What about the stress?

jenjo,

I heard a description of anesthesia that I have always liked:

Anesthesia is 95% boredom and 5% panic.

Well, that is an over generalization, but there is some truth to it. Some days you will have you teeth clenced untill quitting time. Other days you kinda coast through. It depends some on your work setting. And depends alot on just the luck of the draw.

One constant thing though, is that you can never let down your guard. We call it "vigilence" and it is the number one attribute to have when giving anesthesia. Things can go from "coast" to "teeth clenched" in a nanosecond.

While it is rare for a routine case on a healthy patient to go bad, it is not impossible. So if you do this job long enough, eventually it will be your lucky day. And it is those kind of disasters that are the worst. Nobody (including yourself) will fault you for a bad outcome when the patient was at death's door to begin with, and the surgery was a one shot in a million to do any good anyway. But a bad outcome for a healthy patient who came in for a routine procedure is hard on everyone- emotionally and legally.

Don't know if that was exactly what you were asking, but those are the thoughts your question stirred up.

losiane crna

I don't know about after obtaining the license, but during clinicals, today in fact was pure hell. I really got beat up today. Some my own fault, some of it was expectations beyond my current ability. I have been in clinical for a full month, (that's a total of 12 full days) Wed, Thur, Fri. and my preceptor expected me to do the whole case without asking what to give or do next. This would have been fine, but no one else has given me so much rein and I really didn;t know what to do with it. I had never had this preceptor before, I didin't know the way he liked to do things( all of them like different things). And Im slower than I should be.
Don't get me wrong, I am glad I had the experience and I learned a lot. Mostly what I was capable of, but I gave a pt too much neuromuscular block for the case (I didnt know this surgeon and the procedure was so fast). I was lucky he did reverse and we didnt have to stand around waiting. Yes, I learned. I will be doing ALOT of reading tonight.
So, yes, there is high stress as a student, if you were wondering! The good part is I got all 4 of my intubations today and 4 spinals this week. Yeh!

Qwiigly, you had a day full of stress, but sounds like you and your patients all ended up OK. That is the bottom line.

I would venture to say there are none among us who have never overdosed the muscle relaxants. It is part of the learning curve. And you don't really learn until you are making the decisions, with very little "over the shoulder direction". So, as stressful as it was, I would call it a pretty good day for you.

Now, I have to agree with you, sounds like you are still a little early in your clinical experience. Some clinical instructors will nurture you along. Some will let you have plenty of rope to more or less sink or swim, but they are always watching to make sure you don't get in over your head. I have found that the first type are great for beginning students, but not so good for those closer to graduation who need to stretch their wings. I guess the ideal thing would be for clinical instructors to adjust their teaching styles to the level of the student, but from what I have seen, that can be difficult for some people to do.

So my point is, you will have those "nurtured days" again. But the more you progress in your education, the more you will appreciate the days like the one you described in your post.

Sounds to me like you are doing great, keep it up!

loisane crna

Thanks Loisane;
I had a blast these last couple of days. I studied my butt off this weekend in preparation for this week's clinicals and it showed. I was quicker, more confident etc. My instructor this week commented on the improvement. (We get a new CRNA to precept us each week) and this gentleman had not had me for two weeks. So I guess day to day is harder to see improvement, but week to week you can see it.
I am at this clinical site for one more month, I sure do wish I could stay longer. Everyone is soooooo great at teaching and they really have our best in mind. I know I want to do a good job, so their reputation is stellar!
Thanks for the advise Lois!
Qwiigs

I personally think that being a CRNA is the best job in the world. There is nothing better than to make the patient's surgical experience pain free and safe. You MUST keep current in the scientific and clinical aspects of the profession, along with expanding your knowledge of the surgical procedures.

For those of you learning to be a CRNA, take this advise from an old pro--do as many cases as you can, gain as much hands-on experience as time permits and read, read, read. Learn from the patients, and watch how each one responds differently to the medications. Also, one of the things I like best is talking with the patients before and after the surgery. I had a patient today bring me a bottle of good wine in thanks for a great experience and for not vomiting post-op--something she has always done in the past. All of this satisfaction and good money too.