Surviving Night Float

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As of 8 AM this morning I’m officially done with my two weeks on nights with the internal medicine team. Wow, are nights exhausting! The nurses on nights make it look so easy! Honestly, starting my clinical years off on nights couldn’t have been better. Nights are {usually} slower and you have an easier transition into patient care in my opinion.

I’ve gotten some questions about nights from classmates and readers, so here’s a rundown of my tips. Basics first — at Beaumont when you are on night float you’ll be either with the general team, staff team or on MICU. If you are on MICU you don’t present to the attending, so you get to leave around 630 AM {or earlier, depending on admits}.

Flipping your schedule: 

  1. I started on a Wednesday night {my shifts ran about 830P-8A}, so on Tuesday night I tried to stay up as late as I possibly could to attempt to switch my schedule over. I only made it til 2AM {I’m a morning person}. So, my first night was a little rough because I was basically awake from 8AM Wednesday morning to 8AM Thursday morning. But, if you can try to flip your schedule like that it’s worth a shot the few nights before you start on night float.
  2. A lot of people have asked what my schedule looked like as far as when did I sleep/eat when I was on nights. 730PM arrive at the hospital. 8AM shift ends, go directly to sleep. 2-3PM wake up & eat breakfast. 3-6PM attempt to be productive. 6-7PM often take a nap before my shift & grab a snack. The first few days are really hard because you will most likely wake up a few times during the day. I honestly never truly adjusted because on my days off I’d kind of revert back to my old schedule somewhat or just sleep all day. For me, nights were pretty relaxed so I was able to eat another meal during my shift if I wanted.
  3. Buy earplugs and a face mask. These were key to helping me fall asleep when it’s bright outside and people are mowing their lawn. I also had a fan on to help drown out some of the daytime sounds. How cute are these? {here}                               il_570xN.1002511522_byth.jpg
  4. Don’t be too hard on yourself. Flipping your schedule completely for only two weeks is honestly really tough. Many of my days off I had horrible headaches and my body was just plain unhappy with me. I let myself rest and didn’t take it too hard.

General tips 

  1. Ask lots of questions. Like I said, nights can be slower and you have more opportunity to talk with the residents and discuss patients. I used this time to ask any and all {of the stupid} questions I had. Especially on the MICU; I’m pretty unfamiliar with a lot of the hospital equipment and how it works, so I asked a lot of “basic” questions about that either to my resident or nurses that we worked with. As a result, I feel way more comfortable setting up for an A-line, scrubbing in, using an ultrasound, using our portable translator MARTI, and, of course, turning off any unnecessary, annoying beeping from the monitors.
  2. Bring lots of snacks and load up on your “rescue drink.” My body felt pretty out of wack the first few nights and it’s pretty easy to get a faint feeling when you are up at 430AM. I brought Gatorade as my go to if I was feeling a little off.
  3. Be prepared for a code. In the past two weeks, between the four of us students on nights everyone participated in a code. The first code I saw I didn’t get there until the end, so I didn’t help out. Last night I actually participated in my first code by being one of the people on chest compressions. Prior to starting third-year we got CPR certified through an ACLS and BLS course. But, we used dummies to practice on and the real thing just isn’t the same {obviously}. Even though I was nervous when we got into the room, I’m really glad I had the chance to help out. Some of the residents that I had been working with told me their first code wasn’t until during their residency! The nurses and physicians worked as an excellent team, telling us whether our compressions were effective {speed up your rate or increase depth} and being ready to jump in as soon as the other person got tired. Wow, are compressions truly exhausting. This is why there are so many dang people in the room during codes because you really do need a line up of people alternating on compressions. For codes, don’t be embarrassed if you get tired or need to switch out on compressions — it’s about giving the patient the most effective compressions and you can’t be effective if you are tired. Also, remember to listen to the person running the code. Codes {from my little experience} seem hectic and you need to identify the point person that you can take direction from {they will most likely make this very clear}.

FullSizeRender 40.jpg4. Be prepared to have a brain of mush by the time you present to the daytime team. Honestly, I felt like I couldn’t process things correctly by the time I was nearing the end of my shift, so I ran blank some of the times I got asked questions by the attending. Try not to be too hard on yourself!

Tips for if you want to look good

  1. Check if your hospital requires a code status. The interns I’ve been working with told me they almost always forget this then have to awkwardly go back into the room late in the night to ask about it. So, if you can gently remind them before exiting the room that we should get the code status from the patient that will help them out  a lot!
  2. If you have a patient who needs a translator arrange things for the resident prior to seeing the patient. The one time my intern and I used MARTI for the first time it took about 20 minutes to actually find the equipment and then get it set up and ready to go. If you can let your intern know you will set it up and they can meet you they will be happy to gain a few extra minutes to prep or answer pages.
  3. Have your own equipment ready if it’s needed. Several times whoever I was with needed a pen light or didn’t have a reflex hammer! They seemed pleased that they didn’t have to run back upstairs to grab theirs.

