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Other than administering anesthesia and monitoring patients during surgery, are they responsible for other things? Is it relatively relaxed
Is an anesthesiologist's job hard? What are their responsibilities?
- Thread starter TheBiologist
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AnatomyGrey12
If you consider the fact that one little mistake could kill someone easy then yeah sure their job is easy. If you consider being the last line of defense against a rapidly closing airway easy then yeah sure it’s an easy job. Just like a stroll down the beach
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I think the saying, “99% sheer boredom, 1% sheer terror” is an accurate description as far as how “relaxed” our job is. Most of the time things go exactly as planned, but when it doesn’t it can go south very quickly. You have to be able to manage the unexpected without losing your cool.
The job description can vary widely based on where you decide to practice. I am in a care team model where I supervise 4 anesthetists at a time. I also place labor epidurals, preop patients for upcoming surgery, place central lines in the ICU when needed, do nerve blocks for post op pain control, and handle administrative duties. The old days of “ABC’s equal airway, bagel, coffee” don’t exist much in private practice.
The job description can vary widely based on where you decide to practice. I am in a care team model where I supervise 4 anesthetists at a time. I also place labor epidurals, preop patients for upcoming surgery, place central lines in the ICU when needed, do nerve blocks for post op pain control, and handle administrative duties. The old days of “ABC’s equal airway, bagel, coffee” don’t exist much in private practice.
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Where's the wise @HomeSkool when you need him????
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IIRC, anesthesiologists are also responsible for blood transfusions during surgery so if something goes wrong in that regard, it is also on the anesthesiologist.
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In addition to providing intra-operative and post op anesthesia and pain management, they do labor epidurals (and other blocks).
There are several anesthesia sub-specialties, also. Pain management and Critical Care are just a few.
There are several anesthesia sub-specialties, also. Pain management and Critical Care are just a few.
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Let's not forget how stressful it can be to be in charge of many CRNAs who are encroaching on your job.
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Depends on the difficulty of the crossword puzzle that day.
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Our responsibilities vary depending on the assignment for the day. As Camkiss had mentioned, we do a variety of things besides just OR duties:
1. we cover OB so that includes placing labor epidurals and staffing crashing OB pts
2. we cover airway for the hospital. So any patients on the floor/ICU needs a breathing tube emergently/semi emergently we get called to place it. Also handle difficult airways. Anyone that the ED can't intubate or has some type of mass obstructing their oropharynx we can do awake fiberoptic intubations
3. managing and staffing preop clearance for patients scheduled for surgery
4. we do peripheral nerve blocks to help with post op pain
5. Chronic pain trained Anesthesiologists hold clinic and can do procedures like epidural steroid injections. Some also round on pain management services in the hospital for chronic pain patients who are having a hard time having their pain controlled while in the hospital.
6. ICU trained Anesthesiologists also cover the ICU and manage the patients there.
7. aline/central line/IVs etc
Whether or not it's considered relaxing just depends on the day and what you're doing as well as what your practice model is. Supervising CRNAs/residents although it frees you up also has its challenges as you never know what's going on at any given moment with your patients that you're technically responsible for. SO you have to trust the person in the OR. If they're bad that's a source of stress. Having a good plan in place to address whatever complex issue the patient has can alleviate a lot of the stress honestly. However, the best laid plans can always go to **** quite fast and you just have to be calm under pressure. You may have to run the code in the OR if the patient codes too. Anesthesia is a lot of what-ifs: knowing and having a plan for how to manage the worst possible complications and outcomes.
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My friend just finished his anesthesiology residency and told me that at some point in your career as an anesthesiology, you will kill someone. So yeah, it's probably pretty stressful at times.
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Good morning, y'all! I'm working nights this week, so I just got up.
Anesthesiologists are consultants in perioperative medicine and pain management. Chronologically, we first perform preoperative assessment on surgical patients to determine whether they've been optimized for surgery. If they haven't, we communicate with our surgeons and with other consultants to obtain whatever additional workup and optimization are required to minimize the patient's perioperative risk.
Next, we plan and administer the anesthetic technique we think is best for each patient. That may be general anesthesia, sedation, or regional anesthesia (such as a peripheral nerve block or neuraxial technique). We decide how best to manage the patient's airway, which monitors are necessary, and which lines we'll need. We must often satisfy competing and conflicting goals, and we must consider the patient's comorbid conditions when determining the anesthetic milieu and sequence of events once we enter the operating room.
Intraoperatively, our goal is simply to keep the patient safe while delivering the conditions the surgeons require to operate successfully. That involves continuous monitoring of the patient's cardiovascular, pulmonary, and neurologic status; awareness of what's happening on the other side of the drape; interpretation of intraoperative labs; and communication with our surgeons and other OR personnel regarding any concerning or reassuring developments. We must quickly determine the cause and appropriate management of acute physiologic derangements.
As surgery comes to an end, we decide how best to manage the patient in the immediate postoperative period. We continue monitoring and treating our patients in the PACU to ensure pain is managed, hemodynamic parameters are stable, consciousness is improving, etc.
Beyond our perioperative role, we also assess and manage acute and chronic pain, provide labor analgesia, respond to codes and calls for assistance on challenging airways, and place lines in patients with poor vascular access.
