustrating because often times we see the patient more than they do.

  8. Ur vedios really very motivate me bcz my ambition is also to become a doctor.plz pray for me and support.

  9. Everything on this video is all staged all my God this is all fake can't believe i just wasted 2 minute of my life

  10. Wow….I just got to know about your channel and so far am loving it. Just subbed and turned on the notification bell. Thank you for taking the time out of your busy schedule to shoot and edit these inspiring and educational videos for us, learnt a lot watching this video. Just finished med school and I can't wait to practice as a medical Doctor.

  11. How many times per shift are you using your stethoscope? Or is it more of an accessory to make you look more legit 😂

  12. I just wanted you to know that you inspire me every single day to keep working hard to–someday–call myself a Doctor!

  13. Have you ever seen a patient with multiple sclerosis? Because my dad is a nurse that helps people with that disease

  14. My dad has been a to the hospital 6 times of heart attacks and hasn’t died and I have been thinking of working in the hospital🏥

  15. My dream job is to be a doctor you really inspire me and give me good insight into the life of a doctor
    !!!! Thank you 😊❤️

  16. Heya! I stumbled upon your vlog and I really enjoy watching it! You’re so positive and uplifting and I can just imagine how canning and empathetic you would be to your patients. I just have one suggestion would it be possible for you to create closed captions for your vlogs for the hearing impaired? 🙂 love your site 🙂

  17. after mbbs and 1 year internship from Bangladesh I want to go Canada as a immigrate. then I want do MD degree without doing medical school and then I want to residency, I want to complete whole process in 6 years before I getting my license .please tell me is it possible.

  18. What do you say when you answer the phone? For some reason I hear asmr after your name and I feel like that’s wrong lol

  19. Hi Siobhan! this is completely unrelated, but you should make a video on Frenuloplasty. Might have to get it done soon :-/

  20. my aunt works as a secretary in the ER and she’s definitely seen some of the stuff you’ve seen! really fun to see what actually happens since I could never watch my aunt!

  21. I remember working a night shift in the ICU when my patient was accidentally extubated by the respiratory therapist in interventional radiology during a transfer. He was supposed to be protecting the airway and his hands slipped and he pulled the ET tube out. It put the patient at risk bc they had a difficult airway. He later mentioned he was on his 16th hour of work. I've seen some crazy things happen when hospital staff work overtime. Long shifts shouldn't be allowed for sure!

  22. My daughter got me hooked on your blog. I wish there was more you could say or do, but as a nurse, I realize that HIPPA prevents that from happening. My suggestion is to end as you begin-playing violin!

  23. Hi Siobhan! Can you do a video shadowing a social worker at the hospital. It be really interesting to see the dynamics of a social worker and doctor. Coming from a social worker in the making!

  24. I always love watching your videos! What advice would you give to someone (like me) who wants to become a doctor/surgeon but is only a highschool freshmen? Like, what subjects should be start studying to help prepare us for med school and life as a doctor in general? Also, can you please try to shadow a surgeon for a day?? That would be really cool!

  25. I have watched many of your other vlog type videos and this is by far my favorite! I would love to see more of the full behind the scenes of the team and really understand what happens in the hospital. I understand that is not always possible but when it is that would be great!!

  26. As I watched you grab the blood tubes for the elderly pt. w/ syncope I tried to guess what labs you wanted drawn 😂

  27. Watching your videos- and it's absolutely ridiculous. People's LIVES depend on you and you amazing team, yet you're often on for 24/26 hours at a time. How can this be changed? There's SO much research on how lack of sleep and working for hours like that impact brain function, and it's unbelievable to me that in Canada & The US they still are scheduling like this. You wouldn't want an Uber driver who has been up 20 hours driving you down the block, never mind a surgeon who has your life in their hands! What do you think the best course of action is? Does it have to happen internally, or can the public help? Siobhan, every time you walk into a call room I feel anxious! I think to myself "Oh my gosh, PLEASE don't let the pager go off! PLEASE let her get a little rest!" Haha. Thank you for doing what you do and giving the public a glimpse behind the curtain. I'd love to talk about what you think could be done to get legislation moving. I truly believe this CAN and should be changed to protect both medical providers and patients.

