being in the OR all day

[j_sde]

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question..

so far i'm enjoyin my anesthesia rotation. however, the one thing that botters me... alot, infact,.... is having to be in a room all day. the cases we do run either 2-8 hrs... residents few breaks here and there, but in general your in a small room, with no windows, all day.

does this botter anyone else looking into the field, or residents?

 

[VentdependenT]

That patient in front of you should keep you occupied

 

[jwk]

question..

so far i'm enjoyin my anesthesia rotation. however, the one thing that botters me... alot, infact,.... is having to be in a room all day. the cases we do run either 2-8 hrs... residents few breaks here and there, but in general your in a small room, with no windows, all day.

does this botter anyone else looking into the field, or residents?

It's part of the overall deal with anesthesia. Some cases are less than 5 minutes - a craniofacial could run >24 hrs, although you wouldn't do the whole case. If it bothers you that much, maybe it's not a good match.

And although there are long cases in private practice, keep in mind that cases in training institutions generally take a lot longer than they do in a private practice situation. A hysterectomy that takes 3-4 hours in a med school environment might only take 30-40 minutes in private practice.

 

[apma77]

how can u possibly enjoy the rotation if u hate being in the OR all day
thats the life of a anesthetist unless those that do pain clinic.

you need to look into another specialty where u wont hate being in the place you need to be.

 

[UTSouthwestern]

A hysterectomy that takes 3-4 hours in a med school environment might only take 30-40 minutes in private practice.

You forgot to mention the need for a MAC cordis after the estimated 1000 cc blood loss turns out to be in fact 5000 cc's.

 

[Skip Intro]

I have to agree with what the others have said. If you are having a problem keeping "focused" (not saying you are) or are getting bored, maybe anesthesia is not for you. I've said it a few times on a couple of other threads in this forum, but I get frustrated myself (as an MS4) when I see fellow students who are supposedly interested in anesthesia walk in and out of cases, leave early for lunch, run in to put in a tube or a line then leave, and just generally show little interest in the "nuts and bolts" of anesthesia. Then, at the end of the rotation, they say, "Gosh, I can't wait to be an anesthesiologist!!! The money and lifestyle are so great!"

I want to stangle some of them.

A word to the wise, as well. One of my attendings, at the end of my first rotation, pulled me aside and told me that most medical students are about about half as clever as they think they are. In other words, it is noticed when they jump in and out of cases, when they show little interest in what's going on, etc. This particular attending told me that he told another student who asked for a LOR from him, in these exact words, "you don't want me to write your recommendation, trust me."

Go into anesthesia because you like the field and the job, not solely for the money and lifestyle (which may change in another four to five years by the time you're out in the real world). Although, I won't be dishonest and say that those things are not a factor, they should not be the deciding factor.

Personally, I appreciate your honesty in starting this thread. I hope others will consider the point you've raised. It's an important one. If you're feeling bored already, then maybe this isn't the field for you.

Just my $0.02.

-Skip

 

[j_sde]

i cant believe how quick people are at jumping to bashing...

note, the reason i put the post up ... was cuz, i HAVE been stayin the OR the entire case.... 7 hrs for spinal fusions, 2 hrs for laps, 3 hrs for cranios... etc. That is why, in honest assesment, I'm bothered by 'being in the same room' all day. If i was jumping from cases to cases, not interested in anesthesia, but more interested in doin intubations,etc.... then i wouldnt be in one room all day, and wouldnt have this problem.

anyways you may be rite, anesthesia may not be for me if i dont like being in the OR all day.... i'm still tryin to figure out. although i really do like the physiology and the procedures of the field.

my quesiton was more intended to see if other residents/attendings who enjoyed the field ever felt that way at all. and how they deal with it. or if once your not a resident... and your supervising cases as an attending, that the prob goes away..

