Morning guys, I'm Siobhan, a second year internal medicine resident.
But today, I just got to the hospital and I'm not here as a doctor. I'm actually here to be shadowing an ICU nurse.
(Siobhan) Okay, gotta find Amy now, uh, here she is.
(Amy) Good Morning! Good morning, Youtubers
(Siobhan)Thank you so much for having me along today.(Amy) My pleasure (Siobhan) So my plan is not to slow you down at all
(Siobhan)In fact, I'm gonna learn and hopefully you'll put me to work. Because I actually want to see what you're doing. (Amy) I think you're gonna be a great helper
Alright, so what we start off doing this morning?
So the first thing I do is I get report from the night shift nurse
So I got report on the two patients and then we just get organized for the day
(Siobhan) First thing is to check out the morning blood work. Actually the same thing I would normally do as a doctor
(Siobhan) Luckily, there were no major issues, so we didn't have to page for the poor on-call resident
(Siobhan) Next, Amy's going through and figuring out which medications need to be given at what times?
(Siobhan) This would probably be a lot easier if it was all automated on the computer, but we're not quite there yet.
Oh, hey, how are you?
(Chen) I'm good, how are you? (Amy) I'm good, thank you.
(Chen) Hi. (Siobhan) Hey! How's it going? I'm really excited today.
We actually have somebody allotted to organize breaks so we can all try and get a break today
So the code pagers are...
Dianne on the other side and Christine on this side. All right. Thanks Chen.
All right, so we're on third break.
Okay, I'm already liking this. As a resident we're always, I think I'm always a little bit jealous that you guys get...
Scheduled in breaks, we find time to have breaks and even all sorts of things but having it organized is really nice and you're guaranteed some time
(Siobhan) Okay, now let's head over to our other patient and organize the their schedules for the day
(Siobhan) There goes the code blue team.
(Siobhan)I jumped to my feet when I heard the code blue. It's so weird not to go running with them
Now the job is to get the code blue room setup. So if this patient
Survives, needs to come down to the ICU, we need to get room ready for them
(Siobhan) Brian one of the respiratory therapists is getting equipment ready. So the patient can be placed on life support immediately
(Siobhan) What's that for, Amy?
It's a slider board, so that we can slide the patient over from their bed onto our ICU bed
(Siobhan) No breaking your backs (Amy) Don't ever break our backs
(Siobhan) The room's ready, but sadly the patient didn't survive long enough to make it down to the ICU
(Siobhan) So, we switch gears and we're heading back to our patients now
C'mon down, Kathy. We're just gonna finish off our quick huddle. We are fully staffed today, yay
(Siobhan) So this is the huddle and it's a time for nursing and respiratory therapists to get together and talk about active patient issues
(Siobhan) For instance, it's important to know if there's a sick patient around the corner from you so that you're ready to pitch in and help at moment's notice
(Siobhan) Next we're heading in to assess our patients, which is really similar to what I do as resident
(Siobhan) So asking questions about how the patient is feeling and doing a physical exam. Okay, so the patient doesn't have a bedside table
So I don't know how she is supposed to eat. So I'm gonna go hunt for one
Don't see next one over- Looking for an extra bedside table. No way. Yeah hot commodity
(Background) Yeah
Okay, we'll try to find one
(Siobhan) Whoo-hoo. Okay. Got it. Honestly, that was not as easy as you would think
It's perfect little powder so I can mix it with some water and put it down a tube
(Amy) Okay, round one
Okay, so all the medications have been given and
(Siobhan) We've signed off on everything, you know, it's all about the dreaded charting (Amy) The charting, not a big fan of charting
(Siobhan) I don't think you're the only one I hear this from pretty much everyone. (Amy) Oh, it's horrible
(Siobhan) So, I'm gonna experience the real deal. (Amy) You are gonna experience it
(Amy) We're starting with page one so far. (Siobhan) Oh gosh, how many pages?
You know what I've actually lost track of how many but I'd say close to 25. Oh my gosh, okay
(Siobhan) I'll be counting (Amy)On one patient and we have two
Are you serious?
