Monday, April 27, 2009

reflections from the ICU: a new grad perspective

feb 11, i passed the rn-nclex exam (state boards); feb 13, i began orientation at Mt Sinai Hospital, a "national model for urban healthcare" that serves the west side of Chicago. i started on the unit (CCU/MICU) on mar 2. i now have about 8 weeks of experience under my belt. though time management remains a HUGE issue for me (i know, i know, with time, i'll get better), i feel very comfortable in my specialty choice. i couldn't imagine working the floor, mostly because i enjoy concentrating on the total care of only 2 patients. the unit is always busy; and though my orientation time has been more focused on keeping up with the patient load than teaching, i feel like i'm learning something new everyday. my preceptor and i have a great relationship, but i work well with most anyone on the foor. some people are catty, but that goes with the territory. my biggest challenges now are being able take breaks or eat lunch, keep up with new orders (still using paper charts), AND finish all of my documentation by the end of shift. part of this will come from telling people "NO," meaning, i cannot help clean or turn patients at 5:30pm if i'm not caught up on my pt's meds, documentation, etc. my goal for the next week is to focus on being caught up by 4pm, so that i can ease into change of shift with no problem. the issue with this is that 4:30pm-6pm seems to be what i call "the witching hour". that time period when all hell breaks loose. when patients crash and codes are called. or a critical new admit comes up to the floor from the ER, crashing while we hook him up to the monitors. some days you can almost feel the tension in the air, you know that something's about to jump off. other days start off just fine, then tumble like an old person on a long flight of stars. overall, i welcome the challenge, but there are days when i leave work feeling like i just fought a heavyweight title match. and lost. but i haven't come home crying, nor am i ready to throw in the towel. rather, i look forward to putting on my cute scrubs and jumping into the day head first.