ICU first

[tatabox80]

Hi everyone, I'll be starting fp residency in July and I was thinking of requesting ICU first to get it done with. I have done ICU as a 4th year at the hospital I will be working at...am I going to regret doing this rotation first? Or is this a good idea?

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[drtx]

It is a very good idea. I recommend reading the ICU Book bu Marino - mainly the chapter on hemodynamics and vent management if you haven't already.

 

[Winged Scapula]

Yes and No.

Yes, you will regreat it because doing an ICU rotation first is very grueling and frightening. The patients are sick, need frequent and often, constant attention and have lots of machines and tubes and wires that make funny noises. Its a scary place for the new intern.

No, because starting out on a rigorous rotation really gives you a jump start on your internship, will prepare you for other, less intensive rotations and the ICU nurses can be some of the most skilled, knowledgable and helpful coworkers you can ask for. Have no shame in asking them for help. Its a great way to start...if you have to!The learning curve is steep, but you'll be fresh and eager and I"m sure would have no problem.

 

[danielmd06]

You will be relatively fresh and eager during the first two months or so of internship, and the potential learning curve in the ICU is very steep. Ergo, this question could be answered both ways with relative truth.

I personally think it is a good idea to "get it over with." This will likely be the most difficult month you have, and you'll feel psychologically stronger knowing that it is finished...unless of course you're like me and you have to complete two months of ICU. Also, the winter months seem to bring a much greater quantity of MICU patients into the hospital, meaning that a summer month would likely be less intense than December or January.

It is a more controlled, high-powered, and demanding rotation...but it winds up being a great learning experience and lots of fun for many. You might even find that you actually prefer the ICU to the floors (like I did).

 

[trouta]

I ended up with ICU as my first rotation of intern year (not by choice mind you). Initially it kind of freaked me out, but then I got to thinking it would be nice to have it over with. In the end it was a great experience, not too difficult and prepared me really well for almost anything I saw through the course of the rest of the year. I say go for it.

 

[jennyboo]

I did a unit rotation first. I think it's a good way to start the year. You're nervous no matter what rotation you start on, so why not just dive in? Moving on to the rest of the hospital from the unit won't be a breeze either, but psychologically you'll think of it as "downhill" rather than "uphill."

A unit rotation is tough in terms of hours, but wards are actually much busier than the unit in terms of running around chasing this and that. I thought going from unit --> floor would be a breeze. It wasn't. But it makes you a little less afraid of everything else the rest of your year.

If you want this, email your chief (or whomever creates the schedule) now and request it while they're still putting the schedule together.

 

[carrigallen]

From what I've seen the busy-work is worse on the floors than the ICU. You usually get out earlier in the ICU, and in general the ancillary staffing is much better in the ICU. There are fewer social-work issues to deal with, and all the patients at least deserve to be in the hospital, as opposed to the floors where many do not. Also, things tend to get ignored or overlooked on the floors.