i've made it through yet another call - clinic - call cycle in the NICU! today will be a short day (hooray, only 7 hours!) and tomorrow another much-anticipated day off. it is amazing how much better life looks from this perspective.
wednesday's call actually wasn't that bad, though. i felt like i was pretty on top of things, actually got to sleep for 2 hours, and realized that i am actually making some progress and learning stuff on this rotation even if i never have the will to do any after-hours reading. not only i am learning the nuances of some of the clinical decisions made in the NICU, but i am learning tricks for staying organized and on top of 25 patients at once while overnight on call. IT IS NOT EASY, PEOPLE! there is a lot of triage that needs to be done when 3 nurses come at you from all angles at once (and it always seems to happen that way -- some sort of universal force at work there, i think).
just imagine, all at once:
nurse #1: baby #1's urine output was only 1.0 ml/kg/hr for the first half of my shirt. also, his potassium just came back with an alert value of 6.5.
nurse #2: baby #2's pressures are tanking.
nurse #3: baby #3 is seizing.
ok actually, i just got stressed out even imagining these concurrent scenarios. i'd have to call for backup! but at least with less dire problems, i am better at triaging and knowing what to deal with first. in the above, i would run to the third baby first, start phenobarb, check glucose and electrolytes, and maybe scan the head. while doing that, i'd probably tell the nurse for #1 to stop the K+ in the first baby's fluids, maybe bolus them with fluid (with a lasix chaser), and recheck the K+. and the second baby would get some dopamine, or epi if dopamine was already on board.
seriously, my heart is now palpitating. although that could be from my giant mug of black coffee . . .
short friday plans!
i have a meeting with one of our pediatric endocrine faculty right after i am 'released' from the NICU at 1 pm, and then i plan to spend the afternoon lying around doing very little. although i do plan to reacquaint myself with the gym today after a several-day hiatus. i am looking forward to that a lot, especially since the new runner's world came in the mail yesterday! sometimes i think a few days of doing nothing active are very therapeutic in renewing my love and craving for running.
tonight josh and i are going to be very low-key (he can't drink or do anything crazy because he's on call) and i plan on being an 80-year old grandma and going to bed relatively early so that i don't sleep through half of my day off like i did the last 2 weeks. here's to just one more week of this crazy schedule!
workout: i willfully skipped my run. this week is basically going to be a wash as far as training is concerned, and i'm okay with that! i think some rest is actually what i needed at this point in the rotation.
cooking: i made a mexican casserole-type thing loosely based on rachael ray's chicken salsa verde bake. josh loved it because it involved both chips (i used baked chile verde-flavored chips) and cheese.