what's your morning routine?

[TorpedoSN18]

Roll out of bed and go to work (maximize sleep) vs wake up early/eat breakfast/read/coffee/ect...? I alternate between the two and curious what others are doing. What makes you perform the best at work.

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[Man o War]

Roll out of bed and go to work (maximize sleep) vs wake up early/eat breakfast/read/coffee/ect...? I alternate between the two and curious what others are doing. What makes you perform the best at work.

The one thing I need to feel settled is getting into the OR long before the case to get everything set up exactly the way I like it. Most of my partners poke at me jokingly for it, but this has been my routine for years. I wake up 30 mins before I leave the house, shower, grab something I can eat in the car,get to the hospital, set my room up, go to the lounge for a cup of coffee, and read paper while I wait for the surgeon.

 

[psychbender]

In fellowship now, I get up early, go to the gym at the hospital to work out and shower, then head to either my office or the unit to print a list and look up my patients (yes, I have the EMR in my tablet, but old habits die hard) while I have second coffee before handoff. Light breakfast (yogurt, Belvita cracker) before I leave the house. When I did locums before coming here, it was similar, but I went straight to the OR to set up my room well before cases start. I'm still anal like that, even a few years after residency.

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[Urzuz]

Get up ~1 hour before leaving to work, ~2 hours before first case of the day. Shower. Sit down and leisurely eat my breakfast at home. Drink coffee on the way to work. See patient. Take a dump. Head to the OR after surgeon has arrived to set up and get the day started.

 

[narcusprince]

Lately up at 0430-0500 run, then hit the gym, shower at work. Cases start at 0730, usually done by 1500 or 1600.

 

[Shimmy8]

1. Out of bed 5:15
2. Shower, get dressed.
3. Feed dog.
4. Start coffee.
5. Grab lunch from fridge.
6. Breakfast is shake/apple/banana.
7. Let dog out back.
8. Out door 6AM.
9. Coffee and breakfast in car.
10. At front board 6:20ish to figure out assignments, etc.

I sweat too much to workout in the morning. I go straight to gym every day I'm not on call though, so I get workout in at a decent hour.

 

[deleted126335]

shower, dress in scrubs, fill a coffee thermos, grab a protein bar. Get there earlier than most. Pick my favorite computer terminal, First wave of preops. Run to each room to push drugs and put in lines, next wave of preops. Put out fires in rooms. Rinse, repeat. Exercise after work. Or drink depending on mood.

 

[Gimlet]

Shower the night before...have to wear a hat at work so no worry about bed head.

Up at 5:30, brush teeth, get dressed, take the dogs out, eat a couple hard boiled eggs. Out the door by 6 (10 minutes earlier if nice enough out to bicycle to work). Change into scrubs, grab a cup of coffee from the CV lounge and start seeing patients by about 6:40 for 7:30 starts.

 

[Consigliere]

Watch "American Beauty" to see my morning ritual.

 

[Wolverines83]

Wake up 615, out the door 625, in hospital at 640, room set up by 7, chug coffee, take dump, ready to start case at 725.

 

[anbuitachi]

Roll out of bed and go to work (maximize sleep) vs wake up early/eat breakfast/read/coffee/ect...? I alternate between the two and curious what others are doing. What makes you perform the best at work.

wake up early, read news, eat, coffee. not because i love not sleeping but b/c my body doesn't do well unless i give it time. if i go straight to work i know i will have issues

Basically wake up at 530, leave at 620, arrive at hospital by 630, set up room by 7

 

[bigdan]

OR weeks:
Up at 0415 if shaving my head (M/W/F); 0430 (T/Th)
Always the same breakfast: yogurt, cereal, OJ, coffee.
Shower. Button down shirt, slacks, dress shoes.
Out of house at 0540, in locker room with scrubs on at 0600-0610 (traffic depending)
Preops; cardiac cases in room at 0645.
Physically in house 40-55 hrs/wk.

ICU week:
Up at 0630.
Always the same breakfast: yogurt, cereal, OJ, coffee.
Shower. Button down shirt, slacks, dress shoes.
Play with the baby until around 0730 if he's up.
Drive to work. Arrive at 0800-0815.
Round.
Physically in house 80-90 hrs week; on call 168 hrs.

