ICU week 2

           So I have finished my second week in the ICU. This week I actually had 12 hour shifts.The time flies when you are busy. Hours go by extremely fast. When things are slow time sort of slows down but there is always something to be done to keep busy or something new to see/learn. I have seen a lot of things not talked about during classroom teaching and heard terms that I have no idea what they mean. Its always good and OK to look up something you do not know or do not understand. Do not try to pretend you know something you do not. Just be honest. I have gone to codes, assisted Dr's intubating, transported patients, administered medications, taking blood gases, did patient planning, performed CPR, suctioned patients, analysed x-rays, checked lab values, adjusted ventilation settings as per blood gas results, discussed patients plans with Doctors, set up otpi-flow, did trach care, watched seminars, wrote reports, charted correctly, signed arrest reports, and a whole lot of other things while continuously being quizzed by preceptors, csc's, doctors. 

           When I was told by previous student RT's that clinical makes you feel stupid and it's like hell because you don't really have a life while in clinical may turn out to be right and may not. During the week it is tough as you work from 7-7. Having to be up by 5-5:30 and leaving for work by 6am. Then leaving work around 7:15pm and getting home around 8pm. If you want 8 hours of sleep you need to be asleep at 9pm. That would give you 1 hour to have a life/study/do homework. This is why us clinical students do not get the recommended 8 hours of sleep and probably get on average 4-5 hours of sleep during the week. Going out for dinner saves you time on making it and you can go with friends/family. But you also need to make your lunch and break meals for the next day as well. There is always the weekends to catch up on things such as sleep, friends, studying, homework, normal everyday things. Some of that weekend time gets taken away if you work during clinical year like I do. But it is always good to have some money coming in because school costs money and so does living.

Good Day in the ICU

So, I finished a 12 hour shift in the ICU today. Still have tons of energy and did not feel tired at all throughout the day. Learning a lot and getting to see new things and different approaches to doing certain tasks. All the patients I saw today survived. Not one death on my shift today! The Oath of all health care professionals is " primum non nocere". I will always follow this.

ICU Week 1 over

Today was the last day of my first week in the ICU. After orientation and mock patients/rounds I finally got my own patient to provide care for the day. Presenting the patient at rounds was a little nerve racking as we first present our patients to the other RT's in the ICU and then go see the patients and monitor them. It is a bit intimidating because all the RT's know so much more than I do and have done rounds millions of times while it is my first time ever doing this. Anyways, rounds went well and I went on my way to monitor my patient. The best part about this hospital is how nice the nurses and doctors are in the ICU. They really work well together along with the RT's and the RT's here get a lot of respect from both. I did my monitoring, suctioning,charting,etc and also remeasured the patient and calculated the IBW. Since it was my first time I was kind of slow and by the time I was finished and asked a few questions and what not it was time for break.

Coming back from break and find that the Dr's rounds are just finishing up on my patient and as discussed within the rounds with just the other RT's we decided along with the doctor to switch modes on the ventilator to allow the patient to make their own efforts. Along with an RRT we switched the patient over and talked about the theory behind the new mode and how it works (PAV). We noticed that the resistance was a little higher then it has been so I administered 8 puffs of ventolin and 8 puffs of ipratropium to dilate and increase the radius to decrease the resistance. Just as I finished we hear " Code blue.........." Which is just in the care unit adjacent to the ICU. We rush over. I bagged. I did compressions. The doctors,nurses and RRTs did what we could but we could not save the patient. We brought them back for a short while, but it did not last.

I came back and monitored my patient again and help/follow my preceptor with their patients to learn and get as much experience as I can. A new patient arrives and I ask if I can go recieve the patient with the RRT thats section of the ICU the patient is arriving in. It turns out this patient already had a code blue in Emerg and came to ICU. The Dr. stopped by and all we could get was a weak pulse and couldn't get an ABG. The prognosis for this patient according to the physician was "Very poor" and we were maintaining them until family arrived. It was now time for lunch.

After lunch I come back and monitor my patient. I talk to my preceptor about things I have questions about and then take a blood gas from one of their patients as it needed to be done. I walk back to my patient and find out the family has made the decision to withdraw care as the prognosis of my patient was extremely poor.

That was the end of my day. I did what I could, but it seems like I did not do enough. Not a good day.

First day in ICU

So today was my first day in the ICU and was just an ICU orientation with a lot of quizzing. Even with studying the drugs, dosages, waveforms, disease processes, lab values, charting, different ventilators and their settings, all the equipment, the policies and procedures, everything from first and second year of respiratory therapy school I learned one thing today. I don't know anything. Maybe I should become a nurse.

First Week = Done

So, first week of clinical came to a close on Thursday and what a week it was. Orientation went well as did the multitude of tests that we needed to write daily. As the hospital atmosphere is new to us students, the information given during the week long orientation can be quite overwhelming.  We were reminded that this year of clinical is essentially a year long interview. Now that we are done orientation, the fun starts Monday when we begin seeing patients.I am looking forward to this and am excited and scared at the same time.