Weekend With CRRT

Posted: Jul 30, 2012
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I love a challenge. Really, truly, seriously. I thrive when placed in situations where the stakes are high and the cost of failure, daunting. Often, I find myself approaching a challenge too far inside my own head, not recognizing the amount of teamwork necessary to help each and every patient.

Last Saturday morning I stepped off a plane at PDX (Portland, OR), freshly home from a week-long spay and neuter campaign in Jamaica followed by a two day conference on health care leadership in Boston. After squeezing as much sleep out of the day as possible, I headed in to relieve Meredith and spend 12 hours tending to the patients in the DoveLewis ICU.

Meredith had only one patient to round to me: a petite spaniel in need of Continuous Renal Replacement Therapy (CRRT).

Although I’d previously browsed our CRRT binder and taken steps to understand the technology and clinical care required, I had never had a patient receive CRRT before. Prior to ending her shift, Dr. Herold (our dear leader) took a large amount of time walking me through exactly what I would need to do to keep my patient alive and in harmonious homeostasis.

What followed over the course of the weekend was amazing. All told, I spent 26 hours over two shifts with this patient, monitoring bloodwork nearly every hour, replacing heparin CRIs, adjusting patient recumbency, titrating sedation, and switching out effluent and replacement fluid bags.

When the time came to hand my patient off to an entirely new team on Monday morning, I felt a sense of accomplishment. She survived the weekend, tolerated the therapy, and experienced no immediate complications during my shifts. Furthermore, I was able to walk her new technician through all the nuances and processes I had learned firsthand only 36 hours earlier.

The patient care I was able to provide only happened because we functioned as a team. Drs. Ahlgrim, Herold, and Doolan; technicians Julie, Meredith, Brandy, and James; assistants Kirsten and Jenny; these individuals (and more!) helped me with the numerous tasks necessary to provide medical care for a single, very critical patient. Additionally, the front desk staff, administrative staff, and facilities staff all contributed to process support that allowed me to focus solely on the task at hand.

Such narratives, in my opinion, provide evidence that teamwork isn’t just a buzzword. It’s not a cliched idea we should cynically brush aside. Veterinary medicine is a team sport, and while one individual may temporarily capture glory, it is the effort of every member that allows for stunning achievement. And when you think about it, attaching an animal to what is essentially an external artificial kidney is a stunning achievement. I am so proud of what our team accomplished last weekend.