An example of a terrifying moment

Terror would include:

any adverse event while a patient is in your care. Malignant hyperthermia, cardiac arrest, anaphylaxis, wrong site surgery, surgeon impaired, earthquake or other serious disaster occurring while you have someone asleep, severe need for you to toilet and no one to relieve you - it's a long list.

Hey, good luck, whatever you choose.

hr 110 to 32

Obviously, the person who you read that said Anesthesia is 98% boredom and 2% terror wasn't a CRNA, and they obviously have no idea what we do. As someone who will be graduating from Anesthesia school in 3 months and has had over 4 years CTICU experience there is absolutely no comparison. The reason why people think Anesthesia is so boring is because we make it look that way. People just think, "give half the little syringe, all the big syringe, stick a laryngoscope in someones mouth, put a tube in, and open a magazine." No-one except us and ologists have any idea what is constantly going through our minds starting with meeting the patient all the way through till dropping off the patient in PACU (or wherever). You have to take into consideration Anatomy and Physiology, Patient medications, Surgical needs, Surgeon preference, Past surgical and medical history, and personal experience in every single case, oh and yeah, you have about 10 minutes to figure this out before the surgery is scheduled so you can't slow the OR down. In an ICU you are not the boss, you almost always have help, wether it be other RNs, PCA's, RT's, residents, attendings, etc. and things very rarely happen lightning fast. In an OR, I AM the boss. Do you have any idea how nerve racking it can be during a simple Cataract removal that I, as a STUDENT no less, had to tell an attending surgeon to stop what he was doing because he ilicited an oculocardiac reflex and the patient brady's down to 20. I don't have time to wait or the patient can arrest and die on the table for a supposedly "routine, 10 minute procedure."

Sorry about my little rant, what it basically boils down to is that as a CTICU RN I didn't exactly know why I was doing everything that I was doing. I knew procedure, i.e. if the C.O. drops you did X, if the HR increases you do Y. Anesthesia is extremely different. You have got to know exactly what you are going to do and why or your patient is at risk. There are entirely too many bad things that can happen during anesthesia that most people don't even think of, because we take steps to prevent them from happening. Simple things such as hypothermia and nerve damage from positioning can be devastating. The most terrifying moment in anesthesia, that I absolutely hope will never happen, is when I get a subpoena to be deposed in a surgical case where I caused a permanent problem in someone because I became complacent.

Anesthesia is not 98% boredom, and if you do think that, there is no place for you in giving it. It deserves respect, and someone who can take the responsibility seriously.

Trust me, your patients will thank you for it! Good luck

Nah, Rich it wasn't meant to be a rip and I apologize if it sounded like it. I just like to clear up peoples thoughts of just how important it is what we do. Any path you choose to further your education will be rewarding. I am just really biased towards anesthesia! Good luck with whatever you choose!

Actually, the saying that anesthesia is 99% boredom and 1% sheer terror (or 98% and 2%) has been around a long time, quoted often by anesthesia providers. Perhaps boredom is the wrong word, but the idea is sound. Translation: Anesthesia (once you have graduated and have experience) does become 'routine' to a great extent. However when things go wrong, or difficult situations arise, it often happens suddenly and/or without warning, requiring immediate and decisive actions with little room for error. Often a CRNA is the the person all heads in the room turn to anxiously waiting for guidance. The patient may be vomiting and aspirating, exanguinating, in cardiac arrest, in laryngo/broncho spasm and turning purple, may be a 2 year old or 92 year old, may be flailing wildly about, or any combination of these and others.

how about doing an ERCP prone on a 350 lb patent, when gastroenterologist rips his scope out so fast it extubated my patient and caused laryngospasm. He left, Nurse left to see next patent, I was in Endo sweet with a x-ray tech, and a xray tech student and thats it. had to turn her over, suction, paralyze, and reintubate with the help of only the techs....

or losing 2500 cc in blood loss in 4 minutes during nephrectomy and finding out that blood bank screwed up and no blood available.....also not that fun.