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pelugi

Hey guys,

I was just wondering what you guys thought were your favorite and least favorite parts of anesthesia?!

Thanks!
 

jetproppilot

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Hey guys,

I was just wondering what you guys thought were your favorite and least favorite parts of anesthesia?!

Thanks!
Favorites: Quick, dynamic, social environment full of people I enjoy working with....cool procedures and science, interaction with patients thats long enough to be enjoyable but can be extinguished at any time with pharmacology; no clinic; no rounding (except on pain day); reimbursed well for my time; plenty of time off.

3 least favorites:

1) Call

2) Call

3) Call
 

2win

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Favorites: Quick, dynamic, social environment full of people I enjoy working with....cool procedures and science, interaction with patients thats long enough to be enjoyable but can be extinguished at any time with pharmacology; no clinic; no rounding (except on pain day); reimbursed well for my time; plenty of time off.

3 least favorites:

1) Call

2) Call

3) Call
1) best - time off
2) worst - call
3) best - the patient is asleep
4) worst - the CT surgeon
5) best - going home and free of worries
6) the feeling that we are loosing ground in the ICU and pain ...
 

2win

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peeing in a bottle after 8h in OR without a break... part of the deal. I didn't have a cam in OR otherwise I could be sued...
 

Planktonmd

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peeing in a bottle after 8h in OR without a break... part of the deal. I didn't have a cam in OR otherwise I could be sued...
I keep hearing this disgusting example about having to pee in a bottle because you can't leave the OR!
I say it's absolutely B.S.!
I can't think of a surgical case that lasts 8 hours where under the worst of circumstances you can't find a quite moment where you can tell the nurse to watch the monitor and run to the bathroom!
How long does it take you to pee?
Even if your prostate is the size of a grapefruit!
 

militarymd

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Although you are right about taking a quick break....this is an instance where you would actually be violating a standard of care as defined by the ASA..

People love to throw that term around ....STANDARD OF CARE.....and 99% of the time, they are wrong......but this IS a standard of care.

I keep hearing this disgusting example about having to pee in a bottle because you can't leave the OR!
I say it's absolutely B.S.!
I can't think of a surgical case that lasts 8 hours where under the worst of circumstances you can't find a quite moment where you can tell the nurse to watch the monitor and run to the bathroom!
How long does it take you to pee?
Even if your prostate is the size of a grapefruit!
 

Planktonmd

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Although you are right about taking a quick break....this is an instance where you would actually be violating a standard of care as defined by the ASA..

People love to throw that term around ....STANDARD OF CARE.....and 99% of the time, they are wrong......but this IS a standard of care.
I know, but you are not going to leave for an hour, or go across town to meet your girlfriend!
You are going to leave for 2 minutes Max, and if the alternative is you emptying your bladder in the OR I am sure the jury will sympathize with you, and if they don't, screw them! I will be glad to go with you to court and be your expert witness.
Maybe I should have said S CREW THEM instead?
 

Planktonmd

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About standards of care:
A "standard of care" is basically a legal term that means:
What a reasonable professional with similar qualifications would do under certain circumstances.
The ASA and all similar organizations don't define "the standard of care" they only issue practice guidelines that when adopted by the majority of practitioners in that field might become considered by lawyers standards of care.
So, even if the ASA says that a certain thing is a practice guideline it's really up to us to make it a standard of care or not.
 

fakin' the funk

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About standards of care:
A "standard of care" is basically a legal term that means:
What a reasonable professional with similar qualifications would do under certain circumstances.
The ASA and all similar organizations don't define "the standard of care" they only issue practice guidelines that when adopted by the majority of practitioners in that field might become considered by lawyers standards of care.
So, even if the ASA says that a certain thing is a practice guideline it's really up to us to make it a standard of care or not.
OP: you should really make another thread because this one just got JACKED.

BTW, wouldn't a "reasonable" doctor run to the bathroom rather than piss in a bottle in front of people? What if it was a chick?
 

urge

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I hate- lazy staff. As in "it's 3'o clock,why am I still running 2 rooms?" when in reality the rooms were started by other people and you haven't even bothered to check the rooms.
 

urge

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I can't think of a surgical case that lasts 8 hours where under the worst of circumstances you can't find a quite moment where you can tell the nurse to watch the monitor and run to the bathroom!
Lung transplant.
 

dr doze

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.
 
