24+6

I survived the first two 24+6 calls. "24+6" denotes the hours of the call - 24 hours of call time plus a maximum of 6 hours post-call time for education and transfer of patient care to the next call team.

As an intern in a busy service like Medicine, it means in most cases you don't get any sleep at all. Last night we had 16 admissions overnight amongst 2 interns and 1 student - and with me and the other intern in the team being new to this whole system (this is our first general medicine ward month) it didn't really help. We had some really interesting cases though, not just the usual "CP r/o ACS" kinda thing. We had a patient with lupus who came in with neutropenic fever and cutaneous lesions all over her body; a guy who was brought in after being found lying unconsciously in the hospital lobby; a guy with sickle cell disease who is stupid enough to stand in the back of a truck and fell off when the truck accelerated; a schizophrenic social admit... the list goes on...

Partly because we are not efficient enough, and partly because there are just darn too many things to follow up, I stayed until around 3:30pm the next day, which means I have worked for at least 28 hours straight without a second of sleep. I started dozing off while writing for patient's note, and felt like a zombie walking around the hospital. The good thing that my fellow intern and I noticed though is how fast we have already improved our efficiency a lot in one short week (with a seal of approval from our R2). Hopefully this will continue to improve.