This OS has NO Virat. Only Sai. So if you are looking for a Sairat OS, this is NOT for you. Its just a narration of a day in the life of Dr Sai Joshi. Theres not much of a "story" perse. So my apologies in advance..
If there are medicos on the forum, this may hopefully be something nostalgic and relatable. To others, this will hopefully give you a realistic take of what a day in a doctor's life is like. Its obviously not always like this- and work is different depending on whether it's a junior duty doctor or a senior consultant, what specialty they are in and what shift they are working etc etc.
Sai's shift in the ICU had started at 7pm. As she was getting a handoff itself a new unstable patient was getting wheeled in. In the time that the nurses were situating the patient, she got an express hand off from her colleague to relieve him and let him go home and had to jump straight into work. She assessed the young man who had come in. Fairly young. 40 years but looked obviously jaundiced. Reeked of alcohol and looked like a cirrhotic. Had come in with bleeding. His extremities were clammy and the IV lines placed in the emergency room were not working anymore. She quickly grabbed the ultrasound machine and was working on another line. Just as she was doing so, he had another massive bleeding episode and the pulse was gone. As the nurse activated the code , Sai was on top of the bed thumping on his chest doing CPR. At the same time she was instructing nurses on the meds she wanted. Her colleague from next door ran in to assist with finishing the line Sai was working on and securing it. They continued compressions and activated a massive transfusion protocol. Finally an hour later the guy had a pulse back and a recordable blood pressure but was needing medications to keep his blood pressure up. He was going to get an emergent bedside procedure to try to stop the bleeding by the gastroenterologist. After stabilizing the patient she had to inform the patients distraught wife that while her husband was alive, there was no telling how much the time he was down may affect his mental status. It was too soon to tell and her husband was very very sick. After breaking the bad news she turned her attention to the other patients. She needed to follow up their labs. After making ventilator adjustments on 4 patients, ordering blood transfusions on 2 of them as she was sitting down to catch a breath, as the nurse next door started talking aloud- "Dr Sai, come quick, this patient is not responding"
Sai ran to him.
This was a 60 year old smoker with chronic lung disease. He had come with trouble breathing and was on a non invasive mask but as Sai assessed him, he still had a pulse but he was not waking up, just grimacing to pain, she needed to emergently intubate him. She stood at the head end of the bed, barking instructions as she was bagging the patient with oxygen. Her friend Gaurav, the respiratory therapist stood there to help. As they were waiting on the nurse to load up the medications, both of them were chatting.
G- Sai yaar, you are such a black cloud. Jab bhi tera shift shuru hota hai , everyone starts crashing.
S- haan, tu toh bolega hi! She rolled her eyes at him but smiled at him.
G- accha, iss ke baad ek coffee break lete hai. Aur voh purvi ka birthday hai toh na 12 baje cake cutting karenge.
S- nice! Purvi ke liye cake n all haan.... Good job! Propose kab karega.
G- blushing. Ae kya bol rahi hai. We're just friends.
S- accha, just friends. Thik hai...
But their chatter was interrupted as the nurse handed her medications.
They stopped talking and got to work. 20 mins later the breathing tube was in.
Next Sai noticed that the alarm on one of the other patients was going off, she had come with septic shock and her BP was low. After assessing her, instructing the nurse to hang fluids and making sure the blood pressure was better, Sai went back to the guy she had just tubed. His blood test results were back and she made some adjustments to his ventilator. Then she picked up the phone to call Dr Kulkarni and inform him of the updates.
Dr K- haan Sai, bolo kya ho raha hai.
Sai told him all the action of the past 2 hours.
Dr K - good. I think you have it under control. Call me if you need to run anything else by me.
Sai leaned on the nursing desk.
Gaurav came and said- accha toh mein coffee aur biscuits laane jaraha hoon neeche tapri seh.
Everyone including Sai gave him their orders.
In the meantime Sai was following up on the alcoholic patient. He had stopped bleeding and the gastroenterologist had finished the procedure. He barked some instructions to Sai because she was the duty doctor and left.
Sai politely nodded but was so annoyed at the guy in her head- samajhta kya hai khud ko. Ugh.
Sai was ordering labs and medications, blood products that the gastroenterologist requested.
