Day in the life - page 2

Along the same/similar lines as the Induction list, I'd be interested in hearing from folks (CRNAs and SRNAs) what a "typical" day is like for you. What is your day like? Are you in the OR all day... Read More

  1. by   yoga crna
    Until now, you have heard only from students. I am a CRNA and have an independent practice in an office surgery setting. As an aside, I also am the administrator and president of the corporation that runs the surgery center.

    Yesterday i did anesthesia for a 9 hour facelift, blepharoplasty and fat injections. The patient was a physician and had several bad facelifts in the past. I saw him the day before, did a pre-anesthesia assessment and talked to him about the anesthesia plan.

    I arrived at the office at 8:00 am, set up my room in about 10 minutes (I have been doing this for a long time and I was the last anesthetist to use the room). Before the surgeon arrived, I ordered oxygen for Monday delivery, inventoried the crash cart, signed some deliquent charts, brought the "difficult airway" box in the room (I anticipated a difficult intubations after examining the patient the day before) and did a nerve block on the office manager who hurt her back.

    Started the surgery at 9:15, ended at 6:30 p.m., turned the care of the patient overy to extended care RN, cleaned up my anesthesia cart and machine, set up for Monday's case, helped the circulating nurse take the dirty linens and insturments out of the OR and left for home at 8:30 p.m. I had lunch at the OR door while watching the monitors and ventilator and had some coffee at my anesthesia corner during the case. No relief, because I am the only anesthetist there.

    I made good money yesterday, but I was on constant alert for problems and put up with all of the issues that go along with working alone. Office anesthesia is for the confident, the experienced and the strong practitioners.

    YogaCRNA

    PS. I came home and did a half hour of yoga and read some good fiction. Life should be more than just anesthesia.
    No cases today, so I will work on getting my financial information ready for the accountant and do quality assurance to get ready for accreditation visit.
    Last edit by yoga crna on Jan 28, '05
  2. by   NeuroNP
    [QUOTE]No relief, because I am the only anesthetist there.

    I made good money yesterday, but I was on constant alert for problems and put up with all of the issues that go along with working alone. Office anesthesia is for the confident, the experienced and the strong practitioners.

    YogaCRNA

    [QUOTE]

    As the only practicitioner there, do you ahve to stay until the patient fully recovers and is discharged home? How does post-anesthesia care work in a setting like that?

    bryan
  3. by   yoga crna
    One thing I love about my practice is that I have control over how it is done and there is no rush to get the patient to recovery.

    I keep the patient in the OR until they are awake, have all their reflexes and can assist with moving them. They then go to recovery and stay there until they are either discharged from the facility or to the care of an extended care nurse. I use my own judgement as to when I leave. I would never leave if the patient needs airway support or is unstable. Otherwise, I take it on a case to case basis, with staying longer if there are any doubts. I am not into time frames, such as staying for 30 minutes (very technical nursing practice, not professional anesthesia practice).

    YogaCRNA
  4. by   apaisRN
    Quote from jewelcutt
    On the weekend I study 6-8 hours each day, catch up on cleaning, workouts, doctors appointments, call friends.
    How do you stay focused to study so many hours on the weekends? Do you break it up?
  5. by   pigtails
    Hi Yoga!

    Three Questions.
    A 9 hour face lift! Holy Crap! My SO is a well regarded PS who performs only cosmetic surgery and does facelift revisions averaging 2 hours. How are the results?
    What state are you in?
    Third, I am ultimately interested in getting into office based anesthesia after school. Would you please offer some pearls regarding getting the most out of my education to best prepare for autonomy in practice?
    I am a self starter and will enjoy the responsibility and fulfillment this type of practice can allow.
    Thank you,
    Pigtails
  6. by   snakebitten
    Typical Day--Today


    To work at 715, set up room draw up drugs machine check. I work in rural New Mexico town, where we are independent practitioners (We are one of the opt-out states). On todays schedule. C-section, AV graft, Ex-Lap, colonoscopy-EGD, AV fistla. Declot of grafts. A coupleofhe patients are ASA 4's one with a Potassuim of 7.1. Oh well, gave him an Albuteral TX, Insulin, Kaexalate and went with it. Things were done by 5.00. On call till Monday-alone. The best part of my job is I do what I want by myself. There are 2 other providers, we get along well and help if needed but you are expected to work alone. Went home to start the hard work--4 kids under 10

    Mike
  7. by   yoga crna
    I practice for a surgeon is considered one of the top five in the world. Most of our patients are plastic surgeons or their families. Nine hours is a little on the long side, but he is known for his results, not his speed. The revisions are cases usually botched up and require attention to detail. By the way, he is very supportive of CRNA administered anesthesia and doesn't hesitate to tell the patients.


    Get as much experience as you can, volunteer for the difficult cases, ask questions, read and the rest will come easily.

    I had hoped to have some students spend some time with me in the office setting. One school turned me down--the students are overwhealmed, but maybe in the future, it would work out for someone who is interested.

    Yoga
  8. by   jewelcutt
    Apais, once you get used to studying for long hours it really becomes second nature, I don't have any commitments anyways (kids, husband, work) and without work it's like a job, you have nothing but time to commit to anesthesia. I usually do break it up, like 4 in the morning and 3 in the afternoon with workouts, etc in between. I usually get up at 8am automatically because I'm used to getting up earlier during the week, and I usually go out on friday and saturday night or watch a movie. It's really not that bad at all, and besides I try to make up for study time I should have gotten done during the week but was too busy or tired. I study a lot more when the weekend before an anesthesia exam.

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