What time do you get to the hospital?

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NOLADO84

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Our morning report starts at 7. I plan to get to the hospital for 5 everyday to get a bulk of work knocked out prior to meeting.

Is this realistic or will I burn out quickly? What is your routine?


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The answer to your question is very variable. Depends on the program/ rotation/ your upper level preference.
You need to know the volume of your patients, make sure you pre-chart them and get numbers in the AM, pend a note, and have some time to pre-op the first cases in the OR (if any)
In some rotations I needed to be there before 4am sometimes, others 6am was enough.
Burnouts depends on you primarily, and how you handle stress, and your team if they are supportive or not.
My advice, enjoy your rotations, have fun and research each case and try to get OR experience as much as possible, you won’t even feel tired.
Good luck.


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Are you a starting intern? What specialty? What have other people done in the past at your program? If the expectation is for you to be there by 0500, then there isn't a lot of wriggle room unless your seniors say otherwise.

In general surgery, depending on the size of our service, we usually rounded as a team starting at 0600 and finished by 0645-0700 to get to the OR. Interns came in about 0530 to get sign out from the night crew and organize the lists for rounds.

A lot of variables go into burnout. Starting work everyday at 0500 can take some adjustment if you're not used to it. But the early time alone is not going to cause burnout.
 
NOLADO84 said:
Our morning report starts at 7. I plan to get to the hospital for 5 everyday to get a bulk of work knocked out prior to meeting.

Is this realistic or will I burn out quickly? What is your routine?


Sent from my iPhone using SDN
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It varies depending on your individual program. I usually did my best to arrive at 645, got quick overnight signout, went to 7am morning report, then got the bulk of my work done over the next hour and a half before rounds around 930. When it was a busier service (MICU), sometimes at 6 or 630.

Peds usually started earlier than medicine at my hospital, I think they had signout for the day team around 6am.

Ob and surgery were even earlier, but hell if I knew the specific time.
 
First things first, OP, what specialty are you? Big difference between what a surgery intern needs to do before morning report and what a medicine intern needs to do before morning report.
 
evilbooyaa said:
First things first, OP, what specialty are you? Big difference between what a surgery intern needs to do before morning report and what a medicine intern needs to do before morning report.
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Neurology. So first year will be IM.


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OK. So. You don't have to have your notes done by morning report, most likely, based on my experiences with IM programs. Confirm that this is the case at residency oreitnation.

But, your patients have more going on with them compared to most surgical post-ops.

It will depend on the length of your list. More patients to see the following morning = get there earlier.

I would try to get a sense from orientation when 'most' people get to the hospital. First day of a new rotation (where you don't know any of the patients) try to get maybe get there half an hour earlier than your 'normal'. After a few days, if you have an IM service that doesn't turnover routinely (especially if you're capped) you'll be able to get more done in less time with each patient.
 
As a medicine chief if your morning report is at 7 I would suspect you will probably getting to work anytime from 6-630 or even 650 if you are super lazy (don’t be that guy, we all know that guy and even if you’re a prelim we are all friends with the prelims before you and we do tell them about their problem children). They will tell you what time sign out is and you will show up by that time at the latest, probably 30m-45m earlier than that at the beginning because you won’t be as efficient with your time for a few months.
 
HemeOncHopeful19 said:
As a medicine chief if your morning report is at 7 I would suspect you will probably getting to work anytime from 6-630 or even 650 if you are super lazy (don’t be that guy, we all know that guy and even if you’re a prelim we are all friends with the prelims before you and we do tell them about their problem children). They will tell you what time sign out is and you will show up by that time at the latest, probably 30m-45m earlier than that at the beginning because you won’t be as efficient with your time for a few months.
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Hey! I resemble that remark.
 
I guess I should clarify that when you get to that point you will know it and you won’t gave to ask SDN 😀
 
HemeOncHopeful19 said:
I guess I should clarify that when you get to that point you will know it and you won’t gave to ask SDN 😀
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Nah, I *hate* waking up in the morning. We had two intern teams - half the time when I was on with an early riser they'd just get signout for the whole team because they knew I'd be borderline late.

I always worked my ass off, was the first one to stay late to do whatever was needed, I just am about as far from a morning person as possible. When I became a senior, I was rarely there before 7am - interns got signout.

That said, when it was a busy service and I needed to be in early? I'd be in at 6 for those MICU shifts or whatever. You need to know your team and do what's necessary for the patients.
 
smq123 said:
A PA told me he gave his dog Benadryl once. He felt bad about it, but it did work.
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VA Hopeful Dr said:
It does, weight for weight dogs require weirdly high doses of that though
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For a while there, both of my parents and their ~100 lb dog were all prescribed gabapetin. The dog's dosage was much higher than theirs--due to the metabolic rate, I'm guessing.
 
ThoracicGuy said:
They both generally sleep from about 830 pm to 730 am. Sometimes as early as 700, sometimes as late as 9. They are 2 and 4. I wish they would sleep later on weekends.
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I hate you. Don’t remember the last time my kids slept in til 7am. They wake up usually 630 ish, but stay in bed till 715ish (We let them read in bed). They are 2 and 5. They also go to bed by 7pm. So there is that.

I used to get to the hospital at like 615 for an 8 am morning report. ICU was dependent on the ICU staff. One guy I pretty much had o be there at 5am to make sure I had personally examined every single patient’s backs, and grill the repertory therapist about cuff pressure and get detailed reports on the consistency of the stool from the nurses (I only wish I was joking).

