I wake up at about 4:30. Clinical is only 25 minutes away if I leave by 5 am but if I leave much later it can take up to 45 minutes to get there. Typical traffic issues! After I get ready and make sure my “anesthesia bag” is good to go I head out the door and drive to clinical!

 

 

 

I arrive at the clinical site usually at 5:45. First thing I do is head to the board and make sure my assignment has not changed. I actually cannot think of a day where something was not different! Either a case cancelled, the room changed or cases added! Flexibility is important in an anesthesia department. Once I have confirmed the room I am in I go and set it up.

 

Setting up a room initially, sounds like a simple process; check the machine, load up some dry syringes and pre-fill a few for the first case and get any equipment you need. However, as a student you are setting up the room based on the preference of the attending and CRNA you are paired with. Trying to keep this straight when you are at a department with 20 MDAs and 40 CRNAs is near impossible! So the room setup is sometimes much more complicated than it would be if I were not a student!

 

The next step is to review the cases I have for the day. Even though I did careplans the night before the schedule often changes and so I have to review the new cases which I have been assigned. I head to the break room, pop open M&M and go over it all. I usually work out my morning so I have about an hour to review before my first case at 7:30. If I didn’t stay up to late the night before doing careplans for cases which have been cancelled, I usually don’t nod off while reading M&M!

 

7:15 and its time to go to the holding area and see if my first patient is there. Once I find my patient I do a review of the chart and go say hello. I have learned not to say the word “student” to patients and I now say that I am ‘part of the anesthesia team’. When patients hear the word ‘student’ they think of a rank amateur and often get very nervous right away. This ends in me spending 5 minutes explaining how I have been an RN for a very long time and this isn’t my first IV! Anyway, then in goes the IV and 1-2 mg of versed. Good times!

 

Now besides the interaction with the patient there is the interaction with the CRNA and MDA. This is certainly an important part of the morning dynamics as it can set the tone. After 6 months in the clinical area I am asked every day if I’m a senior or a junior. With such a big department and so many students it would be near impossible for the staff to keep track of who we all are. If I’m lucky I have been with these people before and they know something about where I am at. Unfortunately even if they have been with me before and remember it, in their mind I’m at the same place as I was the last time we were together, which may well have been a month ago! If I am REALLY unlucky I am with someone who has never been with me before. Well, this is what I have come to call the ‘ground-hog day’ experience. Just like the movie, you relive the very first day of clinical all over again! What does this mean? Well, someone is ‘teaching’ you how to put in an iv and how to place the leads on the patient all over again and basically all over you. It can be a frustrating experience but this leads me to the next mantra I have developed ‘cooperate to graduate’!

 

 

Cases turn over quickly and you have to learn the ‘rhythm’ of the OR in a hurry. There really isn’t much time between cases to be slow. Once the case is over its off to the PACU to give report to the RNs there. This can be a right of passage in itself! Sometimes these RNs treat the SRNAs like they are idiots. Unfortunately, even if you have been an RN longer than the PACU nurse your talking to, you are now in the student role and therefore, at the bottom of the rank list! Again remember the mantra, cooperate to graduate! From the PACU it’s a dash to the holding area to do it all over again!

 

While there is a ‘theoretical’ clinical day of 8 hours I am usually there from 6 am to about  4 pm. There is an unwritten rule that if you are in a case then you finish your case. This may sound unrealistic with everything else you need to do once you get home, but you are certainly judged by this expectation.