Today I am at a third hospital. Clara Maas, a community hospital in Belleville, NJ. This hospital as been overwhelmed by critically ill COVID patients. This is the fourth ICU with COVID patients in one week I have been assigned to. For me, it is very hard to transition to many ICU's in a short period of time. It requires me to learn new critically ill patients every time I arrive at a new ICU. I must spend many hours to review the course of each patient. But it has also allowed me to see how multiple ICU's function and to evaluate what is effective not only regarding patient care but also how the staff interacts. This hospital has had an overwhelming amount of COVID patients, opening new ICU's to take care of mechanically ventilated patients. The hardworking physicians and staff are just trying to keep up with the increasing amount of patients. They have been overwhelmed and exhausted. Today when I arrived at this ICU to oversee the care of these patients, I could see there were better ways to perform patient care. Up until this point, it seemed that the healthcare providers did not have a systematic way to oversee the care of the patients. Together with the advanced practice providers, I saw every patient early in the morning. I suggested that after we reviewed the ventilatory status, labs, medications, that we meet again to go over these results. I've had the benefit of seeing how it was done in multiple ICU's and could evaluate what I thought was effective. So our team, convened at lunch, meeting together as we ate, and I discussed how I thought we could be most effective and efficient in terms of taking care of these patients. I discussed how I thought it was important to contact family members after we rounded as a team, so that we could give consistent messages to families. I encouraged each team member to reach out to family members to discuss the wishes of the family in the event of decreasing blood pressure, heart rate, or ventilator status. I reminded each member to reassure the families that there was always a team member with their loved one so they knew their loved ones were not alone. Although I have been tired learning all of these patients, having been moved to different ICU's, I have learned something, many things, from the other ICU's that I could apply to this community hospital and their ICU. I think the people I work with at Clara Maas appreciate the lessons I've learned at other hospitals. Thats all for now.
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