Why am i suddenly so stressed from anesthesia?

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LowWafer8

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Been doing this 15 years. We all know this is a demanding and stressful field no matter what. I never really FELT stressed though. I'm not sure why, now each morning I get up with anxiety about the day when (I think) I didnt in the past, whether it's for a day of "simple" solo sedation cases or supervising multiple rooms. I'm nowhere near retirement and feel like I get plenty of downtime / off time. Not sure what to do. Is it reasonable to stop doing OB and taking call mid-career and just do locums? I don't mind labor epidurals but stat sections and irritated surgeons over a little pt movement and all of that is getting to me I think.
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I think about dropping OB all the time or going somewhere with lower volume only. You going to have to deal with **** surgeons everywhere.

I wouldn’t drop a reasonably stable W2 job right now. 1099 is its own beast and headache. You would need at least 3 spots to credential and for some reason, there is still a stigma of people doing locums. It’s not like all the crap docs are doing it.
 
NightyNight said:
I think about dropping OB all the time or going somewhere with lower volume only. You going to have to deal with **** surgeons everywhere.

I wouldn’t drop a reasonably stable W2 job right now. 1099 is its own beast and headache. You would need at least 3 spots to credential and for some reason, there is still a stigma of people doing locums. It’s not like all the crap docs are doing it.
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Agree if you do full time have at least 3-4 places (hospital) credentialed to flip flop immediately

Stand a lone surgery centers not affiliated isn’t big hospitals or big entities you can get credential immediately so those are not a problem
 
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I've noticed this phenomenon as I got older. Noticed it in my older colleagues and had a short stint of it during the pandemic. My theory is that as you gain more tenure in this profession the numbers catch up. You start seeing the rare complications and adverse events since your denominator gets larger. You then begin to perseverate on the rare instances rather than seeing those events as they truly are...rare. These "what if" events begin to enlarge and encompass our cognitive space. Now you practice in this weird space of fear and anxiety . You get a form a paralysis through analysis. I had to embrace the fundamental fact that you can't control everything and that you control what you can control and let the cards fall where they may. Got my mojo back soon after. Hope this helps. BTW F*CK OB. I dropped it recently and couldn't be happier. (I'm about half a decade further along in my career as context)
 
If dropping OB is an option, always drop
OB.

I’m early mid-career and seriously contemplating dropping call…or at least only doing call on my terms. My family notices a change in my mood for the worse in the days leading up to a call and an irritability in a few days after a call. I don’t know if what I feel before a call is anxiety. It’s more like a sense of dread. I don’t feel particularly anxious about doing a case, but rather the dread of having no control over my life for 24 hours.
 
I’m only 2 years out and had the rare/surprising opportunity to drop OB coverage but keep everything else the same at my job. I couldn’t do it fast enough. Bunch of old timers telling me I’m too young to “give up” that skillset. Don’t care. The old and the sick needing emergency surgery in the middle of the night doesn’t bother me in the slightest. But caring for young people thinking/hoping this is gonna be one of the most magical/happiest moments of their life only for it to potentially turn into a nightmare at the drop of a hat, that caused me serious stress/anxiety, to the point where it was negatively impacting my life. Happy it’s behind me.
 
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I think someone touched on this earlier.
Sleeping okay, losing interest in activities your normally like, any feelings of guilt, lack of energy, losing appetite, agitation, thoughts of hurting yourself?

I think it’s normal to have intrusive, weird, untrue thoughts and irrational anxiety. It depends on how we interpret them, and being stressed from call, depression or personal life factors definitely compounds them and makes them hard to let go of.

Reach out to someone you trust or a professional. You’ll likely find you’re not alone. If all of us got together and put all our thoughts, stress and anxiety in one pile, a lot of us would go pick ours back up after seeing what other people are dealing with. You’re not a robot and you’re not alone.

You can PM also.

Wish you the best.
 
