There are so many areas of critical care that could have faced me on the first day. My preceptor is not only one of the smartest physicians I know, but he started to challenge me from the start. On the first day we discussed some serious conditions, recognizing them, testing for them, and managing them. Ill be honest, I was a little overwhelmed. This rotation was not like any of the others that I have done so far. The level of medical knowledge needed for critical care is unreal, but respectable and admirable. Unlike some specialties, critical care is like internal med on steriods. In order to treat these patients, basic concepts need to already be first hand knowledge so that difficult cases can be handled quicker and more accurately. For example, a clinician in this area does not just need to know what pneumonia is and how to treat it, but he also needs to know what antibiotic to choose in a complicated patient, how to manage that patients' condition and maintain their stability. In many cases, the lives of these patients is in the hands of the clinician. It is crucial to make the best choices and discuss topics with the families. This is why I believe that I would need a lot of experience and training before I, as a new grad, could really feel confident in treating these types of patients. Nevertheless, I am still in the first half of my rotations and that thought may change as time allows.
These first two weeks, I have been reading chest x-rays and CT scans multiple times a day. Some clinicians just read the "impression" left by the radiologist and go about their day, but the physician I am working with likes to interpret them on his own, then compare and look at the impression. He believes that this is the best way to make sure nothing is missed. I know it will take me time as a new provider to sit and read all these scans, but there is something that I find fascinating about interpreting them. I am no where near his level of expertise (nor may I ever be), but after practicing with him, I cannot wait to start looking at them on my own and getting better at interpreting them.
Why I love this...
Critical care, in my opinion, is one of the most involved specialties. Providers need to know a lot of medicine in order to treat their patients effectively and independently. Obviously, treating sick patients and helping make a difference in their lives is a nice side of critical care, but I also love that there is a higher level of thinking involved in the day to day job. Yes, this job can be stressful, but to a different level, this job is not repetitive day-in and day-out with the same cases. There are many common cases that occur, but there is a higher level of care and management of these patients. Some of my classmates prefer less critical patients and rather work in an office setting, or even urgent care setting; however, I have a grown to a fondness of this type of critical setting.