A Day in the Life of an All Children’s Hospital Johns Hopkins Medicine Ward Intern

by Admin 21. September 2014 09:05

6:30 a.m. I arrive at the hospital and work my way up to the Resident Workroom on the 9th floor of the hospital.  There, I meet my co-interns and begin my pre-rounding activities.  The 12-computer workstations and workroom were specifically designed for me and my co-residents (and our day-to-day activities) in mind.  

6:45 a.m.  Time for signout!  The Blue Team walks down the hall to the Resident Conference room where we meet the overnight attending hospitalist.  There, we utilize evidence-based transitions of care strategies to ensure that we, as a team, are up to date on the overnight events for our patients.  Additionally, we learn about any new patient admissions for which we will be caring that day.  Today we’re caring for everything from a peritonsillar abscess to a febrile urinary tract infection in a 15 day-old neonate to respiratory distress in a medically complex child with multiple chronic health problems.  I am always amazed by the range of pathology we see here at All Children’s Hospital Johns Hopkins Medicine!  On our way out of the conference room we grab a quick cup of coffee, a definite perk (pun intended) to arriving early! 

7:00 a.m. Let the pre-rounding begin!  A quick trip down a flight of stairs and I find myself on the pediatric medicine floor.  There, I have the opportunity to speak with the nursing team to learn of any point-of-care issues.  This is also my opportunity to speak with my patients and their families about any overnight events.   It is at this point that my plan for the patient is discussed, my workflow is formulated, and I initiate any orders that need immediate attention.  After completing my pre-rounds, it’s back up to the Resident Workroom to start my notes.

 8:30 a.m. Time for Family Centered Rounds!  We grab our mobile workstations (or as we call them, Howards) and take to the wards, but not before taking in the beautiful view of the Tampa Bay from the Resident Workroom.  A favorite of our residents, this view is truly amazing and serves as a constant reminder of how lucky we are to train in such a beautiful location.  The core rounding team consists of the three interns on service, the senior resident visiting us from Johns Hopkins School of Medicine in Baltimore, and our attending physician.  The focus of our rounds is the patient and their family.  Room by room, patient by patient, we communicate a breadth of medical knowledge to our patients and families including physical exam findings, laboratory values, and the care plan for the day.  On our rounds we involve the patient’s family by encouraging questions and ensuring understanding of the plan for their child.  Additionally, we strive to include nursing and allied health staff in all of our rounding activities to present a united care team to families.  Outside of the patients’ rooms, teaching topics are discussed, where a resident-led, attending-supported educational approach encourages us to take ownership of our education.

11:00 a.m. Once rounds are complete it’s back up to the Resident Workroom where we finish up our daily notes and begin coordinating patient discharges for the day.   One unique focus of the ACHJHM program is involvement of the community primary care providers in coordinating the care of our patients.  Throughout a patient’s stay at ACHJHM, we strive to communicate with a patient’s primary physician to alert providers to new developments as well as ensure appropriate follow-up once a child is discharged.


12:00 p.m. Next, I am off to the Outpatient Care Center for Noon Conference.  There is nothing traditional about these didactic lectures.  At our Noon Conference, we are exposed to the expertise of physicians and other healthcare providers both at ACHJHM as well as the Johns Hopkins campus in Baltimore.  On Wednesday afternoons, we participate in a pediatrics ambulatory care curriculum through the Johns Hopkins Medicine Physician Education & Assessment Center modules.  These modules are designed to complement our experiences in Continuity Clinic and strengthen our core ambulatory pediatric knowledge base.   Additionally, Our program leadership focuses on providing interactive, audience response-based didactic and board preparatory sessions that help solidify key topics.  We would also argue that we have the best food in town!

1:00 p.m. With noon conference over it’s back to the hospital.  The keyword for our afternoon activities is autonomy.   A focus of the ACHJHM wards team (known throughout the hospital as the Blue Team) is to allow the pediatric interns to serve as the primary contact for patient care.  From one-on-one counseling with patient families, to coordinating patient care conferences, to speaking directly with subspecialty attending physicians—this is what sets ACHJHM apart from other programs.  This level of supervised responsibility is unmatched elsewhere.  

3:00 p.m. We catch word of a new admission! Once on the first floor, we are in the trenches of the state-of-the-art pediatric Emergency Center at ACHJHM.  While a history and physical exam are the bread and butter of our practice, the coordination of care from triage to admission is a streamlined process where I, even as an intern, serve as a leader among all providers on the team to ensure a patient receives the quality of care expected of our hospital.  

4:00 p.m. Once the new admission is staffed and all orders are in place, it’s back up the workroom!  The Resident Workroom is known for its afternoon chalk talks put forth by one of our amazing subspecialists, another benefit of having one-on-one communication with attendings!  

5:00 p.m. The nighttime hospitalist team arrives and it’s once again time for signout!  This is our chance to communicate to the team what was accomplished and what remains to be done for our patients.  

6:00 p.m.   After tying up any loose ends, it’s time to head home for the evening.  It’s been a great day—busy but rewarding.  My day as an intern on the wards at ACHJHM reminds me why I chose to train here.  I leave every day having taken ownership of my patients’ care and utilizing evidence-based practices to guide my development as a pediatrician.  On my walk home I pause to look out over the Tampa Bay (a beautiful sight indeed) and I can’t help to think how much I love being a resident at ACHJHM.  


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