Wakemed week 6--Introduction to Critical Care

I started my ICU rotation last week, I was frustrated at first because I had trouble time to figure out pt's Calorie and Protein needs. There are too many factors should be considered before choosing the right range, such as age, stress factor, other medical conditions, body weight (IDW, Admission, Average, Adjusted). It is hard for me to pick up all information from beginning, and Doctors' handwriting are horrible, weird abbreviations... Only for weight, every person did kind of different way to assess for protein/Kcal needs. I have been told several ways: such as always use IBW for protein, use Average/Adjusted weight (>135% IBW-- However, I was told by other dietitian in Rehab, use Adjusted weight when >145%, some people just used Average weight). I was confused, and busy to follow different people's style/format... 

There is other thing I wanted to mention: I assessing one pt in MICU, with admission weight at 160 kg, (some CHF, CKD issues), however, after 2 days, Pt's weight changed to 106 kg for continuously two days. I was confused and had hard time to choose weight I should believe. Sometimes, it is useful to enter pt's room and assess pt's actual weight by your eyes. The data in medical record may not always be right. (they may not take off bed's weight when measuring pt weight)

It has been challenging last week, there are a lot of stuff I need to learn for critical ill patient, I am getting there...

I will have neurosurgical ICU for two weeks!