Day in the life of an ICU doctor [specifically, a critical care anesthesiologist]
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- เผยแพร่เมื่อ 15 ธ.ค. 2020
- If you've ever wondered what the day in the life of an intensivist (ICU doctor) looks like, look no further! I share from when my alarm wakes me to the end of my day in this video. I'm an anesthesiologist in addition to my role as an intensivist and that plays an important part in my day, too! Check out the video to figure out why.
I also go into hour-by-hour detail of my day in my blog post here: blog.amandaxi.com/2020/12/16/a...
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DISCLAIMER: I never record videos during active patient care. Opinions in my videos are mine and not representative of the organizations I am part of. Videos are meant for education and are not medical advice. Links included in this description may be affiliate links. If you purchase a product or service with the links that I provide I may receive a small commission. There is no additional charge to you! Thank you for supporting my channel!
![7 reasons I love being a critical care anesthesiologist [ICU doctor/intensivist + anesthesiologist]](http://i.ytimg.com/vi/GNIcWEkHeKo/mqdefault.jpg)
![7 reasons I love being a critical care anesthesiologist [ICU doctor/intensivist + anesthesiologist]](/img/tr.png)
![Day in the Life - ICU Doctor [Ep. 6]](/img/n.gif)
Loved this video? I hope you'll check out my NIGHT SHIFT one, too! th-cam.com/video/0Hj3Wd8nHBo/w-d-xo.html
Let me know in the comments what other types of videos you want to see!
God Bless doctors and everyone that takes their work home that is SERIOUS dedication. I’m in nursing school and my head is already spinning!
I think most of us take *some* component of our work home with us. It's part of the profession and our commitment to serving our patients! But... it is *SO* important to know how to leave work at work in order to prevent burnout. Good luck in nursing school!
6:54 thank you for being conservative. I've seen so many other healthcare professionals on social media doing otherwise. It really means a lot for those families who have lost loved ones due to this pandemic.
I felt that with the devastation and destruction I was witnessing, I could not justify taking risks. This pandemic has really done a lot of damage; I do hope that we are finally moving in the right direction now. Stay safe!
Thank you for doing these videos amidst your busy schedule!
Thank you for taking the time to watch!
Thank you for taking the time to do this! Not a lot of videos for specifically Anesthesia CCM. I also struggled thinking i won’t do anymore OR anesthesia and transition to maybe doing 100%ICU for all the exact same reasons you mentioned. So your perspective in this helps a lot. And there are a lot of things to carry over from the OR to ICU.
Hi Alex! Thanks for watching the video. I hope to post another video in the future really talking about my career path and decision to pursue anesthesia CCM. There were definitely times in the OR where I was *really* miserable, but now that I'm in a care team model, I actually don't mind the OR as much [and thus, at this point, am not looking to do 100% CCM]. I didn't think I'd like OR anesthesia as much as I do, but now that I'm not stuck in the 12 hour train-track cases, I feel like I can either spend my time focusing attention on education with residents OR I can take care of some administrative tasks if I'm only working with CRNAs. Perhaps that feeling will change with time, but definitely give OR anesthesia a chance when you finish!
Hi Dr Xi! Just wanted to say thank you for hard work and service!!!
Thank you so much!
Hi Amanda,
I loved your video! You inspired me even more to consider in applying to medicine. Can't wait for more videos from you. Stay safe always!❤️
Hi Lexay! Thanks for watching. I'm so happy to hear that you've been inspired by my video; just remember that the road to medicine is long and hard, but it's a gratifying job. Please feel free to reach out with questions or for advice as you need!
This video is so well done! Everything you included worked really well together!!
Thank you for watching! I appreciate it.
I am a respiratory therapists and i love that you respect and mention mote than just doctors. Healthcare is a team job
It takes a village to provide excellent patient care!
Hi from your instagram!! I'm starting med school in August! Loved this video :) I did research in the PICU in undergrad and I also love the team-based approach in critical care like you mentioned!
CONGRATULATIONS on your acceptance to medical school! Glad you had a chance to see the power of good clinical teamwork during your PICU research -- please feel free to reach out at any time with questions or during clinical rotations [especially if you're thinking about anesthesiology and/or critical care]!
Currently working from a Paramedic to Anesthesia/Critical Care, thank you for this video! Solidified that I want to pursue this dream!
So glad to hear it! Let me know if you have any questions along the way!
@@AmandaSXiMD I will definitely bend your ear. I’ve subscribed to your channel, but have lots of questions and needing some guidance on things. Thanks Doc!
Can totally relate to that. Though I do like OR anesthesia much more than ICU.
Cheers from the covid ICU in Kuwait ✌️
I definitely like OR anesthesia MORE now that I'm an attending, but would feel less fulfilled without some time in the unit. Either way, we need people who like both so it works out!
I hope things are manageable with COVID in Kuwait! Hoping you have access to the vaccine soon, too.
I love the day in the life of videos!!!!
