 You know, and we're in there like doing stuff, we're trying to put in lines, we're trying to get to deliver medication, we're giving him bicarb, we're giving him like D5, like it's just, we're just trying to like save his life. And ultimately like we weren't able to because his injuries were so extensive. Oh, doing my dance, hey. I'm doing my dance, don't mind me. I'm doing my dance. What's up you guys? So Donna, welcome back to my channel. Thank you guys so much for joining me on this journey. If you haven't already done so, take some time, look at my channel, see if you like what you see. And if you do, continue to join me and support me by hitting that subscribe button and also the notification bell so you can know every time that I come out with a new video. This video is going to be the juicy details on everything that I did in my ICU rotation. So I did my ICU rotation as my inpatient medicine rotation. It was one of the core rotations that I required for graduation through PA school. And I chose ICU because I figured that it would be pretty intense and I would learn a lot. And I was absolutely correct. So in my ICU rotation, they worked three 12s a week, which is pretty, it was like, when you're dealing in the ICU, like that's a lot. Honestly, like it's a lot, it's a whole lot. Like it's very, very, very draining being in the ICU. And I swear, like those three 12s felt like, I don't know, you know, two to three 24s type of thing. It's day in, day out. Usually I did them back to back so that I would have like a five day weekend, essentially. And I needed it. I needed that weekend because it was really draining. I would start my day off pretty early, around like 540-ish. I was able to like just get myself together and then get my daughter together and make sure that she was ready for school. On the days that I would drop her, I would drop her off pretty early to school. But for the most part, I couldn't drop her off to school because I had to be at the ICU for seven o'clock. So the day started at seven. But you are getting there a little bit earlier, like, you know, 630 or so, because you wanna make sure that you're able to see the print out of the patients. So then we'll do sign out at seven, from seven to 730 is sign out. And they would literally go through all of the pods. There were three pods in our particular ICU that I did, over 20 beds in all of the ICU. And we would walk through and they would give a report on each of the patient, like how they were doing overnight, if there were any events overnight. If not, you know, what is the plan to continue on in the future? If there were events, what adverse effects or what changes happened? What medications, new medications are they on? How much of it? And then what are the plans again in the future? So we'd run through that early in the morning and then we'll like go quickly, get something to eat and then meet back around like 815-ish for rounds. So as the PA, the PA, they did trauma ICU. The residents and the med students, they did the medical ICU. So they dealt with the medicine aspect of things because they were all like internal medicine residents. And then, you know, the med students that were coming from that school as well, they went to the medical aspect of it. The PAs and the PA student, myself, we did the trauma ICU. So the majority of the patients that we saw were trauma related. However, I did, like I said, all the time, like you guys have to carve out your own learning experience. So all of the time, like I would do stuff with the PA and the trauma ICU aspect of things, but I would also go and ask, you know, like the attending on duty that was doing the medicine aspect, hey, you know, are there any like interesting cases? Can I see, you know, some of your patients, that kind of thing with the med student? Just because I wanted to make sure that I got that aspect of it as well, because on my end of rotation exam that I would have to take for this rotation, I'm not only gonna be seeing trauma, you know, I'm gonna actually be seeing people that are coming in with like your endocarditis. And this is where I saw like my classic endocarditis, like this lady came in, you know, we're like, what's going on? Does she have like AIDS or HIV? Like GCS was really, really low. And we're like, what's going on with her? She recently had like a dental procedure. And then all of a sudden now she's altered. And then we do like a CT scan and we see like these lesions on her brain. Like we're like, what is going on? And it came back to be endocarditis. And so classic endocarditis, I would not have been able to see that had I only been doing my trauma. But don't get me wrong, I love trauma. So after we came back and we would do rounds, let's say there was like 13 patients each, 13 or 15 patients each between the medical side and the trauma side. So there's a trauma attending and the PA that are seeing all of the individuals in the trauma ICU. So we'd go through, we'd look at them, we, you know, we got a lot of like MVCs, a lot of falls, we'd have some falls, but the majority of them was either motor vehicle accidents or motorcycle accidents that would be flown in or are busted by the ambulance. So we'd go through, we'd see them had a lot of spinal cord injury individuals, anterior and posterior cord injuries. So they're, you know, we're treating them differently. We're making sure that everybody, like for the most part initially is on like precedence, you know, cause we're trying to make sure that we're able to like sedate them enough to take care of them, help them, help their body to just get better. But also at the same time, making sure that, you know, they're not super agitated cause if they have a trachin or if they have a pagan or if they have the tube, the ET tube or something, like we don't want them like fighting us off. So that was like all, all of that. And in the ICU, like you have to be really good with like acid base disorders because, you know, a lot of these people are on like the ventilators. And so you're trying to make sure like, hey, like do we need to up the peep or lower the peep, which are all things that I'm still like super vaguely familiar with. I still need to do a lot more learning. I'm sure if I had more experience in the ICU, I would get that. But those are things that they're talking about. As we're going through our rounds and we're seeing each patient, maybe a patient needs central line placement or an arterial line placement or a bronch. So these are the procedures that the PA