Typical Routine

Typical Routine

Every ICU is a little bit different, but in general they will follow a similar work pattern on a daily basis. Often, the day will start with the doctors and nurses who were present overnight giving “signout” to the folks coming on for the day shift. This includes a brief summary of why the child is there, what the team has done and is currently doing to help them get better, and whether or not those things seem to be working.

In some places, especially those with residents and fellows, you will be woken up in the morning by people coming in to see your child. Sometimes they flip on the lights without warning you, and most of the time they talk loud. Surgical residents are especially notorious for coming in very early and turning on the lights in order to examine your child. The intent is not to bother you or your child, but to gather information about your child’s condition that will later be discussed on rounds.

A more detailed discussion of the patient’s condition is discussed on “rounds.” Some places gather the entire team outside the patient’s room to discuss all the details, while others will meet together in a nearby conference room. After the details are discussed, the team will formulate a plan for the day, making sure everyone knows what they will be doing differently and what they will be doing the same in order to help your child heal. This will be done for every patient in the ICU, one by one, until everyone has had their turn.

Most places invite and encourage the child’s family to attend “rounds” so that you can know what’s making your child sick and what the team is doing to help your child. We know that these discussions always contain terminology and language that is impossible for someone without any medical training to understand. The very end is usually the point at which someone from the team will summarize the discussion for you in terms that you can understand, and also give you the opportunity to ask questions. “Rounds” are the BEST chance for you to hear about your child, their condition, and what is being done to help them. You should make every effort to be awake and present for rounds so that you can be informed. If you want to shower or grab breakfast, ask your nurse to estimate when rounds will occur so that you can take care of yourself but be back in time to participate in your child’s care. Although we recognize that we are often a large group and that that can be intimidating, please do not hesitate to ask questions on rounds if you don’t understand. Our job is not only to take care of your child, but also to make sure that you understand what’s going on.

Following rounds is, depending on the time and if we are able, when we eat lunch! Trust us, you don’t want us to be a bunch of “hangry” (angry ’cause we’re hungry) people!

In the afternoon the various members of the team will see new patients, work on our paperwork, and most importantly, repeatedly check on your little one to make sure that the plan discussed on rounds is being implemented and that it is having the desired effect. These moments, when we come into your room to check on your child, are another opportunity for us to talk to you about your child and for you to ask any additional questions you may have thought of.

There is usually another signout in the evening, when the day team will update the folks coming in for night shift. At some places, the night team will also conduct a very brief rounds right before bedtime to make sure everyone is on the same page and has the same goals. Then, hopefully, you and your child will be able to get some rest through the night before starting the routine all over again the following morning.