If you are ever curious about how a typical day goes for an orthopaedic intern, let me enlighten you with a timeline (say for today). Hold your breath, here goes.
6.30am - Arrive at the surgical ward. Update patients' list. Add on new admissions, check progress of all patients overnight, chase bloods and imaging results. Do your own pre-rounds (before the reg's pre-rounds, and wayyy before the actual ward rounds) if time permits.
7.00am - Registrar arrives at ward. Print patients' list to hand out to the team. Paper round with registrar to update him/her/them about all patients. Registrar does his pre-rounds. Carry out new jobs (eg: order repeat bloods/XRays for post-op patients)
7.15-7.30am - The rest of the team (consultants, allied health members and occasionally nurses) arrives. Official paper round of the morning - team will discuss patients' issues, and coming up with plans. Intern to note down plans and carry most of them out later in the day.
7.30-7.45am - Commence ward rounds. Interns leading the way and showing the team to the rooms and patients. Also looking for patients' obs chart. More jobs might be added to list as we go.
8.00-9.00am (depending on patient load and complexity) - End of ward rounds. Consultants and registrars off for coffee/clinic/operation theatre. Interns return to doctor's office to write progress notes in retrospect for the ward rounds in each patient's folder. Liaise with nurse unit manger about plans for each patient under our care. Also liaise with nurses looking after each patient if there are any specific jobs to be done (catheter to come out/new medication charted or ceased/obtain urine sample/stitches or staples to come out etc).
9.00am to 12.30pm - Completing jobs and chasing up results. For today, we had to chase an ID consult, chase an ECHO, chase x2 blood cultures, chase x2 urine mcs, discharge x3 patients, and also prepare discharge scripts and paperwork for another x2 patients for discharge to nursing home tomorrow. Also x1 palliative care referral and x1 opthalmology referral. While we are going about completing jobs, nurses might approach us about new issues about patients under their care, and we will need to review or manage accordingly. For today, we had a post-op young guy who failed to void and requiring a catheter. There was also a cannula to be resited. Multiple medications to be recharted. A lady with low blood pressure and query to withold frusemide for today. Meeting family member of a paediatric patient to discuss ongoing management and compliance issue. Providing
12.30-1.30pm - JMO education sessions every Tuesday for an hour. Today we learnt about how to assess journals from the hospital library.
1.30pm to 5.00pm - Continuing where we left off, completing the rest of the jobs leftover from the morning. I attended the palliative care consult for one of our patients, and discussed the plan with the consultant. Received phone call liaison by the ID team at the Royal Hobart Hospital (gosh I miss that place!) and confirmation of antimicrobial therapy for patient with septic knee. Then I received a call from pre-admission clinic to see a man who is due for elective L total knee replacement - completed assessment, pre-admission and paperwork. Chase up post-op bloods and XRays to see if all were well. Then I returned to discuss ID consult results with registrar and carry out plans as per discussion. Went to talk to patient and explain her condition and tentative management plan. Printed patient information for her.
5.00pm to 6.00pm - Was just about leaving for the day when registrar called up to admit a patient from ED with a L neck of femur fracture. Did admission and bloods and ordered CT. Waited for registrar to arrive to take over admission and discuss plan. Finally got to leave when all paperwork was settled and handed over to evening ward cover intern to chase up CT for the new patient.
Kudos if you have endured to read up to this point.
And to think that I once aspired to be an orthopaedic surgeon! Thank God that was a brief phase I have long since gotten over. Oh, but I guess that was mainly about the money anyway. =P
Have I told you how much I hate waking up early in the morning? ARGH.
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