I've had the privilege of working in the ICU with patients who are some of the most severely and critically ill in the state. Working here during my first month of residency is doable, although, it definitely wasn't easy. ICU patients for example can be here for for brain bleeds, massive strokes, seizures, post op from neurosurgery, post op from any surgery, severe GI bleeds, severe infectious processes, severe burns, traumas, drugs and alcohol, sepsis, you get the idea... I've spent a lot more of my time in the Neuro ICU.
Here's a day in the life:
4:00-4:30 a.m. Wake up Call , Jake cooks me a breakfast while I braid my hair and do a five minute skincare and makeup routine while drinking coffee and a huge glass of water
5:00 - 5:30 a.m. Leave for work -- these times vary because it depends how many patients I have to see before rounds. Some very sick patients or new admits require me to spend a good deal of time reading their histories and ensuring I know everything that is going on, which means looking a lot of things up.
6:30 a.m. Handoff from the night shift, listening to significant events about our patients that happened overnight or hearing about new patients that were admitted.
7:00 a.m. - 9:00 a.m. Spend this time walking around and seeing patients alone while talking to them and doing physical exams. Nursing staff lets me know anything I need to order/reorder if I've forgotten as well as any concerns they have for the patient. I also spend this time going through every patient's blood labs from this morning or imaging (x-rays/CT scans/ MRIs).
9:00 a.m. - Noonish . We spend this time with our attending, critical care fellow, case manager, and pharmacist sitting at a table discussing each patient and the plan for the day. After our "table rounds" we walk as a group to see each patient in their room again, often the families are around at this time and can ask more questions they may have.
Afternoon: I will work on grabbing something quick to eat, finishing up the documentation from the morning, entering orders for my patients, and answering pages from other staff about orders they need or if I need to come back up to the floor and see a patient again. Sometimes families want to meet in the afternoon, usually we have an hour lecture at some point in the afternoon, and if there are any procedures the fellow is doing I usually like to try and watch those as well. The afternoon is of course also spent keeping an eye on labs that come back throughout the day in case our patients need to be transfused, or have electrolytes replaced, or need a new head CT, etc. I spend time each day moving patients to "the floor" (the normal hospital rooms - since we are ICU) if they are healthy enough, and we accept new patients from outside hospitals and the emergency rooms too. That all requires paperwork, phone calls, and documentation too.
7:00 p.m. Handoff to the night shift, explaining what happened during the day with each patient and any specific things to watch for tonight
Dinner after that, chat with Jake, repack my bag for tomorrow, charge my devices, and try to be in bed by 9:00 asleep by 9:30.
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