What do you mean by a "One on One" patient??

Patient is post-op day 3 for a triple Coronary Artery Bypass Graft surgery.

Amiodarone drip at 17, Norepinephrine drip at 25, Diprovan drip at 10, Nepro per Orogastric Salem Sump at 10 (if tolerating increase in incriments of 10 to a goal of 30cc/hr), Right Central Venous Line, Right Swann Line (which is stationed in the Pulmonary artery, by the way), Left Radial Arterial Line, Right Brachial peripheral IV, and Chest tubes x 3 (yes, that's right, three tubes running into his lungs each about 2/3rds the width of a hot dog).

Patient also has a Dual Left Subclavian Line for their Continuous Renal Replacement Therapy (yall would call it continuous dialysis). MD orders to withdraw 75cc fluid more than they're taking in hourly to decrease patients generalized edema due to lack of any significant kidney function.

Patient is on the ventilator Pressure Control with a Pressure Support of 20, a Positive End Expiratory Pressure of 14, an FiO2 (fraction of inspired O2) at 100% with MD orders to decrease in incriments of 10 to a goal of 50% as long as SpO2 remains above 92%.

Not to forget you've got to hang a unit of blood, draw labs, chart vitals hourly, give meds, check blood sugar levels every four hours and regulate the Insulin drip per results of the blood sugars, explain to random and different family members every six hours what YOU are doing to their loved one and why you are doing it, and put up with all the doctors that come through. OH and by the way.... ALL of these orders are subject to change at ANY moment depending on when any ONE of the patients 3-5 doctors decides to come strolling in (wondering why you haven't completed all HIS orders).


It was actually a REALLY good day!! I had a great time and acheived all my patient goals for the day.... as well as a few goals of my own. This is ALL pretty standard stuff for the patients that are on my unit (except the CRRT machine, that comes special when you have bad kidney problems). My patient is slowly getting better.... little by little... and next to what God has been teaching me VERY recently.... it's the most fulfilling thing I've ever had to joy of being a part of.

God be with you all my friends!