Author: Rana Waqar

What happens in the hospital stays in the hospital. Mostly because these healthcare providers were too tired to remember any of it.

Day-old coffee, Cheetos, Sour Punch Straws… it sounds like the diet of a gamer who hasn’t stepped away from their console for days, but it turns out junk food is practically a dietary staple for many medical residents—yes, the future MDs who will someday tell you to eat healthy.

When you’re trying to stay on your feet through a 30-hour shift while handling literal matters of life and death, candy and caffeine go a long way. It’s not the only way students stay awake, of course—you need an arsenal of coping mechanisms when you’re regularly working for an entire day (or more). We asked a handful of residents (and one surgeon who lived to reminisce) to tell us how they keep from passing out mid-procedure.

Megan Shaner*, Seattle, Washington

I think when you’re new, you’re nervous, and the adrenaline of the situation keeps you awake. You show up with a grocery bag full of snacks and always end up eating. That’s why people gain weight during residency. It’s like… Cheetos. Nobody is eating anything that’s good for you at 3 am. I would drink caffeine—probably like three Americanos a day. If you pushed through, it got a little easier in the morning because there are people coming on and they’re fresh and they smell like they’ve showered and their energy can kind of carry you through. Plus, in the morning, the attending would usually bring us breakfast: bagels, donuts, that kind of thing.

Tamara M. Johnson, Newark, New Jersey

The longest shifts I’ve worked have been 27 to 28 hours. As long as there was work to be done or patients to see, I didn’t have an issue staying awake. Once things calmed down and the hospital was quiet, I just kept moving and consumed a lot of candy. Sometimes I’d even run up and down the staircase. Go outside and let the crisp air awaken you. When all else had failed, I had a playlist of my favorite songs and I’d listen to music and dance in the call room.

Daniel Becker, Voorhees, New Jersey

During my internship year, we were on call every other night. Approximately 120 to 125 hours out of the 168 hours in a week were spent in the hospital. Essentially we were living in the hospital. Our entire life—work, friends, meals—took place in the hospital. If you accept the concept, then it is fun—that is, if you are single and have no responsibilities outside of the hospital. If not, for instance if you are married, then it would be a miserable experience.

There was a saying: “Eat when you can, sit when you can, sleep when you can.” Everyone did it, and we all got through. You develop survival skills.

I have been a sonographer for 18 years, and this year I was awarded Distinguished Sonographer at the 2018 AIUM Annual Convention. I can say without reservation that it is the biggest career honor that I have ever received and a moment that I will never forget. My path to becoming an Ultrasound Practitioner with a faculty appointment in the Department of Reproductive Medicine at UC San Diego has been rewarding, but it has not been easy. To be honest, I wasn’t always sure that I wanted to be a sonographer for more than a few years. I remember asking myself: Is this career as a sonographer enough or should I push myself further and go back to medical school? I have an incredible husband (who is also a sonographer) and he would have supported any choice I made, but ultimately – I decided not to pursue medical school. Even though I made that choice, I also told myself that there was nothing stopping me from learning as much as I could—my degree would not limit my potential and would not be what defines me.

Since then, I have been studying the fetal heart A LOT. I enjoy all aspects of Maternal-Fetal Medicine (MFM) ultrasound, but the heart has always been an area of fascination for me. I love that it is both dynamic and complex, and, in my opinion, the most challenging aspect of fetal ultrasound. I have taken every opportunity to learn as much as I can from the incredible mentors that I have had the privilege of working with over the years. To this day, I am still learning, and I am amazed at all of the details we can see in these tiny little hearts! I eventually got the opportunity to cross train in pediatric echo and I jumped at that chance as well. I really enjoy being a part of a team of providers that can help the families affected by congenital heart disease.

I am, or I guess I should say I used to be, terrified of public speaking. I am proud of myself for overcoming this fear. Being in an academic center, I was used to teaching one on one, but it was about 8 years ago when I really pushed myself out of my comfort zone by lecturing to larger groups in the San Diego community. Putting together lectures can be time-consuming, difficult, and even stressful. I have spent many hours on weekends and evenings working on them, but I have also learned so much in the process. I started by speaking at local societies and hospitals, but over the years I have progressed and now I am proud to be invited to lecture at AIUM, SMFM, and other CME events around the country. Overcoming my fear of public speaking has been a huge stepping stone in my career and I love representing the sonographer voice on a larger platform.

So, how did I become a Practitioner with a faculty appointment?

I had a vision of how an Ultrasound Practitioner could function in our department. After all, by that point in my career, I was a seasoned MFM sonographer with 10 years of experience and I was still incredibly driven to learn and grow. I was keen to expand my skill set to function as a mid-level provider. Ultrasound Practitioner is not a new concept; SDMS had proposed a working model for an Ultrasound Practitioner in 2001. Dr. Beryl Benacerraf, among others, had already been successfully using an Ultrasound Practitioner for years. But working in a large academic center – my vision took years to bring to reality. I knew it would never happen if I didn’t continue to push for it. Along the way, I struggled, I questioned myself, I got overwhelmed, but I never gave up. I also had the support of some key physicians who believed in me. Their support was crucial to my eventual success.

I have now been an Ultrasound Practitioner for 6 years and as our department has grown to 8 ultrasound rooms, my role has expanded. Some of my responsibilities include: checking sonographers’ cases for quality and completeness, directing sonographers to get more images, obtaining images on difficult or complex cases, deeming the exam complete, writing preliminary reports, and discussing routine sonographic findings with patients. This working model frees up the physicians to spend more time with patients with abnormal findings and also allows the sonographers to keep moving with their schedules while ensuring quality patient care. Of course, this is only a snapshot of my day to day work, I still perform many of the fetal echocardiograms. I love to scan and I wouldn’t have it any other way.

My path to becoming a faculty member in the Department of Reproductive Medicine at UC San Diego was similar to my journey to becoming an Ultrasound Practitioner: it took time, lecturing nationally as well as teaching locally, coauthoring research papers and once again, having mentors who supported my appointment.

So, when people ask me about my success, I tell them it is because of hard work, persistence, believing in myself, and having mentors who believe in me too. My advice to sonographers is to know how important your role is; you are not “just a sonographer.” You should always keep learning, take pride in your work, and don’t be intimidated by the hierarchy of medicine. Our voice is crucial to the care of our patients, and that is really what matters.