My Anesthesia Rotation
Here I’ll reflect briefly on my anesthesia rotation experience. As you can see in the picture, we were required to wear N95 masks and face shields, and medical students were not allowed in the COVID-positive rooms. Overall I felt extremely safe throughout my time.
I was really nervous going into my anesthesia rotation for a few reasons. In general, the OR (operating room) wasn’t my favorite place during third year, so I was nervous about going back. I think those feelings just stem from the fact that I felt the least helpful to the patient and the team in the OR setting, and admittedly it was where I tended to get the most “pimping” questions wrong and it always felt like I was failing in front of an audience. I was also nervous as this rotation would be my first time attempting to intubate patients.
The first few days were very difficult for me. The way my hospital has the rotation set up for us students, and I suspect this is the case for other anesthesia rotations as well, it is up to us to find our patients and the attending before the surgery and ask if we can assist them and attempt the intubation. This pushed me extremely out of my comfort zone, as I just felt that I didn’t really have a place in this, I was just asking to get in the way and slow them down. However, I was really fortunate and built great rapport with the CRNA’s (Certified Registered Nurse Anesthetists) and several attendings, and once I knew them better I was much more comfortable doing procedures with them. My major piece of advice for any students reading this is just to push through the discomfort, be professional and honest, and don’t take things personally if it doesn’t work out.
By the end of my 2-week rotation I was able to do about 20 intubations using direct laryngoscopy! I enjoyed this procedure and I’m excited to really build this skill during residency and in my career. This was the perfect environment to do my first intubations in, because it is safer for the patients. If a patient is healthy enough to undergo surgery, their oxygen reserve is usually good enough that there are extra seconds to minutes for a novice like me to adjust my view without the patient desaturating (without their oxygen levels decreasing). I know my environment and the patients in the ED someday soon will be much different than this controlled OR, but I’m really grateful I was able to learn in this setting.
A few notes for students on an anesthesia rotation:
- Study beforehand things including the induction medications and their mechanisms of action, how to assess an airway on a physical exam, ASA (american society of anesthesiologists) classifications, etc.
- Introduce yourself to everyone you can in the OR so they know your roll
- Help the staff take the patient to the OR and get transferred to the bed, hooked to the monitors, get blankets, etc. This helps the nurses and techs a lot and it’s great to feel like a useful part of the team in doing this.
- After the patient is settled for the surgery, it may vary by attending whether or not they expect you to stay for the remainder of the surgery. Most of the attendings I worked with encouraged me to leave and try to go see other patients, but I always remained a bit hesitant and felt a bit awkward as I was leaving. Just feel out the situation and it’s okay if there are some awkward moments.
- If you have a good enough rapport and feel comfortable with the attending, ask if they can watch you draw up medications, help you start some IV’s, and ask all you can about the IV set ups and troubleshooting. These are skills that you may not have had exposure to at this point, as they’re often overlooked, but they are extremely useful and important.
- All attendings will have their own way of doing things, so be prepared to learn many different techniques and don’t get stuck on doing things just one way.
This rotation really gave me a new appreciation for the operating room.
I definitely enjoyed being on the anesthesia side of the team in the OR, again I think because I was actually able to be helpful on the anesthesia side. Anesthesiologists are known to be masters of physiology, and I liked learning from them and how they think as they monitor the patient’s status in real-time.
Looking back now, I think a lot of the anxieties I had originally associated with the OR during my third year were more general anxieties about being a medical student on clinical rotations, rather than really being related to the OR. In fact, multiple evaluations I received from attendings on this anesthesia rotation specifically mentioned that I should “be more confident,” so obviously my initial discomfort was pretty evident. Overall, I’m grateful that my last experiences in the OR as a medical student could be so positive so I can feel a bit more comfortable in the future as a resident.
