Does time pass slow in the OR?

  1. 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.
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  2. 21 Comments

  3. by   goof1552
    LOL - I am still in school chip, so I cant tell you about "years go on" part, but I can tell you that unless the case is really long I usually always have something I could do to keep busy. Getting drugs ready for the next case, charting, getting new circuits, IVs, and suction setups ready, etc. If all that isnt enough to keep ya awake, you can always watch the surgery, talk to the surgical team (they tend to talk alot about weird random things, believe it or not), and usually music is playing too. Topping everything off is constantly re-evaluating where your patient is, too deep vs the amount of stimulation, too light, etc. I also try to time my anti-emetics and postop pain meds properly for DOA and onset, so I have to think about that as the case nears conclusion. In fact, alot of time I am hauling **s trying to be fast enough, as the cases are short alot of the time and I want to be prepared for the next case before this one ends. For example in the cysto/gyne room you may do 7 -12 cases a day and after you have sedated the patient and the surgeon begins, you may only have a few minutes until you have to start awakening the patient.

    Bottom line for me, no - its not boring, preferably not TOO exciting , but not bad either. I have yet to hear many people complain about it being too boring!
  4. by   paindoc
    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...
  5. by   ali anesthesia
    Sure anesthesia can be boring, so if it is excitement you want, try something else. I happen to love the boring part and am not interested in a lot of drama or adrenalin rushes. Watch the patient, watch the surgery.
  6. by   jewelcutt
    I wouldn't call it necessarily boring, maybe sometimes lonely because your always someplace different. We have our busy times, beginning of a case, end of a case, in between cases. So I actually welcome the chance to sit for a while and catchup on my charting and stuff. There are days you have 5-10 patients a day and no time at all to even sit. what I think you are referring to is the long cases in which everyone sees us just sitting there watching the screen or surgery. Well, that can be a little tedious, but like the above poster said, i don't mind it. i don't at all think its 99% boredom 1% panic, those numbers are exaggerated quite a bit. i will take "boredom" anyday over the excitement of cleaning someone's pee in the ER or listening to families complain in the ICU, the real exciting times.
  7. by   nursenary57
    Everybody here has made great points. I've only been in school for 6 months (about 130 cases so far) and there are definitely extremes. One day it is cysto after cysto (some done in 20 minutes, some up to 45) and then the next day is an open belly for a bladder tumor with creation of a new bladder from small intestine plus a prostatectomy. God only knows what else they did in there!

    The only time I have felt bored is on those all day cases where you have got your agent dialed in just right and VS are railroad tracks. To combat that I pull out my Mass Gen anesthesia handbook or whatever I've got with me and study up on something I haven't looked at in awhile. Of course I'm still watching VS, UOP, blood loss, end tidal CO2 and listening for any wayward expressions from the surgeon such as "Oh crap."

    Depends on what surgeon you are with you can learn alot about the surgery itself. I just finished a rotation at a large teaching hospital so he was already talking about stuff to the med student and residents. Learned a couple of things but not as much as I wished I had.

    I'm actually looking forward to the point where it becomes boring. Hopefully that means I won't be scared to death everytime I walk in there! When I got out of nursing school I would look at the older RNs and think "When am I gonna feel comfortable with my knowledge/skill/experience level where I can come in to work without being scared to death?" I feel the same way now. I'm sure it will be awhile before I get there.
  8. by   hell000nurse
    im still a staff nurse in the ICU, and havent started school yet...but just wanted to say that ive loved reading these personal experiences/opinions...really helps put things in perspective!
  9. by   Samplesix
    Quote from hell000nurse
    im still a staff nurse in the ICU, and havent started school yet...but just wanted to say that ive loved reading these personal experiences/opinions...really helps put things in perspective!
    Hello all,

    I agree totally with "hellooonurse". Though I am still in school for my BSN, I appreciate being able to read about the opinions and experiences of others. It sheds light on some of those areas that were somewhat of a mystery :spin:
  10. by   gaspazzer
    Enjoy the boardom. It usually means that you are doing a good job. Just remember to be vigilant at all times orherwise something will jump up and bite you:gandalf:
  11. by   TopherSRN
    Bring a few magazines to the OR with you. They always help time pass quickly.
  12. by   paindoc
    Some MDA programs do not permit any reading material in the OR at all since it has been shown to decrease attention to the task at hand. I am not privy to the policies of CRNA programs.
  13. by   ali anesthesia
    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
  14. by   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:

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