Posts filtered by tags: Critical Care[x]


 

How my son helped me rediscover the art of medicine

When the pediatrician woke me at midnight to get a blood test from my three-month-old son, I knew things were serious. I should have known this already. Four weeks prior, my four-year-old daughter passed along a respiratory virus to my husband, me, and her brother. Her brother’s low oxygen level and inability to keep down milk […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Pediatrics, Physician, PA NP, Critical Care, CRNA


I fear that I’m not doing the right thing and I do it anyway

I fear that I’m not doing the right thing. You’re trusting me with your life. I hear you telling me that you don’t want me to do what I am about to do. I see it in your eyes, the resentment as you look toward your family. And hatred for me, your physician. You trust […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Pediatrics, Physician, PA NP, Critical Care, CRNA


Death: friend, foe, or something else?

The thing I think would surprise people the most is my relationship with death. I’m a critical care anesthesiologist. It’s an exciting, rewarding field – I tell my medical students and residents that it blends expertise in the human body with mastery over crisis. I started my career imagining every day in the ICU as […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Physician, PA NP, Critical Care, CRNA


How a physician breaks bad news is just as important as the bad news itself

Medicine is an art. One can learn about symptoms, diagnostics, and treatment plans for various diseases, from textbooks and journal articles. It is harder to study empathy, compassion, and human connection from conventional academic resources. The art of medicine is discovered, acquired, and absorbed on the job by interacting and connecting with patients and their […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Conditions, PA NP, Critical Care, Oncology/Hematology, CRNA


Being a neonatologist and a mother [PODCAST]

“Being a neonatologist and a mother is living with the knowledge that the question ‘What would you do?’ could so easily become real, not hypothetical.  And so what would I do? I don’t know, heartbroken mama. Because I feel too much, but I don’t feel enough. Because I know too well, but I don’t know […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Podcast, Pediatrics, PA NP, Critical Care, CRNA


Maybe life is happening: the power of language in patient hand-offs

“But if thought corrupts language, language can also corrupt thought.” – George Orwell The “difficult” family At 2 a.m., on my first night shift as a pediatric resident, a patient, Casey, transferred from another hospital. She had a rare, progressive chronic illness, was medically complex, and was currently receiving treatment for an acute systemic infection. […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, George Orwell, Casey, Pediatrics, Physician, PA NP, Critical Care, CRNA


Critical care physicians have been through hell

It was a cold winter morning in January 2021. Another day in the ICU, another day caring for critically ill patients with complex medical conditions, another day caring for patients on their death beds, another day interacting with patients’ families and their emotions, another day of putting on a strong face for my patients, their […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Infectious Disease, Physician, PA NP, Critical Care, CRNA, COVID-19 Coronavirus


An inability to emotionally deal with failure

General Douglas McArthur said: “However horrible the incidents of war may be, the soldier who is called upon to offer and give his life for his country, is the noblest development of mankind.” The soldier is trained to kill, and they learn to kill well, they have endured great physical and psychologic trauma and horror […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Physician, PA NP, Douglas McArthur, Critical Care, CRNA


Create a positive light in nursing

I was an assistant nurse manager (ANM) in a 24 bed ICU in my younger, energetic years. Before that, I was a manager in a very small emergency department. I must say, I loved it. I loved the thrill and the challenge. I was able to work with the Joint Commission; I ordered EKG monitors […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Nursing, Emergency Medicine, Joint Commission, ANM, Conditions, PA NP, Critical Care, CRNA


The aftermath of death

Drip. Drip. Drip. It’s 8:00 p.m. I’m staring at the IV tubing. We forgot to stop the fluids. I’m standing in the resuscitation room alongside the naked, broken body of a teenage male. Unable to break my gaze on that dripping IV line, thinking, We’re going to flood him. But it doesn’t really matter. Somewhere […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Emergency Medicine, Conditions, PA NP, Critical Care, CRNA


Surgical smoke evacuators and inertia in the time of COVID [PODCAST]