Finally 15 mins later, gaurav was back with the hot beverages n some biscuits.
As Sai was midway through her cup of coffee, the nurse started yling in bed 1.
Dr Sai, this patient is getting restless. Please order something to calm him down.
Sai gave instructions for sedatives and stood by the bedside trying to calm the woman holding her hands, lest she pull out her breathing tube.
20 mins later she had calmed down but the guy next to her started vomiting.
After ordering medications, fluids and helping the nurse she went back to her now cold coffee and gulped the remainder of it but all the biscuits were gone :(
Sai looked at the clock and thought- its ok, theres cake cutting in an hour anyway. "Sabr rakh Sai" she told herself.
The next one hour was relatively calm. And Sai caught up with doing some of the clerical work like updating all the order sheets for all the 12 patients.
At midnight, they crammed into the small break room as Gaurav brought a blindfolded purvi in.
They sang the birthday song and wished her. Purvi was thrilled with her surprise.
The cake was cut and Gaurav had arranged a full on bash with some pakodas n chips too.
The food was being passed around in paper plates when Sai's phone went off.
She knew what that meant.
It was an emergency on the other ward. A patient got acutely sick and was getting wheeled over.
Sai immediately left along with 2 of the other nurses. This was a cancer patient who had really advaced disease.
Had become acutely confused, short of breath, was also having fever. This would take a lot of work....after securing lines, tubes, ordering antibiotics and updating the family she looked at the clock and noticed it was 2 hours later!
When she went back to the break room all the cake n pakodas were gone but there was crumbs of Lays chips in one packet. Sai grabbed the crumbs and also a glass of water.
As she stretched herself she realized she felt sore in her hands and back after that vigorous CPR from few hours ago.
Doing CPR was literally like a work out.
As she stretched herself she decided that since everyone seemed kinda stable she could use the next hour to maybe get a little studying done.
She sat down at the nursing station and grabbed her sweater from her bag.
The ICU Air-conditioner was always a little chilly.
She was 20 mins in doing some MCQs when suddenly Gaurav walked to her with the results of the midnight labs on all the patients. As she looked through each, she noticed all the electrolytes to correct and put in orders for all of that and informed the nurses. Turns out the vomiting patient had been vomiting all day and had really deranged electrolytes. So she got an ECG of his heart and made sure that it looked ok, ordered some aggressive repletion of fluids. As she went to assess him the nurse had 50 other complaints about his line, about how she cant run all the medications ordered - coz this cant go with that, and that with this. š After calming the nurse down, getting an extra IV on the patient for good measure she finally made her way back to the central work station desk.
She followed up all the radiology results, day time notes to make sure everything was going ok.
But of course just as she thought things were ok, bed 6 started seizing. After giving him urgent meds, coordinating a stat CT scan of his head and had to wake up the on call neurologist to get a consult in the middle of the night.
But looks like the drama with this patient somehow got the blood pressure of the neighboring patient up š and she ended up needing a drip to control it.
As Sai looked up it was finally 5am. So only 2 more hours to go!
5am was when the nurses started giving care to the patients- cleaning them, repositioning them.
Sai used this time to do her morning assessments when the sedation was lightened as well.. It was often the time that they'd yell at her to grab a towel or a blanket or give them a hand or worse- some patient's line or tube would get dislodged and there'd be trouble. And exactly as predicted, bed 8's alarms were going off and the patient was agitated, the ventilator wouldnt stop beeping and ultimately after several mins of a flurry of activity, Sai had to reinsert the breathing tube and paralyze the guy to be in sync with the ventilator.
And before she knew it, it was 600am, time for the morning family visits. As she walked from bed to bed giving updates to the family members , she tried to reassure them, yet be realistic. This was the toughest part for her. Seeing these hopeful sometimes clueless family who would react in a variety of ways - tears, anger, confusion.
And finally an hour later , the morning shift colleagues started rolling in. This was the best time of the day- Time to go home!
After updating them on the events of the night, she finally stepped out of the ICU to the changing room. After a quick shower, she changed her clothes and grabbed her things to leave.
An hour later as she was zipping away on her scooty with the wind on her face, Sai had a smile.
A smile of happiness, accomplishment, and also exhaustion.
It was just another day in the life of Dr Sai Joshi!
Anupamaa
