survived my first intern day in ICU

[lfesiam]

1 day down, 364 days to go! whoo hooo

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[Gimlet]

1 day down, 364 days to go! whoo hooo

Strong work!

I'm still waiting for my first day as an intern to start (at 11 PM tonight in the ED).

 

[bigdan]

Hey guys!

I started on June 24th in the ICU; I'm post call (and profoundly delirious). Not only have I survived my second call, but all my patients did too!

Our schedule is in 4 day cycles:
1: day off precall
2: call, using every single minute of the "30 hour rule", going from 7 am - noonish the next day.
3: The rest of that post call day is off.
4: "Line team day" - any lines requiring placement in the ICU are done by the line team. Nice.

Our medical school never had us do anything longer that the occassional 24 hr shift, so this 30 hr thing is a f*cking monster right now. I haven't done anything during the later hours of my call to harm a patient yet (too many checks and balances), but I got about 45 seconds into presenting a new admit to an attending before I realized that I had just given her the information about the patient next door...That said, I like things very much so far; come check me out after two months of this, though.

Hope things are going well for all. Enjoy it or not; they can't stop the clock!

dc

 

[psychbender]

I got to start off internship today with Medicine in the Heme/Onc ward...opioids and antiemetics, FTW.

Bigdan, that actually sounds like a pretty snazzy setup you've got there. Our MICU is alternating 30-hour and 7-hour days (standard one day off in seven). Did that rotation as a fourth year, and it was actually ok after the first few days (then again, my intern would let me sleep from 0300-0530 when on-call if nothing too interesting was going on).

 

[TayShaun]

Enjoy it or not; they can't stop the clock!

Very true!

In other news, your call schedule seems *really* nice actually, espeically with pre-call day off. That's a real luxury. Our ICU calls are Q3...when you're on call, you're on from 7:30 until rounds finish the next day (anywhere from 11-1PM). Post-post call, aka swing day, we do lines but otherwise we try to get the swing resident out. The following day, you're back on call again.

At my internship (at another hospital), call was Q4, with call days lasting until post-call rounds finish, and the other two days of the cycle are regular work days.

 

[fakin' the funk]

First two days of internship in ICU: hell on earth
Next 5 days: tubed a dude, put a TLC in, and got a couple of ARDS'ers to the floor. Don't call it a comeback!

 

[Mista Suprane]

Very true!

In other news, your call schedule seems *really* nice actually, espeically with pre-call day off. That's a real luxury. Our ICU calls are Q3...when you're on call, you're on from 7:30 until rounds finish the next day (anywhere from 11-1PM). Post-post call, aka swing day, we do lines but otherwise we try to get the swing resident out. The following day, you're back on call again.

At my internship (at another hospital), call was Q4, with call days lasting until post-call rounds finish, and the other two days of the cycle are regular work days.

are you at JHH? this is exactly how we do it...

 

[DrDre']

1 day down, 364 days to go! whoo hooo

You will much more confident with each call night.

Don't stress about your UOP over night. It almost never seems to matter (as long as all other parameters are good!)

 

[lfesiam]

You will much more confident with each call night.

Don't stress about your UOP over night. It almost never seems to matter (as long as all other parameters are good!)

i dunno Dre, my bladder is quite hyperactive with all the red bull/coffee overnight.

 

[sethco]

Heh!

3 out of my first 4 rotations during my intern year were Unit months (either ICU or CCU). They really did crush me and I was probably pushing over 80 hours almost every week.

But you know what? I loved it. The part that killed me during my intern year were the general floor months with the endless rounding and social issues/admits galore. By the end of the year I was seeking out other interns to trade their unit months for my floor months.

I tell you what, though. My very first day of internship was spent on a 30 hour call in the ICU and I have never been so scared in my life. The "senior" resident that I was on call with was her first day of her PGY-2 and only her 2nd Unit rotation.

 

[bobg504]

I started internship June 23rd in the ICU. Initially I was worried about starting in ICU, but am surpisingly happy with my experience thus far. Although exhausting, I feel like im learning and growing each day. Its so weird (and scary) to be giving orders. I really feel the responsibility now. It motivates me to do my best. My program is q3, where on pre-call days we see our patients (that we admitted from last call), round, following rounds we signout to the on-call team (out the door by 1pm). On call be work from 7:00AM on call day till 12-1pm post call day. We have 4 days off in the month. We do 2 ICU and 1 CCU rotations in my internship. Hopefully they will be helpful! My resident is awesome! Pray for me guys!

