A Day in the Life
CA-1: Drs. Christen Behzadi and Matt Grunert
CB: The alarm goes off at 04:15 and I wake up my husband Pedram to remind him to wake me up on time. I then hit snooze every five minutes for the next hour until my husband kicks me out of bed and pulls the blankets off. I then drink coffee and put on make-up and a really cute outfit because scrubs don’t make me look like a woman but lipstick and wedges do!
MG: I wake up around 06:00-06:15.
CB: I get into work around 06:00 and I take a nice long walk from the parking lot. Then I change, get my drugs, and go to my OR. I am usually listening to my iPod this whole time so Michael Buble and I are setting up my room together. This used to take an hour but now it takes 15 minutes. It’s a miracle!
MG: I need five minutes of Zen before I see any patients or attendings.
CB: I then enthusiastically skip to morning conference if it is Monday or Friday. I drink my coffee and fill my mind with all kinds of anesthesia fun facts.
MG: I look forward to the chocolate chips muffins and have been known to get a little violent if someone takes them all before I get there.
CB: After any morning lectures which are usually from 6:30-7:00am twice per week I go to the pre-anesthesia waiting area and greet my patient. I have already written on the chart the day before when I “pre-op’ed” the patient. I review my notes and the anesthetic plan I came up with and discussed with my attending. I go talk to my patient to review their history, allergies, when they last ate, what meds they took on the morning of surgery and examine them. I discuss the anesthetic plan with the patient. Finally, I get my attending who also speaks to the patient and after all the forms needed to go to the OR are signed I wheel my patient back to the operating room.
CB: As a first-year, the cases I do most often are gynecology cases, lots of laproscopic cases (cholecystectomy, appendectomy, hysterectomy, oophrectomy, even the living donor of kidney transplants), orthopedic cases and I usually go to ECT (electroconvulsive therapy suite) once a week (where we learn to perfect our masking skills-an art in anesthesia)… Once the patient is in the room, I put on all the monitors, call the attending, and pre-oxygenate the patient. Once the attending is present I will induce the patient, intubate them, and start my case. The first 30 minutes or so is a very busy time in the case for the anesthesia resident.
CB: Once the case is going and stable I’m constantly scanning the equipment making sure everything is exactly the way I like it to be. I do a lot of calculating up front for my patients to make sure they are getting the right amount of tidal volumes, fluid replacement, pain control, anesthesia, etc. It's not totally necessary to do this for every case, but it's good in the first year, I think, to be more obsessive about these things while we are still learning. Some patients are really high maintenance in the OR and need a higher level of care throughout the case, while some patients just ride smooth and it's more relaxed for me. Either way, my mind is always going during the day; I ask myself questions like “what if the oxygen saturation dropped right now, what would I do?” “What would be the differential?” “What would I do if my peak airway pressures went up right now?” I have a notebook in the OR that I keep in my bag with me. If attendings tell me things and when I read on my own I keep the notes in the same notebook which I review during cases if I have time. This is a big advantage of Anesthesia. As residents we get lots of 1:1 didactics with our attendings in the OR and we also have time alone to read/review things during the day . I really enjoy that when I have a specific question, I get a 1:1 attending lecture on that topic. It's great. Our attendings all carry phones and are available in seconds if I need anything in the OR.
CB: I get a 15 minute break in the morning, a 30 minute lunch break, and a 15 minute break in the afternoon. The days fly by so fast now because it's so fast paced in anesthesia. At the end of my day around 4 or so I go to the chart room and pull charts for my cases the next day. I read over the charts and check the computer system for additional information. I call or page my attending. We discuss the patients and I propose an anesthetic plan. There is more teaching, more discussion about the cases for the next day. This whole process from start to finish takes about 30-45 minutes. Then I’m done for the day and go home anywhere from 4:00pm-5:30pm. It’s a long day in Anesthesia, no doubt about it; but it's so rewarding and fun. I have gotten so much exposure already in only 4 months and I’m very excited to start some of my specialty rotations coming up in the next 4 months including regional anesthesia, OB anesthesia, cardiac anesthesia and transplant anesthesia all in my CA-1 year!
CA-2: Dr Aaron Young
Each day I get up around 5:15 a.m. which is early enough for my morning routine of eating and showering, and then I'm off on a10-minute bike ride to work arriving at the hospital just before 6:00 a.m. After changing to scrubs in the locker room, I grab my meds for the day and head to the OR to set up. Since I had discussed cases with the attending anesthesiologist the night before, I know what to expect and I setup the room accordingly for the day's cases. Usually, I give myself about 30 minutes to set up so I can make it on time to the morning lecture at 6:30 a.m.. The lecture ends at 7:00 a.m., and then it's time to meet the first patient in Pre-An. A quick chat, physical exam, and discussion of the case with the patient, and then we head to the OR for an on-time 7:30 a.m. start. I always have a lunch break and usually a morning and afternoon break throughout the day. My cases generally get done or I am relieved by another resident or CRNA in the afternoon between 3:30 and 5:00 p.m. Then it's time to pre-op the cases for the next day and call the attending. Another quick bike ride and I'm home usually by 6:00 p.m., and then I have the rest of the day off to spend time with my wife and kids and read up on the next day's cases. On a call day during the week, it's not too much different and I'll do an extra case or two.