 Well, what's up you guys that I know welcome back to my channel, okay? So I said that I'm going to break down a full 24-hour shift for you guys I'm gonna try to go Hour by hour but not necessarily hour by hour because there are some hours where it's just kind of low, right? So I want to make sure that you guys just get the nitty-gritty of this So that's what this video is gonna be about so thank you guys so much for joining me today And welcome to my channel. All right, so with that being said in a 24-hour shift I told you all in my previous video about my actual time on my 24-hour shift So if you haven't already seen that one you can go back and look at that But we get there early like six o'clock in the morning. So Typically what I'm trying to do is get there around like five Fifty ish, you know close to six because I want to get myself settled and changed and all that stuff because We're in our like our scrubs that the hospital provides so although I walk in in my regular clothes We're changing into our scrubs So I want to give myself enough time to get ready and get settled like put my things in my locker all of that stuff Because at 6 30 that is when we are usually giving sign out So what exactly is sign out sign out is kind of what it sounds like I am signing out of My shift to the next PA that's coming in so I'm letting them know everything that happened overnight I'm letting them know things that they may need to do throughout this day things that they may need to follow up on all Of that good stuff So we're doing sign out with the residents because we do have residents on like staff with us as well On the general surgery because we do have residents on staff like on general surgery service with us So we're giving them sign out as well And they're like the ones that I said before that are kind of typically Running through the patients are seeing them throughout the day They're kind of managing their care until they leave at five There are sometimes in some moments where the residents actually Stayed the whole 24-hour shift with us where they are on call with us Which will be very helpful because you know they're there to help and we're there to help them So it's a going to be a benefit but in the moments where they are gone at five then it's on you So after 6 30 and giving out the sign out then we'll typically go and do a pre rounds Just to kind of see the patients Especially with the residents because they didn't see the patients overnight And so for me, although I just saw the patients at like five o'clock for 30 445 ish in the morning if I'm coming off of my 24-hour shift I'm going to go see them again Well, I'm not going to go see them again if I'm coming off But if I am coming on since I didn't see the patients the night before I would go with the residents and round with them and see the patients there They'll get kind of an idea of what has been happening with this patient Like what exactly you know is going on with them overnight if there are labs already available They would look at that we would see what the labs are saying for the patients and we will know like Okay, well, this is what we need to do. This might be something we need to talk to the attending about And make note of for them, you know for us to mention that hey, this is what's going on So we'll see them around like We'll probably finish sign out maybe like 6 45 7 o'clock. We'll go and we'll round and we'll see the patients Might finish rounding on all of the patients around like 7 30 ish and then from that we have like Table around so so this is where we are with the other trauma PAs who are solely like on trauma and then The attendings which are like general surgeons slash trauma surgeons So we'll be talking about all of the patients on both services I'm just kind of getting an idea of like what's going on with them things that they may want us to do Um, you know orders that they may want us to run again Like this is just like repetition of care almost, you know, like in continuity of care We're going from like us by ourselves to now the attendings and then We'll typically finish that maybe around like 8 15 ish After that we will go either to breakfast And get our free breakfast than the hospital provides for us, which is a blessing So we'll either do that or We will go straight to kind of round with the attending So if we are doing a rounding with the attending that may happen around Like I would say around 8 30 ish 8 30 9 o'clock it depends on what they're doing And so we will go and we'll round with the attending And we'll see all of our patients. So when we're doing that again, it's the same thing that we just did at 7 30 in the morning. We're going through we're Going room to room seeing the patients Looking at any lines that they may have in so like if they have IVs in that may need to be taken out Because we're advancing their diet to like full liquids or like a regular diet You know, we'll have those lines taken out if they have any central lines that need to be taken out because you don't want central lines in for too long because they are a very high source of infection and so You know, typically you're like trying to have them in the least amount of time as possible So we'll take those lines out. We'll be feeling on their bellies making sure that it's soft and not tight and distended So those are all the things that we're going through and we're looking at You know talking to the patients and seeing like, hey, what's going on with them? Do they have any concerns now? One thing that I've learned like through this thus far is that A lot of this medicine thing like it's not Like