 

[lfesiam]

I started internship June 23rd in the ICU. Initially I was worried about starting in ICU, but am surpisingly happy with my experience thus far. Although exhausting, I feel like im learning and growing each day. Its so weird (and scary) to be giving orders. I really feel the responsibility now. It motivates me to do my best. My program is q3, where on pre-call days we see our patients (that we admitted from last call), round, following rounds we signout to the on-call team (out the door by 1pm). On call be work from 7:00AM on call day till 12-1pm post call day. We have 4 days off in the month. We do 2 ICU and 1 CCU rotations in my internship. Hopefully they will be helpful! My resident is awesome! Pray for me guys!

5 codes tonight on call, it's 4:30am, time for coffee and am labs!

 

[SaintFrances]

I just started my first intern ICU rotation on July 1 as well. Tomorrow is my first call. Its a good thing that this week started officially on a Wednesday cause I will be pushing 70 hours by the end of it. Even though the work is hard, the days are just flying by. I don't have time to eat, but it really doesn't matter cause I don't even notice feeling hungry!

I nailed my first official "solo" central line this week as a doctor. Man that felt good!

Does anyone else keep almost introducing themselves as Student Doctor ____? Its so hard not to sign MSIV all the time.

Anyhow, good to hear that lots of you are in the same boat regarding starting intern year in the unit.

 

[DO4lifer]

Does anyone else keep almost introducing themselves as Student Doctor ____? Its so hard not to sign MSIV all the time.

I have no trouble with introductions, but the signature part is still a struggle. Its like changing the date when the new year starts.

I'm looking forward to some ICU action. Need some tube touching.

 

[lfesiam]

I have no trouble with introductions, but the signature part is still a struggle. Its like changing the date when the new year starts.

I'm looking forward to some ICU action. Need some tube touching.

Yep... Floor intubation is a beast especially during code/rapid response (ICU is responsible for the whole hospital). Done 4 so far on nights. Good lord, one had a full belly, no time to drop an NG... blood & aspiration usually clogged my view.

good old manual suction was my best friend. thank god for my anesthesia rotations.

so the end of first week in the unit: 12 codes, 4 intubations, dropped 2 central lines, 2 LPs, 3 art lines, some ivs here and there, 1 death pronouncement (DNR - VTACH is the best way to go), did some vent management (YOU CAN LEARN ALOT FOR THE RTs!).

 

[bigdan]

lfe -

Nice numbers, bro! I had what I thought was a robust start - averaging one central line per call - but that lasted for a grand total of two calls. What I have become proficient at is admitting patient to the ICU all night long. At the hospital I'm working at, anyone requiring more that 6 L/min of O2 or a potassium above 6.5 HAS to go to the ICU, so lots of my "critical care" admissions have been anything but critical...

Sounds like you're settling in quite nicely down there, my friend! Things have a wonderful way of working out, don't they?

dc

 

[narcusprince]

lfe -

Nice numbers, bro! I had what I thought was a robust start - averaging one central line per call - but that lasted for a grand total of two calls. What I have become proficient at is admitting patient to the ICU all night long. At the hospital I'm working at, anyone requiring more that 6 L/min of O2 or a potassium above 6.5 HAS to go to the ICU, so lots of my "critical care" admissions have been anything but critical...

Sounds like you're settling in quite nicely down there, my friend! Things have a wonderful way of working out, don't they?

dc

The Padawan will soon beocome a Jedi.
Good luck Big D

 

[Direct Laryngoscopy]

In the open heart unit. Not too bad. Doesn't count as an ICU month though (considered a surgery rotation). Q3 call blows, but I'm becoming efficient enough to get 4 -5 hours of sleep as long as no one is crashing and I don't have any consults to see. 353 days left, but who's counting

 

[lfesiam]

lfe -

Nice numbers, bro! I had what I thought was a robust start - averaging one central line per call - but that lasted for a grand total of two calls. What I have become proficient at is admitting patient to the ICU all night long. At the hospital I'm working at, anyone requiring more that 6 L/min of O2 or a potassium above 6.5 HAS to go to the ICU, so lots of my "critical care" admissions have been anything but critical...

Sounds like you're settling in quite nicely down there, my friend! Things have a wonderful way of working out, don't they?

dc

dc, what up dawg!

here's a funny story, (dre, you will like this)

Got called for a no UOP. Went to see patient. Foley was in the vagina. Sigh...