Does time pass slow in the OR?

[Chip_04]

I find the OR to be a fascinating place to be and during my time shadowing a CRNA I was completly astounded by what was going on with the patient and how complex everything is. I have heard that anesthesia is thousands of hours of boredum followed by minutes of terror, but it would seem that it would be hard to be bored during surgery.

Im just wondering how time pases when you are in the OR especially with a very long case. Does the excitement wear off as the years go on?

Any thoughts would be appreciated.

[gaspazzer]

Why would you want to spend your time reading a magazine. Your patient deserves your total attention. You may miss suttle signs such as the developement of ST segment changes, increases in airway pressure etc. The next thing you'll probably want to do is turn all the volumes down and maybe even the alarms so that they wont disturb you reading. If you want to spend your time reading become a librarian or something so that your in attentiveness will not kill someone. This is the sort of thing that give us a bad name. If you were a student of mine you would have got a failing grade for this clinical.:redlight:

[London88]

I do not read magazines in the OR period. Like gazzpasser said I do not want to miss anything. When I speak to my pts in holding I promise them my undivided attention and that is what they get. However, i am not trying to tell any other CRNA how to practice . If a student brings a magazine to read during a case with me it will be the last day that they do a case in my room, and if I have a say they will be booted out of the facility!

[TopherSRN]

I thought twice about reading gossip magazines during cases when I first started too. I thought it would be hard to concentrate with all the alarms beeping. But then I just started silencing them and it became much easier to concentrate on my reading. Crossword puzzles, soduku and Ipods are great ways to pass the time as well.

[paindoc]

lol....this has to be an attempt to bait us guys... No one, not even a military CRNA at Guantanamo Bay, would be so callous as to put their patient's lives in jeopardy by playing games with their patient under anesthesia...

[asianrn]

I thought twice about reading gossip magazines during cases when I first started too. I thought it would be hard to concentrate with all the alarms beeping. But then I just started silencing them and it became much easier to concentrate on my reading. Crossword puzzles, soduku and Ipods are great ways to pass the time as well.

are you for real?.. i'm not in school yet, but when I take care of my very sick patient in the ICU I don't even have time to pee let alone an Ipod in my ear..

turning the alarms off are grounds for termination..

[TLC RN]

I know where time passes slow...waiting for your acceptance letter and waiting for school to start in the fall! That is where time has passed slow for me

[gasmaster]

Once I was working ICU contract at a small hospital. The ICU only had 4 beds. Anyway, the OR had a long case going & called for me to bring my defib. Theirs wasn't working apparently. Anyway, when i got there the pt was face down (lami), and was B-L-U-E. I mean BLUEBLUEBLUE. First thing I noticed was...DEAD SILENCE...NOT A SINGLE ALARM. Well, when the case went to court it was discovered that the MDA has turned down all the alarms cuz they were bugging him and didn't' notice when she desated and then went into v-tach. So, pt suffered anoxic brain injury, lived for a year, then died. MD got reprimanded (didn't lose his license) but had a hard time finding another job in the area. I'm pretty sure if that had been a CRNA the license would have been revoked.

[TennRN2004]

I employ nurse anesthetists and if I found one reading a magazine while doing anesthesia, they would be out in a second. The patient deserves your total attention and nothing less. It is amazing how quickly something goes wrong. Just yesterday, the ventilator stopped working and I had to hand bag for an 8 hour case. If I had been reading a magazine or out of the room, it could have been a disaster for the patient.

Cherish the boredom.

Ali

I want to say before anyone reads this and goes crazy, I am just getting ready to start school in a month, so I am not entirely sure what the resposibility/pressure of an anesthesia case entails yet. However, to play the devil's advocate, I have also heard the arugment that when you are totally focused on the patient and surgery, some people find themselves drifting off mentally. One of the best anesthesiologists at the hospital I worked at as a unit nurse was reading an anesthesiology magazine one night when I walked in to watch my open heart patient. I would trust him with myself or any family member any day. I didn't feel in any way that he was neglecting the patient or not being as vigilant as he should. He felt that reading such an article kept him stimulated and he wasn't as likely to zone out during the case. I don't know about anesthesia providers talking on their cell phones doing stock deals and personal business like building a house, but I think professionally related material is not necessarily a bad thing to have in the OR. What do some of the CRNAs who've been doing it for a while think?

[jackson74]

I don't start anesthesia school till aug. but even as an ICU nurse I try not to do anything that gives the appearance that I'm not being vigilent. It also helps my coworkers to feel more confident in my skills and my overall practice. Just my opinion.

[lawiti]

Generally there is a large potential variation in vital signs before injury or end organ damage occurs. Couple that fact with the very safe drugs we now have for anesthesia use and one finds the profession to be primarily a technician's job. 99% of the time, one could give the exact same anesthetic to everyone with no demonstrable outcome differences. The 1% of cases that compels a CRNA or MD to be hypervigilant may not be those that you think are going to be difficult. It is usually not the expected that causes problems (cardiac EF 25% with concurrent renal diseae and unstable hypertension) since you are prepared for these issues. The unexpected difficult case is often the one that is the most challenging and perplexing, but it is for those few cases that it makes any sense at all to have a professional delivering the anesthesia. Otherwise, take anyone off the street and give them one year of training....they could handle 99% of cases....

I have seen CRNAs and MDs completely asleep at the top of the table. I saw a CRNA effectively contract out building his house and micromanaged it from the OR for 6 months. I have seen MDs standing out in the corridor outside the OR making stock deals for 30 min. One MD anesthesiologist that should have had his butt fired, but was not since he was on the executive committee of the hospital, actually left a patient under general anesthesia and intubated during an open urology case for 45 minutes while he attended a board meeting in another part of the hospital. The circulating RN in the room was given a syringe of propofol and some pavulon and told to give these if the patient moved.... In that case, no other physician anesthesiologist was contacted prior to his patient abandonment and there are no CRNAs in that hospital. The patient did just fine and since no one was killed, the hospital credentialing committee and board decided there was no foul. Obviously that anesthesiologist believed patients do not need to have an anesthetist of any kind around during a general anesthetic and the hospital tacitly agreed. So, I suppose you may conclude it can be boring to be an OR dog...

This was great reading Paindoc