mainly medicine like a lot of times when you're dealing with the patients it's really about like kind of management like management of the patients and Their emotions their feelings on the situation because the medicine is like pretty like just kind of matter of faculty almost But a lot of times it's a matter of like getting that connection with the patient and making sure that they have that trust in you because If they lose trust or faith in you like that is it, you know, like they're not going to be compliant And you want them to be compliant with their care throughout their hospital stay and then afterwards so That is something that I have been learning like how to talk to patients how to try to like get them on your side So they're actually like kind of following your directions But after we're done with that, you know, it might be around like 9 15 ish 9 30 ish depending on how many patients we have So after we're finished with that then like we're off on our own, you know We're off to write the notes that we have to write on, you know The patients like what plans we have for them what our assessment was If we have to discharge patients we have to you know, write that discharge summary or that note and You know get everything set up in place for the patient to leave the hospital So we'll be doing that But I mean if we didn't have time to have breakfast at like 8 30 or so Then we'll go down and get breakfast because the cafeteria closes. I believe it's at 10. So We'll go have breakfast and then we'll come back and write notes. So from around like 10 to 11 12 Like we're we're working right we're writing notes We may have to go back up and see the patients or put something in their chart We may get a call like hey, and g-tube is not working or we want to go put an ng-tube to suction Back to suction from gravity or vice versa to kind of see how The contents of that patient's stomach or abdomen is like draining Because again, like I said the the trauma slash general surgery people like a lot of it is like The things that they're doing is in the abdomen a lot of their surgeries are like in this Abdominal area and so we want to make sure like our patients aren't aren't distended and things like that so We'll be doing a lot of that like running around going up and down the stairs And we'll do that until around like, you know, 11 30 12 o'clock and when it's time to go to lunch So we'll have lunch and depending on if traumas are called or not Um trauma p a's have to go to the traumas So the residents only go to level one traumas and as a trauma three I am Not really trying to go. I want to go to level one traumas But I think i'm not going to really go to the level one traumas during the day Just because there's just so many people like when I've gone to the level one traumas You have the two trauma p a's you have like the three residents and the attendings and you know everybody else anesthesia Respiratory I see you and so there's a lot of bodies a lot of moving pieces in that Smaller to trauma base. So just to kind of like alleviate some of that extra bodies um, I Will respond to level two traumas to see if my colleagues need help Um, and then obviously again when the residents are gone I will attend and you know try to see if they need help with the level one traumas as well But when you're having lunch like you have no idea Like if you're going to have an uninterrupted lunch or not because again traumas can be called and then you have to leave um, but apart from that like lunch goes pretty smoothly and then you're back on You know in the room in your call room like writing notes if you haven't finished all of your notes seeing patients Um, you know taking consults. So you'll get consults from like the hospitalists or internal medicine um He might get calls from like the icu on a patient that you may have in the icu like maybe something is bleeding or maybe There might be like a wound or like the Opening from surgery that a patient may have had that looks a little bit Peralent and you know infected and so they're just kind of Calling you to inform you on that but also kind of just ask your opinion on what that you want them to do So again, like it's pretty like nerve racking a little scary, but I mean, this is what you signed up for right you signed up to direct these patients care and like make these decisions and so Um, that is like typically what you're going through throughout the day The residents will leave like I said at five Um, and they will give sign out to you. So like we typically run the list like maybe Three to four times during the day Um, because we will go again at like around 330 ish three o'clock to run the list With the attendings to see hey, all right. So what was done today? Um, were these directives like followed through and are there anything is there anything that I need You know to know about as the attending To see hey like I need to watch out for this tonight or Is the patient doing fine? And so we'll go through the list and say like this patient was discharged or you know, this patient Went to the ICU or this patient has to had to go back to surgery What are the case maybe we will address that on our second table rounds, which is typically at three or 330 Um, and then that is it The at that point in time you really shouldn't have any notes to write or anything like that and you know just kind of reading waiting around waiting for You know a new consult to come in or a call to come in that you know on a patient that you may have so Like I said the residents leave at five unless they are on call and so They will give sign out to you They'll let