So, night float is over. Of course my body doesn't know that. So despite the fact that I start general surgery tomorrow and have to be in to write notes at 4am I am wide awake in the middle of the night. Which would be okay except I've only slept for 3 hours so far. Oh, the transitions. This is the part of the job that you really don't prepare for. But despite what it seems, I am really not complaining. Night float for two weeks certainly beats the alternative of being q4 on-call. Because on-call really means just working for 30+ hours straight. So the night float system is fine with me. I am now quite comfortable doing consults, responding to traumas, writing post-op notes, etc. I don't know if that means I am ready for the real thing, i.e. 6 weeks of gen sx but I'm about to find out.
And without further ado here is a brief recap of nights: what I saw and what I did, when the rest of the world was sleeping.
10 Trauma Consults- pt in the ER and stable but being consulted for C-spine clearance and/or possible sx. For example if you crash trying to land your hang glider or a wheel falls off your ATV you'll get a full H&P from the surgery team starting with the medical student. And this does include a DRE. Fun all around, right?!?
2 Trauma Alerts- ER pt that requires a trauma team response (medical student, residents and all ER staff). Perhaps you cut a major artery b/c you were drunk and mad and punched your hand through a glass window- this is where you'll end up.
5 Trauma Activations- ER pt is being transferred or walks in off the street in possible critical condition so entire trauma team + Attending responds. (Medical student does the paperwork.) Stab wounds, gunshot wounds and high speed MVAs all end up here.
ER Consults for Surgery/Admission- Abdominal pain that might be surgical. Post-op pts with irretractable pain or a fever. People that do stupid things requiring surgery for removal. These are the bread and butter consults. My most common consult was for gallstones +/- pancreatitis.
3 lap appys (2 x I got to drive the camera)
2 toe amputations
1 perineal abscess I &D
1 open exploration for small bowel obstruction
- suturing is harder than it looks!
- first knots tied = fun (thanks Dr. BF for all the tutorials)
- first opening incision
Not to mention countless hours of TV watched in the resident lounge and a few hours of sleep stolen while waiting for something to happen. All in all nights were an okay way to get my feet wet, now it is time to swim.