Why I put up with it.

Some days make it all worth it.

Long story short, I have a patient who we are having trouble weaning from the vent because he flips the hell out when the propofol is turned down.We have orders to extubate per protocol if weaning tolerated because the only thing holding up the process is the damned propofol. So RT and I decide to go for it.

I go tell my charge nurse I'm going to be MIA for a while and to please keep an eye on my other non-critical patient whose awaiting transfer orders and I drag a chair into the room and pull the curtain.

I dial down the propofol. He opens his eyes and two seconds later that familiar reaction ensues. I gently take his hand and calmly talk him down. He mouths around the tube "I can't breath!" and "What happened?" I remind him of his surgery and the fact that he's on the ventilator and assure him I will be right there so everything will be OK. He calms little by little, closes his eyes and drifts back off to sleep.

This process lasts an hour with be turning the propofol down and calming him down; propofol down, calm him down; propofol down, calm him down. Finally he is mostly awake and trying his hardest to stay calm.

"Ok go." I tell RT who has been in and out of the room the entire time. She is already set up to extubate.

I turn off the remaining amount of propofol  and RT pulls the tube a few minutes later. After the usually coughing and gagging has subsided, he takes my hand and squeezes tightly as he begins to cry.

"You are my angel." are the first words out of is mouth. "Thank you."

"You're welcome." I say.

"Really, you are an angel. Are you married?"

"Not yet, but I will be soon." I say, showing him my ring.

"Good. Tell that boy he better be good to you. Or he's going to have me to deal with!"

Sometimes I just love my patients!!