New Attending Comments

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jetproppilot said:
Must be a buncha ex- CA-3s out there....who are now attendings in private practice/academics...

HOWS IT GOING OVER YOUR FIRST FEW WEEKS?

WHATCHA THINK?
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Will be starting Aug 1st. M.D. only practice,all types of cases including cardiac, peds, heads, etc. A bit nervous....brushing up my TEE skills. More scared of not having enough help when I need it, i.e. difficult airways, etc....I'll post more after my first week...if I survive that far....
 
sevo85288 said:
Will be starting Aug 1st. M.D. only practice,all types of cases including cardiac, peds, heads, etc. A bit nervous....brushing up my TEE skills. More scared of not having enough help when I need it, i.e. difficult airways, etc....I'll post more after my first week...if I survive that far....
Click to expand...

Where are you at? Sounds like my group.
 
4 days done and it's actually pretty fun....keep thinking someone is going to walk in and give me a morning coffee break or a lunch break but nooooo...... 😀 it's also a little weird being presented with a rather difficult case and thinking of all the pros/cons of each maneuver then just implementing whatever you want - rather than presenting it to your attending and having him tell you what to do in the end.

but all in all - it's a breath of fresh air. especially now that i've slept through the night 😱
 
I could not agree more - the knowledge that your final decision is IT is more than a little unnerving.

I'm just finishing up my second week of private practice in a large community hospital with a pediatrics hosptial as well. For all of you that are hearing from your attendings in academia that the private practice life is "just propofol and an LMA", let me give you what I've done so far....an adrenalectomy, a less than 4 month old, a gyn procedure on a patient with severe aortic steonsis, 3 spinals, an axiallary nerve block, a thoracic epidural, 2 alines, one cordis, 2 crash c-sections, several labor epidurals, a blood patch, and half a dozen kids under 5. And I haven't taken any call yet. And I've only worked 7 days.

The things that have surprised me the most: how HELPFUL all of the nurses are, and how friendly and appreciative of anesthesia the surgeons are. I loved my residency, but it is amazing how much everybody wants to get stuff done when it means we can all get out of the OR earlier. I'm also surprised how reasonable the day is - our OR doesn't start until 8am, so I don't get here until around 7am, and I'm done anywhere between 4-5pm most days. And I have gotten a lunch either between cases or thanks to a break given by a collegue every day.

And my group is really great about looking out for me - everyone has went out of their way to make me feel at home and made sure to let me know that they are available for questions. I'm also very impressed by how they run stuff by one another to get someone elses imput. Its nice to see that kind of collegial atmosphere.

Other good stuff - free parking, free food...why is it when you finally aren't a broke resident and are finally making some real money that people start giving you stuff for free???

To all of you CA-3's - hang in there, life is really, really good on the other side. Of course, it will be better once I find out whether or not I've passed the written boards... 😳
 
PiPhiDoc said:
I could not agree more - the knowledge that your final decision is IT is more than a little unnerving.

I'm just finishing up my second week of private practice in a large community hospital with a pediatrics hosptial as well. For all of you that are hearing from your attendings in academia that the private practice life is "just propofol and an LMA", let me give you what I've done so far....an adrenalectomy, a less than 4 month old, a gyn procedure on a patient with severe aortic steonsis, 3 spinals, an axiallary nerve block, a thoracic epidural, 2 alines, one cordis, 2 crash c-sections, several labor epidurals, a blood patch, and half a dozen kids under 5. And I haven't taken any call yet. And I've only worked 7 days.

The things that have surprised me the most: how HELPFUL all of the nurses are, and how friendly and appreciative of anesthesia the surgeons are. I loved my residency, but it is amazing how much everybody wants to get stuff done when it means we can all get out of the OR earlier. I'm also surprised how reasonable the day is - our OR doesn't start until 8am, so I don't get here until around 7am, and I'm done anywhere between 4-5pm most days. And I have gotten a lunch either between cases or thanks to a break given by a collegue every day.

And my group is really great about looking out for me - everyone has went out of their way to make me feel at home and made sure to let me know that they are available for questions. I'm also very impressed by how they run stuff by one another to get someone elses imput. Its nice to see that kind of collegial atmosphere.

Other good stuff - free parking, free food...why is it when you finally aren't a broke resident and are finally making some real money that people start giving you stuff for free???

To all of you CA-3's - hang in there, life is really, really good on the other side. Of course, it will be better once I find out whether or not I've passed the written boards... 😳
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very nice mix.. sounds like

you are gonna get real good quickly.. i started out in an all md practice as a locum in phoenix. My first couple of months as an attending were pretty freakin interesting.. I think I did more fiberoptics those 3 months then I did ever before and since. I did all the patients with stridor and all the peds. The partners were like if its hard.. let the locums earn their money. Just some advice.. at least starting out.. If you are not over ninety percent confident you can intubate.. Dont induce.. do it awake.. period.. you have nothing to lose.. thats what I kept on telling myself when i started out.. and it worked.. and i did a bunch of fiberoptics.. but better safe then sorry.. and being on call all alone in a regional medical center.. makes you know plan b and c cold... buena suerte..

oh and make sure you have a escmanns stylet on call or at least know where to get one quickly
 
sevo85288 said:
bump. more advice for new attendings would be appreciated.
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Be confident, not arrogant, and do not show fear even if you are ****ting your pants (tell everyone the patient must have had a code brown or farted). If you leave the impression that you can get flustered, you will have that reputation for a long time to come.
 
UTSouthwestern said:
Be confident, not arrogant, and do not show fear even if you are ****ting your pants (tell everyone the patient must have had a code brown or farted). If you leave the impression that you can get flustered, you will have that reputation for a long time to come.
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Great UT, you just scared the crap out of them. :laugh:
 
Great thread!

I'm just starting my CA-3 year, but am already getting nervous about being an attending. It's reassuring to hear that the new attendings are having (mostly) positive experiences.

P.S.
UTSouthwestern... will your group be hiring in a year?
 
H&P-Stat said:
Great thread!

I'm just starting my CA-3 year, but am already getting nervous about being an attending. It's reassuring to hear that the new attendings are having (mostly) positive experiences.

P.S.
UTSouthwestern... will your group be hiring in a year?
Click to expand...

Too early to tell, but I would say probably.
 
UTSouthwestern said:
Too early to tell, but I would say probably.
Click to expand...
:laugh: what is that about 50 people so-far asking if there is an opening in your group?
 
UTSouthwestern said:
Be confident, not arrogant, and do not show fear even if you are ****ting your pants (tell everyone the patient must have had a code brown or farted). If you leave the impression that you can get flustered, you will have that reputation for a long time to come.
Click to expand...

Dude what about me...I'm doing my 4th yr rotation in anesthesiology and I feel like a perfect idiot. Maybe 4 smooth intubations out of 10...0/4 on attempted a-lines...I couldn't even start the IV!!!

You want to talk about feeling flustered? I know it doesn't matter in terms of patient care, but man...the incompetence is underwhelming.
 
You suck worse 😉

My amazing CA-3 who has taken me under his wing said, "Here let's get some lidocaine and you can practice on yourself"...and I actually took him seriously til he winked. I'm awesome at hitting the vein though!
 
hey sammich,

don't sweat the little stuff man. The only people i intubated as a med stud were edentulous (4/10). Here is a little advice now that I am a CA-3. We as medical professionals tend to worry about the smallest things and end up consuming our lives with the dummest things. Just let it flow. you will get plenty of chances at intubation and a-lines in residency. Enjoy the rest of your 4th year and for crying out loud don't stay at home during your summer. Peace out.
 
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