I work in a combination unit CCU/MICU 7pm to 8 am. This is basically my day:
19:00 to 19:30 get verbal report from day staff,review moniters, ***** ***** ***** about various things. Check to see if there are now orders that need to be done right away. See patient #1. Prioritizing is the key here, see the least sick one first, teh sicker one will take up more time initially. Meds and initial assesment. now it's about 20:30. See patient #2, meds, asssesment...,now 21:00, see patient #3 if there is one. I contantly glance at the moniters to make sure everything cool. Check again for new orders, we usually don't have a secretary. Start filling out the flow sheet for the next 24 hours, start baths... Call docs, deal with family phone calls, get ready for a transfer or admission, suction at least q 2 h, moreif necessary, t&P q 2 h, vitals q2 for stable pateints, more frequently for less stable. In between going pt to pt. i complain about where i live, my damn sinuses, and why the 94 yo multiple system failure pt isn't a dnr/dni and that i will haunt anyone who keeps me a live if it were me. Wheni get a break i usually eat somthing and go have a cigar or go to visit friens that work on the floors and thank God that i work in the unit on not on the floor anymore. 0400-0500 I draw my labes. 0645 put labs valuse in chart. Pretty musch do the same till 6 am than its med time again, get everything in order for next ship, get people preped for angio or surgery, fill ina ll the paperwork that needs to be done, chart... 0700 ***** that day shift is late again. 07:15 give report, make sure everything is signed off leave about 0800. Thsiis a night when everyone is basically stable.
Part of our assemsnts are: draw labs, start iv's make sure peolpe are sedated properly, not too much, not too little, suction, draw abg's get cvp reading, get swan reading, if they have one, which is rare. dressing changes, wound care, constantl;y listening to breath sounds, q 2 neuro check on stable medical patins, 1 per shift on cardiac, q 2 outputs. Call docs to reprt labs, recomend interventions to docs, change/maintaing drips... road trips if there are any, but days usually gets stuck with those. Thats all i can think of right now.
Of course this is all on relativly stable patients, it's all different whne sombody crashes, for example, we coded a 49 yo guy for 2 hours a few days ago, doc was a little too gung ho on this one, his pulplis were blown after the 2nd time we got him back.
Oh i forgot, according to some on day shift all we do is sit around and eat pizza, so ther's that too.
Feel free to email me if you have any specific questions