LOVE my job.

 

[pgg]

Watch "American Beauty" to see my morning ritual.

Egg shells and Miracle Gro?

 

[pgg]

OR day when I have a resident minion to do my bidding and set up my OR: Wake up about 6:00, out of the house about 6:20, in the hospital about 6:50, in the OR for the surgeon & periop RN & anesthesia team brief at 7:05.

Day when I'm the floor runner / director: same, except instead of the team meeting in an OR, I pick up the pagers and stare mournfully at the add-on list.

OR day when it's just me: Subtract X minutes from those times where X = number of minutes for me to set up the OR myself.

I'm not a breakfast eater. I'll snack through the morning, if I remember to.

 

[leaverus]

The one thing I need to feel settled is getting into the OR long before the case to get everything set up exactly the way I like it. Most of my partners poke at me jokingly for it, but this has been my routine for years.

can you please add me to the list of people poking at you jokingly for it?

 

[Noyac]

in the OR for the surgeon & periop RN & anesthesia team brief at 7:05.

Can you tell me what is actually discussed during this "team brief" and what is your role in this? I always wondered about this idea.

 

[Man o War]

can you please add me to the list of people poking at you jokingly for it?

Yep, weird "thing" of mine. Old dog set in his ways.

 

[pgg]

Can you tell me what is actually discussed during this "team brief" and what is your role in this? I always wondered about this idea.

We use the TeamStepps scheme, which I fully admit, the first time I was exposed to it, I thought was the absolute evil epitome of useless clipboard-commando nurses run amok with checklists and JC/CMS catch phrases. These preop team briefs are mandatory here.


The usual format, in practice, is that the surgeons give a very brief presentation of each patient along with any unusual concerns they have, including any special instruments, sutures, implants, tissue products, or whatever else they want or need. The scrub techs and periop RNs confirm that they have the usual stuff or special things to do the case, per the surgeon's preference card. Postop destination and bed availability is confirmed. The anesthesiologists bring up any concerns they have and note if and how it will change their plans (lines, atypical regional, need for monitored bed postop, etc).

It sounds tedious and silly, and one would think that all of the above would be hashed out well before day of surgery. But in reality a lot of little things slip through the cracks, and the team brief thing actually works well in practice. Usually amounts to less than a minute per patient, unless we're doing something unusual or complex.

It tends to be the most useful for same-day add-on cases. It also has the pleasant side effect of guaranteeing that the surgeons are actually physically in the $*@(! hospital when we're ready to take the patient to the OR.

Things still fall through the cracks, but it's rarer for them to be big things now. In the last couple months, the only big screwup I can think of (anesthesia induced only to find the desired implant wasn't in the hospital, case cancelled) was in a case where the team brief was skipped in violation of policy. I'm a fan.

 

[BLADEMDA]

Wake Up 0505
Shower/Shave
Breakfast
SDN
Drudge Report
E-mail
Leave for work 0610
Arrive early and begin the day of preops/firefighter
Exercise most days if I'm not too late getting out

 

[narcusprince]

We use the TeamStepps scheme, which I fully admit, the first time I was exposed to it, I thought was the absolute evil epitome of useless clipboard-commando nurses run amok with checklists and JC/CMS catch phrases. These preop team briefs are mandatory here.


The usual format, in practice, is that the surgeons give a very brief presentation of each patient along with any unusual concerns they have, including any special instruments, sutures, implants, tissue products, or whatever else they want or need. The scrub techs and periop RNs confirm that they have the usual stuff or special things to do the case, per the surgeon's preference card. Postop destination and bed availability is confirmed. The anesthesiologists bring up any concerns they have and note if and how it will change their plans (lines, atypical regional, need for monitored bed postop, etc).

It sounds tedious and silly, and one would think that all of the above would be hashed out well before day of surgery. But in reality a lot of little things slip through the cracks, and the team brief thing actually works well in practice. Usually amounts to less than a minute per patient, unless we're doing something unusual or complex.

It tends to be the most useful for same-day add-on cases. It also has the pleasant side effect of guaranteeing that the surgeons are actually physically in the $*@(! hospital when we're ready to take the patient to the OR.

