Wednesday in the MICU

• I can't figure out the afternoon drive time. I got there 30 minutes early (again) so I went in search of a gas station so I'd be full for the anticipated snowy drive home. I was almost late because of traffic between the gas and the 4 blocks back to the hospital, then my usual parking was taken! I literally ran to the building, making it to the locker room flustered but still 5 minutes before shift technically starts (I prefer 10-15 min early)
• I nearly took independent care of one patient. He's a very large gentleman with hypercapnic respiratory failure and possible anoxic brain episode. Yes Brian, I wiped a lot of scrotum today. But that's not all I do! It only constitutes 10 minutes of my 12 hours on shift!
• I got to watch a thoracentesis. The docs weren't that familiar with the kit, so they spent a lot of time fiddly with devices and sounding unsure about themselves. Their patient was very nervous and despite lots of morphine (why not ativan?) was shaking like Molly shakes when we take her to the vet. Poor guy. They pulled 500cc out of his lungs. The puncturing part made me woozy, like when I saw the PICC insertion. I guess I don't do well with long jabbing needles that take some brute effort to get in.
  
• My preceptor bought me a hot cocoa, right when the snow started!
• I walked through the steps for hanging blood, from lab to vein, with my nurse.
  
• My feet ache and stink after 12 hours of work.
• We got a late night admit, "a train wreck" of a guy. I was able to get 15 min vitals, label tubing, get poop and pee samples, MRSA swab, and generally felt useful and able to function without being in the way or asking what to do next.
  
• One of the respiratory team was behind me on the way to the med room and booed loudly. He totally got me and giggled for 5 minutes over the spooked yelp I let out. :-P
• Other students from other schools are popping up on my unit. Tis the season for practicums.
  
• I'm surprised how well I work at night. My preceptor was dogging me for zoning out yesterday around midnight, but I'm quick to remind her that that was because I'd only had a bowl of cereal since noon, we didn't get a break until after 1 am. Today with proper nourishment I did fine, like I usually do. In fact, I feel inclined to call my folks on the drive home to chat about my shift, and then I realize what time it is for them.
  
• But night shifts are isolating. The unit is this weird secluded environment where you obsess over your patient's status constantly. You don't think about the news or blog feeds or friends or even meals. You get home when everything is closed and your husband is fast asleep. Then you wake up midday and feel like the world has passed you by - your inbox is full, there's a ton of news feeds you missed, everyone else is winding down for dinner while you slurp cereal trying to rev up. On your days off you're left alone again when everyone else goes to bed. So you read or watch TV on headphones. There's no where to go out, no errands you can run. You don't want to wake the household with too much bustling. Nights are more difficult emotionally then physically.