Your anesthesia clinical rotations are hard. Suddenly, you are thrust into a foreign environment and culture and are expected to instantly assimilate. You also have to prove yourself each time you rotate to a new clinical site. Then, just when you feel like you are getting your legs and jiving with the swing of things, poof! You’re gone. Then you move on to the next hospital and start the maddening process of proving you’re not a liability and moron all over again.
The anesthesia community is a small one. It seems like everyone knows each other through some complex, six degrees of separation, social network. This is why it is imperative that you look good, wherever you go. Each rotation is a potential working job interview or reference source. This becomes especially crucial in a tight job market!
We all are being judged on a daily basis. Every day we step into the OR, we are on stage for our CRNA peers, anesthesiologists, surgeons, scrubs, operating room assistants, and circulating RNs. You can know every drug in the anesthesia cart and intubate class IV airways all day long, but if you don’t project yourself well, you won’t gain the respect and admiration of your colleagues. Keep these five points in mind the next time you are in the OR.
1. Show up early and stay late. Arrive before the anesthetist you are working with does. Set up your room for the cases that you will be doing that day and read about any surgeries and pathologies that you are unfamiliar with. If a great case is about to start in your room around quitting time, call home and let them know you’ll be late for dinner. This segues nicely into the next point.
2. Seek to learn. This is the time in your career to dive in to the big, complex cases. Don’t worry about looking like a fool, you’re a student. Expectations are adjusted accordingly while one is actively learning. Besides, if something goes wrong, this is the time to have it occur. You can tap the mind of a knowledgeable and experienced CRNA!
3. Don’ t be afraid to say “ I don’t know”. (just don’t say it too much) If you have no clue to the answer of a question that you are asked, be honest. Write it down, go home and look it up, and find the CRNA or MD that asked you and knock their socks off with your new and exhaustive knowledge of enflurane and its link to thyroid dysfunction in the fetal cat.
4. Talk the talk. When you explain a drug, organ, or physical ailment, use the appropriate terminology, i.e. medical lingo/jargon. Talk to your friends, spouse, or dog about up/down regulation, rate pressure product, endogenous vs. exogenous ligands, kallikrein, ad nauseam… This will serve you well while abiding by the law of being a student. Be able to explain your rationale for each and every action you initiate.
5. Offer to do the little things. This is where hidden gems of clinical education lie. Go start that IV on the 400lb ESRD guy who hasn’t been dialyzed in several days or intubate the lady in NICU who extubated herself in a halo. Assist the CRNA or MD with preop blocks or a blood patch in the ER. Go see the patient that is having their tongue and mandible resected in the AM for oral cancer. Do postops in OB and talk to the lady who had to be put to sleep after a bad SAB and unsuccessful ketamine IV sedation. Help set up the heart, vascular, ped. ENT, neuro, or trauma rooms. People will notice and you will be exposed to some special learning opportunities.
Bad days pass, bad rotations end. Good luck, and remember how far you have come!