you know like the patients that may need a post op check like if they went to The operating room with the patient, um, then you may have to do like a night of surgery check on this patient Typically within the first three hours. I believe it is You want to go see that patient make sure they're doing okay make sure like they're fluid, you know Their fluids are where they need to be they're not dehydrated all of that good stuff. Um, And you'll replenish anything electrolytes fluids blood whatever maybe low you replenish that And you try to make sure that the patient is well taken care of on A pain scale like so you prescribe whatever pain meds you think you and the attendant think is appropriate So that that patient is doing well throughout the night After around five o'clock five six o'clock like that's kind of it. It's kind of downtime I know that there are people that like try to take like a little really quick nap Like for me the first day that I was there like I didn't take a nap I was just kind of like again reading up on things that I didn't really know about Chart checking my patients like crazy making sure that no one was you know like getting tachycardic or um tachypne meaning like their heart rate was um racing or their Respiratory rate was increasing. I just wanted to make sure that they were okay I told you that I do a check at eight So I did go and see my patients again at eight But these are things that like it all depends on the person, right? You know, there are people that may not check on their patients until 10 Um, and then that's it uh for the night and you will check on them again in the morning or go down there When they're called but for me since I'm so new I wanted to make sure like, okay Is there anything that I need to do? Can I help the nurse out with anything? So I went and I would check on my patients at eight And then I got in the bed after that like around nine o'clock. I got in the bed and was just kind of like just chilling Reading looking up like how to do various different procedures on youtube Um and just kind of learning taking that time to learn Of course, I talked to like my family throughout the day Um and just try to check in on them and make sure that they were okay Now the cafeteria does not open for dinner So if you did not get like something a little extra during the lunch period Then you really don't have anything to like eat at night unless you bring something from home And so that is something that you have to be aware of like For me, but um that is really Not that the cafeteria doesn't open at dinner But more so like not having things to eat later at night Is something that you have to worry about now because there is like another like kind of sub pizza shop in the hospital But it's closed currently because of covet So once like things start to open back up then obviously like it's going to be a lot better You know because people we're going to have that available to us if we need it But currently that's not the case and so Um that is just something that you have to be mindful of you know Like how are you going to eat like I typically try not to eat after eight anyways So for me like I'm not that hungry throughout the evening time and then By that time you're like just trying to wind down and go to bed So it doesn't even really matter But for somebody that needs to eat constantly that would be something that you have to be mindful of Um after around nine o'clock and you're just kind of chilling It's really just like a waiting game. You're waiting for consults. You're waiting for calls You really don't have much to do throughout the night. Uh, you just have to make sure that you update the master list I explained this list to you guys where you know, it's very imperative that the list is um updated Because as the new pa coming on you may not have been seeing these patients for days And so the list will kind of direct you on who the patient is what they originally came in for how long they've been there And then kind of to-do list like tasks that we have to do and follow up on with these patients So that is definitely something that um, I always try to make sure that it's up to date And then also like all of our patients typically will get morning labs So you want to make sure that they all have morning labs ordered so that when you know Five o'clock comes around in the morning The lab can draw these labs and you know, we get to see exactly like how our patients are trending So I'll make sure and do that and then like around Midnight, I will go and do like a last Minute check on these patients just to see how they're doing and then I go to bed That's when I'm like actually like trying to go to bed and like trying to get rest and sleep Now obviously typically like I have no Control over what happens. I've no control over like who calls or who doesn't call or what's going on with what patient but Ultimately like I feel like that is like a good model to follow for myself at this moment in time Now if I'm in bed and I get a call then I have to go see the patient and so I Got several calls When I was doing my first 24 But like I was saying some of them were just like oh, I could kind of address it over the phone Others I did have like two of them. I had to go check on the patient just to make sure they were doing well And because I wanted to see them like there's nothing Like seeing the patient and so the patient was doing fine Clinically like like physically speaking like I could see like they were doing fine But like medically like, you know, there was a lot of drainage and stuff So I wanted to make sure that I took care of