NICU week 2

I have been in the Neonatal Intensive Care Unit (Level 4, Research Medical Center) for two weeks now.  Tomorrow is my last day of the two week run.  I will be here for two more weeks and then I move to the Pediatric Intensive Care Unit, I dont know what level - whatever the highest level is probably...

I have had only around 30 total patients with around 8 needing real therapy over the course of the two weeks, but even that load is pretty heavy considering the acuity.

I don't know how I am going to write about the cases specifically, I am attempting to stay as anonymous as possible, but when I know everything about the patients and apparently I think the world revolves around me; I can't help but feel obvious about who I am talking about.

This is something I suppose I will have to have someone read as a 3rd party before publishing to this blog.

In the most general of terms, hopefully I will get brave and get more specific later; I have managed some jet ventilators, some nitric oxide therapies, oscillators and a lot of conventional ventilators.  I have bagged a 500g baby and have gotten really good at a task im sure is overlooked, the capillary blood gas (CBG).  The CBG is so humdrum its almost not even worth mentioning when asked what you've been doing for the last hour, but as a new therapist, I can't help but get excited when I fill my vial without any errors.

Vent Checks are okay, but I wish that there was a system in place for recommending a ventilator change.  In acute situations, we are allowed (RRT only) to use clinical judgement to change ventilator settings to fit the need of the moment, but for general care when everything is fine except maybe a blood gas tweak, it would be nice to have a place to submit a suggestion for physicians to view when they round.

Giving report is hard when some receiving therapists want to know nothing really, and some want to act like the clinicians we're supposed to be.  I have started to give a full clinician report every time and just deal with the eye-rolling.  I can't get in trouble for being too-informative, at least thats my mantra for the week.

I know this was choppy but I wanted to log something.

Talk to you soon.