Thursday, October 23, 2014

Surgical Intensive Care Unit

Posted by kamer234 at Thursday, October 23, 2014

It’s hard to believe that I have finished half of my rotations. It is one thing to know P4 year will go by quickly, and quite another to experience it!

So far I have completed my community, drug info, institutional, and surgical ICU rotation. I have had wonderful preceptors and experiences across the board, but I think the SICU tops the list. I worked with extremely complicated patients and was continuously exposed to new disease states and twists on familiar conditions. There was a steep learning curve, and it took me longer to feel comfortable on this rotation than any of the others because of the complexity inherent in each patient.

I started off the rotation following 2 patients and worked my way up to "owning" 10-12 and keeping tabs on the rest of the patients in the unit. One major plus of this rotation was the autonomy that Dr. Miller afforded me. I determined when I was ready to take on more patients.

My typical day started at 6 am when I began working up my patients. While working up patients I would look for medication related issues and would run it by either the resident or my preceptor prior to rounds. I would work up patients until rounds started shortly after 8am. Most days I rounded with the PGY2 resident or the pharmacist, but occasionally I would round by myself. Rounds on the SICU last anywhere between 3-4 hours, which can feel long some days, but I found that increasing my patient load helped keep my interest engaged. I also tried to listen for at least one unfamiliar condition, lab, drug side effect, etc per patient that I could look up later. 

My afternoons were spent reviewing patients, following up on questions, and one of my favorite parts of every rotation - topic discussion! I may be an outlier among my classmates, but I find topic discussion to be an efficient learning opportunity. In theory, it may sound similar to preparing for a therapeutics class or an exam, but in reality the material feels more practical and easier to remember after the topic. I find my learning to be facilitated by the opportunity to connect the topic to patients I see every day. 

My family and friends often asked if this rotation was difficult from an emotional perspective. During my 5 weeks in the ICU I saw many different types of patients and outcomes. While some cases were more difficult to face, most patients recover enough to leave the ICU, and there are a few patients who make the type of rapid recovery that refreshed my emotional stores. 

This rotation provided innumerable learning opportunities. This rotation is great for anyone looking to challenge themselves and learn a lot in a short amount of time. 

-Kallie Amer, PharmD Candidate 2015

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