  28. Great video…wow your schedule is crazy! I hope you re looking after you 🙂 I’m going to be applying to Med school in the U.K. soon and it’s so fab to see real life shifts. Thanks so much for sharing your days (and nights!) You re positivity is infectious 🙂 Take care Doc 🙂 👍

  29. how many of these are staged? I keep seeing people walk in to rooms an not commenting on the camera… or even being caught walking in to the room… did you have the camera out the whole time? Or when you talk to a college some one else is holding the camera? What is your setup and filming strategy?

  30. This may be a silly question but… with all the death around you,and that you have probably witnessed, does it ever make you overthink things in a way/affect you significantly? Or have you built a sort of resistance to it?

    I know some who have been around death, and all their reactions are different. Just wondering.
    Thank you for this video by the way x

  31. You seem like such a great MD to work with!!! I am a RN in a trauma 1 facility… Jacobi Medical Center in the Bronx NY!!! Your videos are awesome. I love watching and comparing what we go thru in our crazy hospital. Lol. Good luck with all. 😊😊😊

  32. Hi there , what made you decide to go into Emergeny Medicin ? I am hoping to get into medicine myself by the end of this year, have I gone in the wrong direction? As not everyone believes in me !

  33. Watching your vlogs make me sooo happy I left paramedicine (was an EMR). I could never be fully ready on call 24 hours a day. I feel sorry for Physicians and residency MDs (don't get paid enough for this). Will feel the burn out the older you get. Best of luck !

  34. I have binge-watched your videos !! Stumbled upon your channel while my search for some med school advice and I have been hooked! keep creating amazing content !!!!!

  35. Why is the medicine service admitting brain bleeds from trauma? Lol. Do you not have a trauma service?

  36. You should do a video explaining what exactly a resident is and the difference between a resident and med students

  37. I can't stop watching your videos im almost through all the medical ones and so far they are all amazing. Thank you for doing all that you do. <3

  38. I love watching you can’t wait for you to say “ 3rd year “ keep it going .. so proud of you 😭😭🙏🙏

  39. Love your videos! Maybe this is a stupid question, but what happens if you get a page while you're with a patient?

  40. After watching your videos, it was the last thing I needed to inspire me further to continue my studies towards becoming a doctor. I was questioning myself a lot, doubting myself majority of the time. Watching your videos I felt like I was there with you, I really wanted to experience what it is actually like once you're in the position of a doctor. Whether that'll be doing shifts, working in the hospital environment, etc. You really need to consider all the aspects of becoming a doctor before you put so much effort in.
    You explain things so well, you are so passionate about what you do and that is absolutely amazing. Thank you so much for your videos!!!!!

  41. hi Siobhan, I saw you had timmies in one of your other previous videos and was wondering, where at in canada do you live?

  42. Hey im just a 12 year old European girl who aspires to do my studies in the US. I really want this goal to be achieved but i know that it is really hard for a foreigner to study medicine in America. Well, it is actually everywhere but i especially like the US and lets say that the cost is really high which thats the thing that tears me down because it is hard for international students to get scolarships. And yes, i know im too young to think about college/university now but i just cant help myself from doing the otherwise. I started doing my research, taking notes for all the information i could i find online for foreign students in the US but still don’t tell me if theres a chance (i dont know how to explain it lol). As you can see im very stubborn. What im trying to say is that, is there hope for me? Can i do it? Will i eventually find myself in a college then in a med school and then finally apply for residency? Please i want to know if there will be a chance. Im waiting for your reply 🙂

  43. I just started as a junior resident at psychiatry..i'll be doing my first oncall in a couple of weeks and im honestly freaking out..i wish i was as confident as you😭

  44. I have personally fallen and had a brain bleed from it! Actually lost my sense of smell due to my brain bouncing off my frontal lobe. The ICU team loved me and was always visiting cause I was still in good spirits even though my head was pounding! Thank you for everything you do, us patients really appreciate it ☺️

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