“Early in the pandemic, in thinking of and discussing possible solutions to help protect health care workers, two of my former colleagues and I recalled a device called the Surgical Smoke Evacuator (SSE), which we used extensively since the 1990s when we worked together at the University of Pittsburgh to collect and safely dispose of […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Podcast, Infectious Disease, University of Pittsburgh, PA NP, Critical Care, Anesthesiology, CRNA, COVID-19 Coronavirus


Understanding critical care in the ICU: then and now [PODCAST]

“I write this as a caregiver, patient educator, and clinical researcher. The coronavirus pandemic has shone a spotlight on intensive care units (ICUs).  Due to the rapid and continued increase in critical illness from COVID-19 infection, discussions about capacity and specialized equipment have become commonplace. Terms such as ventilators, ECMO, PPE, emergency use authorization, and […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more. ...
Tags: Health, Infectious Disease, Patient, PA NP, Critical Care, CRNA, COVID, COVID-19 Coronavirus


Dear families: We are strong, but we are tired

After 33 years as an ICU RN, I had finally decided I couldn’t do this anymore. It was my last nightshift. The last shift convinced me I had made the right decision. The CNA and I went door to door to turn each ICU patient that was not capable of turning themselves. ICU-06:  Mrs. Thelma […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Infectious Disease, CNA, Conditions, PA NP, Critical Care, CRNA, COVID-19 Coronavirus


Pay attention to science and medicine, or else you may be the next careless victim

I enter the hospital to work again. I must work as I have three small children and a husband presently out of work because of COVID. He is “non-essential.” A violinist is playing at the employee entrance. I know they do this to lift our spirits. But it’s a slow, sad string that reminds me […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Infectious Disease, Conditions, PA NP, Critical Care, CRNA, COVID-19 Coronavirus


I am an emergency medicine physician. I had COVID-19 infection twice and I’m tired.

I am a critical care and emergency medicine physician, I have had COVID-19 infection twice, and I’m tired. My first infection was early on in the pandemic.  I had to place a Blakemore tube in a young man who was going to die from his massive bleeding from cirrhosis.  I didn’t know then that the […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Emergency Medicine, Blakemore, Physician, PA NP, Critical Care, Hospital-Based Medicine, CRNA


I am an emergency and critical care physician. I had COVID-19 infection twice and I’m tired.

I am a critical care and emergency medicine physician, I have had COVID-19 infection twice, and I’m tired. My first infection was early on in the pandemic.  I had to place a Blakemore tube in a young man who was going to die from his massive bleeding from cirrhosis.  I didn’t know then that the […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Emergency Medicine, Blakemore, Physician, PA NP, Critical Care, Hospital-Based Medicine, CRNA


Do protocols and pathways improve care?

As I’ve written before, I have to confess I’ve never been a huge fan of pathways and protocols. They often struck me as rigid and insensitive to the nuances of differences between patients. There are also times when they are just absurd when physicians, especially mid-level providers, implement them when analysis of the clinical situation […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Conditions, PA NP, Critical Care, CRNA


Put your thank you into action: Wear masks correctly and avoid large gatherings

I have a video visit in the pulmonary clinic with one of my favorite patients. I ask her how she’s doing and wave to her husband sitting in the background of the living room where she is set up. Deborah says, “We’re good. We’re healthy. We are staying home. We miss our grandchildren and have […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Infectious Disease, Deborah, Conditions, PA NP, Critical Care, CRNA, COVID-19 Coronavirus


Scared to death and learning to trust

Cardiologists with national reputations were available at a hospital just an hour away. I had connections there and could get what I was sure would be better care for my mother than she would receive in the small hospital where she had been taken following a heart attack in her office. But what if she […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Conditions, PA NP, Critical Care, CRNA


Did we do right by her? Did we do right by her family?

