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.