The ICU

So, I finally get a day off from the ICU today. It's not bad, but there have been a few situations where I felt like I was biting more than I could chew. This is the place where the sickest patients go. It's pretty scary to be playing doctor with people who are just barely hanging on to life. Just a few hours ago, a patient of mine passed away. He crashed in front of my eyes and I can't help but look back at every order I made (or didn't make) to see if it could have been prevented. What's worse is that I can find things that really could have caused him to crash. I suppose this is the reason why the learning curve is so steep. If you don't pick it up quick, lives will be lost.

The fact that I, as someone who hasn't had any meaningful responsibility in a hospital, suddenly am seen by others (patients, nurses, family members) as an expert whose every wish will be carried out (if it's correctly entered in the computer) is terrifying. What's worse is that there never has to be a backup. Yes, there are other interns, residents and attendings, but there is a lot of on-the-spot decision-making that falls on me. Most of it is harmless, but there are times (especially at night) that it can irreversibly affect a patient's health. There are many orders I've put in that I am not confident of (or as a fellow intern said about an order a nurse suggested to her, "I don't know what it was, but I ordered it"). Things go very quickly, there's high patient turnover, and people die (signing your first death certificate is a pretty strange feeling).

I've only worked in the ICU for 7 days, but it's felt like a month. It's an experience where you learn a lot, but it wears you down. I'm glad I'm getting the experience, but I know it's not for me.