This week I felt pretty independent. Not that there wasn't a lot to learn, but for the most part I felt like I could've done a lot of it without a preceptor. I have to admit- I thought it would be harder than this. The vent and ABGs and pressors and paralytics are really the newest things... for the most part though, it's business as usual. I draw labs myself, and get bladder and central venous pressures, and bag people occasionally. But I had a CF patient that made me feel at home- always on the call light, and in pain. We ambulated her and I bagged her the whole time!
Today my patient had a 1 in 2 million rare lung disease called alveolar proteinosis. It can only be fixed with whole lung lavage. Only trouble is, he can't oxygenate well enough to undergo the procedure- so he is going to placed on ECMO and then they're going to try. This is a ground-breaking surgery, that's never been done on someone this sick, and that could only be performed in a very small handful of hospitals by only a few pulmonologists in the world. I got to listen in on the meeting with the family, and I felt like I was part of a discovery health special.
Of course, this lavage on ECMO crazy revolutionary procedure can't be done tomorrow, because the president is coming, and specialists are prohibited from performing intense procedures that may tie up precious resources... just in case Obama develops a chronic lung condition in a matter of hours!