a week in the PICU (read: pick-you)

the second week of june was spent in the PICU, or the pediatric intensive care unit.

the PICU is a section of the hospital reserved for seriously ill children whose medical needs require intensive monitoring and support. kids in the PICU are placed there, generally, because they need pressure support (i.e. they’re breathing with the help from a ventilator), constant heart/blood pressure monitoring, or because they are sedated (i.e. medicated until unconscious).

while i was able to see a lot of interesting cases and receive an introduction into the MNT (medical nutrition therapy) of critically-ill children often with multi-system failures… i also learned that the PICU is not for me.

my preceptor (MP) loves the PICU because of the critical importance of nutrition in the health and healing of these patients. she is constantly reading a patient’s lab values (electrolytes like sodium or chloride, minerals like calcium or phosphorus, or enzymes like alkaline phosphatase or creatine kinase) that signal whether or not an organ is working properly or that aid in the assessment a patient’s nutrition status, healing progress, or tolerance to feeds.

monitoring a patient’s daily and sometimes hourly course is absolutely a necessity for a PICU dietitian; however, this places her in front of a computer screen for hours reading laboratory values, culling through research to decide upon the best plan of care, and writing chart notes. often the only human interaction the PICU RD has is with the medical team to discuss the disease state or nutrition interventions.

while this is exactly what some RDs are looking for (my PICU preceptor especially), this internship has showed me that while i like researching and writing chart notes, i also love and need patient interaction.

if a PICU child is intubated and sedated (on a ventilator and knocked out by drugs), there is, obviously, very little patient interaction happening. parents are often in the rooms and can offer a bit of a human touch, but mostly the child is so acutely ill that parents rarely bring much information to the table past being an historian (i.e. telling us about the child’s past medical history).

i absolutely learned a lot about treating the acutely ill (and a lot about what i don’t know), but the PICU life may not be for me.