 So imagine working in a hospital for 28 hours straight every four days. It's exactly what we'll talk about in this episode. Let's get into it. All right guys, welcome to the empty journey. We're here, we help you succeed on your medical journey with less stress. My name is Lux. I'm an internal medicine physician and resident in training. In case you're new here, here on this channel we make videos and step-by-step advice kind of topics on how to do well from anything from studying productivity, you name it. And today I'm excited because we're gonna be starting a new series here on this channel and I'm not sure exactly what I'll call it, probably something along the lines of what it's like. And the idea is basically going to be me sharing what it's like as different parts and aspects of a physician. From today specifically, we're gonna talk about what it's like working a 28 hour shift. Now a little bit of a background is I mentioned I'm an internal medicine resident. That means I'm still in my training after medical school. Currently I'm a second year of the making of this video. And at least at my institution, second years and third year of residence are where you start doing your overnight shift. So not only do you work during the day but you stay in the hospital overnight and then you leave a little bit before noon the next day. Now you may be asking is this something you do all the time? And the answer is kind of, you know, on a lot of the common rotations, things like very general medical awards, ICU rotations, cardiology ICU rotations, basically we have a call cycle. So essentially every four days I'm on call. I usually have three other colleagues that will alternate with me. So on day one, I'll be on call where I'll basically go to work around 7 a.m. and I'm gonna stay all the way until 11 a.m. the next day. So I'll stay overnight in the hospital. And then day two, three and four of my colleagues will then have their respective call days. Now what do you do on a call day? How's it different from a normal kind of hospital day as a doctor? Well, usually on a call day is a day that you're admitting. So there's obviously patients who are coming from the emergency room, from other hospitals, from other parts of the hospital that need your care. And so on the days that you're on call will be the days that you admit those patients. So on an internal medicine service, let's say I'm on my cardiology rotation. If anyone has any cardiovascular issues, then on that day, I will be the person and the doctor who will admit them to my service. And so with the 28 hour call, and not only am I admitting and accepting patients throughout the day, but also throughout the entire night. So it definitely has the opportunity of being extremely tiresome. So in this episode, I wanna give it a little bit of behind the scenes of what it's truly like. Now the first thing people ask is, you know, how much sleep do you really get? And when you're working an overnight shift, it really depends on where you are. So if you're in ICU, you can imagine that your sleep is probably gonna be pretty low. One, because you're admitting all the sickest patients that come to the emergency room or get sick at other parts of the hospital, and you just have to be ready to admit them. But also two, you're still taking care of actively of all the patients who are currently in ICU. So on those days, your sleep is probably gonna be pretty minimal. When I was working over nights on ICU rotation at the VA at my institution, probably would get about one to two hours. And those hours were glorious when I could get them, but you definitely were sleep deprived, just knowing that the patients were probably the sickest of any other rotation that you'll do. Now on the flip side, they're also just general medicine rotations that you do where you're admitting people for pneumonia and abscesses and basically things that aren't really a life or death situation. They need the hospital and they need, you know, more direct care, but they're gonna be okay without somebody bling eyes on them every single hour or a few hours. And so usually in those situations, there's not really much that goes on overnight. Usually the patients will sleep and the nurses will leave them alone. And so you're not really having to actively take care of those patients overnight. But usually in those situations, I'm still admitting patients from the emergency room who may come in and need medical care from me. Maybe their blood pressure is high or their sugars are lower high. In those situations, I admit them, I take care of them. But again, it's usually not a life or death situation. And so it's a little bit easy to take and start their management and still have enough time to sleep. Now that sleep may be a little fragmented because I get paged when I'm sleeping or I may have an admission that may take me an hour, an hour and a half to complete and take care of, but then usually I can go back to bed. And so usually the total cumulative hours ends up being about four or five hours. Now the next question that people often ask is why do you really need an overnight call? Not really, this depends on the institution you work at. For me, the residents or the internal medicine residents definitely run a good portion of the hospitals. We run the ICUs, we run the cardiology ICUs. And usually it ends up being our responsibility to take care of those services even at night. Now when you're taking care of multiple hospitals, we have three personally that we work at. And then you work at the ICUs and really kind of high acuity care on all of them. You can imagine that you get short staffed if you try to add somebody as the ninth person. So that's really what it comes down to. It's a little bit of math of how much manpower you need as well as how many hospitals you cover with that manpower. And as you guys can imagine, you definitely want to have a doctor overnight to take care of the patients or at least know about them. And so on my call days, that just happens to be me. Now one thing to keep in mind that's often forgotten is when you're working at night, not only are you taking care of your own patients and then the patients you're admitting, but you're also taking care of all the patients for the physicians and care providers who have gone home for the night. So if I am on call, I am taking care of not only my patients, but also the three teams of the colleagues who