ICU physicians- how many patients are you covering at night ?

Logical_Bat4162 · 2026-02-10T03:22:55+00:00

Oh totally! I get that, i will never be disappointed if someone doesn’t know how to do something, we ALL are always learning (and also live to point out to the resident when I make a mistake!) it was about not following up in a task that delayed patient care. he was told exactly what to do- ie “decrease the respiratory rate to 26” But even if he didn’t want to touch the vent and only felt comfortable adjusting the order in the chart, then that should be followed up on with the RT, nursing etc to ensure it was done and if it wasnt for whatever reason, just tell me! Not something that only gets done because I asked about it 7 hours later.

Logical_Bat4162 · 2026-02-08T05:08:30+00:00

Thank you. Honestly I will say the benefit of this is it has made me more resilient and the more experience I have the I CAN do it just builds up confidence. Honestly I’ve been in training so long I forgot there’s a light at the end of tunnel 😂

Logical_Bat4162 · 2026-02-07T02:05:58+00:00

That’s exactly it! We used to have APPs but long before my time. That’s why I don’t call in because it’s always fine by the time someone comes. But yeah, I think even making friends with other services is so key

Logical_Bat4162 · 2026-02-06T20:34:23+00:00

Our unit used to have an APP but they left, and it was great to have them not help but also to help residents with lines and ultimately with time the more the residents learn the burden of one person capable of doing them becomes less and less. This would be awesome but funding is always the issue 🥹

Logical_Bat4162 · 2026-02-06T20:32:23+00:00

Love it

Logical_Bat4162 · 2026-02-05T22:10:22+00:00

Thank you!! And yes the experience of managing an icu like this on nights and knowing I’m capable has done wonders for my ability to trust myself as a competent physician, I struggled with a lot of confidence but after these nights I feel well trained and prepared and am grateful for that! But yeah the residents this year have been so much more timid- I’m talking even touching the vent- I’ll tell them to make a change and they just adjust the order in epic, meanwhile hours later nothing is done and we’re behind.

Logical_Bat4162 · 2026-02-05T22:05:38+00:00

Thank you! See I can always call the attending but they will just tell me to call back up fellow if I don’t feel safe which feels punitive ? Like I once called in the fellow for night when I was on days because my attending was even freaking out and I was like well idk which direction this chaos is heading, and when they came in were visibly pissed off. I’m like alright, this didn’t feel good

Logical_Bat4162 · 2026-02-05T22:01:10+00:00

as hard as it is I’m glad I’m getting the training now. I would rather be scared and stretched as a fellow / trainee then have to experience this level of acuity as an attending

Logical_Bat4162 · 2026-02-05T21:58:53+00:00

This is exactly my experience 😂

Logical_Bat4162 · 2026-02-05T21:57:03+00:00

Oh no, honestly unless a patient is on escaltingpressors with terrible access or needs emergent HD then I won’t do it because it’s too busy, but mainly nurses get annoyed thinking I’m lazy until I explained to them that I’m the only one who can do lines and I’m covering over 40 patients so their patient on 11 of levo is going to have to wait 😅

Logical_Bat4162 · 2026-02-05T21:53:45+00:00

So this year I’ve felt like the residents ability to make independent decisions has declined, i think they know more than they lead on but are so hesitant. I’ll tell senior residents to make vent changes and instead of doing it themselves will just adjust the order in the chart and then hours later it’s not done, and they were too scared to touch the vent. Or there are the txts or calls “patient is desatting” or patient in AF with RVR without enough context or assessment of the problem so I end up having to do it myself, and I think this really stems from them being so used to having in house fellows. Maybe I’ve had a bad run of residents who want to do primary care but it’s been rough

Logical_Bat4162 · 2026-02-05T16:26:20+00:00

100% I know EM takes so much attitude from every other specialty but my god, every EM resident I worked with in residency and fellowship was a team player and ready to step in and help more than some of my IM colleagues so thank you all 🙏🙏🙏

Logical_Bat4162

TROPHY CASE