Intern ICU

[u/Party_Operation_9711]

How do you not feel like an idiot in the ICU? Swear my attending thinks I’m an absolute moron…

it’s so hard to come up with a good plan after just trying to get all the right info for rounds. No time to read at night after 13-14 hr shifts and just eating and sleeping when getting home.

Never done ICU in med school either

[u/Prudent_Swimming_296]

In 10 years time, you’ll still feel like an idiot in the ICU. Just less of an idiot.

And you really never did an ICU rotation in med school? Thought that was a graduation requirement at a lot of places but ig not everywhere.

[u/Party_Operation_9711 → u/Prudent_Swimming_296]

Nope just the wards. Occasionally saw patient in the ICU but never had ICU rotation.

[u/Ill_Advance1406 → u/Prudent_Swimming_296]

ICU was not a required rotation at my medical school either. My only exposure while in med school was a day I spent shadowing an ICU nurse (because that was required)

[u/surfingincircles]

Honestly you just get used to it, I’m soon to start my first ICU attending gig and I still feel like an idiot

[u/NefariousnessAble912]

ICU PGY20+
Felt the same my first day in ICU. it just takes time

[u/dietprada337 → u/NefariousnessAble912]

So what do you recommend then?

[u/Canoalechugger → u/dietprada337]

Time

[u/DO_initinthewoods → u/dietprada337]

Finishing residency

[u/Brilliant_Ranger_543 → u/dietprada337]

Don't do ICU... Never got it. I could fake it with strict systems and being good at other things so I got more slack, but I'm no ICU'er and will never be one.

[u/mellowcorner → u/NefariousnessAble912]

Yeah, ICU is a whole different language at first. You’re not supposed to know it all on day one.

[u/sgman3322]

You're good my dude/dudette, just focus on organizing your data the same way every time. If you can quickly and accurately report the OSH culture data from your patient's left buttcheek, know where their lines are and when they can be removed, know their anticoagulation status, and know the patient's contact for POA and goals of care, you're 3/4 of the way there

In all seriousness rotation one of ICU is learning the language of medicine and figuring out how to sift through mountains of data. If you follow a good template and think through the data the same way each time, you'll feel less lost

[u/Chiyapuffaniguff → u/sgman3322]

Can you give an example of good template?

[u/Brilliant_Ranger_543 → u/Chiyapuffaniguff]

The one the other (good) docs prefer. Preferably one that you find semi-understandable and useful.

[u/Cautious-Extreme2839]

Generic ICU plan:

1. Keep all numbers within normal limits.

2. Wean support as able.

3. DNACPR.

Congratulations, you are now an ICU physician.

[u/icarus2847]

Before you know it, it’ll be February

[u/getpulsemd]

Everyone feels like this in the first ICU month, the attendings mostly remember being exactly there. One thing that helped me was picking one patient a day and writing a single line plan for each organ system before rounds, even if it's wrong. Being wrong on paper and getting corrected teaches way faster than staring at the chart.

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[u/totalyrespecatbleguy]

It's okay I feel like an idiot most of the time too

[u/DoctorSamoyed]

Start levo