I’m back from my second shift on nights in the MICU. My biggest fear is relieved: my preceptor is a very nice, competent nurse who was very excited (requested in fact) to have a student. She has been working with me on all levels- tasks, time management, and global care/pathophys. I’ve done new things already: put a foley in a man, heard rales, rhonchi, and wheezes, drew blood cultures, trach suctioning, and EKG interpretation. Our patients are REALLY sick and have a lot going on, both in terms of diseases and a mass of lines going into their bodies. They are constantly on the borders of their vital sign parameters, thus I have alarm bells ringing in my head right now. Our patient today was tachycardic all day, going from 115 to 125 every minute or so, setting off the alarm every time it pass 120. Ugh.

I’m doing eight hour shifts and at this rate I kind of like working nights.
1) no traffic on your commute
2) You don’t feel guilty for sleeping in
3) the gym is less crowded at 2 pm
4) fewer visitors/therapists checking on your patient
5) more attention from the single doc on call for your patient

We’ll see if I’m so enthusiastic when I go to twelve hour shifts, or after the adrenalin of a new place has worn off.

One thing that confuses me: the nurses have acting fairly horrified at some of the things I have seen in these two days. Deep fistula-like wounds between the scrotum and thigh, nasty diarrhea-like urine, booty stank, and fungal-like cellulitis head to toe with massive peeling. Isn’t this what they see all the time? Are they putting up a show for me? Or am I seeing a skewed sample of the type of skin and genital conditions that they normally receive?