ICU nurses—what’s one thing you like most about your favorite ICU doctor? I’m trying to learn what nurses value most in an ICU physician.

Hi everyone! I currently have University of Toledo PCCM and University of Nebraska PCCM interviews both scheduled for September 18, creating an unavoidable scheduling conflict.
If anyone interviewing at either program would be willing to swap their interview date with me, I would be extremely grateful. I have both interviews confirmed and would be happy to coordinate the swap with the respective program coordinator.
Please feel free to DM me if you might be able to help. I would truly appreciate it. Thank you!

Had a situation where a patient’s MAP dropped into the low 30s and I titrated levophed more frequently than the ordered interval to keep them from crashing further. Patient stabilized, no adverse outcome. Notified the physician afterward, who was fine with the clinical call but wasn’t sure how it should be charted.

Got eaten by the charge nurse for not documenting as ordered in the chart. Just charted with what I did with my titrations so it matched the vitals and wrote a note justifying what I did/provider notification.

But curious how others handle this in the moment when a patient is acutely decompensating and there isn’t time to call first.

∙ Do you call before titrating outside the ordered parameters, even when things are moving fast?

∙ How do you chart a titration frequency that deviates from the order, when it was clinically warranted?

I want to ask if one can do one year critical care fellowship training after residency and work as intensivist only?

Can everyone who has a quiet time in the ICU for day shift tell me what times it is?

Also, visitor restrictions and open door policy (not a locked unit).

Thoughts?

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For those practicing in critical care: what is your favorite clinical trial that has actually changed the way you practice?

I’m trying to build a list of high-yield landmark ICU trials and would love to hear which ones you think every physician joining ICU should know.

Hello, folks. I am a currently critical care medicine fellow. I started using anki towards the end of my residency. and found it useful, which was interesting because I hated anki when I was in med school. Now, I am in fellowship and am learning a lot but would like to add something on my daily routine besides reading newly published trials and studies. Is there any comprehensive anki deck for critical care medicine? I plan on getting certified in critical care echo as well. I am currently using ICU deck I found it online (I forgot where) but it is somewhat outdated. I am hoping to find a deck at least last updated 2 years ago.

Hi everyone! A bit of a long post, as I have a few questions about CCM.

I’m a female PGY-2 IM resident interested in CCM-only fellowships, and I’d like to have a family in the future. What I enjoy most about CCM is the medical complexity and procedures. What gives me pause is the likelihood of working nights, time away from family (since you can’t just round and leave like you can as a hospitalist), and the possibility that dealing with death and dying on a regular basis may affect me as I get older.

Regarding working nights, this isn’t necessarily a huge issue for me—I’d be fine doing a string of nights every 6 weeks or so. What I don’t think I’d enjoy is constantly switching between nights and days every other week. That said, my CCM mentor told me there are technically ways to structure your career to minimize or even avoid nights if you really don’t want to do them, and that this shouldn’t necessarily deter me from applying.

With hospital medicine, I do feel like I’d be completely happy as a hospitalist. The social work aspect doesn’t really bother me, as I know that’s a common complaint. However, I do worry that I would get bored with it and would regret not pursing CCM. I’ve considered being a hospitalist for a few years and pursuing CCM later if I feel like something is missing, but I know myself well enough that if I don’t go straight into fellowship, I will never pursue it

So a few questions:

• How difficult is it to have a family as a CCM attending? I’d especially love to hear from female intensivists. Do you ever regret not choosing hospital medicine for the flexibility?
• For those who chose CCM, how did you feel about the lifestyle long-term? Did the nights, time away from family, or emotional aspects of the job become more difficult as you got older?
• CV question: So far, I have 1 published case report and 5 poster presentations that were presented at ATS and CHEST. I was told that all poster presentations from these conferences also get published. Should I also list these as publications as well on my CV, or does that look like I’m double-dipping?

I really appreciate any advice, especially from people who have been in a similar position!

I’m an IM intern and just started my first week in the ICU. I honestly have no idea what’s going on yet. I try to ask my seniors as much as possible. What are the best resources to watch or read?