would do. And we also had one NP that was working in the ICU as well. The majority of them were PAs. And I like, this is where I got the most of my experience. It was this and trauma, but it was great, you guys, because I literally was in there like doing central lines, you know, obviously. So we did like a couple of subclavians, but although that is like the best place, you know, you want the subclavians, the best line is the clean area. It just has the most risk of, you know, complications because the lung is right there. And so you could puncture the lung and you don't want to give your patient a pneumothorax after they're already in like critical condition. So they used, we got really good. I got really good at using the ultrasound. So they did a lot of ultrasound guided like femoral lines. As far as arterial lines go, that was just like free hand sticking, you know, like you touch, you palpate, you feel the radial artery and then you put the line in. Once you see that blood come up into like the little catheter needle and then it will go back down. And then you know that that is, you're in the right spot. You're not in like a vein. You're in the artery because you'll see it pulsing as well. It was pretty cool. I love that. I got, you know, initially, like I was kind of shaky on arterial lines. I'm like, man, like, where is it? But then I would get it. And I was like, yeah, so I got it. So excited about that. And I also, like I said, got to do a lot of femoral lines, like super a lot. Obviously it's not like the best place. You only want to leave it in there for like what, maybe about three days. We try not to leave the femoral lines and they're very long. I think it was three days that they were doing it because it is a dirty area. So we'll put in the femoral line to make sure that they're able to like get their medications or things like that that we can draw from because there are some lines that you can draw from. But apart from that, it's out in like two days. And then we try to do something else. And I got also really good at doing pick lines with ultrasound as well. So I had a great experience with that because once we did our rounds, then it would be like, okay, these patients need lines. This patient needs to be drunk. This patient needs this or that. And we would go through and we'd run through all of our procedures. And for the most part, the procedures time, like, you know, we go through our rounds and let's say we're doing rounds from like eight to 11. And so we would start maybe a procedure around 11. We go take lunch at 12. And then we'll come back and finish off all the rest of our procedures. As a PA student, we're not able to do any notes on the patients that we've seen, but, you know, the PAs and the physicians have to write up notes. And so the rest of that time, like from maybe three on to seven o'clock at night because they're 12 hour shifts, they would be doing notes. And, you know, if we have like a patient on the fourth floor who's like in our intermediate ICU, then we'd go up there. But it's like it's just kind of after the morning rush of things, the evening is a little bit more of a lull. And that's when I'd be like, okay, so can I go see like the medical patient or go study or things of that nature? But it was really interesting. I mean, there would be times when you'd have a trauma busted downstairs in the trauma unit. And then we have to go see them as well because likely they're coming up to the ICU. So that was also something like anytime, like traumas were called, depending on the level of the trauma, we'd have to go down to the emergency department or the trauma bay and see those patients as well because we'd likely see them. And I distinctly remember like, one case I got in there, it was like a Sunday morning very early and there was a trauma called all of, you know, the ICU had to go down there, like our trauma ICU had to go down there. We were literally going through like just kind of giving this guy by car and stuff because he was a motorcycle accident. And like there was just so many broken bones and nothing that was open, but essentially he was just losing volume. You know, and we're in there like doing stuff, we're trying to put in lines, we're trying to get to deliver medication, we're giving him bicarb, we're giving him like D5, like it's just, we're just trying to like save his life. And ultimately like we weren't able to because his injuries were so extensive, but that was like literally 7.30 in the morning. We didn't even get to complete our, you know, our rounds or sign out. We literally just had to run down there and do that. For those of you that are interested in critical care, you're excited about like, you know, just doing procedures and then kind of also having that rush of adrenaline and things like, it's a good option for you. Critical care is a good option. It's very stressful though because your patients are critically ill, but it is a good option. So, you know, just look into it a little bit more, but that would pretty much be my day. I literally started at seven, I would end at seven-ish sometimes, you know, something might happen to a patient and then we have to go a little bit later until like 7.30 or sign out my goal a little bit later. But I did the majority of my shifts during the day because they didn't have like an overnight suite for the PA students only for the PA. I learned a whole lot. I learned how to really do my procedures. I did like suturing on that rotation, but not really a lot. Like the suturing wasn't like what I did on my trauma rotation or I'm actually suturing up lacerations. It was more so like a drain stitch for the anchoring of the central line. And that's really like the extent of the suturing that I did. But I also got to see a lot of innovations done, a lot of like people on ventilation. So learning how that machine works and you know, what happens if I up this, up and lower that, like all of that stuff. So if you were a respiratory therapist and you still want to be in that role, then the ICU being an ICU PA is for you. If you kind of want that like adrenaline, it's also for you, but yet you'll still get a few minutes of downtime. So those are some good options for you to look at if any of you are interested. If you have any other questions for me, you know what to do, leave it in the comment section below. If you haven't already done so subscribe and follow me on Instagram at AdanaPA. And thank you guys so much for watching. I will talk to you guys next time. Bye.