HOME BASE:
You will be based in 4700. There is no "call room", just 5 nurses stations with first-come, first-serve computers. Your patients, as expected, are almost always in 4700 or 7200. Your patient list can be accessed on epic on patient handoff tab but a medicine resident will have to add the MICU black or yellow team to your account.
TEAM:
The attendings will change once a week (Monday-Sunday). You will share the patient load with 1-2 other interns and two 2nd year medicine residents. There is often a pulmonary critical care fellow who will round with you and may occasionally even round with you alone in place of the attending.
THE SCHEDULE:
The schedule is less intense than some other rotations but you still have a lot of call. They SHOULD email you your schedule before the rotation starts but they have forgotten to do that for some people, in which case you’ll need to contact the medicine office to get the schedule. There are no days off during the first few days so that everyone can get adjusted to the ward and figure out how things work.
Then you will fall into a Q4 call schedule that consists of:
You admit on both short and long call days.
CALL ROOM: None
DAYS OFF: Every fourth day off after the first 5 days of the rotation (average of 5-6 days off)
TYPICAL DAY: Rounds typically start at 8am but some attendings prefer to start earlier. The senior who is post call/ admitting overnight will round first so they can go home.
5-7am: Pre-rounding
8-Noonish: Rounding with the attending
Noon-6pm (short call) or 8pm (long call): Finish rounds, complete procedures, follow-up labs and imaging, admit patients
Paperwork:
All lists are on epic and under patient handoff
REVIEW: Sepsis, shock, stroke, GI bleeds, anything/everything pulmonary including ventilators and pulmonary catheters, electrolyte abnormalities, strokes (ischemic and hemorrhagic), vasopressors. Know your ACLS pathways, you may run codes while on MICU.
PROCEDURES: You should get a fair number of central lines on this rotation unless your seniors are pushing to get them. Arterial lines are abundant. Intubations occur occasionally. How many procedures you get will depend on the fellow. They likely will have done few intubations and central lines themselves so it can get competitive.
WHERE TO FIND COFFEE: 4700 nurses break room. There's also hot chocolate and graham crackers/peanut butter if you're on Bland rounds and starving.
PEARLS: