My first two weeks as an anesthesia resident (I feel it's a bit premature to say, "...as an anesthesiologist...", though I am one who studies anesthesia) were good. I worked with one attending anesthesiologist who I've mentioned before, Dr J. Dr J (not to be confused with doctorj.blogspot.com) is a cardiac anesthesiologist who is regarded by several of the residents as "the smartest person I know." He also tends to do several of the "celebrity cases" at this hospital.
Dr J is also one of the funniest people I've worked with! I laughed a lot during the first two weeks. However, his dry sense of humor meant that sometimes I didn't know if he was serious or joking (what people often say about me). This is a little problematic when he says, "Why you touchin' that dial?" He's either serious that I shouldn't turn it, or just making me justify why I want to turn it.
I feel fortunate that there wasn't too much excitement my first ten work days. The first day was the most stressful as I was learning how to enter passwords, where to file paperwork, how to give report to nurses, where to get drugs. My first two cases at this hospital were insertions of inflatable penile implants. (!)
My attending was also very laid-back. He left me in the room alone for long stretches, whereas other attendings kept hawkish watch over their first-year anesthesia residents. During one such time--in the middle of one of the penile implant cases done under spinal anesthesia--a CRNA came in my room to see if there's anything I needed. Around this time, the patient began to "wake up" a bit. This wasn't a problem since he had spinal anesthesia--he shouldn't have pain--but people can be a bit disoriented. I reached for the propofol infusion...adjusting the rate upward should put him back to sleep nicely. Unfortunately, at that moment, the patient's hand flew up, pulling out his only IV! He became more and more restless by the second, and I stood there paralyzed by fear realizing the patient was waking up during the surgery, and I had no IV access to put him back to sleep!
My hero of the day was the CRNA who quickly gathered IV equipment, pulled back some of the drapes, and deftly started the IV, through which we bolused a little propofol. Normalcy quickly returned.
Lessons learned
- It never hurts to have an extra IV
- Have a cool head so that I can start an IV in the middle of a stressful situation
- Appreciate CRNA backup!
2 comments:
Objection, your honor, form. The blogger is using too much jargon that a lay reader does not understand.
For example, "My hero of the day was the CRNA who quickly gathered IV equipment, pulled back some of the drapes, and deftly started the IV, through which we bolused a little propofol."
What is a CRNA? Bolused? Propofol? As for "drapes," it seems like it is not referring to window treatments here, but I can't be sure.
Ha ha!
CRNA = Certified Registered Nurse Anesthetist. This is a nurse who does a couple years of critical care and then goes to nurse anesthetist school. Usually practiced under supervision of an anesthesiologist.
IV = short for intra-venous catheter. A tiny plastic tube that goes into the vein through which we give medicines.
Drapes = 1) window treatments. 2) Sterile, fluid-resistant disposable fabric used to cover patients during surgery to keep sterile things sterile.
Propofol = IV medicine that will quickly make someone fall asleep.
Bolused = past tense of "bolus," to rapidly give a dose of medicine. This is in contradistinction from an "infusion," in which medicine is given very slowly via a pump or gravity.
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