As an attending anesthesiologist in an academic medical center, my role is to simultaneously supervise up to four other people (either residents or nurse anesthetists) running surgical cases. I'm constantly evaluating my patients, directing my personnel in management decisions, and sometimes personally running particularly complex cases (as I did last night). I'm also expected to teach residents and med students in formal and informal didactics both in and out of the operating room.
As @camkiss pointed out, most of the time our job goes smoothly, but things can go sideways in a hurry. When that happens, we have to remain cool and make decisions very quickly and often with imperfect data. My best friend, also an anesthesiologist, is fond of saying, "Critical care is anesthesia in slow motion." It can be a very stressful job. Like emergency medicine, anesthesiology attracts people who enjoy acute care and who are willing to stand at the head of the bed in a crisis.
@Lucca: You can only do a crossword once. Minesweeper is forever.
Anesthesiologists are consultants in perioperative medicine and pain management. Chronologically, we first perform preoperative assessment on surgical patients to determine whether they've been optimized for surgery. If they haven't, we communicate with our surgeons and with other consultants to obtain whatever additional workup and optimization are required to minimize the patient's perioperative risk.
Next, we plan and administer the anesthetic technique we think is best for each patient. That may be general anesthesia, sedation, or regional anesthesia (such as a peripheral nerve block or neuraxial technique). We decide how best to manage the patient's airway, which monitors are necessary, and which lines we'll need. We must often satisfy competing and conflicting goals, and we must consider the patient's comorbid conditions when determining the anesthetic milieu and sequence of events once we enter the operating room.
Intraoperatively, our goal is simply to keep the patient safe while delivering the conditions the surgeons require to operate successfully. That involves continuous monitoring of the patient's cardiovascular, pulmonary, and neurologic status; awareness of what's happening on the other side of the drape; interpretation of intraoperative labs; and communication with our surgeons and other OR personnel regarding any concerning or reassuring developments. We must quickly determine the cause and appropriate management of acute physiologic derangements.
As surgery comes to an end, we decide how best to manage the patient in the immediate postoperative period. We continue monitoring and treating our patients in the PACU to ensure pain is managed, hemodynamic parameters are stable, consciousness is improving, etc.
Beyond our perioperative role, we also assess and manage acute and chronic pain, provide labor analgesia, respond to codes and calls for assistance on challenging airways, and place lines in patients with poor vascular access.
As an attending anesthesiologist in an academic medical center, my role is to simultaneously supervise up to four other people (either residents or nurse anesthetists) running surgical cases. I'm constantly evaluating my patients, directing my personnel in management decisions, and sometimes personally running particularly complex cases (as I did last night). I'm also expected to teach residents and med students in formal and informal didactics both in and out of the operating room.
As @camkiss pointed out, most of the time our job goes smoothly, but things can go sideways in a hurry. When that happens, we have to remain cool and make decisions very quickly and often with imperfect data. My best friend, also an anesthesiologist, is fond of saying, "Critical care is anesthesia in slow motion." It can be a very stressful job. Like emergency medicine, anesthesiology attracts people who enjoy acute care and who are willing to stand at the head of the bed in a crisis.
@Lucca: You can only do a crossword once. Minesweeper is forever.
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Thanks for the informative (per usual) post, HomeSkool! I have a related question: was there a specialty that competed with your interest in anesthesiology, and, if so, what pulled you towards your ultimate choice?
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As a matter of fact, there was! I initially thought I wanted to be a surgeon of some variety, and I was convinced as an MS3 to do an anesthesiology elective. I found that I'm very well suited to the acute care nature of the specialty, I enjoy spending my days in the OR, I'm very good at keeping my head during a crisis, and I love the physiology/pharmacology/procedures mix. Over the course of that first anesthesiology elective, I found myself drawn more and more to the field. Eventually, I participated in a very memorable emergency case that helped me finalize my decision to change my career goal from surgery to anesthesiology. I've documented that case in this post on my blog: Gas Words: The dance.
Of note, I also enjoyed emergency medicine immensely (not surprising, since it's another acute care specialty); however, I had to finalize my application for the military match before I'd done my EM rotation as an MS4. It's just as well, because subsequent work in the ED has shown me that anesthesiology really is the right place for me.
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Oh my god, that was a beautiful piece and very well-written. Was your personal statement for residency applications similar to that in nature or style?
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As they say, if your favorite place in the hospital is the OR, do anesthesia. If your favorite place in the world is the OR, do surgery!
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Thank you! I can't remember exactly what my PS looked like, but it wasn't a dramatic narrative. I feel like that goes over much better in a blog or a book, whereas it can bite you in the butt in a personal statement. My PS is probably buried in a folder on my computer at home (I'm at work right now -- viva la night float!). I'll have to check tomorrow. @Goro thinks I should write a book, and I may someday...gotta get more material first.
Ironically, I get to spend more time in the OR than they do. They have to go to clinic a couple times a week, but I get to go to the playground every day!
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That was great. Beautiful piece. We all realize that EM and anesthesia have a ton in common, and I have immense respect for my fellow "resuscitationists" in the OR.
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Well you just turned my idea of an anesthesiologist on its head... great piece!
