I had high hopes of enjoying “the easy life” of an upper level resident in the ICU. But it’s not turning out the way I had anticipated. I was looking forward to teaching and supervising interns performing procedures, having time during the day to mull over charts and get to know about patients, spending time talking to patient’s families which I had been much too harried to do as an intern.

The reality is that I spend most of the day doing “road trips”…accompanying patients out of the icu for CTs, MRIs and other procedures that take place outside of the ICU. While I have supervised several procedures, and performed a few myself, there is often only one upper level and five interns in-house on any given day. When I need to supervise several interns throughout the day, combined with the road trips, there is little time left to actually see and get to know patients. On top of all this, the new attending wants the upper levels to have a plan prepared for their half (8 of the 16) of the ICU patients prepared for morning rounds at 7:30 am.

I have no disagreement that the upper levels should be participating in patient evaluation and planning, but it’s next to impossible to do this with any level of thouroughness and consistancy for each patient we are assigned to. Meanwhile, the interns have only 1-3 patient each (because we’re ‘overstaffed’ with interns) and are expected only to collect numbers and enter then into the computerized ICU note system. UGH.

So the interns are doing clerical work, and the upper levels are expected to double see 2-3 times as many patients. And to add one final insult, every 3 days, the upper levels switch sides of the ICU due to our limited coverage (sometimes there is only one of us). So in addition to being expected to present the assessment and plan on 8 ICU patients after having prerounded on all of them, the kicker is that every 3 days, it’s an entirely new set of patients to see!

So the question is… am I just bitter because I spent 2 months as in intern on q3 call with 5-7 patients at a time, getting up at 4 am, prerounding, entering data AND presenting the patient including my own assessment and plan…OR am I justified in thinking that the new expectations of upper levels are too high???