that and so I you know Cleaned the wound and did all of that and then went back to bed and try to get some more rest And I think I may have gotten like Four hours or so like two hours here one and a half hours there that kind of thing And then it was time to wake up and see the patients again for the third time Make sure that there was nothing going on overnight. You check their charts And this is typically around like 4 35 o'clock. I'll go they're usually getting labs drawn So I wanted to I want to do it at a time where they're already awake I'm not trying to like awaken them up out of sleep because I know what it's like being a patient in a hospital And then people are like constantly coming in and out to like give you meds or whatever the case may be I'm like, I'm not here for that. I'm not trying to have that right you're cranky or upset and so to kind of just Be as make this patient as least upset as possible I wanted to go I try to go through to a time that they already have to be up And awake so I'll do that and then After that, I'll go back to the call room after I've seen all my patients This may be around like 5 45 ish 5 30 ish I'll make sure that the list is updated from any new things that I've seen I'll make sure that if there are any labs drawn because again, you want to make sure that your patients are Trending in the right direction. So you want to make sure like white blood cells are trending down, which is an indication of They're not like, you know having any type of infection if it was trending up Then you're like, okay, they're probably getting an infection They might be fibril again a sign of an infection and that's not necessarily what you want. So With that being said, I'm always looking at the chart just trying to make sure that the patients are doing well And then preparing myself for sign out. So like I said sign out will happen at 6 30 The new pa's might that may be coming on Or the residents that may be coming on that may not have been on call the night before We'll typically start trickling in around like 6 15 ish We'll do sign out at 6 30 and then that is it my 24 hours is done I get to change my clothes a clock out and go home now Obviously if you live far away because there are some of the pa's that live like 45 minutes 10 hour away They might like stay a little bit longer Get a little nap before they leave. Um, they would obviously clock out before they take their nap But they'll clock out take their nap and then wake up and There is an option to take a shower at the hospital. I Don't know how I feel about that yet And so I haven't like that's not necessarily like something that I've taken advantage of yet But there is there's like a shower outside of the call room that you can Use and I know like several people that use that. Um, for me, I don't live that far away So I decided that I will just take a shower when I get home And so um, I go home take a shower and then go to sleep. Um, so far I've been sleeping for like a good four Anywhere from four to six hours After I come off the 24 I think it's all dependent or after I come off the night shift because I've done a night shift before where I So for like four hours when I came off this 24 I stopped for like six hours just because I was up Like several like so many times throughout the night. Um, so I didn't really get good rest but I think probably on average it'll be four to six hours that I will sleep and then wake up and You know go about the rest of my day, but that is typically how the 24 hour shift works. Um, Obviously you are not working 24 is back to back There's just no way possible that you would be able to do that because you'll be Extremely tired. So you will be missing things. There will be things that you will miss Um on your next 24 if you were doing it back to back. So with us You're only working six shifts a month at minimum You can work more obviously, but you at minimum We're only obligated to work six shifts a month. Um, and that Kind of just works out to be three shifts a pay period So you'll work like two shifts one week and then one shift the other week So if you're looking at that just, you know By numbers wise in terms of days You're working obviously three out of 14 days. So there right now my schedule is where I might work one day I might work a Monday And then I don't come back again until Thursday Um, and if I work on Thursday and then I get off on the Friday morning I don't come back again until Tuesday or it might be my weekend to work And if it's my weekend to work, then I'll come back on Sunday And then I might be off that whole week So it's actually like a pretty sweet shift. I like I love it. Um at the moment obviously I I like having time with my family I like being able to kind of Just get a break from hospital life, which is nice. Um, because you see a lot of crazy things You see a lot of hard stuff. So it's nice to be able to like decompress Um, but right now like I'm loving these shifts And so that is typically how the 24 hour shift runs. Um, you are on call the full 24 hours You do get to eat Yes, you do get to sleep and take naps. Um, but it's all dependent on like how busy you are and like how many patients you have to see But I will keep you guys posted on this Of course on how I do on these upcoming 24 hour shifts If you have any questions for me, please leave them in the comment section below, you know, I'm I'll be sure to answer anything that I may not have answered in this video. Um, so leave me a comment on that And if you have any video ideas, leave those as well Thank you guys so much for watching. I will talk to you guys next time. Bye