 

What tips does everyone have for night shifts? Leave a comment below!

X/O A

Hello, It’s Me

I’M ALIVE! I made it to the other side of Step 1 and found out this week that I passed! Sorry for the uber long hiatus from blogging, but welcome to the new site! Super cute, right?

So, this post isn’t going to have too much medicine in it, mainly because I want to update you all on my life! Eek, there are SO many exciting things happening right now. Let’s backtrack for a hot sec.

Last time I “signed off” my old site http://amchang9.wix.com/medicineinmichigan and let you all know that I had some exciting stuff in store for when I returned. I’ve gotten almost all of my old posts moved over to my new site {in the title should have “old post”}, but will still be working on adding some tags/organizing so it’s easier to navigate {bare with me!} But, if you’re new here {or even better, a new OUWB student check all the old posts out for some killer tips. Also, if you currently follow my site- share it with your fellow pre-meds/med friends pretty please!}.

Next piece of business, I’m going to be working on a mega post for tips and tricks for Step 1. I made some mistakes along the way and I want YOU all to learn from them! This is going to take me a little time but this will be coming soon.

Okay, now on to the fun stuff. Life updates!! So, after I took Step 1 {worst time period of my life, not a joke}, I got crazy busy. I did a few short trips for weddings and went to the Kentucky bourbon trail. In between soaking up the short summer weekends that I did have, we completed three mini-courses. During the month of June, we took 1. EBM {evidence based medicine} 2. APM 5 {we got to do the M/F pelvic exams which were actually way less nerve wrecking than I anticipated} 3. Diagnostic Medicine {basically gave us an overview of some stuff at the hospital – where labs were, what kind of testing was available, etc.}. We also squeezed in ACLS & BLS training {CPR, codes, etc}.

Yeah, having no summer kind of stinks– so, you have to squeeze every once into those nights & weekends {head to the lake & soak up some rays}. During June we didn’t really have any “work” to do, so it was pretty relaxing.

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After these courses, I had about 6 days off and B and I jetted over to San Francisco. We went sailing on the bay, took a ride in my uncle’s convertible around town, met up with friends and spent time with family. We also hit Napa Valley for a night, which was amazing. If you are ever there prepare to #1 spend a bucket load of money {We air bnb’d and borrowed my aunt&uncle’s car, but it was still super pricey} #2 drink oodles of amazing vino {but really, who can really tell the difference between $10 bottles and $100 bottles, not me — yet!} #3 fall in love with whoever you are with, because it’s just so dang romantic there #4 go to Bounty Hunter Wine Bar & Smokin’ BBQ, seriously hands down amazing.

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On the last day of our trip, B, my baby brother {the only person not smiling in the pic above, don’t kill me J} and I headed out for a 10-mile hike in Muir Woods outside of SF. AND this is where my life totally changed. After a 5-mile hike up to a coastal overlook, my little brother ran off to “snap some photos.” After a few minutes of him disappearing we went to follow him and thru a meadow of grass was a blanket and champagne {I thought it was a parachute laying there at first and was super confused, ha!}. B got down on one knee and proposed! My sneaky little brother captured the moment perfectly. To say I’m ecstatic is an understatement.

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Doesn’t this look like it could maybeeee be a parachute from far away?!

When we got back home I started on night float with the internal medicine team at Beaumont {more on how internal medicine is in another post soon}. It’s been super fun and a very good way to start out my clinical experience. Even though working from 830PM-730AM is rough, the residents have so much time to help us figure things out since they have a smaller patient load at night. I’ve even gotten to assist with putting an A-line in {I felt pretty BA even though I was just assisting}.

To sum it all up, life is just pretty darn amazing right now. I have one more life update coming soon {hopefully in the next week or so, stay tuned}.

 

Tip of the day: Be willing to try anything during clinicals. So I saw an A-line getting put in last week at 530AM and felt pretty whoozy {lol, can you tell that I don’t want to go into anything procedural ? — maybe this will change}. It kind of freaked me out because I was like what’s going on? BODY, please don’t pass out on me. I quickly excused myself and got it together before re-entering. This week when they asked if I wanted to assist with the line in the ICU, I was a little bit hesitant {I didn’t want to embarrass myself}. But, with a little nudge from my classmate, I decided to go for it. Everything went smoothly and I learned so much from being right in the action. So, lesson learned. Try to give everything a shot, even if you aren’t totally comfortable with it. Test the waters and if at any point you are feeling off, just excuse yourself {seriously, the residents are so understanding}.

X/O A