MICU

This week I am in the Medicine ICU. I love it. I'm pretty sure that an ICU (probably surgical) is where I will probably work when I graduate. We are a very small hospital and so our MICU is also very small. We only have 8 beds and aren't full right now. I had my own patient (pretty much) to take care of and some cool gear to play with. My patient was really not very acute, he was actually waiting to be transferred to a regular medical floor, so it was definitely something I could handle. The MICU is so much nicer than the regular floors. The A/C works, they have the continuous monitors with touch screens that are connected to a computer program that can automatically update the computerized charting. WAY COOL. Also, the people are really great, nurses AND doctors! I think the docs were nice because it was their first week in the ICU. They are brand new residents and usually need help finding things like the bathroom and the elevators. The nurses were very welcoming and were actually kind of happy to have some extra help.

Peeve of the week: I hate those disposable stethoscope. My patient is on contact precautions for MRSA and so you can't use any of your own stuff, everything has to be disposable or hospital gear because it can't leave the room. I have a really hard time hearing with those crappy disposable steths.

I'm baaack (again)!

Ok, it has been a month since I last posted, so you would think I would have a lot to blog. Not so. I went on "vacation" for two weeks and have been back at work for about a week. I have moved to the surgical floor (much better than medicine!) and am loving it. The patients don't stay as long and they are generally not total care. There is also a slightly better staffing ratio so although there is a lot of patient turnover, it doesn't seem as busy as the medicine floor. I like the staff better and they seem a bit more organized than my previous floor. Bottomline: there isn't as much crap, literally.

The other note for this entry is that JCHAO is here. Those in healthcare know what I'm talking about. Those in the military, it is like when the Inspector General comes. It has been hilarious watching everyone run around trying to get ready and hide stuff and put the signs up that need to be up and make the patient education notes in the charts and all the other stuff that tends to get pushed aside normally. JCHAO may also account for the good staffing ratios!

Patient story of the week: I had Mr. S as a patient, he had had a CABG and was being discharged that day. The AC in the hospital hadn't been working that great and the whole time he had been there, he had been hot. We got him a little fan for his room, but it was still hot and he was sweating. He had gone down to the shower with the occupational therapist and the next thing we know, the OT is calling a code from the bathroom. Mr. S had gotten too hot, got dizzy, and was starting to pass out. So the code team comes a runnin' and everyone gets in the bathroom and he is laying on the floor, but doing ok. I really felt bad for him because all he wanted to do was go home, and now he was going to be stuck in the hot hospital another day. But hey, after that, the hospital director, the director of nursing, and the director of enviornmental services came up to see just how hot is was on the floor. The Dir. of Nursing gets off the elevator and goes, "damn it IS hot up here". Well, no kidding, did she think we were making it up?? Magically, fans started appearing on the floor and we got it kind of cooled down. This morning when I came in, the enviornmental guys were walking around taking back all the fans because the AC was "fixed". BUT IT WAS STILL HOT, WE STILL NEEDED THEM.

One last thing: if the lights are off in a patient room, you might want to ask before you just turn them on, especially if it is a multi-bed ward. The biggest thing my patients complained about today was that all night people kept coming in the room and turning the light on. There are overbed lights for each bed that they can use, they don't need to use the big overhead flourescent lights to take vitals. Heck, as far as I'm concerned, there is enough hallway light that you don't need lights at all to take vitals. The IV machine is backlit so you don't need lights for that either. The overbed light gives plenty of light for giving injections, etc. It doesn't seem like a big deal, but if they don't sleep at night then they want to sleep all day and there are even more interruptions then. It just cascades and you have pissed off patients who are cranky. Fun.