At 7:29 a.m., an ambulance arrives with a woman who is struggling to breathe. Dr. Susan “Susie” Kennedy joins the UNC Health emergency team assessing her.
A typical day is already in high gear for Kennedy ’23 (MD), a third-year resident in emergency medicine.
Kennedy, who owned a hair salon on Ocracoke Island for 10 years before moving to the Northwest, is originally from Indianapolis. She attended community college classes before graduating from East Carolina University. After UNC School of Medicine, Kennedy matched for a residency at UNC Health. Her interests include palliative care and social medicine.
Follow Kennedy through a day in the emergency department.
⏱️ 7 a.m. I get sign-out from the overnight resident and my workday begins.
⏱️ 7:29 a.m. Emergency Services brings in a lady who’s working hard to breathe. Nursing staff and a respiratory therapist are already bedside putting her on monitors and assessing her respiratory status. Ms. S has a history of COPD (chronic obstructive pulmonary disease). Respiratory starts biPAP (bilevel positive airway pressure) as I order nebulizers, steroids and magnesium.
⏱️ 8:20 a.m. I’ve met my patients, brought them warm blankets, reordered pain meds and updated families. The charge nurse says a trauma will arrive in 10 minutes. I check on Ms. S as she is my sickest patient. She indicates that she’d like a sandwich — that’s a great prognostic indicator.
⏱️ 8:33 a.m. Wearing my trauma finest (plastic gown, bouffant), I see EMS come in with our patient, a 57-year-old male who was racing his nephew on a dirt bike and hit a tree. Fortunately, he is awake and stable. I use the ultrasound to check for internal bleeding as the trauma team does a comprehensive exam prior to imaging.
⏱️ 10:20 a.m. A young, otherwise healthy patient presents with chest pain. She’s low risk for a pulmonary embolism so I evaluate for ACS (acute coronary syndrome), pneumonia, pneumothorax and metabolic causes of her pain. Ms. S is off BiPAP and enjoying a sandwich. I start her on antibiotics for COPD exacerbation and page her out for admission because she requires supplemental oxygen.
Kennedy chats with Dr. Justin Myers, an attending physician in the emergency department. (Johnny Andrews/UNC-Chapel Hill)
⏱️ 11:30 a.m. A radiology resident calls. He’s read scans of the dirt-bike accident patient. I immediately recognize his voice. We were in UNC med school together. We quickly catch up about how our training programs are going and reminisce about our early days in PCC (the doctoring class). He’s concerned for a splenic laceration on the CT (computed tomography). I call the surgical resident to update her about the CT findings.
⏱️ 1 p.m. I see a young woman with a pilonidal abscess. She is so uncomfortable. Ultrasound shows a pocket of fluid right under her skin. We discuss an incision and drainage. She consents to the procedure. I anesthetize the area, then drain the abscess. She immediately feels better.
⏱️ 1:33 p.m. EMS brings in a 97-year-old man for altered mental status, who struggles to breathe on a non-rebreather mask. He is febrile with concerningly low blood pressure. We get him on the monitor and nursing starts an IV. As I assess his ABC’s, EMS hands me his DNR/DNI (do not resuscitate/do not intubate) paperwork. I worry about septic shock and order fluids and antibiotics in addition to all the labs. Because he is too confused to provide much history, I leave the room to call his daughter.
⏱️ 2:11 p.m. Mr. M’s blood pressure has responded well with the fluids. His daughter has arrived. Fortunately, he is followed by UNC geriatrics. His PCP (primary care provider) has had many conversations with him and his daughter about his goals of care. His daughter says that he would want antibiotics to treat an infection but would not want an intensive care unit stay.
⏱️ 2:50 p.m. I check on all my patients in preparation for sign-out to the oncoming resident at 3 p.m. My patient with chest pain feels much better and her work-up is reassuring. I connect her with a UNC PCP and discharge her home.
Kennedy is one of roughly 1,000 medical residents at UNC Health, the health care system’s second-largest workforce segment. (Johnny Andrews/UNC-Chapel Hill)
