Nervous about CA1

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burnermdaccount

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I recently switched into an anesthesia residency despite doing no anesthesia electives (due to OR shutdowns). I've done just a few days of OR shadowing (<5 days) and still very uncomfortable in the OR. I've done 1 IV, 1 art line, no successful spinals. In my program, I would be considered CA1. I'm very very nervous.

My plan is to read Lange cover to cover and try to get more shadowing experience. Any other suggestions? What are the expectations for CA1s on July 1st?

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I recently switched into an anesthesia residency despite doing no anesthesia electives (due to OR shutdowns). I've done just a few days of OR shadowing (<5 days) and still very uncomfortable in the OR. I've done 1 IV, 1 art line, no successful spinals. In my program, I would be considered CA1. I'm very very nervous.

My plan is to read Lange cover to cover and try to get more shadowing experience. Any other suggestions? What are the expectations for CA1s on July 1st?

Zero expectations. Watch some youtube videos on procedures. Nysora good for blocks and nejm are ok for lines. Read about your patients.

I read through yao and artusio and ranger blue or red which I thought was helpful. Uptodate has some good articles about cardiac stuff like the bypass machine.
 
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It’s ok to be nervous. There are literally no expectations. There are many people who switch into anesthesia never having done any before. I think UpToDate has good info. Baby miller is more than enough. Your basic tasks are to place IVs, lines, intubate. Attendings and seniors are usually close by or in the room for the case the first month and basically tell you what to do, just ask why. After 2 months of general anesthesia you will all be on equal footing more or less.
 
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I think the important thing is that you prepare diligently for each case, especially for the first 5-6 months.

Jaffe is a good quick reference when you're doing a case you've never done. It helps inform you about what you should expect, from positioning, lines or labs needed, or expected blood loss, etc..

Stoelting's Anesthesia and Coexisting diseases is a fantastic resource to review anesthetic considerations for particular pathologies. I regularly looked things up in this book. Still do actually.

As mentioned, UpToDate has some good articles. A ton of articles actually. Just search "anesthesia for ______" on UpToDate and you'll often find it to be a good reference.
 
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Don’t worry. There was a day that every anesthesiologist and CRNA who ever practiced didn’t know how to even turn on the machine.
 
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Don’t worry. There was a day that every anesthesiologist and CRNA who ever practiced didn’t know how to even turn on the machine.


Where’s the locker room? Where’s PACU? What’s a bougie?
 
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Thanks for the reassurance. I feel better. And yes I am that green. I'm still waiting for a good time to ask my anesthesiologist to show me how to do a machine check, turn off/on the machine, basic things like that. The only thing I can think of to make up for my lack of practical knowledge is to increase my book knowledge. Already done 10 chapters of Lange, and hope to work my way through the rest before July 1. I will get Stoetlings for sure.
 
Nervous is good..keeps you on your toes and keeps you motivated to study and pay close attention.

Complacency is an anesthesiologists worst enemy.

You just need to learn to be aware of that nervous feeling and not let it cloud your judgement
 
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Order of expectations:
Availability
Affability
...
...
...
Ability

Show up and have a good mood. If it makes you feel better in your skin to study a textbook then that's on you. No one expects it.
 
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Act interested. Have a good attitude, even when in a bad case. It’s ok to not know. I can teach someone how to do an a-line or intubate, if they’ll listen. It’s much harder to teach someone how NOT to be a lazy a-hole.

It’s ok to have to be told how to do something, by an attending. Don’t be the guy who has to be told THREE times how to do something, by the SAME attending.

If all else fails, ask the attending what they like to do for fun, and about their family. People like to talk about themselves, and it gets them off your back.
 
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