She was dead when we walked in the room. Lungs ventilated, kidneys dialyzed, on pressors to maintain enough tension within her blood vessels to keep blood traveling to her brain and with a tentatively beating heart, but dead, nonetheless. The microbes had done their damage. Necrotic fingertips and toes curling and black, contractures sharply flexing […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Conditions, PA NP, Critical Care, CRNA


Understanding critical care in the ICU: then and now

Late one evening, an ICU physician calls a family to say Dad’s breathing rate had slowed to such an extent that he did not believe Dad would survive the night without life support. This seasoned doctor added that he had never seen patients come back from this condition on their own.  Although Dad had do […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Dad, Conditions, PA NP, Critical Care, CRNA


All intensivists are not created equal

I’d like to preface this story by saying that the majority of the intensivists I have worked with have been exceptional, caring, and professional. We had all established a good camaraderie, and we had mutual respect for each other. We worked well together. But there always seemed to be one that was the exception. And […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Conditions, PA NP, Critical Care, CRNA


Who could understand what it’s like to tell someone their loved one is dying? 

I sat outside my patient’s ICU room, my eyes glancing from his chart to him and his wife.  The picture was grim.  My patient, Tom, was a 56-year-old man, severely ill from decompensated cirrhosis, was admitted for the third time in a month with hypothermia from sepsis.  Despite antibiotic therapy, he was not improving.  Now […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Tom, Physician, PA NP, Critical Care, Hospital-Based Medicine, CRNA


Death still affects me. I’m not numb. I’m human.

It had been a long day. Our progress notes were done. The last scheduled case in the operating room was done, and it was time to wrap up loose ends and sign out my patients to the night team. But that’s when Room 4 died. I walked onto the Burn Unit. The nurses were frantic. […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Surgery, Physician, PA NP, Critical Care, CRNA


Reflections of a critical care nurse [PODCAST]

“Grandma Lilly is 87-years-old and in the ICU. She’s on a ventilator with her wrists restrained to the side of the bed. Grandma can barely see because her eyes are puffy: scleral edema. And her heart races: 140 beats per minute. Her blood pressure is low and Levophed and vasopressin drips are ordered. Her family […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Podcast, Nursing, Lilly, PA NP, Critical Care, CRNA


Apocalypse now: climate change, cardiac arrest, and the price of inaction 

It seems impossible that 2020 could have brought another existential challenge to life as a lung and ICU doctor. As COVID-19 broke out earlier this year, I found myself on phone calls with physicians practicing in far-flung areas, helping host regular calls and webinar to keep doctors in my state updated on the rapidly changing […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Conditions, Pulmonology, PA NP, Critical Care, CRNA


A nurse remembers her true hero

I had to earn my “stripes” in ICU. After I graduated from nursing school, the “big” hospitals wouldn’t take me into the ICU, as I had no experience as an ICU nurse. Back in the early 1980s, there was no such thing as an internship program. I desperately wanted to become an ICU nurse. So […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Nursing, Conditions, PA NP, Critical Care, CRNA


The act of being there for our patients is an act of love

She started crying. This tough, capable, juggernaut of an ICU nurse looked just a little broken for a second while she cried. “It’s not fair. It’s immoral—or unethical. I don’t know—I know it’s the right thing. We have to protect the patients and staff but … if it were my dad! I just … I […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Infectious Disease, Physician, PA NP, Critical Care, CRNA, COVID-19 Coronavirus


Our patients matter, but at what cost to our families? 

Is it possible to have it all?  Can you have a job that you love, helping people and using your brain and hands all at the same time; plus, a family, with a spouse and children, that you are always there for?  Is it possible to have a balance between your work and your family […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Policy, PA NP, Critical Care, Hospital-Based Medicine, CRNA


Why storytelling and writing are so important in medicine [PODCAST]

“They needed the final story to let go of her body, yet retain her spirit. Looking back on it, that’s when I saw the greatest honor of all — the everyday honor of storytelling for our patients. Maybe that’s the only cure we have for death … translating what happens from the body into the […] Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Tags: Health, Podcast, Primary Care, PA NP, Critical Care, CRNA