picu

Today was one of the first days I've had in my nurse externship that I've been excited about being a nurse. I'm assigned to a respiratory and general pediatrics floor as my home base, but we got to choose another unit to work on for a day, just for a change of pace and different exposure. Since I had originally put as my preferences when I applied that I wanted to be in the Emergency Department or an Intensive Care Unit (the two areas of the hospital that specifically interest me), I was hoping I would choose one of these units. Thankfully, I did draw the ICU. So today was the day I got to spend a 12 hour shift in the world of critical care medicine.

First of all, the nurse I was paired with was a young, fun, and energetic chic who's been out of school for 2 years, but who was knowledgable and a great teacher. She definitely worked in a way that fits my style. There was another nurse who was new and orienting with one of the nurse educators and their patients were right next to ours, so that nurse educator took me under her wing for part of the day, too. It's nice when people want to teach, and are good at it, while still balancing the patient load.

Secondly, the nurses let me do a lot of things that I haven't done yet outside of the simulation lab at school. The patients that we cared for were unusual neuro cases and their exams were very abnormal, so for once I got to experience in real life what I've only been told would be the case (in lab, we practice on each other, and we're mostly normal). I saw the tail end of my first code and got to help get the patient (who was transferred into the ICU as a result of the code) get set up in her room. I placed her nasogastric tube- a big first since for a while now I've only been recommending what goes down the tube, but not putting the tube in. I also placed her foley catheter- another first because up until now I've only ever placed straight catheters, which are slightly less involved. I drew blood from a venous line for the first time. I could go on, because there were a few more "firsts".

I loved that we only had 2 patients and could really focus on their care. I love that we knew when the docs were coming by and were able to be in the room while they did their exams and talked with their patients. I was definitely treated like a nurse and not a nursing student. I loved that even though it was my first day working as a "nurse" and not a dietitian in the ICU, I felt very comfortable.

We had 2 very sad patients today. One of them is just short of brain dead. Her family was very kind and is very optimistic about her recovery, though it is highly unlikely. Our conversations were my first really candid ones about reality and the poor prognosis. It was also the first time that I've had a patient whose family, because of their religion, had beliefs that contradicted my personal convictions and at times I didn't know what to say.

Today was a full day and it went by too fast. I wasn't finished learning, trying, and seeing new things. I want to work there again, but I have to return to the regular floor tomorrow. At least I know that the ICU is a place that, as I suspected it would be, is very stimulating to me as a "nurse", just as it is for me as a dietitian. I'll keep looking for opportunities to work in trauma/critical care.