Thanks for watching and commenting!
You are living my dream! ❤️❤️❤️
Thanks for watching! I'm sure that YOU WILL MAKE THIS DREAM A REALITY for yourself! It's not always an easy road, but it's so worth it. You got this.
@@AmandaSXiMD thank you so much, doc amanda! 😍
Heeey.
I came from trilingual_med's instagram.
Don't stop posting, I loved it.
Cheers from Brazil!
Thank you for watching and your support!
Thank you for a glimpse into the life of an intensivist. One of the things I love most about working as a critical care dietitian is the rounds and meeting face to face with the team of experts to more efficiently care for the patients. I just love the meeting of the minds! I was quite surprised to hear that you did not mention a dietitian as taking part in your rounds. Was this an over site? Proper nutrition is pivotal in the care of critically ill patients! Thanks again for your time and effort you put in with sharing your knowledge!
Our dietitians do not participate in our rounds, however we definitely work closely with them on ensuring adequate nutrition for our ICU patients! Do you regularly participate in your ICU's rounds?
I attend every weekday. On the weekends our staffing goes down to one dietitian for the whole hospital. So we rely on consults on the weekend. I also anticipate what nutrition support patients may need over the weekend and I will put in recommendations in a note and I let the weekend dietitian know what they should be looking out for. Say, a patient is on a high amount of propofol on Friday, but if that comes down over the weekend the pt will be underfed sometimes by 1,000 kcal or more if the tube feeds or TPN is not adjusted accordingly. It’s nice to hear, but unfortunate, that the intensivist and pharmacy really miss a dietitian being in rounds on the weekend!
Hi! I’m a third year med student and I definitely want to do internal medicine! My dream after that would be to match critical care or pulm crit care/ID crit care. Loved your video and love how you buy coffee for your residents and even appreciate people you work with!!
Thank you for watching and commenting! We can always use more smart people in pulm CCM/ID & CCM! Good luck to you.
This is such a great channel. You’ve given me a lot of information other channels don’t give such as you’re schedule and the struggle you had as a resident. I’m applying to medical school this year and I’ve started thinking what I’d like to go into. I have my eyes set on anesthesia ICU Doc. Thanks for the video. I’ve subscribed.
Thank you so much for your comment and kind words. Please reach out if you have any questions along the way!
Same here! Still waiting on int but want to do critical care Anesthesiology
@@Naijagyal22 It's a great field!
Can you make a video about the differences between Anesthesia CCM and Medical CCM ? Regarding residencies, life and work being an attending and maybe differences in education and knowledge. Thanks !
What a great idea! I'll definitely start working on this!
Can you make a video about how you write notes or how you format the assessment and plan?
Thanks for a great idea for a teaching video in the future! I have a couple of anesthesia-specific videos I'd like to create, but I'll add this to the list.
Do you use templates for your notes or are they all free write?
I'm about 1 year into my training as an anesthesia resident and seriously considering CCM. I still remember how nervous I first was as a medical student to intubate, but now I'm much more confident with straightforward cases. I think there's so much opportunity for growth via a critical care fellowship, but the thought of being the ICU attending is still intimidating. When did you start to feel more confident filling the role as an ICU attending during your training?
Hi there! Thanks for watching and commenting. I think CCM really makes you a better anesthesiologist and doctor overall so I highly recommend it! During the last few months of CCM fellowship was when I felt like I had a better grasp of how to manage patients and direct care. That being said, I still call upon my colleagues when I'm unsure about a path or direction to take to get their opinion or thoughts. I am constantly learning as an attending and find that to be one of the most rewarding parts of the job! Hope this helps!
@12:15 You mentioned that you spoke with your residents about cardiac anesthesia vs. critical care; Are these the main fellowships that residents pursue?
Great question! Every year of residents it changes - critical care is quite popular among the residents at my institution because we have such a strong program so many self-select to come here. There has been a recent trend that many have been doing the dual training - cardiac + ICU [which, I don't say in this video, but I actually did apply to both but ultimately decided to only pursue ICU for various reasons]. Fellowship interest changes year-to-year, some years there's more interest in pediatrics or chronic pain!
Rules for docs, eat when you can, sleep when you can, and don’t mess with the pancreas.
So true!
Nice video 👍🏻
On an average how many patients do u see on a daily basis?
Weekly how many hours work will be der? In Uk its 48 hrs a week .
Thanks for watching the video! When I'm assigned to daytime shifts, I typically care for ~10 patients, but on certain other units, that can go up to 18-20 patients. On nights, the census is closer to 20-26 patients.
As a resident/fellow, I worked between 60-100 hours/week depending on the week. Now that I'm an attending, generally I work 50-70 hours/week when I'm in the unit. I have a mixed practice, so I also work in the operating room, which can change my weekly hours worked.
The European system feels so different from the U.S.! Do you ever work longer weeks?
Hi Dr. Xi! Is there a space where students can ask questions about your residency journey and your specialty?
