Settling In

My working space.

After two to three days in the ICU, I became accustomed to answering phone calls. The ICU runs on a lot of these important calls. Phone calls usually mean someone on the unit had paged another department or a doctor needs a report on the patient he is monitoring from his nurse. Phone calls could also mean that a visitor needs me to buzz them in for a visit or a patient’s relative would like to speak to a nurse. Above all, it is my duty to get these calls to their respective owners.

My trip to the Blood Bank.

Answering phone calls was not the only thing I had been allowed to do. At one point, I was able to run to the blood bank to retrieve red blood platelets. I am given a slip of the checked item I am to retrieve and present it to a blood bank worker. There, they give me a pack of the order I needed from a refrigerator and carefully wrap, label, and place the packaged blood in a biological hazard bag for me to give to the nurse who had asked for it. The blood was to be used for a transfusion that took place later that day. The transfusion was successful and I believe the patient was discharged two days later.

Day 1

On June 9, 2009 I began my internship at Mount Sinai Medical Center. I had been placed to work in the Intensive Care Unit located on the sixth and seventh floors of the Greene building. After meeting my mentor, Nina Santos, and the majority of the ICU team, I was set to do paperwork. I was informed that the nurses were almost always short on patient application forms and so I began to assemble them. Each form contains intricate charts and checklists that the nurses need to document. These include:

* Patient diagnosis
* Nutrition
* Problem lists
* Interdisciplinary patient/family teaching
* Kardex,
* Admission medication reconciliation
* VTE Prophylaxis
* Vaccine screening
* Ventilator management
* Sedation protocol
* NCI Checklist
* Patient education/ acknowledgement for
o Stroke
o pneumonia
o CHF
o MI
o SCIP
* Patient belongings/valuables.

Here I am assembling the patient application forms.

Although making these forms was an imperative albeit mundane process I, unfortunately, got to witness my first DNR. As many know, the ICU is a unit in which extremely ill patients are placed and sorry to say, do not always survive. It was on my first day of internship that I witnessed a death. DNR stands for Do Not Recessitate. This means that the patient requested that if he or she were on the verge of death, no life support or medication was to be used that ensured physical stability. Later, the nurses wrapped the body up and transferred it out of the room while I continued to put together patient application forms. It surprised me how a death seemed so habitual. I guess after so many deaths, it becomes easier and easier to not feel anything.