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Day in the life of an intern - Ben hale

My name is Ben Hale and I’m a Med-Peds intern. An important part of being an intern today is working night shifts, where the focus is on admitting and cross-covering patients in the hospital. Here is a description of a typical night shift while on pediatrics at C.S. Mott Children’s Hospital:

I arrive just before 6:00 pm and meet with the rest of the night team, which consists of two senior residents and two interns, in our workroom. Each intern is assigned three of the six inpatient ward teams to cover overnight: general (Blue, Maize, and Silver) and subspecialty teams (Cardiology, Pulmonology, and Hematology/Oncology). After the assignments are made, we grab a phone and a bright red code pager and head to get sign-out from the day teams.

During sign-out, the day team runs over their patient list with the night team, giving a brief description of each patient and why they are admitted, identifying labs, studies, or consultant recommendations to be followed up on overnight, and providing contingency plans for expected issues that may arise. Sign-out is a crucial communication skill and important for patient safety, and is taken seriously by both the day and the night teams. It is a point of pride for the night team to help the day teams finish their work and leave so they can enjoy their life outside the hospital.

As the day team is leaving, they forward their pagers to mine, and the night team becomes the first point of contact. While we don’t formally round as a night team, I make a point to meet some of the patients and families that were identified in sign-out to potentially have the most active issues. Throughout the rest of the night, I answer cross-cover pages as they come in, and help with admissions at the same time. The cross-cover pages range from simple clarification of orders, to acute concerns developing overnight that need to be addressed urgently. I love the autonomy I get to exercise on nights. As I am the first point of contact, I get the first chance to make a treatment or evaluation decision. While I always get this opportunity, my senior resident is always nearby to back me up on the decisions I make.

Similar to cross-cover, admitting patients overnight provides the opportunity to make and enact initial treatment plans. If workload is high, the senior residents don’t hesitate to help interns with all parts of the admission. Our outstanding medical students are also present to help with admissions. Although the workload on pediatric nights can be very busy, with everyone working as a team we are able to finish our work in time to signout the overnight events and new admissions to the day team at 6:30.

Sign out is usually done by 7:30, after whichI head home to rest and spend time with my family. While on pediatrics nights we work four nights, and then have two consecutive nights off, which allows for some quality time to spend with friends and family and exploring the Ann Arbor area! Overall night team is an excellent learning opportunity with a high amount of patient contact that provides invaluable lessons in autonomy and pediatrics in general.

Ben Hale

Benjamin W. Hale

University of Michigan

Med-Peds Resident - Class of 2017

E-mail: hbenjami@med.umich.edu