Things still fall through the cracks, but it's rarer for them to be big things now. In the last couple months, the only big screwup I can think of (anesthesia induced only to find the desired implant wasn't in the hospital, case cancelled) was in a case where the team brief was skipped in violation of policy. I'm a fan.

Team Stepps is useless in a well greased hospital system. Its good because most of the techs and nurses are usually very new in the military. Things do fall through the cracks. It does catch a lot.

 

[GA8314]

1. Out of bed 5:15
2. Shower, get dressed.
3. Feed dog.
4. Start coffee.
5. Grab lunch from fridge.
6. Breakfast is shake/apple/banana.
7. Let dog out back.
8. Out door 6AM.
9. Coffee and breakfast in car.
10. At front board 6:20ish to figure out assignments, etc.

I sweat too much to workout in the morning. I go straight to gym every day I'm not on call though, so I get workout in at a decent hour.

Yeah man, I'm a residual sweater also. Some push ups in the morning but anything serious or cardio and I'll be sweating through my cap at work....lol

 

[GA8314]

Wake Up 0505
Shower/Shave
Breakfast
SDN
Drudge Report
E-mail
Leave for work 0610
Arrive early and begin the day of preops/firefighter
Exercise most days if I'm not too late getting out

Blade, you are a good role model for this forum. For what it's worth.

 

[periopdoc]

- Wake up at 4:30.
- Close out overnight futures that haven't stopped out. News scan. Finalize daily trading plan.
- Wait for 5:30 alarm (don't know why I bother setting an alarm as I haven't needed one since fellowship ended)
- Start some coffee. I don't eat breakfast.
- Shower
- Drink coffee. Enter pre-market positions. Set stops.
- 6:30-6:45, take dog to daycare
- 7ish at work, change etc
- 7:05-7:10 Preop then head to OR
- 7:15-7:30 Start case.

I don't always set the room up in advance. Easy enough to draw up meds as I go. Even if I set up, it's only induction meds and airway plan A, unless I'm really concerned about the airway or post-induction hypotension.

Maybe 3-4 times a year I'll have airway plan-B opened and setup. (Plan A-B-C-D always in OR just not opened)

Typical door to induction time hovers around 5 min if I'm drawing up as I go.

Never really understood the need to have two, or more, airway options open, two pressors, backup stick of sux etc, but won't criticize those who do.

Heart room, I do predraw epi, neo, and nitro since I use neo and nitro on just about every case. Epi I use rarely, probably no good reason to have it predrawn except tradition.

 

[pgg]

Team Stepps is useless in a well greased hospital system. Its good because most of the techs and nurses are usually very new in the military. Things do fall through the cracks. It does catch a lot.

I couldn't disagree more, that "well greased" hospitals don't or wouldn't benefit. I've never in my life worked at place that was so "well greased" that always got it right, 100% of the time. In fact, the better greased and efficient a hospital and surgeon are, the more likely that rare stuff out of the normal flow will get missed.

Assuming that your hospital and staff are too competent to miss anything smells a lot like an airline pilot who's too competent to use a checklist.

There's a lot of inefficient pointless crap that goes on in academic hospitals, but a couple minutes set aside for surgeon, anesthesiologist, and OR crew to talk to each other before a day's cases isn't one of them.

 

[dhb]

- Wake up at 4:30.
- Close out overnight futures that haven't stopped out. News scan. Finalize daily trading plan.
- Wait for 5:30 alarm (don't know why I bother setting an alarm as I haven't needed one since fellowship ended)
- Start some coffee. I don't eat breakfast.
- Shower
- Drink coffee. Enter pre-market positions. Set stops.
- 6:30-6:45, take dog to daycare
- 7ish at work, change etc
- 7:05-7:10 Preop then head to OR
- 7:15-7:30 Start case.

I don't always set the room up in advance. Easy enough to draw up meds as I go. Even if I set up, it's only induction meds and airway plan A, unless I'm really concerned about the airway or post-induction hypotension.

Maybe 3-4 times a year I'll have airway plan-B opened and setup. (Plan A-B-C-D always in OR just not opened)

Typical door to induction time hovers around 5 min if I'm drawing up as I go.

Never really understood the need to have two, or more, airway options open, two pressors, backup stick of sux etc, but won't criticize those who do.

