Stress - Job satisfaction

[ARealist2]

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I've gotta question for anesth. residents . . . I've heard that anesthesia can be very stressful. What is it that makes it so stressful. Do patients crash often, or do you have a large volume of patients; or is it just working in the O.R. with annoying surgeons. Also as a first year resident, are you expected to have picked up on the basic anesth. principles during med school, and you run the cases yourselves at the beginning of residency....or is there a lot of teaching during the first year.

 

[Mman]

I've gotta question for anesth. residents . . . I've heard that anesthesia can be very stressful. What is it that makes it so stressful. Do patients crash often, or do you have a large volume of patients; or is it just working in the O.R. with annoying surgeons. Also as a first year resident, are you expected to have picked up on the basic anesth. principles during med school, and you run the cases yourselves at the beginning of residency....or is there a lot of teaching during the first year.

I believe you are expected to know almost nothing when you first show up. That's the point of residency, they can and will teach you everything. I'm 99% certain that all CA-1s across the country start out 1-1 with an attending for a few weeks until they get the hang of it and aren't running cases by themselves at the start.

 

[gaslady]

Patients do crash from time to time, but we also cause a lot of tachy and bradycardia and hypo and hypertension. We make most of them apneic at induction and if we can't secure the airway & provide supplemental ventilation they WILL die from respiratory arrest. We do this so they can have surgery, but it is still something that is iatrogenic. You get good at it so it becomes routine, but it is stressful. There's not many other areas where you consistently have patients' lives in your hands on a minute-to-minute and second-to-second basis.
As a new CA-1 you will get orientation. Different places do it differently. They don't expect you to know how to do anesthesia. It's helpful if you are familiar with some of the vocabulary though, but you can get that by doing a lot of reading when you start.

 

[soon2bdoc2003]

My biggest gripe has nothing to do with the OR but with the way its run. OR's are cash cows and there is alot of pressure in my program for fast turnover and maximizing profits. Attendings always cover 2 rooms and 1 of them is usually an ambulatory room so they are just running back and forth between rooms and have zero time to teach. Surgeons are respectful up to a point but if they are running behind schedule they will always try to make it up out of your end which leaves you with 5 minutes between cases to flip through a chart slam in the iv and bring the patient into the room. More then once a patient that could've really used an epidural or regional technique winds up getting general because of time issues. On the back end, lots of patients are ambu'd to the recovery room rather then wait 15 minutes to extubate in the OR. If it takes you more than 8-10 minutes to wake up a patient the cleaning crew will be tapping their feet at the door waiting for you. Probably the biggest skill i gained as a ca1 is how to time the drapes coming down with the tube coming out. Nice skill to have in private practice but there should be a little more slack in a teaching program. Unfortunately many hospitals see anesthesia departments as cash cows and will stretch faculty and residents to the limit trying to maximize their profits.

Other than the above I really love my job.. something tells me my concerns will be somewhat alleviated when I finish up and get an overnight $200k raise 😉

 

[jetproppilot]

Probably the biggest skill i gained as a ca1 is how to time the drapes coming down with the tube coming out.
QUOTE]

If you're doing this as a CA-1, you're star destined. Awesome. 👍