As a PGY-2 I work a lot and don't sleep as much as I would like but thus far is entirely tolerable...definitely pushing the envelope of the 88-hour work week though. I think this is pretty typical for the beginning of the academic year when everyone is a bit green in their new responsibilities and everything takes somewhat longer than my senior residents would like.
We round at 6:00 and it's me and the other 2's job to see all the ICU patients and write notes (on our service and the consults) before then. This can take anywhere from 45 minutes to 2 hours depending on how many patients there are (the ICU census varies between 10 and 30). On the weekends it's just one of us (but we usually round at 7:00). Rounds at 6:00 start by looking at films as a group then walking rounds. With a ICU and ward census total often nearing 50 patients it goes fast as we've only got an hour.
We have conference every weekday at 7:00. The OR start times vary between 7:30 and 8:30 depending on the day. For us junior residents, one of us gets to the OR most days of the week but one of us must be out of the OR to handle consults and ICU emergencies and since we're on call so much there's often someone post-call and therefore fewer OR cases than I'd like for now (it promises to get much better).
There are also rounds with the neuroscience intensive care team that usually start at 8 that us two PGY-2's alternate attending month to month.
While one is in the OR the other is running around seeing consults, checking test results, talking with families, doing some bedside procedures (EVD's, LP's, Bolts, central lines, swans, lumbar drains, etc.), and taking the nurses pages. If there is time you grab a bit to eat.
We try to afternoon round in the evening before 6 p.m. but sometimes it runs later. These are just work rounds to settle plans for the patients overnight and review any new films or findings.
On non-call nights I'll get home anywhere between 5:30 and much later.
Call nights are every fourth...not usually much time for sleep but a 15-minute cat nap here and there on those nights as it's rare that the pager doesn't go off at least once ever 20 minutes.
As junior residents we handle the brunt of the overnight call and consults. It's a level 1 trauma center and that can keep us busy. We have 2 neurosurgeons that do endovascular work as well as 2 that do a lot of open cerebrovascular surgery so we get a large amount of vascular cases referred our way from hospitals across the region. For spine trauma, we alternate call with the orthopedists week by week.
It's busy and there's a lot to learn. It can get crazy at times being pulled in 10 directions at once and the pager going off 2 or 3 more times in a row before you've even gotten a chance to pick up the telephone for the first beep..beep...beep. With a dedicated neuro ICU and a separate dedicated trauma ICU (of which we are involved in the care of most of those patients) there is impending disaster at any moment. But it also means specialized nurses that know their stuff and usually know when something is an emergency and when it's not...the ER is a whole other story.
Only 82 more call nights and the year is over...
