I actually had a cup of coffee today. Yuck.

Day two in the ICU (with the only patient). Only this time without my rockstar buddy. The thought of working in an ICU that is physically separated from the wards and all the other staff gave me the heebie jeebies, but again, I don't know why I worried. The vast majority of the time I wasn't alone- a veritable smorgasbord of nurses and doctors. A lot of cooks in the kitchen to be sure, but I enjoyed it and in the end it worked out well. I spent somewhat less time frantically searching for supplies and more time pushing fluid boluses and trying to keep an SBP above 75 (Fail. Hello central line and levophed.). Can I just say one more time how much I enjoy the staff here for putting up with my questions and blank stares ("you use what? where? how?") and investing so much quality time in me as the patient's nurse- with orders, moral support, and just plain help with it all?

As I mentioned before, the ventilators here are positively ancient. In my other hospitals, nurses don't touch the vents except for maybe a tweak or two- depending on the respiratory therapist on at the time. And here? We do it. The anesthetists are here to direct and oversee, but I find myself looking at the machine thinking, "if this thing malfunctions, there are only a handful of us onboard who can work it- apparently now I'm one of them." Out of this world. But I'm ok with it- it's exciting and we're all starting from the same spot, so double and triple checks are expected.

Same with medications- the concentrations are variable day by day (depends on what brand is available), so there are a lot of "hey, does this look right to you? Will you triple check my math?" I mean, levophed was ordered today in mL/hr, not mcg/min. Because we mix our own drips (maintenance fluids down to the pressers!) and it's ordered differently in various locations, I'm learning to get a grasp on different prescribing methods. Fun :)

So I'm brain dead. I miss sleep and it feels strange to be only a few yards away from my patient but not responsible for their care. The proximity is strangely disconcerting. Then again, maybe it's just the rocking of the boat and lack of sleep. Sleep. Ah, sleep. Oh how I miss it. One hour last night plagued with nightmares. The Lariam can't clear my system quickly enough.

Surprisingly, I was able to stammer out a few intelligible things in French to my patient's aunt today. I'm afraid to think how my grammar and pronunciation has fared over the years of lying dormant in my brain, but apparently I was understandable. A nice little confidence booster- especially after the one and only disastrous episode of using French in the healthcare setting years ago. It was gratifying to make her smile despite the sobering situation two feet away.

I honestly don't know what to expect for our patient, coming in with a disease process as advanced as his. Say a few prayers, would you?

On a random note, I wonder if the rocking of the ship has much of an impact on the transducers for the art line and CVP. Thoughts?