Now I pretty much get to work at 740-800, but I like the 0500 boot camp at the gym . . So there’s that.
 
ThoracicGuy said:
They both generally sleep from about 830 pm to 730 am. Sometimes as early as 700, sometimes as late as 9. They are 2 and 4. I wish they would sleep later on weekends.
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You have a two year old that sleeps till 9?!!! If my two year old did that I’d probably wake up in a panic at 8 thinking she’s run away somehow. If she sleeps till 8 I feel like I won the lottery. Whatever you are doing keep it up!
 
SirGecko said:
You have a two year old that sleeps till 9?!!! If my two year old did that I’d probably wake up in a panic at 8 thinking she’s run away somehow. If she sleeps till 8 I feel like I won the lottery. Whatever you are doing keep it up!
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Sometimes,it's rare though. He'll still take a 2-3 hour nap in the afternoon too. It seems on weekends they decide to get up closer to 7... I wish they would sleep longer at least on weekends!
 
There is no way to really answer this. But can give you some guidelines.

During your rotations as med student, what time did you residents and medical students arrive before morning report?

How long does it take you to round on a patient? How many patients do you have?

Ideally, you should have seen your patients and have almost everything ready to go by morning report or at least before rounds. When I was a wee little lad in medicine I arrived 4:30-5am every day. Saw my patients, reviewed the charts, labs, etc. Went to morning report, worked on my notes and "house-cleaning" chores before the Attending waltzed in.

So it is absolutely do-able, many people have come in every day around the same time. But really it is going to be up to you and how you work. The expectations of your seniors and Attending.
 
ThoracicGuy said:
They both generally sleep from about 830 pm to 730 am. Sometimes as early as 700, sometimes as late as 9. They are 2 and 4. I wish they would sleep later on weekends.
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1589817625792.png

But seriously what is your secret? Exercise? Room set up? Secret white noise? Herbs? Voodoo? I must have this secret!
 
yeasports said:
View attachment 306650
But seriously what is your secret? Exercise? Room set up? Secret white noise? Herbs? Voodoo? I must have this secret!
Click to expand...

They have a schedule and generally stick to it. Dinner is usually around 6:15-6:30 pm. Bathtime is about 7 pm. This is followed by stories around 7:30 or 7:45 start time. The youngest usually gets to bed about 20 minutes later and the oldest about 20 minutes after that. Sometimes it varies if dinner ends a bit later, if we go out to eat or whatever.

We had a much harder time with our oldest since we would give him a bottle and rock him if he woke up at night. We started out our youngest different and there was no coming in and giving a bottle or rocking once he hit about 3-4 months old. This morning, they were both still in bed when I left for work at 8:30...
 
NOLADO84 said:
Our morning report starts at 7. I plan to get to the hospital for 5 everyday to get a bulk of work knocked out prior to meeting.

Is this realistic or will I burn out quickly? What is your routine?


Sent from my iPhone using SDN
Click to expand...

I think it depends on the individual program, rotation and the culture of each. At my residency for example, inpatient medicine sign out was at 7am, but we had a nightfloat team that was expected to be managing the patients up until that point. So we might come in for 6:30-6:45 just to review the list before sign out, but any earlier than that would not make sense since the nightfloat team was actively managing the patients.

For pedi, it was a different story. No nightfloat team, so we would come in for whatever time we needed to to see all the patients before rounds, which could vary depending on which attending was on.

Some electives I did more super hard ass and would want me to round on everyone and have notes done before sign out at 6:45 am, so I would come in at 5 in those cases. That was miserable and very short lived, but it depends on how much you hate mornings.

I would say ask your senior residents what the "norms" and "culture" of the rotation you are starting are. Those are not always reflected in the daily written schedule.
 
NITRAS said:
I hate you. Don’t remember the last time my kids slept in til 7am. They wake up usually 630 ish, but stay in bed till 715ish (We let them read in bed). They are 2 and 5. They also go to bed by 7pm. So there is that.
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I don't have a human child, but my fur baby wakes me up at 6:00am almost on the dot every single morning. Except Fall DST, when she wakes me up at 5am instead until I convince her I'm not getting up until 6. Usually takes me a week. Every once in a blue moon, she'll let me sleep in til 6:30am.

I'm Peds, but we'd get there at 6am on inpatient for signout, and 5am in PICU (rounds started at 715, and it was anyone's guess how many admissions came in overnight). I got extremely annoyed as the night resident when the EM residents would stroll in at 615, cause it meant I was sitting around wanting to sleep for about 45 minutes before I could actually leave.

Now as a fellow, you're lucky to get me to the hospital before 8, and it's usually closer to 8:30 or 9.
 
ThoracicGuy said:
They have a schedule and generally stick to it. Dinner is usually around 6:15-6:30 pm. Bathtime is about 7 pm. This is followed by stories around 7:30 or 7:45 start time. The youngest usually gets to bed about 20 minutes later and the oldest about 20 minutes after that. Sometimes it varies if dinner ends a bit later, if we go out to eat or whatever.

We had a much harder time with our oldest since we would give him a bottle and rock him if he woke up at night. We started out our youngest different and there was no coming in and giving a bottle or rocking once he hit about 3-4 months old. This morning, they were both still in bed when I left for work at 8:30...
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As amazed as i am that your children sleep that well, I'm even more enthralled that you leave for work at 8:30 as a surgeon.
 
FM intern here, on inpatient months I typically arrive between 5:30 and 6:00, but I'm also super slow. Morning Report at 7:00 and we're supposed to have all notes done by then. Round at 8:00.
 
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