Is Anes right for me?

[doctorwho09]

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I am considering anesthesia- I have question. I have a fear of when things going wrong during a case, intubating correctly, etc. Do you think this is something everyone has and gets over eventually as they do more cases? Or should I do something else as my personality is not conducive to this field? And are skills like intubation, PIVs, centrals, etc. easily teachable?

 

[Planktonmd]

I am considering anesthesia- I have question. I have a fear of when things going wrong during a case, intubating correctly, etc. Do you think this is something everyone has and gets over eventually as they do more cases? Or should I do something else as my personality is not conducive to this field? And are skills like intubation, PIVs, centrals, etc. easily teachable?

Fear never goes away but you learn how to control it and turn it into vigilance.
If you have no fear you should not do anesthesia.
The skills can be learned.

 

[Pilot Doc]

Agree with above - the skills are teachable.

Your personality may or may not be OK for anesthesia. Have their been similar things that scared you before but you learned how to manage (e.g. clinical rotations) or are you generally a petrified and nervous type even after spending significant time in an activity?

 

[G-Man82]

I am considering anesthesia- I have question. I have a fear of when things going wrong during a case, intubating correctly, etc. Do you think this is something everyone has and gets over eventually as they do more cases? Or should I do something else as my personality is not conducive to this field? And are skills like intubation, PIVs, centrals, etc. easily teachable?

I'm a bit like you as well. I'm a 4th year in my first rotation, General Anesthesia, which is what I am pretty sure I'll go into - just waiting to see how I feel at the end of this month. I'm only 4 days in, but I'm still terrified of intubating. My attendings are good about letting us do it, I've made 2 attempts and failed at them both. But, I still love the philosophy of the field - managing medical patients with surgical problems and instant gratification- so I'm sure I'll get over my fear eventually. Try the elective and see how it goes and forget thinking about the residency for now; first determine if the field is something you can handle, then put it into the resident's perspective.

 

[Arch Guillotti]

Crush your fear like Yoda, but try and stay awwy from the doobies.

I can remember intubating as a med stud. It always seemed like everyhting happened so fast and I never had time to mentally prepare myself and man I would shake like crazy putting that tube in. Waiting for that CO2 tracing to pop up was nerve racking for me. Fast forward to now when I have hundreds of tubes under my belt and I feel pretty darn good about bailing out folks from bad airway situations.

Never lose the fear because you are a fool if you do. Learn to get comfortable with doing things and when things go wrong, keep your cool. In residency there is always help if you need it. By the time you are done you will have seen and done so much you will look back and laugh at the med stud days. There are always going to be times when things don't go right and sometimes you are going to be pushed to your limits to do things that you may not be comfortable with. Push yourself and remember when things go wrong rely on your training skills, and Jedi mind to bail you out of a jam.

 

[RussianJoo]

The Docs at my hospital only let the students intubate the really easy patients, they take a look themselves first and if they clearly see the cords then, they take out the laryngoscope, make sure we can bag the patient and then let us try.. So I can proudly say i am 3/3.. and it feels great. however, I know that this isn't how it's going to be all the time..

then again I feel like by letting us tube the easy ones, it build confidence and allows the students to be more proactive which is a great way to teach...

 

[switching2gas]

As a recently-graduated med stud, let me be a source of encouragement. You will have good days and bad days. The first week on my elective, I hit everything - got all my tubes and PIVs and art lines without any problems. The second week, I blew half my veins and couldn't get adequate views with DL to attempt 3 or 4 tubes. (Note: I never goosed a tube bc if I didn't have a clear view of the cords, I didn't intubate. That should be your motto too, hand it over rather than cause airway trauma and/or goose it.) The third and fourth weeks, I relaxed and my skills came back. I was never perfect, but the point was to not let the fear mess me up, bc that was a surefire way to miss.

It is very easy to let your fear consume you, but once that happens, it'll become a self-fulfilling prophecy. The more nervous I got about blowing IVs, the more IVs I blew. The more nervous I got about DL, the less successful I was at sweeping the tongue and successfully intubating. But if you enjoy the intellectual aspects of the field (as I do,) you have to trust that the procedures will come. We're med students (or at least, I WAS, haha) and we are not expected to be perfect. Shoot, on my last day, I even caused a small lac in a patient's upper gum (he was edentulous) with my blade. I felt like a total jackass, but my attending wouldn't let me sit out the next intubation, he said that I would never get better if I let the fear of messing up consume me.

Anesthesia is a great field; if you love the intellectual aspects, don't let the procedural worries stop you.

 

[pillowhead]

It is very easy to let your fear consume you, but once that happens, it'll become a self-fulfilling prophecy. The more nervous I got about blowing IVs, the more IVs I blew. The more nervous I got about DL, the less successful I was at sweeping the tongue and successfully intubating. But if you enjoy the intellectual aspects of the field (as I do,) you have to trust that the procedures will come. We're med students (or at least, I WAS, haha) and we are not expected to be perfect. ****, on my last day, I even caused a small lac in a patient's upper gum (he was edentulous) with my blade. I felt like a total jackass, but my attending wouldn't let me sit out the next intubation, he said that I would never get better if I let the fear of messing up consume me.

The above is very good advice and still hard to follow sometimes even as I'm almost finished with my CA1 year. For some reason, peripheral IVs still frustrate me more than any other procedure and while I'll happily (and usually with reasonable speed and high success rate) do intubations, spinals, epidurals, central lines, and art lines (maybe a little less success/speed here) all day long, I just have this thing about peripheral IVs on people who have anything other than superb veins. I have no doubt that it has become a self-fulfilling prophecy after a string of missed IVs.

Very important to keep jumping in there and keep trying and to remain as objective as you possibly can about your own skills so you can focus on what to change to improve rather than just get more nervous.