on tiny victories. . .
Last week, we sat in rounds on Monday and talked about our tiniest patient – she had been on the vent 25 days. A record. The longest we had ever had a premature baby on the vent. And we all knew each day she needed it was a calculated risk.
She was improving- it had been a hard fought battle where we had utilized every resource we had.
The new monitors from last year that read accurately on even the tiniest baby
The syringe pumps that titrated things to the nearest 10th of a milliliter
The ventilator training we had been doing on cycle with our PICU nurses and their determination to care for her with delicate precision
The round the clock care by our PECCCOs.
The new ventilator from AMH that we had used in several modes.
The training on weaning Dr. David had done with us in March.
The new protocols for BPD in infants that our fellow had brought up the last week.
A tiny donated central line in her right upper chest the surgeons had placed.
Our team of nurses and chaplains to encourage her mom daily.
Our nutritionist and pharmacist to make sure the medications she needed were available without fail.
“We are extubating tomorrow,” I said at the end of her bedside rounds.
The team looked at me with appropriate skepticism. But something deep inside of me was determined. We had done what we needed to do. Deliberately, minute by minute, step by step. She was ready. And so was our team.
Throughout the course of the day we prepared and said it with more conviction and step by step excitement spread.
The next day, we finished rounds and the sweet girl looked at me with eyes wide above the tape securing her tube. Mom sat with us in expectation and we removed the tube.
The nurses cradle her as we gave her breathing treatments to open her swollen airway and the team cheered when we heard her first hoarse cry.
She still has a long road ahead of her and this week has not been without minute to minute care and use of our bubble CPAP and constant suctioning, and controlled tapering of her meds – but when she grasps my finger and sucks on her pacifier, I cannot help but count the road of tiny miracles over the last 45 days and the years before that made those mundane actions possible.