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The older I got, the more money I had, and the more I felt I had to LOSE (and less to GAIN), by doing risky cases/doing night and weekend call/putting up with a-hole and incompetent surgeons…

It definitely makes you more risk averse, a little more “worried”, and in my case, even less tolerant of “BS” (I was finding myself angrier, rather than “mellowing out” with age, while in the hospital).


My kids have also hit the adolescent stage, and while I’ve made a point to be there for most of their activities, I definitely found myself getting angry, wasting time on call/waiting for surgeons to arrive/waiting on slow surgeons to finish, when I COULD be spending time with kids that won’t be in the house, much longer.

I finally went half-time. Not saying it’s the solution to YOUR problem. but it may be. I simply found I had better things to do than spend all my time in a place I didn’t like, with people I didn’t like, doing cases I didn’t like—-to make money that wasn’t going to change my “lifestyle” in any appreciable fashion.

Any bad incidents, lately?? Any of your partners have a lawsuit/etc, that’s making you “think” a little too much?? It MAY be time to just put your foot down, and back away from some of the call obligations, or certain surgeons that are just a real pain in the rear.
 
I'd much, much rather do OB solo any day over supervising. The only thing I really dislike about OB is the fact that more than 50% of it happens at night or on weekends.

I don't feel like anesthesia is especially stressful, except when trying to keep track of what CRNAs are doing in 3 or 4 rooms.

I enjoy cardiac. Very rarely do any peds, and the it's healthy stuff.

Fortunately I'm solo the large majority of the time.


If you're stressed and working ACT maybe that is what you should drop.
 
Busy ob service will suck the life out of you especially at night.

I consider busy ob at least 4 epidurals from 10p-6am solo.

You need 12-4am sleep or 1-5am sleep. Those are essential hours. The 1-4am is the most critical hour of sleep.

Different ballgame if crnas cover ob.
 
Stress on call increases exponentially when high turnover or other factors remove your confidence in nursing staff, I certainly feel a lot more alone on call due to this.
 
I'm nowhere near your experience level, but what I'm seeing for myself, is the reality of the market showing I could make almost the same amount of money in a job with no supervision, no call, no weekends. My kid is still pre-elementary age, but I could see the time sacrifice feeling less worth it as society continues to create more lifestyle-friendly jobs.
 
Dynamis said:
I'm nowhere near your experience level, but what I'm seeing for myself, is the reality of the market showing I could make almost the same amount of money in a job with no supervision, no call, no weekends. My kid is still pre-elementary age, but I could see the time sacrifice feeling less worth it as society continues to create more lifestyle-friendly jobs.
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This is entering my calculus as well. The pay differential between working banker’s hours and being in a hospital all night without sleep is almost negligible in a lot of places. Supplement that with some per diem work or locums and you probably come out ahead while having greater control over your time.
 
GravelRider said:
This is entering my calculus as well. The pay differential between working banker’s hours and being in a hospital all night without sleep is almost negligible in a lot of places. Supplement that with some per diem work or locums and you probably come out ahead while having greater control over your time.
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Not in my area. Call is bad...but the pay differential for nights weekends is significant. Usually No problem for those who want to give away call.
 
Agree with drop OB. Pregnant mommies can be the most unrealistic people on earth. It’s easy to get outta bed at 3 for gsw or septic ex lap… adrenaline will get you going…. But rolling out of bed at 3 to bolus an epidural or start an iv on a sweet lady or a poltergeist - you never know what you’re going to get.
I think OBs and L&D nurses can both be the type to miss the forest for the trees. Have had a dumb RN ask my eclamptic patient about skin to skin while we are trying to induce…. Last I checked seizing patients dont converse - go away.
 