(Siobhan) Okay, that's so much worse (Amy) So we're gonna power through it
(Siobhan) Okay lets do it, lets do it (Amy) Because we got rounds in like fiveish minute
(Siobhan) You see the medical team right now, is just rounding that's right. It's like two patients away
Yeah, no one patient away we're up next now we don't know what to do at this point. We can wait
(Siobhan) They could be a couple minutes. It could be a teaching session. It could be ten minutes. (Amy) Yeah, they could be an hour. (Siobhan) Or an hour. Mm-hmm
Okay, so we're gonna assume that they're only gonna be a few minutes
So try not to engage into too much so that we can be available when they have it do them
Which is so nice cuz you know, I'm gonna do rounds without the bedside nurse is really not very helpful
True we like to think that
(Siobhan) Sorry, guys, you can't listen to this part
(Siobhan) But this is an opportunity for the whole medical team the nurses respiratory therapists residents and the attending physician to discuss each
(Siobhan) Medical issue systematically and then create a plan
Okay, you have now done rounds on our second patient and now it's break time, although it's only five to eleven
I guess it won't last that long
I'm going to do a coffee run or as you guys know tea run
I like my teas and I'm gonna get Amy a tea even though she said she doesn't want one
I feel like I want to thank her for allowing me this opportunity
My other big thing I want to do this today is
Start some IVs, and I know that sounds silly like I can put in central lines and I can do procedures
But we don't get a lot of practice with IVs, Nursing does all of them here, really
It's a skill. I think we need to have, so I need to practice
So, I think my favorite thing so far is just seeing the environment here with the nurses working together walking down the halls, people are saying
Oh, can I help you with anything? How are you doing? It's just a nice
environment and I don't know if it's just here in the ICU because
The nursing stations are set up outside patient rooms like this, or if it's like that in all of Nursing, but I don't know
It's a really great environment
Okay. So what we right now 12:30, how are we doing?
(Amy) Still a bit behind definitely, definitely behind in charting (Siobhan) Charting, okay
So personal care I guess i'm fluffing, you know spa days
Yeah, so patients get washed and cared for every single day, which is so important
and again just wanna look at her chest to make sure it's
Working well still, and we've had to make a few changes on the ventilator
So just kind of see how she's responded in terms of those changes to the ventilator
Okay, so you're gonna gather all the items that we need to do a complete bed bath
(Siobhan) Ooh, excellent
So start with the- all right
Okay, I think we're ready
(Siobhan) Perfect!
And the other thing we're gonna do, we're gonna sneak in here
(Amy) So we're gonna do a little shopping (Siobhan) Ooh
(Amy) So I know, were I the patient, she would like to brush her teeth. So, we're gonna get a toothbrush (Siobhan) Excellent
(Amy)and a toothpaste (Siobhan) Excellent (Amy) and...
(Amy) Her mouth has been a little bit dry. So I'm gonna give her this little spray
Okay, I haven't been part of this other side of all of the the patient care produ-, I'm usually waiting the other side of the
Of the curtain waiting for it all to get done so I can go into the patient. So getting in part of the action
(Siobhan) Caring for a person while they're so vulnerable is really a privilege
(Siobhan) I'm struck, by the way, Amy creates an environment of respect and dignity for the patient while still remaining efficient
(Siobhan) It also gives me a huge insight into how physically demanding Nursing can be
(Siobhan) Alright care done. (Amy) Yep care done. Beds have been given
Now... yeah, multiple times
Charted, multiple times
Multiple times and there's probably more to go
What about the other patient? We need to- anything going on?
Not really anything going on at the moment
We'll see, the other nurses kind of popped in to see if she needed some care done
But it looks like we have to deal with some hypotension in this room. Oh
(Siobhan) Oh. Low blood pressure, gotta go (Amy) Back at ya
Alright, so with that low blood pressure. We just went and um, I spoke with the resident, its' kind of funny
He's one of the first year internal medicine residents
So he's one of my juniors, but of course, I'm not in that role right now
So got him to come over and assess the patient and actually we ended up just changing the position of the patient and blood pressure came
Right back up. So
There's an easy fix which is always nice
Well, the pressure is low again
we just chatted with the resident and fellow that are on and
(Siobhan) They concur with us pressure is- (Amy) They'd like to give a bolus (Siobhan) Still low- bolus you guys what that is
That means we just give a bunch of fluid reasonably quickly and that should improve it. So, this will just go into them, perfect
Let's hope it helps
While we wait for the bolus to finish it's time to go and give our other patients some medications
soon for the propofol
propofol shipping
(Amy)Take one out take of our little portable pharmacy here. (Siobhan) Fantastic
(Siobhan) How many times have you done this?
Time for a lunch break now the second break I'll show you what the break room is like
So we have just about made it till 7 o'clock almost done the whole 12 hours (Amy) few minutes shy
And... Jessica who's the nurse that's taking over
(Siobhan) We're gonna give her hand over. (Amy) That's right. It's an exciting time for us because we get to go home. The end is near
This has been such a fun day. Thank you so much. There's something about your compassion and your caring not just to patients
Who are awake and talking to you, but the ones who are not conscious you give them just as much care and respect and dignity and it's really
Amazing- and the way you were with your colleagues. So this day has made me want to be better in to continue always
(Siobhan) Acting as you do in my career, it's really been a fantastic day. So thank you so so so much (Amy) No, thank you
I appreciated having you here. It was it was it was a fun day
(Siobhan) It was (Amy) A very educational informative day, but it was very fun.
So if you guys have any questions about
What it was like with, the role of nurses, you know, comment below we would love to hear about it
And maybe there'll be a follow-up video if there are a lot of questions, so bye for now. Bye