are not on call. And on the days that I'm not on call, when I get to go home, I tell them about my patients. And so if anything happens overnight, either good or bad, they can be aware and be ready to act. And so depending on the service that you're on, you can easily be taking and cross covering about anywhere from 40 to 70 patients. And yes, 70 patients does seem like a lot, but the good thing is is that most of them tend to have a pretty quiet night, they just sleep through the night. But sometimes you do have patients who get acutely sick or they have been sick throughout the day and we just wanted to hope that they would do better throughout the night, but unfortunately they're making a turn for even the worst. So they may have to go to the ICU or surgery or get some more imaging and tests done. And those nights tend to be a little bit more active for you, just depending on the patient population. Now since we're talking about these nights getting busy, I know when I was a first year internal medicine resident, when I didn't have to do overnight calls, one of the biggest things that I dreaded was like, what if I don't know what to do? That's something that always goes in the back of my head. You know, in posture syndrome of like, what if I'm put into a position where I don't know what medicine to give or what's going on with this patient? What do you do? And the question basically comes to, are you nervous or anxious during your night times? And it really just depends. You know, I feel like there are certain topics that I'm really good at. So if there's a problem that comes over the rises, then I can really take care of them effectively, but there are also other problems where like for example, if I have to take care of a cancer patient, I personally just don't have enough experience or kind of triaging abilities and I may need a little bit of help. And so in those situations, while you may feel alone and the nights are really quiet, you still have the numbers to potential fellows who are at home and ready to respond to your calls as well as attending. And so when I first initially did my first few overnight calls, I definitely felt a little bit out of my element. I definitely felt a little tired, but adrenaline and a little bit of caffeine will get you through. And to end this video off, I wanna share with you probably the most surprising thing that I've learned about working overnight shifts. And that biggest surprise is that I absolutely love practicing medicine independently. Now that may not make sense initially, but you have to understand what a typical schedule is for a medical resident. Usually we get to the hospital really early to see all of our patients and make sure they're stable. And then we see them again with our attendings and our supervisors. And that usually takes the first half of the day. Then you come back to your rounding room, you work on your computer, do your notes, do your orders, call any consultants. That takes another two, three, four hours. And when you look at your entirety of your day, how much medicine you truly practice is pretty minuscule. It's a lot of administrative and just making sure everybody's on the same page kind of stuff. At night, all of that goes out of the window. All you're really doing is practicing medicine. When somebody is extremely sick and I see you, you get paged that their blood pressure is dropping, that they're not breathing well. And that is just your job to fix. There's no notes to write, no points to present to. All you have to think about what do I acutely need to do right now to make this patient better? And while there's definitely a little bit of anxiety where you just hope it's a quiet night, nothing goes wrong, when you do get paged on something really serious, you go take care of that patient. I really enjoy the abilities of saying, okay, in these situations, this is what I think I should do. And then when it works, that confidence or my own confidence, my ability to be a physician to take care of really sick patients just continues to go up. So I found that personally, I learned the most about how much I actually know as a doctor overnight than I do during the day. And so in conclusion, do I like overnight calls? Not really. Obviously if I have a choice, I'd rather be home with my loved ones and my puppy instead of being at the hospital. But when you can nicely get through a busy night and the day team comes and you're saying, hey, you know, this patient had a really busy night but were able to get them through it. Those are a little bit of a kind of successes and wins that you carry long past your residency zone. But hopefully this video was able to give you guys a little bit of an insight of what it's like working a 28 hour shift. Now on that note though, if you do have more questions, I'm sure I missed them. Drop them in the comments section down below whether it's related to doing an overnight call or if you wanna know anything about what it's like to be a physician, I can add it to other feature videos that we do here in the series. Hopefully it's gonna be something that's popular here on the channel. And as always, before I forget, if you do want more step-by-step advice on your medical journey, whether it's through your pre-med, your medical school or your residency career, definitely consider checking out the Metalete Academy which is a platform designed for those on their medical journey but doing it with less stress where you find courses, guides, Q&As as well as a community forum to help you succeed on your journey. And if you're interested in giving the Academy a try, there'll be a link down below where you can get the whole platform or try for a whole week just for a dollar. But with that being said guys, thank you so much for watching. Before you click off, make sure you hit that and smash that like button. It definitely obviously supports the channel but too, it also tells me that you enjoy content like this and you wanna see more like this in the future. Speaking of content, make sure you hit that subscribe button and that notification bell in case you happen because we're putting out two pieces of content in videos and episodes every single week. If you stuck around to the end of this video, I definitely appreciate the support. Thank you guys so much for being a part of my journey. Hopefully I've been a little helped to you on yours and I'll see you guys in the next one. Peace.