From Wharton to Intensive Care

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I have to "stick" my patient to draw some arterial blood. Although the patient understands the need to draw blood, nobody enjoys having a needle stuck in. I then send the blood to the lab for testing.

1:25 a.m.—I finally get a chance to sit down and get a quick bite to eat. A pot of coffee is brewing in the kitchen. I wasn't a coffee drinker before, but ever since I started the night shift, I drink a cup to get me through.

2:00 a.m.—The nurse from the staff office comes up, and I begin to give her a report on another patient in Bed 2. She is an 79-year-old who is having a second aortic valve replacement done.

2:30 a.m.—The front door of our unit opens and the anesthesiologist and surgeons come wheeling the new patient into Bed 2. While I gave a report to the new nurse, other staff had set up Bed 2 with all necessary monitors and emergency medications ready to go. Just as we did during the admit earlier in the night, my fellow nurses and I work together as a team.

3:00 a.m.—This admission goes much better than the previous one. After the patient is hooked up to all the monitors and is relatively stable, I receive a report from the anesthesiologist, who informs me how surgery went. I then go into the room and do my normal assessment routine, making sure all monitors are working and that the patient is in a safe situation.

4:30 a.m.—The patient starts to wake up. I tell her she's in the ICU and that surgery is done. After completing a neuro check, I turn the sedation back on until I get new orders from the surgeon.

4:40 a.m.—I start filling out paperwork, charting everything that has happened thus far.

5:00 a.m.—Although the patient is somewhat stable, her cardiac monitor numbers seem marginal at best. Because of her age (79 years), this patient will probably be staying in our ICU longer than someone younger. The surgeon tells me to increase her inotropic medications to give her heart a little extra kick for now.

6:00 a.m.—My shift is almost over. I try and clean up the place a little bit. Nursing is a 24/7 job, so I don't want to leave my day-shift replacement a mess.

6:30 a.m.—The surgeon comes in, and I give him an update on the patient's progress. He tells me to titrate the sedation a little. The patient still currently has a tube in her mouth that helps her breathe. That tube will probably be extubated sometime in the early afternoon. She'll have to be awake for the extubation.

7:00 a.m.—I give a report to the day-shift nurse. Everything looks good so far. I personally think she'll have a good day, but you never know.

7:30 a.m.—I get in my car and drive home. Listening to the radio, it sounds like it's going to be a nice sunny day in L.A. with temperatures in the 80s. I'm not working tomorrow, so if I get up early enough, I just might head to the beach to catch the last remaining rays of today's sunlight.

8:00 a.m.—I arrive home. The first thing I do is get out of my scrubs and take a shower.

8:30 a.m.—After a refreshing shower, I make myself some "breakfast" (or "dinner," whatever you prefer). One of my roommates has just woken up and is making himself some breakfast, too. I ask him how his day was yesterday, and we chat for a bit while we eat.

9:30 a.m.—My roommate gets ready for work and is on his way out. I unwind a bit before I get to bed. I check my e-mail, read a little of today's newspaper, and watch a little TV (thank God for Tivo).

10:30 a.m.—I jump into bed and begin to think about my day. It's always nice to think about what went right and how I could improve. It invigorates me for the next day.

11:15 a.m.—I finally fall asleep. Some people have a hard time sleeping during the day. I am definitely not one of those people. I'm out until my alarm wakes me up in a few hours.

Although I did not need a business degree for the job I have now, I know that it will help me in the future as I progress in my career. There are so many opportunities that come with being a nurse. Many nurses stay at the bedside, where their experience and skill are unmatched and a necessity in all situations. Many nurses also go back to school and get a master's degree for various occupations, whether nurse practitioner or nurse anesthetist, MBA, or even an MD (see BusinessWeek.com, 8/7/06, "B-School is Hip Again").

Oftentimes, especially with the nursing shortage that the nation is facing, the problem isn't finding a nursing job but finding the right nursing job that fits you. I went through UCLA's summer externship program the summer before I graduated to give me a better clue as to which unit fit me the best. After spending time at UCLA's emergency room, operating room, and departments of oncology, liver transplants, gerontology, and cardiothoracic, I finally decided that cardiothoracic fit me the best right now.

If I had to go back to college and take more courses, I think I would take more history, psychology, or sociology classes that would help me understand human emotion and culture. Because when it comes right down to it, a nurse's job is to heal, not just physically, but holistically, and to understand human nature and provide compassion.

Patient information and procedures were changed to ensure patient privacy.

Oliver Chu is a gradaute from the University of Pennsylvania Health Care Management Program with a Bachelor of Science degree in economics from the Wharton School.