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Gimlet

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...interaction with patients thats long enough to be enjoyable but can be extinguished at any time with pharmacology...
LOL, I was just thinking about that today during a longwinded rant by one of my demented patients on Geriatrics. I was like I can't wait for the day when I can just say "Okay, time to go sleepy-bye now..." :D
 

SleepIsGood

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Although you are right about taking a quick break....this is an instance where you would actually be violating a standard of care as defined by the ASA..

People love to throw that term around ....STANDARD OF CARE.....and 99% of the time, they are wrong......but this IS a standard of care.
Sorry Mil gotta go with Plank. According to the 1986 and 2003 ASA house of Delegates
"Standards for Basic Anesthetic Monitoring"....


"....requires the temporary absence of the person pimarily responsible for the anesthetic, the best judgment of the anesthesiologist will be exercised in comparing the emergency with the anesthesized patient's condition and in the selection of the person left responsible for the anesthetic during the temporary absence".

No reason to think that having to urinate isnt an emergency...you could be compromising pt care by obsessing over the fact that you have to go. Again, cant use this to go to a bank or something random like that...but can use it in this sort of situation.

Thought I'd bring this up because I read this in Morgan yesterday.
 

militarymd

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About standards of care:
A "standard of care" is basically a legal term that means:
What a reasonable professional with similar qualifications would do under certain circumstances.
The ASA and all similar organizations don't define "the standard of care" they only issue practice guidelines that when adopted by the majority of practitioners in that field might become considered by lawyers standards of care.
So, even if the ASA says that a certain thing is a practice guideline it's really up to us to make it a standard of care or not.
the asa actually uses the word "standard"....it is quite clear...and it is also used in VERY FEW situations.

even though it does allow interpretation of what is considered an "emergency"......well I suppose you can consider having to go pee an emergency.....even though you probably know ahead of time when you will have to go.
 

2win

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I keep hearing this disgusting example about having to pee in a bottle because you can't leave the OR!
I say it's absolutely B.S.!
I can't think of a surgical case that lasts 8 hours where under the worst of circumstances you can't find a quite moment where you can tell the nurse to watch the monitor and run to the bathroom!
How long does it take you to pee?
Even if your prostate is the size of a grapefruit!
But...it's true...I could be sued for what? I would contaminate the field? You cannot leave the room - or if you do it it's your call. So I choosed the less likely way to get in trouble (for me and the patient). However - I CAN SAY THAT WAS GREEEEEAT!
I do believe that the safety of the patient was not jeopardized. The drapes were high enough. I had gloves. Also I changed them after that. Pleasures of anesthesia...
 

Monty Python

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Hey guys,

I was just wondering what you guys thought were your favorite and least favorite parts of anesthesia?!

Thanks!
Militant CRNAs who don't know what they don't know and thus make themselves look foolish.

Robotic cookbook CRNAs who can't think outside the box, nor simultaneously see the forest and the individual trees.
 

2win

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put a foley...There is no excuse to leave the OR. I will not be the one to let a nurse to monitor my patient. I do have some assets to be protected...
 

fakin' the funk

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However - I CAN SAY THAT WAS GREEEEEAT!
I do believe that the safety of the patient was not jeopardized. The drapes were high enough. I had gloves. Also I changed them after that. Pleasures of anesthesia...
Sounds like the ultimate version of one of those nice camping/hiking outdoors bathroom breaks...
 

Surfer

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the asa actually uses the word "standard"....it is quite clear...and it is also used in VERY FEW situations.

even though it does allow interpretation of what is considered an "emergency"......well I suppose you can consider having to go pee an emergency.....even though you probably know ahead of time when you will have to go.
Mil, the ASA does not dictate practice. They can no more tell me how to practice anesthesia than the easter bunny can. My medical license allows me to practice medicine according to state laws. If I get sued for leaving a room, my expert will say patient care would have been compromised by me NOT taking a 2 min bathroom break during a non-critical portion of the case.

The ASA is a joke anyways.
 

militarymd

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Mil, the ASA does not dictate practice. They can no more tell me how to practice anesthesia than the easter bunny can. My medical license allows me to practice medicine according to state laws. If I get sued for leaving a room, my expert will say patient care would have been compromised by me NOT taking a 2 min bathroom break during a non-critical portion of the case.

The ASA is a joke anyways.
you're right there...but they do represent all of us whether we like it or not.
 

urge

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I love: (pt is waking up breathing spontaneously at 40/min) Anesthetist says "I cannot bring the RR down, I have given a bunch of fentanyl and dilaudid"

Me- "WTF"

Clearly that wasn't enough. Keep trying.