NICU
As a third-year resident, we spend one month as NICU Senior. Here, it is our responsibility to supervise two interns during daily rounding, attend and take the lead at all deliveries, and assist/teach with procedures including intubations, umbilical lines, and lumbar punctures. This rotation is "q4," meaning every 4th night is an overnight shift. I sign over the patients the next morning and leave by 1:00 p.m. We work 6 days per week on average but get one "golden weekend" (Saturday and Sunday off!!!).
Here's a typical day as NICU Senior:
I arrive to the NICU at 7:00 a.m. The two interns have already been here for about 30-60 minutes pre-rounding on their patients. I quickly check on them to make sure there are no emergencies, and then I find the post-call senior. This person, a second-year resident or a nurse practitioner, passes the high-risk delivery pager to me and gives me sign-out on the night's events. After this, I check in on any sick babies or help out the interns with any last-minute needs before rounds begin.
At 8:00 a.m., rounds begin. The rounding team consists of the NICU attending, fellow, senior resident (me), two interns, a respiratory therapist, each patient's nurse, and most importantly the baby! We do "walk" rounds going from isolette to isolette discussing each patient's condition and plan. The intern presents the patient's history and overnight events, including fluids, medication, respiratory status, and any complications. The nurses, attending, fellows, therapists, and I all chip in and add our two cents. At the end, the intern summarizes the patient's plan for the day. As we round, I am putting in orders and looking up x-rays on our portable computer.
Rounds are interrupted at 10:30 a.m. so that the team can go to radiology rounds. Here, we review all the films for that day as well as discuss any other studies that have been performed.
We head back to the NICU at 11:00 a.m. and finish up by 11:30 a.m. We spend the next 30 minutes putting in orders (if there are any that I haven't already finished) and talking to families. At noon, we sign out the post-call resident and then disperse to grab lunch and make it back for our 12:15 "noon" conference.
After noon conference, the remaining intern and I perform any remaining procedures, talk with consultants, call more families, and check in on our patients. At 4:00 p.m., we have sign-out rounds for the night team. If it is my call night, I get sign out from the NICU intern, the intermediate care nursery residents, the nurse practitioner, and the newborn nursery residents. If it is not my call day, then I sign out the unit to the covering resident or nurse practitioner.
Our day is often interrupted by deliveries, new admissions, sick kids who need our attention, and good humor from our attendings. At the end of my day, I go home tired but fulfilled knowing that I am a crucial part of the NICU team that together is saving lives.