LowWafer8 said:
Been doing this 15 years. We all know this is a demanding and stressful field no matter what. I never really FELT stressed though. I'm not sure why, now each morning I get up with anxiety about the day when (I think) I didnt in the past, whether it's for a day of "simple" solo sedation cases or supervising multiple rooms. I'm nowhere near retirement and feel like I get plenty of downtime / off time. Not sure what to do. Is it reasonable to stop doing OB and taking call mid-career and just do locums? I don't mind labor epidurals but stat sections and irritated surgeons over a little pt movement and all of that is getting to me I think.
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I get this. Stress usually comes from call/working at 2am, lack of sleep, difficult patients, complications, trauma cases intra-op deaths, bad/malignant nursing, etc.
It gets more stressful the older you get.

Great thing about anesthesia is that in most jobs, you can tailor down the older you get.

Definitely take care of you first.
 
I would consider taking some time off either take a vacation and I would also see a psychiatrist or therapist to take care of yourself.

I would also drop ob call if possible. It’s soul sucking. The rns treat you like **** and are unrealistic. I haven’t done it since residency but I’m sure it hasn’t gotten better. I remember the OB rns paging me nonstop because they wanted me to leave a C-section to preop a patient smh. Some of the OB doctors would also do a C-section end of shift just so they could leave. I got tired of the lack of clinical knowledge and morals of the ob docs. Not doing OB has done wonders for my life span and personal outlook.
 
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I wonder if it will ever go to ob call from home and epidurals are not done 10pm-6pm. Obviously highly unlikely, and crnas may fill the void. But dropping ob is becoming a more and more common thought in people's minds.
 
For OB, a lot of our inductions get admitted at 6pm. Which means around 2am or so, they are calling for you know what. Getting awoken at 3am to bolus an epidural is the worst, especially when the RNs have mismanaged the patient, and/or their expectations.
 
GravelRider said:
If dropping OB is an option, always drop
OB.

I’m early mid-career and seriously contemplating dropping call…or at least only doing call on my terms. My family notices a change in my mood for the worse in the days leading up to a call and an irritability in a few days after a call. I don’t know if what I feel before a call is anxiety. It’s more like a sense of dread. I don’t feel particularly anxious about doing a case, but rather the dread of having no control over my life for 24 hours.
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This.

.
 
dabears505 said:
I wonder if it will ever go to ob call from home and epidurals are not done 10pm-6pm. Obviously highly unlikely, and crnas may fill the void. But dropping ob is becoming a more and more common thought in people's minds.
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That's always been my "hot take" about CRNAs wanting to take over anesthesiology. They're clamouring to take over the OR but its crickets when you say "fine. go do OB"
 
Some good advice. Take a sabbatical, find therapist, get some new hobbies. A lot of colleagues have had similar to you - combo of bad outcomes accumulating (e.g. advising a noob cutter to compress the aorta below the renals while the circulator pages overhead for help), becoming one-dimensional, too much call, or other outside work stuff creeping.

And by all means, drop or give away your OB shifts. Journal your thoughts now, and after the month to reassess.
 
You are not alone. Many of us are in the same boat and I have felt it a little more myself over the past year than ever before. I am mid-career at this point as well (early 50s, 17 years in practice) and feel a little more anxious as call days approach. As written above, I think it is the loss of autonomy for a set period of time that makes it tougher. Even if my phone doesn't go off at night, I never sleep as well and sleep with the proverbial "one eye open," always expecting a call for something (intubation/stat section/lines/stat ex lap). Our group is working on a way to institute a night float with a comp week off as a way of managing call stress. As a W2 hospital employee we have no extra financial incentive for call so it would great to eliminate that completely.
I have wrapped my mind around the need to keep generating $$ as I have enough people for whom I am providing a college education and other toys. I derive great joy from watching my wife and kids thrive and enjoy what my work provides and that has centered me tremendously. I made my last tuition payment for my oldest who just graduated college, have 9 months of funding left until my wife completes her doctorate, have a step son who is a rising college sophomore, another is a rising high school junior, and 2 daughters behind him in the pipeline. The second half of my life has been centered on providing for all of them and I find that that makes me happy.
I am sure all of us are here if you need to decompress and chat via DM.
Hang in there!!
 
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