Sunday, September 19, 2010

Using my Brain

I walked into the PICU last Thursday having NO idea what kind of patient(s) I would be taking care of. After 4 months of taking care of my chronic kids, it was all up in the air!!! So I walk into taking care of the sickest kid on the unit. Correction: sickest MAN on the unit! I had a 37 year old male who had a huge heart surgery the day prior and was sick....really sick!! I was super busy all day....I didn't sit down the entire shift! He had blood pressure issues, arrythmias, and sedation problems. I had to contact numerous docs to get the answers that I wanted. It was tiring. It was mentally exhausting. And it was AMAZING!!!

I left work remembering why I truly love the PICU!! Being able to use my brain, to critically think, to act quickly in response to the slightest little's so exciting!! People walked by throughout the day and said, "Wow, they really didn't ease you back in, huh! They just threw ya back in there!" Oh yeah, they did. And, oh yeah, I loved it!!

And then the next day came my first day of clinicals. Clinicals in a primary care office setting. Could not be any more opposite of my exciting, amazing, PICU setting.

And yet, it was WONDERUL! I truly cannot say enough great things about it!

I mean, I really surprised myself with how much I learned and how much I LOVED it!!! The idea that office work is boring is just plain wrong! In fact, it was just as busy as many days in the PICU....without the stress of having to keep patients alive! SO nice...go figure!

My "preceptor" is a Pediatrician, and although medical students receive very different training than Nurse Practitioner students, this doc is one amazing teacher!! She had me come in and observe the first two patients of the day...and then threw me out on my own! Hello!! She figured that since I have had PICU training/experience, that this should be a cake walk for me. She was more excited that if someone came through those doors super sick, she'd have someone with her knowing exactly what to do!

It was honestly so great! I would go in and see the patient, take a history and do a physical....then I would go present the patient to the MD who would then go do a follow-up exam...and we would send them off together. I am learning SO much about basic, healthy kids (ie: immunization schedules, basic developmental milestones, skin disorders/rashes etc) and it's awesome!! Those are things that are clearly not of importance when a kid is on life support in the it gets pushed to the back burner.

And what's great is with my PICU experience, I'm able to give parents so much information on disorders and diseases from an inpatient perspective that the pediatrician is not able to give.

SO- on my first day here's what I got: a TON of well patient check ups ranging from 2 weeks (SO cute!), a few 6 and 9 months, a few 12 months, and a few back to school check-ups. Then, we got an asthmatic that we admitted to the hospital, a football player with a broken finger, a cross country runner with shin splints, and a 16 year old who was self diagnosed as pregnant....and sure enough was (that test came back positive in less than a 3-5 minutes of waiting necessary!)

I think the biggest reason that I love this setting is the amount of patient and family education that is involved...and I'm realizing more and more what a passion I have for teaching. I always know that eventually I would want to teach at the college level, but this shows me more that whatever job I take once I graduate, a big component needs to be revolved around teaching!

On the job front, I haven't been back since my last post, but I have had several people call and text me: the boy I just sent up came right back down : ( Apparently he got a mucous plug in his trach which occluded his airway...which caused him to "brady"(heart rate go down too low), which caused him to get compressions, which bought him a one way ticket to the PICU. So, I know where I'll be on Tuesday at work!

So while I may not be "using my brain" as much as last Thursday when I go back to work this week, I know I'll be giving some great PICU care to a boy who probably needs a familiar face right now....and that makes this PICU nurse ready for the adventure chill as that may be : )

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