Does the feeling ever go away?

[Iso4ane]

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In anesthesia there are so many ways to skin a cat, that despite feeling reasonably confident in what I know, I know there is a lot I don’t know, which leads to feelings of inadequacy. Does that feeling really ever go away?

 

[sevoflurane]

Yes it goes away.
Nobody is perfect 100% of the time.
Be open to the way others do it and keep on trying to tweak your practice for the better. Right out of residency you have a long ways to go, but it all gets better.

“Life time learner” is a good description on what you should be aiming for.

 

[DM27]

Echoing the above, the best thing you can do is to not get stuck in your ways or develop a cookie-cutter routine, especially early on. My mentality is there are a number of wrong ways to do a case, you just need to pick one that you think suits that patient best and be open to the input of others unless it seems to be dangerous or extremely illogical.

 

[Guillemot]

Don't worry! The feeling definitely goes away! I have actually worked with many board certified anesthesiologists that are under the impression that they know just about everything. So what if they are functioning at what I would approximate to be a CA-2 level? They feel good about themselves, and that is really all that matters when you get right down to it!

 

[Mman]

you will come to understand that you don't have to be an expert at every way to do every case, you just have to be comfortable finding a few ways to do each case

 

[Paingas]

thinking there is only one or two ways to do a case is what should worry you

 

[dannyboy1]

Even if the anesthetic is “wrong”, patients usually do ok unless you fu(k up the airway.....

 

[2Fast2Des]

Not as much nerves but always have in the back of my mind all of the potential ways things could probably f up and if I think I have the ability to manage, or how little I can get away with if I need to push the button. So yes still always on guard, don't know if that will ever go away, I'm still less than first year out. I still try to put a poker face even when things are going south, just manage accordingly and a couple of F bombs here and there haha

 

[Planktonmd]

In anesthesia there are so many ways to skin a cat, that despite feeling reasonably confident in what I know, I know there is a lot I don’t know, which leads to feelings of inadequacy. Does that feeling really ever go away?

Medicine is not mathematics and 1+1 don't always equal 2, once you truly understand that fact (i mean truly), you will stop having these negative feelings.

 

[Twiggidy]

Medicine is not mathematics and 1+1 don't always equal 2, once you truly understand that fact (i mean truly), you will stop having these negative feelings.

Anesthesia really does transition between science and art almost day by day.

 

[Dejavu]

Speaking for myself, after 40+ years, what doesn’t go away is the thrill.

Seeing chemistry in action, in minutes, every day, every patient, never gets old.

Like Twiggidy said, going between the worlds of science and art, and then back again, in seconds, all day long is just awesome.

 

[T-burglar]

Even if the anesthetic is “wrong”, patients usually do ok unless you fu(k up the airway.....

Lol this is essentially what anesthesia and critical care boils down to

 

[Noyac]

I am gonna take a different course here. I think some people may never move past the feeling of inadequacy. Fortunately, that is rare.

 

[Aether2000]

For the most part, we operate within fairly expansive bands of tolerance for perfusion, oxygenation, ventilation, and drug responses without causing major organ damage or death. It is possible to use only one technique in anesthesia, become proficient in it, and use it for 99%+ of all your patients, without harm. But the finesse (and fun) in anesthesiology is to develop an ever expanding toolbox acquired over the years, in order to select your best choice for the patient. With any new tool you add, there is a steep learning curve, but with practice and study, the novice inadequacy complex rapidly dissipates.

 

[deleted9493]

Don’t fall into the trap of thinking that “I always do ‘x, y, and z” because that is what the majority in my practice do...or that is how I trained.” Keep up with current evidence, glean what is good (and not) from your partners’ practices, and most importantly, follow up with how your patients have done as a result of your choices. Nobody has a zero complication rate—the best are those that can contextualize their complications and use the aforementioned to improve practice. Finally, do not let a single complication cause you to fear a particular management strategy; practice driven by fear—as in parenting—will often not produce the best outcome.