I'm better about replying on my IG account @amandasximd - also look out for shadowing events that I participate in [I usually post them on my IG].
Hi Amanda, Thanks for de video!
I’d like to ask you if it has some difference between doing IM and fellow ICU and doing anesthesiologist and fellow ICU, especially in a day routine as an ICU doctor.
Thank you so much
Thanks for watching and commenting!
I go over some differences between medical intensivists and critical care anesthesiologists in my video here: th-cam.com/video/YZYfJLSWXh4/w-d-xo.html
I think that our daily routine as an ICU doctor does NOT differ between medical intensivists and critical care anesthesiologists, however, both specialties can practice medicine outside of the ICU, and I think that can be different. Also, depending on the type of ICU being practiced in, that can be a bit different, too. Having trainees also changes the workflow.
Hope this helps!
@@AmandaSXiMD Thank you!
Hi I am also a anaesthetist,not happy happy with branch.... totally dependent
Sorry to hear that you're not happy as an anesthesiologist. Like everything in life, there are downsides to the specialty. In fact, I just recorded a video talking about some of my personally perceived downsides. I hope you'll be able to find something within the specialty that you're passionate about though!
How can I become a intensivist and an anesthesiologist
Is there a difference if someone pursued IM then Critical Care Pulmonary fellowship versus doing Anesthesia residency?
Great question! There's a difference in the # of years of training, skillset and day-to-day clinical work.
For # years of training:
- IM is 3 years of residency and pulmonary/critical care is 3 additional years, so 6 years of training (you can opt to do a 2 year fellowship in critical care alone to make it 5 years of training if just interested in critical care)
- Anesthesia is 4 years of residency (sometimes internship is at a separate institution like I did, but that's in the minority now) then 1 year of critical care fellowship, so 5 years of training
For skillset/training:
- IM residency provides a lot of background in outpatient and inpatient medicine, but most programs are less focused on procedural skills, physiology, and ventilator management
- Anesthesia residency offers procedural skills (intubation, lines, etc), focus on physiology (anesthesia OR cases are a constant lesson in this area!), and ventilator management (we use them every day!); anesthesia requires that you like the OR environment, which is a big difference from IM
Day-to-day clinical work:
- Pulmonary critical care can have a pulmonary clinic (outpatient) with long-term patients AND time in the ICU. They can also practice 100% ICU, but in that instance, it might make sense to just do a 2 year fellowship in ICU alone
- Anesthesia generally means you're spending time in the OR AND ICU; frequently it's more challenging to find a split between OR/ICU coming from anesthesia (generally need to be at a large medical center)
I hope this helps! I plan on making a video really breaking down the pathways to critical care soon.
@@AmandaSXiMD Thank you!! Extremely helpful and insightful, current 1st year and just keeping my options open. Love the channel and what you do
Hi Amanda ! Is cardiac anesthesia a sub specialty ??
Hi there! Yes, cardiac anesthesia is a sub specialty of anesthesiology. You need an additional year of fellowship to practice cardiac anesthesiology.
Do anesthesiologist do like different rotations?
Yes we do! During residency we rotate through different types of surgical subspecialties [e.g. orthopedic surgery, general surgery, vascular surgery, thoracic surgery, cardiac surgery, etc] as well as through obstetrics, pain medicine and the ICU. This gives anesthesia residents broad exposure for practice!
As an intensivist anesthesiologist are you taking care of both adult and children in the ICU?
I take care of adults only. Pediatric ICU is staffed by pediatric critical care (though there are some pediatric anesthesiologists that have been grandfathered into PICUs).
What was in your scrub shirt pocket?
You're a very astute viewer! When we respond to airways and need to intubate, it's common for patients to have low blood pressure after intubation, so I carry vasopressors [medications to raise blood pressure] in case of emergencies so I always know I'm prepared. These medications include phenylephrine and epinephrine. There are also a couple pens in there!
@@AmandaSXiMD you're not the 1st person to mention that.... :-)
Thank you for all the hard work you and the medical community have been doing!!!!
One 💘
How long was your icu fellowship?
One year!
@@AmandaSXiMD thanks for replying; I’m a fellow respiratory therapist and I’m debating whether going to medical school would be the correct fit, I really enjoy anesthetic medicine as well as critical care
It's a long journey, but your respiratory therapy experience would definitely be a big asset if you decide to pursue critical care anesthesiology!
I am medical intensivist. Not anesthesiologist. I see that you completely failed to mention how much time it takes to reason with families, deal with arrogant specialists and surgeons.. And most importantly you failed to mention that critical care is one of leading sub specialties in burnout rate for the past at least 10 years. Just a note.
Thank you for sharing this. There are definitely challenging portions of the job as an intensivist as you point out including tough conversations and a high rate of burnout. I am just at the beginning of my career, so perhaps I'm still in my honeymoon period, but at this point, I still love what I do in the ICU and hope that this passion continues on for the rest of my career.
Where were you born?
In the U.S.!