||My alarm has just gone off which means I've got 30 minutes to take a shower, get ready because I'm on the Vascular Surgery service. I do all of that and grab my bag with some reading material for later and head up to the hospital.
||I go to my call room and log into the computerized EMR to see what's happened to the service overnight. Things look pretty quiet, only 2 new patients on the list I don't recognize. I skim through the available electronic information to get an idea of what their pressing issues are. Next I double check the OR schedule to see if there have been any changes there. looks like one of the new patients is scheduled for a thrombectomy of a failing bypass graft for later in the day. I wonder if I'll get to do that case?
||I'm on the main surgical floor meeting up with the team and my chief resident. The PGY-1 has our patient list prepared and the one that was on-call last night goes over the major events and recaps the new admissions and the plans. The Chief tells me that I'll be assisting on the thrombectomy case, otherwise the OR schedule will follow the one he sent out at the start of the week. We then make rounds, seeing each patient, checking for distal pulses, changing dressings, and ensuring that they are recovering and getting the appropriate therapies that they need. We finish in about an hour, which gives us enough time to grab a bite to eat before we run the list.
||Since it's Thursday we eat and head down for our weekly M&M conference at 7 AM. This is followed at 8 AM by our Surgical Grand Rounds where we have a visiting professor talking to us about a specific topic. At 9 AM the last hour of our protected educational time is spent on taking a quiz on the topic we are studying this week from our curriculum. Once everyone is finished we go over the quiz using an audience response system and review the answers and why they are right.
||The team reconvenes briefly and the plan is quickly reviewed for the patients and the junior residents and PA divide up how they will do the notes on each patient. The Chief and I head off to the OR and he makes sure that I review the in-house patients with the attending I will be working with. I go to the preop area to meet my first patient of the day who is going to undergo a femoral to distal bypass. I introduce myself and the medical student on the service and review her H&P.
||I then head back to the OR and meet the rest of the team. I then log back into the EMR and add my patient to our list and pull up the imaging studies that she's had done and review those with my medical student. The attending comes in and we review the overnight events of his patients and the plan for today, which I convey to the team. We then take one final look at the images for our new patient and we review the operation and what we expect to do as well as possible alterations in our plan based on what we might encounter. The patient is brought in and the anesthesia team does their thing. I go scrub with my attending. We come back and get gowned and gloved for the procedure. We then prep and drape the patient and I get set up to do the groin exploration to identify her greater saphenous vein insertion into the femoral vein, while my attending starts distally. We work our way towards each other until we have the vein freed. It is then ligated and passed off. We then turn our attention to exposing the arteries we plan on bypassing.
||I go check the OR board to see what the status of the embolectomy case is. Looks like the patient just got to pre-op, which means anesthesia still needs to see her and I can grab a quick bite for lunch! I hit the caf and grab some food with the med student and we talk about our first case and a little bit about the upcoming case.
||Looks like the Chief is almost done with his case. I head into his room and take a peek at what he's done. We go over his cases for the day as well as my cases for the day. We head out of the OR together and meet up with the PGY-1 that is on call for our service and go over the plan on all of the patients.
||I call home and see what my wife has planned for dinner and head home. We have a nice dinner together.
||I watch a little TV and then do some reading before I call it a day around 9:30. Gotta get my rest because I've got to get up and do it again tomorrow.