My trauma surgery rotation was definitely, well, hard.
The patients and my coresidents made it extremely enjoyable but the long hours and endless pages throughout the day and night were exhausting. Overall I learned a lot and would gladly go through the rotation again.
A little background info about the Trauma service: we see every major trauma in Nebraska. From elderly people falling and having broken bones and brain bleeds, to people getting stuck in boat propellers, to car accidents, to gun shot wounds or people violently getting attacked. You name it. We evaluate the patients in the trauma bay which is a section of the emergency department and decide at that time if they need emergent surgery. We evaluate the patients head to toe and then get the needed labs and scans within minutes. Sometimes patients need surgeries. We follow the patient's course in the hospital whether that's in the ICU or on the floor. At any point in time our service usually has around 50 patients but many days will have more.
We have our ICU for our trauma patients but also see any surgical ICU patients every morning as well. This includes people who may have perforated holes their intestine, or who have recently had a liver transplant. You name it, anything surgical and in the ICU we will see.
Towards the beginning of the month I would arrive at 5am, otherwise I usually showed up at 5:30 a.m. Similar to my ICU month (that post here), I would spend the first hour researching my patients on the computer and looking at their recent morning bloodwork and imaging. Then I would head up to their rooms and examine them and talk with them and their nursing staff about anything they are concerned with or how overnight went.
At 7:45 we would meet in a conference room with the entire team (attendings, residents, medical students, pharmacist, case managers, social work, P.A.s, Nurse Practioners, etc) and discuss each patient one by one and the plans we had for our patients. We also would do a half hour of education each morning.
From 9:00- Noon, I would head up to the ICU with my attending and the other resident who had seen ICU patients and go room to room and reexamine patients and finalize the plans for each patient every day. We would visit with family if they were there and put in new lab/imaging/medication orders at this time.
In the afternoon, we would get transfers to the ICU or people would arrive after their surgeries and a resident must be there to see them.
At any point in time we will have our pagers go off when nursing staff or other physicians need to contact us about our patients. We spend the afternoon making phone calls for consulting physicians, calling family members who want to discuss the status of their loved one, and finishing up the documentation in the computers.
Our trauma pagers will go off any time 24/7 and at that point we go and evaluate our newest patient and determine their next steps (as described in the second paragraph).
If you are not on call (AND if you are currently not working on a new trauma patient) you usually will be able to head home around 6p.m.
If you are on call, then you are staying until the next morning. Usually you are able to leave after we sit down in the conference room so 9-10a.m. the next day, but it definitely varies.
Overnight you answer pages and are responsible for all of the patients. There is always an attending physician in house to help, but most of the tasks are doable by the resident on call. I always kept my attending in the loop when new/major events were happening of course. Handling all of the ICU patients was not easy. Managing ventilators, starting bipap breathing devices, putting breathing tubes in, managing intracranial pressures, blood pressures, sedation drips, arrhythmias was certainly educational. You don't sleep (your pager will constantly go off), but with the help of lots of snacks and Redbull, it was manageable.
I had a fun experience and it was full of highs and lows. I loved playing such an active role in caring for patients and I loved working as a part of the team that makes up the trauma team!
For more day in the life posts click here.