Heart room, I do predraw epi, neo, and nitro since I use neo and nitro on just about every case. Epi I use rarely, probably no good reason to have it predrawn except tradition.

With all that trading why are you still pushing the white stuff?

 

[sleepallday]

-wake up with first alarm at 5:40, then turn it off
-wake up with second alarm at 5:50, then turn it off
-wake up with third alarm at 6:00, with wife simultaneously yelling at me about setting to many alarms
-shower, get dressed, make coffee for the road, and out the door by 6:30
-at the hospital and changed into scrubs by 7:00
-see first patient by 7:05-7:15
-head to office for second cup of coffee and two hard boiled eggs
-to the OR by 7:25. OR is usually setup and stocked with everything I need. All I need to do draw up drugs
-patient rolls in by 7:30
-if I need to do a block or epidural, I'll skip the second cup of coffee and hard boiled eggs

 

[Shimmy8]

FWIW, there's all sorts of data coming out about eating a large breakfast and an earlier, smaller dinner that is associated with all sorts of heath benefits by maintaining better circadian rhythm conditioning.

I've tried to make it a priority to get a good number of calories in the morning.

www.caloriesproper.com is a great blog for scientific based nutritional reading.

 

[rakotomazoto]

0530: Wake up, put on shorts/shirt, pre-packed backpack.
0535: On bicycle, 4 miles to the hospital. I never drink coffee or anything else to wake up, that's what the bike is for.
0600: Shower and get dressed in locker room, eat breakfast, set up room and see the patient in pre op. First case is 0730 start, if set up is easy then I use the extra time to read/study.
0720: Return to pre op to pick up the patient
0725: Roll into the OR. "on time" start at 0730 is late in my opinion.

 

[Consigliere]

0530: Wake up, put on shorts/shirt, pre-packed backpack.
0535: On bicycle, 4 miles to the hospital. I never drink coffee or anything else to wake up, that's what the bike is for.
0600: Shower and get dressed in locker room, eat breakfast, set up room and see the patient in pre op. First case is 0730 start, if set up is easy then I use the extra time to read/study.
0720: Return to pre op to pick up the patient
0725: Roll into the OR. "on time" start at 0730 is late in my opinion.

Yet another person I've added to my ever growing List of People Who are Hard-Ons.

 

[Timeoutofmind]

With all that trading why are you still pushing the white stuff?

Because it is a virtual certainty he is not outperforming the market… As numerous studies have shown in the long run examining the most savvy and resourced of investors who attempt to time the market or pick individual funds

 

[sleepallday]

0530: Wake up, put on shorts/shirt, pre-packed backpack.
0535: On bicycle, 4 miles to the hospital. I never drink coffee or anything else to wake up, that's what the bike is for.
0600: Shower and get dressed in locker room, eat breakfast, set up room and see the patient in pre op. First case is 0730 start, if set up is easy then I use the extra time to read/study.
0720: Return to pre op to pick up the patient
0725: Roll into the OR. "on time" start at 0730 is late in my opinion.

You are transporting the patient to the OR??

 

[deleted171991]

You are transporting the patient to the OR??

Welcome to the real world. More and more, it's part of the job description. Anesthesiologists are not really doctors, more like an inferior species.

 

[gasdoc77]

515 wake
520 jump rope 1 minute for circulation, impact activation of stem cells in joints, mobilization of lymph, etc
525-invert 10 minutes (doing now ahead of schedule) read SDN?
540- shower
Next, prepare coffee or matcha tea w MCT, coconut oil, and Kerigold to maintain fasting physiology
Pack sardines, boiled eggs, avocado oil mayo, nuts for work and head in staying fasted.
Usually arrive 640 ish. Sip coffee and chat.
Start 7-720
Fast til 11 am.

 

[GA8314]

FWIW, there's all sorts of data coming out about eating a large breakfast and an earlier, smaller dinner that is associated with all sorts of heath benefits by maintaining better circadian rhythm conditioning.

I've tried to make it a priority to get a good number of calories in the morning.

www.caloriesproper.com is a great blog for scientific based nutritional reading.

