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Day in the Life of a Pediatrics PG1 Resident

6:00 am Alarm goes off, wake up ready for another day in the NICU
6:15 Eat breakfast, shower, and head out to work.  On the way in, stop at Star bucks to get my morning coffee (Grande Vanilla Latte).
7:00 Arrive in NICU to get sign out from overnight resident.  One new admission to my team this morning - a full term baby here with hypoglycemia from a mother with gestational diabetes.  I read up on the admission notes in the EMR written by the resident about this new patient.
7:30 Scrub in for the day.  Update all the weights, intakes and outputs for my seven patients in the NICU on my worksheet.  Pre-round, examine and discuss each patient with their nurses about any concerns or problems overnight.  They inform me about orders that need attention and I fix them up on my computer-on-wheels.
8:30 Morning lecture from the NICU attending.  It is about neonates with hypoglycemia.  I think about my new admission and note down the extra signs and complications I now know to look out for.
9:30 Begin rounds with my team, which consists of the senior resident, medical student, nurse practitioner, nutritionist and attending.  I present the updates on each of my patients, outlining my plans for each patient today with a systems approach.  The team gives feedback on my plan.  We decide to continue to wean the medication for a baby suffering from neonatal abstinence syndrome.  A baby with Meconium Aspiration Syndrome is doing really well and is to be weaned from the ventilator to a high flow nasal cannula today.  The attending provides some key teaching points about babies with Meconium Aspiration Syndrome, and gives some hints about possible board questions on this topic.
10:30 Finish rounds.  Before heading off to place the orders for the day, the team discusses interesting radiology images on our patients.  We review the aspiration seen in one of our babies who had a contrast swallow study.  We then discuss the appropriate placement for umbilical lines.
11:00 Enter orders for my patients.  Got some help from the senior resident about how to order the parenteral nutrition properly.
11:30 Head down to the simulation center with all of the NICU residents.  It is my turn to lead the simulation and today's case is a newborn in hypovolemic shock after placental abruption.  We run through the scenario as a team with as simulation robotic baby complete with breath sounds, heart sounds, cyanosis and pulses.  After the scenario, we go through what went well, what could have gone better, and how to improve for our next code.
12:30 Got lunch from the cafeteria with my staff card and catch up the other residents in the NICU and nursery.
1:20 Pager goes off:  Code B in the delivery room for meconium stained anmiotic fluid!  It is my turn to respond.  I head down to the room with the respiratory therapist and the nurse practitioner.  Baby is born and not vigorous in the infant warmer.  I open the baby's mouth and intubate the baby with guidance from the nurse practitioner.  I then suction  meconium from the tracheal through the endotracheal tube and the baby begins to cry.  I perform the rest of the routine warming and drying of the baby with the team and give him some supplemental oxygen.  Once we are satisfied that the baby is now stable, I go over to the new parents to congratulate them on their new baby and update them on what has happened.  We bring the baby upstairs for further care.
2:00 Enter the admission orders at the bedside.  Discuss the baby with the attending.  Finish the admission note.
3:00 Return to the back room.  I receive feedback on the code that just happened with notes on what to improve on for the next time.
3:30 Go through each of my patients to check on the progress of their plans.  Check with the respiratory therapist to ensure the baby with meconium aspiration syndrome is comfortable on the current settings.  Update the parents of the new admission on the baby's progress.  Update the worksheet and the discharge notes for each baby.
4:30 Sign out to the Long Call resident.  Discuss the plan overnight for each of my patients and highlight issues to look out for.
5:00 Leave hospital for the day.  Go for a work out at the gym on the way home.
6:00 Cook dinner and enjoy it with the latest episode of House.        
8:00 Read up on meconium aspiration syndrome with my own copy of the Neonatology textbook provided by the NICU.
9:00 Catch up with a good friend on Skype.  Make plans with my fellow first years for a hike up Mt Tom this coming weekend.
10:30 Off to bed