Heather Chui's E- Portfolio

It has been a really stressful month for me. Hence, the reason I have not updated my portfolio for so long.  Someone very close to me passed away during my ICU rotation. It was a very big struggle to stay focused and complete the rotation.

Despite being preoccupied with my personal life, I did learn a lot during this rotation. When I worked in the dispensary, the ICU orders that would come down were daunting because I never know what all the infusions were for (NE, dopamine, dobutamine, etc)! I finally understand their purpose! It was very amazing to me how some patients would be so sick that they were ventilated and on vasopressors and then a week were well enough to be transferred to the ward!

I also developed a new appreciation for acid/base disorders. Curtis went over numerous blood gases with me during the rotation and I’m finally able to interpret them and identify potential causes. Although I think I still need some more practice on it.

One of my goals for residency this year was to broaden my knowledge of infectious disease. For example, bugs that aren’t covered by pip/tazo are E.faecium, S.epidermis, MRSA, and Stenotrophomonas. We also ordered procalcitonin levels in some of the patients with infections. This is a protein that becomes elevated in the preseence of bacterial infection. Based on the procalcitonin level,  you can use that to deteremine whether you want to start antibiotcs, continue with antibiotics or stop antibiotics on patients.  Right now it is still restricted to the ICU but hopefully in the future it is something we will be able to use on all the wards throughout the hospital.

Overall, I really enjoyed being able to round with the team and even got to know some of the nurses,RTs and intensivists. By the end of the week, I was getting asked many questions on the ward. I owe Curtis a lot during this rotation because he was so understanding of my personal hardships. He even altered the rotation so I could focus on actually working up patients rather than stress about a case presentation (which we ended up omitting). I ended up making a table on antipsychotics for the treatment of delirium in the ICU. Apparently this might get posted on the VIHA Pharmacy Intranet page! I’ve attached a copy here:  antipsychoticsdeliriumICU.