So you are about to start clinicals...

Thank you for the words of great wisdom. They will be jewels for me shortly.

Jennie

Wow. Thanks a lot. I know I will be fine, but I can't help having some anxiety before the real learning begins. Hopefully my instructors will share your attitude....

One thing I will be sure to do is to thank the CRNAs and anesthesiologists who participate in my education repeatedly. They don't have to do it.

My biggest concerns at this point are: 1)all of the outside time requirement that care plans will consume 2)easing patients' anxiety when I'm so nervous myself and 3)the dreaded morning that I oversleep (please please don't let this happen, I keep telling myself).

Thanks again.

the dreaded morning that I oversleep

Unless you live with someone familiar with your schedule (SO, classmates), then it's gonna happen at some point. Take this from a single man.

My remedy to decrease the oversleep:

1. set alarm clock first

2. set cell phone alarm clock about 4 minutes past the alarm clock time. my cell phone will hold 3 wakeups times.

3. set PDA alarm as last.

4. cell phone and PDA are across the room

5. set pager next to bed in the chance you do oversleep, you can at least hear the MD or CRNA paging you from the hospital

Don't worry, once you get into a routine it becomes, well, routine. I have awoken many times at 0450 or 0500 on my own. On the times I did oversleep, most times I awoke on my own in an absolute panic and was able to make it to the hospital in a timely manner (ie, 95mph across the Tennessee River). Never have I just plain slept until 0900 on a clinical morning. Your subconscious won't let you.

Ohmygoodness...what awesome words of wisdom. My front-loaded program didn't start till Jan. so we aren't unleashed on the public till Aug, but these are good words and advice to have...

thanks for them!

sage advice. although i won't be stepping into the or for one more year...i will try to keep all this great advice in the back of my mind. it really is great the support and sharing of information that takes place on here and in the profession. i have an increased respect and awe for all the pro's out there every day.

as the summer approaches, many of the front-loaded programs are about to spring a cohort of students onto an unsuspecting public. if you are one of those, here are some musings from 25 years of anesthesia practice:

first of all, welcome to the real world of anesthesia. there is truly something magical about being able to render someone insensible to surgical assault and then bring them safely to consciousness. never forget to marvel at this. be forgiving of your clinical instructors if they don't show the same level of enthusiasm for the miracle that you do; they really do, but don't show it so much.

next, consider that most of the anesthetists who guide your clinical training are not financially compensated for training you. they do it because they believe in education, nurse anesthesia, and the continuing career we have all chosen. a few might be paid for keeping up with paperwork and scheduling, but they are probably in the minority. many could make more money and work with less stress by moving out of a training facility, but don't. it's ok to thank your clinical instructors for their sacrifice and ability to train you. they enjoy you and delight in your progress. remember that on some days the "river of knowledge" may not flow from them into you as much as others. we're all human.

be enthusiastic and be available. no one wants to hear, "i've already done a bunch of d&cs, i don't need any more." rather, "sure, i'd love to do that case!" it's amazing how often that case turns out to be a patient who prefers regional anesthesia, because they don't want to go to sleep, and "poof" you get to do your first spinal! be proactive as well. ask to do regional, central lines, fiberoptic intubations, etc. although they enjoy training you, your trainers won't always think of exotic skills that you are ready to perform. if you ask, you just might get to do something new. the worst that can happen is to be told "no."

seek out mentoring. for the last year, you've been learning the theoretical science of anesthesia; now it is time to apply that to patients and create the art of anesthesia. don't be surprised if some of the things you see fly in the face of what you learned in class. if you ask in a non-threatening way, you will find out there are lots of ways to skin a cat. once again, no one wants to hear, "that's not what we were taught!" rather, "i heard one way, but you are doing another. show me how you do it." throughout this period, you will find that there are some techniques that you will embrace and some you wouldn't do on a bet. you learn from both examples, and as your clinical education develops, you'll find that you synthesize your own style of anesthesia based on both kinds. of course, your style will be the best (although mine is a little better).

keep up with your case logs. you will soon see how much information has to be logged in on every case. getting behind by even a few days can create a workload that will be overwhelming. you've got better ways to spend your time than trying to remember which drugs you administered last week and trying to recreate an accurate accounting. you've slept since then.

maintain your sense of humor and keep your eye on the prize. clinical education lasts (on average) less than a year and a half. some rotations may only be a month or two. you can put up with most anything for that long, even standing on your head. as clint eastwood said in heartbreak ridge, "don't give the %$#$%'s the satisfaction of knowing they got to you." remember your family is on your side and appreciate them for their support. you can be hard to live with at times.

finally, enjoy yourself. you are about to put all the pieces together while under the guidance and protection of some great practitioners. they'll let you venture out on that shaky limb, but pull you back in before it breaks. it's a luxury you'll wish you could take with you to the first real job! i envy you for the educational journey you are about to make...having made it myself, there is nothing like it. oh yes, be sure and use a straight blade.

some of the realest words ever spoken. thanks for the wisdom. i still can't believe its starts in august.

my remedy to decrease the oversleep:

1. set alarm clock first

2. set cell phone alarm clock about 4 minutes past the alarm clock time. my cell phone will hold 3 wakeups times.

3. set pda alarm as last.

4. cell phone and pda are across the room

5. set pager next to bed in the chance you do oversleep, you can at least hear the md or crna paging you from the hospital

what about asking for a wake-up call (from your preceptor)....

j/k

lifelongstudent