 

[apma77]

this is like saying i love baseball but i hate being on the field

 

[joshmir]

i feel you man.

i don't think the others here are hating. they were just lucky enough to love the gas experience enough to not sweat it, and maybe don't understand our fears...i'm happy for them. i matched in gas, i'm an intern now, and i *still* worry about this everyday. right now, everything is new to me, and i get a rush when the attending leaves me alone in the room for a couple of minutes (as an intern doing a gas elective), but what about when all is second nature? also, i go to the bathroom if i have to pee, i don't hold it. i get coffee when i'm tired, i go to the vending machine if i'm hungry. when i'm on my own, and can't do this, it may really, really suck, i have no idea.

also, for the students that hop around from case to case, that's not such a bad thing if the person you are with is *not* talking you through how to critically analyze minute-to-minute changes and asking you what YOU want to do, then letting you get hands on and do it. i find time spent in a simulator (btw, body sim is pretty cool, google it) is better to help me learn than a case with an attending who's rushed and not letting me make decisions, do things.


i disagree with the metaphor about not liking being on the field but liking baseball...there are so many different "fields" in gas; i often dream about being in laid back ortho cases talking sports with the bone doctors and their assistants, listening to good music on the OR cd player (net radio more often in my hospital). i think it may be cool to be a lounge lizard at an academic center where the residents are fun to teach, joke around with...catching sportscenter in the lounge, reading the paper, theonion.com, shooting the sh&*,etc to break up the boredom (if i get bored with it). working only four days a week may also make the boring parts easier to deal with and feel like less of a sentence. and i'm hoping that if one desires, you could find yourself in a practice situation where you are doing cases that let you read books/magazines the whole time.


i often reflect that in most fields as a med student, you do the crap work where everyone else does the cool stuff (ie, surgery clerkship). gas is the opposite. for that reason it's tough to know that you can deal with the crap. i would put forth the perspective that in people who are having problems making up their minds about specialties, at its most base level, gas is certainly the lesser of many evils that most students can get into (derm, rad onc, rads are innaccessible to most). in that case, where everything is a big ?, lifestyle and reimbursement and not being in the clinic may be good reasons to pick the field...it's better to do gas then switch to medicine then the other way around.

again, not everyone is fortunate enough to fall head over heels in love with the field. some people may use it as a back up for derm or rads and have to grow to love the field, whereas others could barely get into the field so psychologically it means more to them. in some ways, it's like an arranged marriage. would *all* the people who say they love gas so much have gone into derm or plastic surgery in california if they had "that uncle" that was willing to hook them up?

my $.01. as always, i hope if people with more experience disagree with my perspectives, please enlighten me, i am always a fan of seeing the new light.

especially, if any residents are now feeling claustrophobic about being stuck in the room, feel "trapped" in a way that affects their mental well being or bladder functionality, please share your thoughts!

 

[Krony]

I appreciate all of the honesty in these posts...thanks.

In my very limited "preceptorship" experience that I completed this summer I was surprised to find how tired and generally worn out feeling I was after spending hours at a time in the room. I sort of expected it to be more like how I felt after when I used to work in an office setting all day - I'd get home and be anxious and energized to go workout, etc. After hours in the room I felt more like I had just finished driving a very long distance. And of course I didn't even have the kind real responsibility that requires sustained vigilance, and I was never alone.

How does this compare to the experience of some of you more seasoned folks? I suppose 12 hours anywhere, for example, is going to wear a person out - but in general do those of you in residency/practice feel more energized or floored after spending a good chunk of time sitting in the room?

 

[NaeBlis]

i cant believe how quick people are at jumping to bashing...

note, the reason i put the post up ... was cuz, i HAVE been stayin the OR the entire case.... 7 hrs for spinal fusions, 2 hrs for laps, 3 hrs for cranios... etc. That is why, in honest assesment, I'm bothered by 'being in the same room' all day. If i was jumping from cases to cases, not interested in anesthesia, but more interested in doin intubations,etc.... then i wouldnt be in one room all day, and wouldnt have this problem.

anyways you may be rite, anesthesia may not be for me if i dont like being in the OR all day.... i'm still tryin to figure out. although i really do like the physiology and the procedures of the field.

my quesiton was more intended to see if other residents/attendings who enjoyed the field ever felt that way at all. and how they deal with it. or if once your not a resident... and your supervising cases as an attending, that the prob goes away..

