Thursday, February 26, 2009

ICU nurse for a night

Last Monday night when I went into work - I saw my name under the ICU column. My first thought was "ummmm, this isn't good." I quickly figured that these would be PCU patients & that PCU must be I'll just take care of PCU patients in the ICU area.

I get to ICU & ask the day nurse "Are these PCU patients?" She mumbled something which I thought was a yes. But it wasn't. These were ICU patients. The problem is...I have no training in ICU. I know where the bed is & that's about it. Aren't you glad to see that hospitals really care about who might be taking care of you?

So I ask a few questions about these patients, because even though I have no training in ICU...the thought of only having 2 patients is QUITE appealing. From the response I was getting, it appeared to me that these 2 patients should be PCU patients...but for whatever reason (doctors being lazy maybe), they aren't. I accept the assignment with the blind faith that nothing will go wrong.

My night was pretty easy. I must say...having 2 patients is sweettttt. The drawback though...the night crawled by in slow motion. I didn't want to jinx myself by saying anything out loud such as the words quiet, bored, easy. Any nurse will tell you...never describe your night with those words until after the shift is over.

My one patient was diagnosed with syncope. The cardiologist rounded and asked me why the patient was still in ICU. Huh? I wanted to reply "I don't even know what I'm doing in ICU, much less the patient." I have learned that honesty is the best policy & I replied to him sincerely..."I don't know." He then said "You're paying for it." Huh???? I said to him (in a much different tone) "I'm paying for it???" Then he went on about how all taxpayers are paying for it. Ummm...the patient was like 81 years old & on medicare....that's part of the deal you get for surviving so many years here in America. It wasn't like he had no insurance whatsoever & this would be a tax writeoff for the hospital/state. I'm not convinced this cardiologist is from America I think he might have been a little confused or just looks at it differently than I do. If you make it to where you qualify for medicare...then it's all yours. We younger ones aren't allowed to complain about it.

This was a good patient...didn't ask for much at all & slept most of the night. Very easy to get along with, very cooperative & definitely not ICU material.....but that wasn't my concern as I was only there for a night.

My other patient (did I mention I loved only having 2 patients?)...well this one was a little more complicated. He was in for dehydration.....he's only like 29 years old. He also has downs syndrome & definitely does not have the maturity level of a 29 yr old. It was like taking care of a child. We started the shift with him complaining he was in extreme pain. I gave him some Dilaudid & it wasn't long before he was hallucinating. That's the thing with some of these meds....sometimes they can do wonderful things like take away the pain & induce sleep...but other times, they can make the patient seem insane & restless.

Every few minutes this guy would call out. I'd go check on him & he would be having a bad dream. This went on for about an hour or two. I had to reorient him every time. After a few hours went by, he asked for pain medicine. Ummmm, no. Not going thru that again. Amazingly, he never asked for it again & he slept the rest of the night.

That was the extent of it. Simple, easy patients = simple, easy night. I was due for a night like that. A couple of the clinical leaders told me I did well & that I should consider moving over to ICU. It's a possibility, but I would rather be trained at a hospital that has a good ICU training program & deals with much more traumatic cases. Our ICU doesn't see a whole lot as we are not a trauma hospital nor a cardiac hospital. We end up with people that unsuccessfully tried to commit suicide and elderly people that are nearing the end of life. That's about it. That's not what I want to learn. I want it all....haha.

On a side note...I strongly urge all of you reading this....find out what your local hospitals specialize in. For instance, we have 2 hospitals over here that are somewhat near each other......mine, which doesn't really specialize in anything & the other's the place to go for anything heart related/chest pain, etc. I don't know how many times I've received a patient with a heart related condition that I silently said to myself "I wish they had gone to the other hospital"......because we cannot care for heart related conditions the way this other hospital can. It's a delay of care when you end up in my hospital for something we cannot properly treat.

Often times we transfer patients, but sometimes it's a little bit too late. I'm just saying......find out which hospital in your area is the leader in heart related this way if you develop chest pain or anything heart know which would be the better hospital to go to....if you have someone to drive you. If not, the ambulance will take you to the closest hospital.

I'm NOT SAYING that you should delay your own care by skipping a hospital close by for one that is like 2 hours away....I'm just saying often times there are multiple hospitals in a small area & they each specialize/excel in something different usually. It would be good to know who does what prior to you needing them.

If I'm freaking you out, I'm sorry. I just know so many people think any hospital can do it all & we definitely can't. I've already told my parents which hospitals to go to & which to now I'm sort of telling you. Inquire...find out....don't wait until you're having a problem. Know in advance. But in case of extreme emergency - definitely go to the closest hospital possible.

Ok, that's enough of my service announcement. I did absolutely nothing today & I liked it!!! (sing it in the tune of Kati Perry's song) Actually I'm lying. I did do a few things. I talked to both of my best friends, I colored my hair, I went to Walgreen's with the sole purpose of buying Edy's ice cream - it's so yummy, I couldn't resist. So I did a few things, but that's about it. I'm about to resume my tv watching - I have so many shows to catch up on & that's my plan for tomorrow. And the next day.


Pamela said...

You worked in my world for a night! I did ICU for almost 10 years. I just fell into a great training program with a big hospital. They did everything. GREAT training! You are right...that's the kind of ICU training you want. Then, the doors open to you.
Glad it went ok for you. Sometimes it's not bad.
Have a great weekend!

Julie said...

We are the heart hospital in our town of 2 hospitals. The other hospital insists on doing cardiac caths but they can't treat anything they find so they end up shipping you to us emergently in the middle of your cath for the rest of the care. Insane. They should have come here first. The other hospital does neonatal, we always tell high risk mothers to go there. Its about the best care.