Perhaps, but intermittent fasting has many benefits as well. Whatever lowers your daily insulin level the most, will help the most by way of losing the most weight (or maintaining a healthy body weight). High levels of insulin, sustained (via constant snacking on sugar/simple carbs) throughout the day will make it nearly impossible to lose any fat.

 

[Shimmy8]

Perhaps, but intermittent fasting has many benefits as well. Whatever lowers your daily insulin level the most, will help the most by way of losing the most weight (or maintaining a healthy body weight). High levels of insulin, sustained (via constant snacking on sugar/simple carbs) throughout the day will make it nearly impossible to lose any fat.

Many ways to skin a cat. I'd do IF if I were mentally strong enough, so for the average person a large breakfast is most feasible.

 

[WashMe]

Seems like there are a lot of people on here who take themselves way too seriously. All that weird crap you're doing probably won't help you live one second longer.

Anyway, my routine:
6:20 - wake up, shower, get dressed, check SDN
6:40 - out the door, something caffeinated in hand, not picky
7:00 - changed into scrubs, walking to pre-op
7:05-7:20 - pre-op first case, BS with pre-op nurses and colleagues
7:20-7:30 - cup of coffee, restroom break
7:30 - arrive in room same time as patient (RN transport). Set up (drugs, plan A airway) while they move patient to bed and put monitors on.
7:33 - patient had been induced and airway managed by now

 

[eggscal99]

Anyone EMR chart review cases the night before? I find it helps me anticipate any special needs (lines, drips) and set my latest-possible wake up time accordingly. I review cases in-between call of duty sessions.

0600 - wake up
0605 - let the dog out to pee, feed the dog
0615 - breakfast, surf web
0630 - poop
0640 - leave home
0700 - arrive at hospital, scrub change
0705 - see pt, setup, stock my own room as rooms often poorly stocked, pee
0720-0730 - pt in room

 

[thinkorswim]

In residency it was easy:

6:10 - wake up, shower and eat breakfast (can't go without it)
6:40 - head out to hospital (only 10 mins away)
6:55 - in OR to set up (spike IV bag, pull out tube, and draw up meds)
7:10 - go see patient, then either coffee or back to OR if more setup needed (epidural, block, special airway, etc.)
7:30 - patient in OR (they walked in on their own, it was nice)

Now in fellowship... I'm waking up at 4:30, in the hospital at 5:30 to set up, and wheeling the patient by myself into the room at 6:30. It's miserable and I'm constantly questioning my life decisions.

 

[pgg]

Now in fellowship... I'm waking up at 4:30, in the hospital at 5:30 to set up, and wheeling the patient by myself into the room at 6:30. It's miserable and I'm constantly questioning my life decisions.

It'll be a happy memory before you know it.

 

[deleted171991]

Now in fellowship... I'm waking up at 4:30, in the hospital at 5:30 to set up, and wheeling the patient by myself into the room at 6:30. It's miserable and I'm constantly questioning my life decisions.

That sounds like one of the intensive big name cardiac programs, doesn't it? If yes, you've probably made the right choice. It's only 9 more months anyway.

It's your residency that was too cushy.

 

[pgg]

It's your residency that was too cushy.

In residency it was easy:

6:10 - wake up, shower and eat breakfast (can't go without it)
6:40 - head out to hospital (only 10 mins away)6:40 - head out to hospital (only 10 mins away)
6:55 - in OR to set up (spike IV bag, pull out tube, and draw up meds)

OR day when I have a resident minion to do my bidding and set up my OR: Wake up about 6:00, out of the house about 6:20, in the hospital about 6:50, in the OR for the surgeon & periop RN & anesthesia team brief at 7:05.

His residency schedule is my attending schedule on a cushy day when I have a resident.

His fellowship schedule (4:30 wakeup and 5:30 arrival for a 6:30 OR start) is almost exactly to the minute what I did as a CT fellow last year. I'm not going to lie, it was a grind, and I'm glad to be done and back to living a normal life again. But it was well worth it.

 

[thinkorswim]

That sounds like one of the intensive big name cardiac programs, doesn't it? If yes, you've probably made the right choice. It's only 9 more months anyway.

It's your residency that was too cushy.

Ding ding ding! Residency was cush with good hours, but great clinical experience at the same time. Fellowship is at a big cardiac program, and as much as it's draining me right now, I know it'll be worth it in the long run. I'm definitely learning and seeing a lot.

