A few years ago, I received report that a patient was ready to be weaned from the ventilator. He had no respiratory need for mechanical ventilation, and every time the medical team attempted to wean sedation to extubate, the patient “went crazy.” As I assumed care on the night shift, I looked into the eyes of this intubated 67-year-old male patient. I asked him gently and quietly, “Why can’t you remain calm so we can pull out your breathing tube?” His eyes glazed-over and he tried to move his restrained hands. I released one restraint. He started to grab at the air like he was trying to catch something. I released the other restraint. Both hands shot to the ceiling, grabbing the air.

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