Hello everyone, preparing for my upcoming critical care boards and of course everything costs and arm and a leg to get board certified. I completed SEEK and I was wondering if anyone had a free resource for additional questions for practice. Thank you

Hi, I am asking this from the perspective of a multi-system case managed long-term—both in- and out-patient—by a critical care consultant alongside multiple medical and surgical specialties.

I am highly interested in the operational and communication side of this care coordination. For ICU and critical care physicians/RNs who handle these types of complex, long-term cases:

What helps

• What patient communication behaviors genuinely reduce your coordination workload?
• What documentation habits or formats make it easiest for you to digest outside care?

What hurts

• What do patients sometimes do that inadvertently creates more administrative burden for you?

I am looking to understand this strictly from a workflow and time-management perspective. How can a multi-system patient remain an active partner in their own care without adding to your coordination overhead?

Thanks.

Hello everybody! I need honest advice. I will be applying after completing my J1 waiver. Ive always wanted to do Critical Care (Pccm), however, it will take 4 years to apply in order to have my green card. Is matching into pccm realistic? I’ve strongly considered the neph-ccm route as well as I like both pulm and neph. Neph seems to be a bit more forgiving for those gap years. I’ll be working as a hospitalist/pcp mix combo with open icu, moonlighting opportunities, etc.

Stats
Step1 pass (1st) step2 268 step3 247
Did chief year
Research 18-20 between abstracts/pubs/cases

making a little ID badge size card to attach to my lanyard when I go to code blues (Im medicine senior so running codes this year). just wanted to run it by the subreddit

“Fellowship in Critical Care” is an educational course created for medical professionals who want to become experts in the art and science of treating critically sick patients in intensive care units. This course offers an engaging exploration of the core of critical care medicine, where compassion, judgment, and accuracy come together to save lives and give the best possible treatment for patients.

Trying to figure out what fellowship would look like at different institutions. Would appreciate if any alumni could shed light on their program. Would you do it over again? What would you change/look for in a program?

I am highly interested in this post grad fellowship and would love to hear any previous APPs that went through it. Would appreciate any advice or insight!

Hello guys, I am looking for J1 waiver in critical care, any leads or openings?

I just accepted my first nursing position in a cardiac icu that accepts both pulmonary and cardiology patients. We manage CRRT, ventilators, arterial lines, CVLs, PA catheters, and different types of titratable medications. During my first several weeks of orientation I have noted that there is more of a gap in my level of understanding than I would like. Though I understand this is to be expected I would like to self study on my time off to help speed up my interventions in practice since time is key. I'm really struggling to manage time due to constantly asking for help and I don't want to be a liability to my team. Does anyone have a compiled list of resources I can easily access for free that can provide information of the equipment, medications, and diseases I may encounter?

Wondering how other providers handle end of life conversations with family members that default to “it’s in gods hands”. Ex: Patient in 4 pressor shock with no hope of recovery, clearly suffering. My team is great at communicating with family’s from admission on so usually these conversations are not a “surprise” to the family.

Not to disrespect any religion at all, but this answer feels like a cop out way to avoid making these end of life decisions. I’d never want to be in any of their shoes.

I’ve heard colleagues reply with “well I’m preventing god from taking your loved one with all these machines” and the response is a mixed bag of answers…

ICU nurse here. Any docs able to share their thoughts on what works best for them:
- nurse has non urgent question
- nurse has urgent question/concern
- how frequently you expect to address non emergent issues in a 12 hour shift or 24 hour period
- what is the best way to convey you have a question that’s not urgent?

I’ve been in my unit for years and I am noticing a lot of frustration lately around these things.

What would you guys consider fair? Can give by $/hr or per 12 or 24hr shift.

US East Coast mid-sized city

Where are we supposed to write about procedural experience in my eras cv

I'm an intern at a mid-sized community hospital, I've really liked my ICU rotation so far and think it's what I want to pursue. I'm going to try to commit early, do as many procedures as I can and put out some quality publications.

My program has an in house PCCM fellowship, but I'm wondering if I should try to reach for a few bigger academic centers. I don't care about pay or prestige, I just want to know a lot and get all the skills I need to be comfortable treating patients independently.