His fellowship schedule (4:30 wakeup and 5:30 arrival for a 6:30 OR start) is almost exactly to the minute what I did as a CT fellow last year. I'm not going to lie, it was a grind, and I'm glad to be done and back to living a normal life again. But it was well worth it.

That's good to hear! It's an exhausting year with 3 board exams and job hunting on top of the clinical grind. Don't even get me started on research requirements.

 

[PonyUp]

I believe in taking care of myself, and a balanced diet and a rigorous exercise routine.
In the morning, if my face is a little puffy, I’ll put on an ice pack while doing my stomach crunches. I can do a thousand now.
After I remove the ice pack I use a deep pore cleanser lotion. In the shower I use a water activated gel cleanser, then a honey almond body scrub, and on the face an exfoliating gel scrub.
Then I apply an herb-mint facial masque which I leave on for 10 minutes while I prepare the rest of my routine.
I always use an after shave lotion with little or no alcohol, because alcohol dries your face out and makes you look older.
Then moisturizer, then an anti-aging eye balm followed by a final moisturizing protective lotion.

 

[nimbus]

I believe in taking care of myself, and a balanced diet and a rigorous exercise routine.
In the morning, if my face is a little puffy, I’ll put on an ice pack while doing my stomach crunches. I can do a thousand now.
After I remove the ice pack I use a deep pore cleanser lotion. In the shower I use a water activated gel cleanser, then a honey almond body scrub, and on the face an exfoliating gel scrub.
Then I apply an herb-mint facial masque which I leave on for 10 minutes while I prepare the rest of my routine.
I always use an after shave lotion with little or no alcohol, because alcohol dries your face out and makes you look older.
Then moisturizer, then an anti-aging eye balm followed by a final moisturizing protective lotion.

Kudos....I bet you look amazing. What about local organic sustainably sourced probiotics for bowel health?

 

[Ezekiel2517]

I believe in taking care of myself, and a balanced diet and a rigorous exercise routine.
In the morning, if my face is a little puffy, I’ll put on an ice pack while doing my stomach crunches. I can do a thousand now.
After I remove the ice pack I use a deep pore cleanser lotion. In the shower I use a water activated gel cleanser, then a honey almond body scrub, and on the face an exfoliating gel scrub.
Then I apply an herb-mint facial masque which I leave on for 10 minutes while I prepare the rest of my routine.
I always use an after shave lotion with little or no alcohol, because alcohol dries your face out and makes you look older.
Then moisturizer, then an anti-aging eye balm followed by a final moisturizing protective lotion.

What music do you like to listen to in the morning? Do you like phil collins? Been a big genesis fan, ever since the release of their 1980 album, Duke. Before that i didnt really understand any of their work, it was too artsy, too intellectual...it was on duke where phil collins presence became more apparent...i think Invisible Touch is the group's undisputed masterpiece, its an epic meditation on intangibility at the same time it deepens and enriches the meaning of the preceding 3 albums.

 

[Consigliere]

I believe in taking care of myself, and a balanced diet and a rigorous exercise routine.
In the morning, if my face is a little puffy, I’ll put on an ice pack while doing my stomach crunches. I can do a thousand now.
After I remove the ice pack I use a deep pore cleanser lotion. In the shower I use a water activated gel cleanser, then a honey almond body scrub, and on the face an exfoliating gel scrub.
Then I apply an herb-mint facial masque which I leave on for 10 minutes while I prepare the rest of my routine.
I always use an after shave lotion with little or no alcohol, because alcohol dries your face out and makes you look older.
Then moisturizer, then an anti-aging eye balm followed by a final moisturizing protective lotion.

Jesus Christ are you a horse's ass!

 

[WisNeuro]

Jesus Christ are you a horse's ass!

He's quoting from American Psycho.

 

[Consigliere]

He's quoting from American Psycho.

My bad....then he's the man! Previous statement retracted.

 

[Ezekiel2517]

Lmao , people actually thought that was a real post

 

[mmag]

6:30 am wake up, brush, shower
6:45 am eat bowl of cereal
6:50 out the door
7:00 arrive and change
7:07 set up OR then see pt in preop
7:30 push pt into OR