I'll see you in the ICU!

The CCU

What a crazy experience.

The Cardiac Care ICU is very different than the med surg floors or the step downs. I've noticed that once a patient is well enough to complain about their room not having any windows, or something like this, it's almost time for them to be leaving the ICU. If you're well enough to notice or care, you're usually almost ready for the regular step down unit.

There are several patients that are heart transplant recipients, and others that are there for cath lab, so they are in varying LOC from completely obtunded to A/O x3.

Today, my preceptor ran a tape on my patient and said "here, tell me what you see" but walked away. When she came back, I had been staring at the tape for a good 5 minutes and fought back the urge to say "a black squiggly line." I was glad that I'd postponed taking the ACLS test and took my books home with me during the break. Somewhere over the purple mountain's majesty and the amber waves of grain (ie, on the plane ride home or back) I re-learned all the parts of the ECG, what each part means, what's going on at each segment of the wave, and variations of a few. I remembered that an elevated ST segment means ischemia. And I was glad she didn't ask me yesterday when this patient had a depressed ST segment in lead 2 and all I knew was this indicates "injury."

I quickly flashed to the show "Scrubs" when during rounds Elliot always smugly gives her dx. So I tried to contain myself and threw in some doubt.

"I see an elevated ST segment and...possibly a missing R wave?"
"no, there's an R wave, but it's just very, very small. What's that mean"
"ischemia?"

:D

So, if my preceptor hates me it's not for being stupid. It's for other reasons, hah.

She taught me a few things about the ECG that I didn't know, and I was excitedly trying to write it down. SHe said "it's in your books" but I'm pretty sure it is not.

Anyway, it's pretty cool. The 12 hour shifts seem to fly by--by that I mean, even with one or two patients, one is hopping around and still needing more hands, more hours in the day to do everything one needs to do.

I bought my ticket home tonight. A one way.
Free at last!
May 15th, I turn the page, end the chapter and the book that started May 31st of last year.

Ay caramba. It's only been a year, but this program has sucked at least 6 or so years of life out of me...it's like trying to wet your lips with a fire hose. But I talked to one former ETP student there, who also quit after the first year. Does ANYONE go on to finish that masters?

I walked into the med room and two nurses were talking:
"Because Columbia's nursing school SUCKS!"
Neither of them took notice of me in my Columbia School of Nursing uniform...I turned to her and smiled and nodded, and she said "I'm in the master's program now, it's so disorganized, it's a mess!"

and all I could do was nod, and smile and say "the undergrad portion isn't so hot, either"

California, here I come.

posted by sketchmonkey @ 4:28 PM