I'm used to rounds. Every morning in the TG NICU, the outgoing neonatologist rounds with the incoming neo, the team leader (TL), pharmacist, and care coordinator. Each baby gets talked about, each chart gets pulled, and each RN has that small moment of undivided attention to ask the neo to put in or clean up orders. I've been spoiled really. Having an attending, the neonatologist, on the unit 24/7 is a luxury. Even if asleep, he/she is literally a phone call and/or door away.
Rounds at Children's is much, much different. There are residents, med students, ARNPs, and if lucky to catch them, attending physicians, that round on my patients. It's by luck that I see them coming down the hall in their surgical scrubs, white coats, and COWs (computers on wheels). If I'm not so lucky, I get a phone call from a kind soul telling me that they're one room away from my patient. Usually I'm not so lucky, and I'm either doing a sterile procedure, or something relatively important. I'm finding it's hard to find enough hands to pick up the phone in my pocket. Bluetooths; they should give us bluetooths. I am finding that I somewhat have a say in the plan of care of my patient in the rounds at Children's. I'm reminded that doctors were students once themselves; and actually quite enjoy working with the new residents. Physicians are humans too :)
Yesterday, I got an admit from the ED at 1530, smack dab in the middle of my lunch. This admit should have gone to the medical floor, but due to overflow, was put on our surgical unit. Two hours later, I was finally solidifying orders with the residents from the Medical Service. For those two hours, I was in the patient's room with the medical, dermatology, nephrology, and infectious disease teams. This particular patient had an autoimmune disease that was exhibiting some very odd symptoms. I felt like there should have been a video camera in that room; obviously an episode of HOUSE was being filmed. I was SO interested in the physician's conversations as the residents pulled in their attendings and other services to weigh in on this patient. I knew that I had to be there though. There was no way I was leaving that room until I heard from the resident's mouth himself what he wanted ME to do. Needless to say, I didn't mind missing lunch, I was too distracted and interested in what I was seeing to remember my rumbling tummy.
The day before I had a ventriculostomy patient. A ventric is essentially a tube coming out of your brain, draining cerebral spinal fluid. SO interesting. Previously, I couldn't think of anything more satisfying that ETT suctioning little neonates in the NICU. Gross, I know, but pretty dang cool. BUT, draining this ventric is definitely up there! A drain, coming out of the ventricles of a 2-year old, draining crystal clear CSF. Every hour, I would check the level of the drain with a nifty laser beam. Every two hours, I would drain the CSF out of a little collection chamber. I was mesmerized. Gross, nerdy? I know. It just tells you how cut out I am to be a nurse.
All this to say, I am learning so much shift by shift at Seattle Children's. While the NICU still holds my heart, I am so thankful to be continually learning, continually enjoying what I do, and hopefully continually somehow positively touching the lives of these very sick, very vulnerable little children.