My second rotation as a resident is in the progressive care unit (PCU)… essentially a “step down” unit for the intensive care unit (PICU).
This patient population is a stark contrast to the veterans I treated last month. As an example, genetic disorders associated with abnormalities in anatomy, metabolic pathways, and predisposition to infection are clearly different from the management of chronic diseases like congestive heart failure (CHF) and chronic kidney failure (CKD) which I encountered last month at the VA. While some principles hold true, pediatric patients are not “little adults.” In many aspects, they have a completely different presentation for clinical disease. If an adult spikes a temperature, we take Tylenol and advance a workup accordingly. If a neonate spikes a fever, a full sepsis workup is in order. Very different.
I love the workflow continuity this rotation offers – no interruptions because of grand rounds, conferences, or morning report! Instead, the PCU interns have our own interactive lectures in the afternoon run by attending physicians, nurses, PAs, and other critical care faculty. This past week, we practiced changing out tracheostomies on a mannequin and revisited the finer points of septic shock and pressors.
I started the rotation on Thursday, so this coming week will be my first “true” week in the PCU. Here’s hoping I provide the best care possible for these critically ill kiddos! 🙂