This week I was able to shadow the doctors and residents during neonatal ICU rounds, as well as observe the diagnostics and treatments preformed there. The NICU at WCMC is divided into two separate teams that are responsible for a certain babies in the unit. I went on rounds with a team lead by the attending, Dr. Yohay, who was accompanied by a fellow and the NICU residents. Each resident on the team in the NICU is assigned to three to four of the babies that the team is responsible for. Before the rounds begin the residents print out a summary of the each of their patients up-to-date statuses. During rounds the attending and fellow lead the residents around the NICU and the residents go over the information they have for that morning for each baby and the team decides on the plan of the day for each baby.
The residents and doctor discuss the weight gain, fluids intake, residuals, any incidences, etc. for each patient to determine the care needed for that day. Some patients require special testing for heart problems or other developmental defects, which is also taken into consideration during the rounds.
It was interesting that the NICU works on a day-to-day basis. The doctor does not even begin to consider the longer-term future until the patient is stable. This is different from the work in my main area, urology, with older patients. The doctor is able to predict the outcome of the treatments preformed and usually has to only follow up with patients. The NICU is special in that each day the babies are there is uncertain and the main goal is to allow the babies to dictate how well they will do and when they will be released.