The bashing really did start quick, but I think people who choose anesthesia because they like it are frustrated by those who are in it for the quick buck. In terms of your boredom keep in mind, even though u are staying in the OR for the entire case you aren't truly responisble for anything. An attending/resident is always there with you and they are one busy monitering all the stats making sure nothing goes wrong. Believe me, as a new CA1 this keeps you very busy, the time flys by, and you wish you had more time since you are often a bit behind on charting. As you become more experienced, it may be less busy as you have delt with many issues many times, but I think this applies to every field. In my medicine internship, managing COPD/CHF patients was interesting the first month, but after the 20th case, you are pretty much following a routine with them, and hoping for something more interesting, which rarely comes along.

 

[GeddyLee]

question..

so far i'm enjoyin my anesthesia rotation. however, the one thing that botters me... alot, infact,.... is having to be in a room all day. the cases we do run either 2-8 hrs... residents few breaks here and there, but in general your in a small room, with no windows, all day.

does this botter anyone else looking into the field, or residents?

For some reason this is always a big concern with medical students. Fear of windowless rooms must be an inherent phobia in the medical student. You especially hear this concern from people about radiology...because it's a dark, windowless room. You know what, most people work in a single room all day. If you choose, say FP or IM, you'll just go in and out of several windowless rooms all day. I don't see why this would be a big deal. You shouldn't be having enough time as a doctor to stare out a window anyway. Just be glad you get to sit down and take breaks! Not many specialties will offer that.

I can't really imagine any medical specialty where you'll roam around alot. Unless you're going to do house calls as an FP, in which case you'll surely go broke. Maybe if you're a hospitalist you can have the joy of going to the ER, up the floor, back to the ER, etc, etc. But those are all windowless rooms too.

If you really get bored...bring one of those portable televisions to watch during the case. Your attending and resident will be impressed that you want to help diminish the boredom. Seriously though. Get over it. You'll be working in a windowless room regardless of what you do in medicine. Maybe you should have become a forest ranger!

And even if you had a window, wouldn't you just get sick of the view after a while? One can only get so much amusement from squirrels and trees.

 

[Krony]

Maybe you should have become a forest ranger!

On a personal note - in 5th grade I took a career interest test and came up with a tie between Forest Ranger and Physician.

Of course I can only speak for myself and not the o.p., but for me fear of the windowless room flows not so much from an actual fear of an environment devoid of windows or a love of squirrels and trees; rather the room and the general inability to step outside of it stands more as a metaphor...or at least some kind of tangible component consistent with the intensity and vigilance that seems to be required in this field.

This thought is a nice transition to make a plug for the question I asked a few posts ago. For those in the field, does sustenance of this kind of intensity and vigilance leave you feeling energized or worn out at the end of the day?

 

[powermd]

On a personal note - in 5th grade I took a career interest test and came up with a tie between Forest Ranger and Physician.

Of course I can only speak for myself and not the o.p., but for me fear of the windowless room flows not so much from an actual fear of an environment devoid of windows or a love of squirrels and trees; rather the room and the general inability to step outside of it stands more as a metaphor...or at least some kind of tangible component consistent with the intensity and vigilance that seems to be required in this field.

This thought is a nice transition to make a plug for the question I asked a few posts ago. For those in the field, does sustenance of this kind of intensity and vigilance leave you feeling energized or worn out at the end of the day?

On my anesthesia rotations I would always feel pretty exhausted by 5pm, which makes sense, since you start at 6am! I always found the mornings to go very quickly, which is one of my many draws to the field. You can bang out 6 hours of work in what feels like no time at all. If you want, you can find jobs that pay well and have you working less than 6-7 hours/day. I would much rather spend 8 hours focusing intently on a few patients and managing life and death issues, than being bored out of my skull seeing 30-40 patients in a dull medical office 10-12 hours/day.