sedation vacation

Day #1 on the Surgical ICU of Inner City Hospital. We should talk about it.

For starters, we can talk about how early 5:30a.m. is for someone who likes to stay up until 3 a.m. in the morning. (Hint: it's extremely early).

And later, we can have a stimulating discussion on how starkly painful/humiliating it is to go from moderate competency in one's profession to Complete And Utter Stupidity And Denseness literally overnight.

Then, we can move on to Jamie's work-to-sleep-hour-requirement ratio, and how I've magically and literally instanteously regressed not only in job performance, but also, in bedtime ( was in bed and asleep by 9p.m. on Friday after a twelve hour shift. This, my friends, is called "pathetic.")

Happily, although I know nothing about surgical neuro/trauma patients (where, oh where, did my sick hearts go?!) and even less about all the goobledegook they're hooked up to, my previous life as a stepdown nurse gives me the instinctive knowledge that all of our patients range in prognostication from "mildly fucked" (not intubated, but with 8 different drains coming from one area of the abdomen) to "severely fucked" (intubated, brain dead, and waiting for the organ donor people to come and harvest organs).

My patient was "moderately to severely fucked"--with a huge brain bleed requiring her to be vented.

And me? Well, I'd say I'm veering on the edge of "severely fucked" diagnostically myself. I've spent the better part of three hours tonight scouring the internet for ABG interpretation quizzes and mechanical vent setting information--desperately clinging to any little piece of information I can shove into the one or two brain functioning cells that remain in my dull little cranium that might provide me with an "out" when I get pimped mercilessly by my preceptor tomorrow about auto-PEEP and metabolic acidosis with compensatory respiratory alkalosis, or whatever.

I'm told they don't "expect anything" of me, but that sounds more to me like "you poor dumb bastard" than "we're the kinder, gentler ICU experience you've been pining about since you were a wee lass!"