And so clinicals/ residency starts.....

WOw!!!!what a first week!!!Absolutely amazing and i am learning so much. Dont get me wrong, its a lot to learn and a lot to remember from the didactic courses. But everything is starting to make a lot of sense and i am connecting the dots.

So far, the hardest part about clinicals is getting up in the morning. I am extremely exhausted but my body will eventually catch up. I'm just so use to staying up late till 3:00 am and waking up at 9 am to study. Going to bed early is certainty not fun but hey i have to do what i need to do.

Another issue Ive come across so far i having so many preceptors. it's only been 1 week and I've worked with 4 people. And each ones has their own ways and in between that there are also attendings that come in the rooms from time to time and they also want to teach you their own ways. And overall, this a lot to learn and with so many ways of doing one thing. whatever......

Anyways, getting use to the whole sequence on induction, maintenance and emergence of anesthesia. And don't forget, people are like quizzing you like crazy. The CRNAs that your working with are quizzing you and the attendings are also quizzing you as well. Anyways, you know quizzing puts you on the spot and can be nerve racking. But what can you do? you can only do your best and go home and review what you don't know and reread what you have forgotten. Of course, being the slick eyed monster that i am as soon as they ask me a question i'll ask them a question back as well and if they cant answer it, they'll leave you alone. Some people are really helpful quizzing and others just wanna make you look bad i feel. Whatever, i have thick skin and i can certainly handle the criticism with class cause i have a big ASS. LOL!!!

Anyways, school didn't start yet although clinicals did start. The trick now is trying the balance making these careplans every night for my patients and balancing putting in some study time for classes and for clinicals. I dont have any assignment reading for clinicals but doing care plans requires reading and i want to read over whatever i get wrong when my preceptor quizzes me.

I haven't intubated successfully yet. But its only the first week and right now I'm focusing on trying to learn the techniques of others then try them out for myself. Anyways, i haven't had any A-line or really sick patients yet. I've only had the typical hystorectomies, myomectomies, D&Cs, gastric banding, LMAs and ETTs.

Having fun guys!!!!
see y'all later

I had orientation at the hospital

Lets just say that i didn't have a typical orientation and that the welcome to the anesthesia world was interesting.

So, this past week i went for orientation. I knew that it didn't involve any paper work because as i mentioned before this hospital is hardcore, these people just don't play.

Anyways, to start off the OR is HUG. Man, my preceptor had to basically force me to leave the OR and walk around. I was so afraid of getting lost. It was like 4-5 different hallways and countless room. Of course, my preceptors sent me to find some pressors. I was so lucky i didn't get lost, i swear. But i finally left the room after a couple of hours, wondered around the storage room and got myself familiarised with the setting. People were nice and actually this guy took time out to show me around the anesthesia work room and i'm pretty comfortable around there.

Anyways, our first case of the day went smoothly; the patient was successfully intubated, maintained and did well. And that's pretty much the better part of the day. After that, it went downhill. Pretty fast!!!!

So, our second patient, middle aged with hypertention, but not severe enough to warrant an Aline so my perceptor induced this person and i taught this was going to be a smooth course like the first case. Hey right!!!!

Anyways, this is orientation and I'm not allowed to do anything yet. I'm here to observe and they pounded that into me, YOU ARE HERE TO OBSERVE FOR TODAY DO NOT DO OR TOUCH ANYTHING. Ok fine!!!! you don't have to tell me that twice. Clinicals start next week anyways and my insurance didn't kick in yet. No worries.

Anyways like 15 minutes into the case (by the way, i cant go into details ya know HIPPA laws and stuff) while my preceptor was looking down charting, i (the big eye beast that i am) was looking around and BAM!!! the patient's BP was in the toilet and i have no idea why the alarm on the monitor didn't go off. You can not imagine what BP i saw. I swear i was frozen in terror for like 2 seconds (my first instinct was to reach for the phenylephrine or the ephedrine but I CANT TOUCH ANYTHING). So, i go to my preceptor (who by the way was lost in his/her charting and whatever else) and say look at your blood pressure. I swear, i never saw a human being move so fast in my life (the BP was really low guys-you have no idea).

Lets just say that after 50 mg of ephedrine, i don't know how many mcg of phenylephrine, 80 units of vasopressin later the BP was in the toilet. Of course we had to call for backup, the situation was getting out of hand.

Anyways, basically this patient had an allergic reaction. Of course, we don't know which drug because we pushed like 5 meds back to back during induction and on top of that the surgeon injected some locals. So, he/she ended up stabilizing the patient and putting an A line.

Then my preceptor turns to me, smiles and says "so what do you think?". I simply smiled.


what do you guys think of my orientation?

Anyways, clinicals start next week and for some reason I'm not at all nervous. People keep saying they are so nervous. I didn't want to look cocky or overly confident in front of my classmates so i said i was nervous too, but really I've been reading a lot these past few days and i don't think I'm at all a rock-star but I'm just not that nervous anymore. I just wanna get this show on the road.

Anyhow, I'm enjoying my last weekend before clinicals.

Wish me luck guys!!!!

grades are in !!!!!

Grades are in and I'm pretty excited!!!!!All the hard work paid off and i am counting down to the first day of clinicals. This is one of many miles stones completed in this program.

So, 3 semesters down and 4 semesters to go. While clinicals start soon, i still have a heavy class load. With clinicals and class time eating away at 5 days a week, I'm only left with the weekend to study. I still have some more core anesthesia classes to take. I am no where near feeling 100% competent yet but I am definitely on my way.

I know that the first rotation, the preceptors don't have high expectations from you. They expect you to know basic anesthesia knowledge but don't expect you to successfully intubate every time around.

My first few rotations are general rotations and i start specialty rotations around april 2012. my classmates are so nervous about their peds rotation, but I'm actually looking forward to it. It should be fun fun fun!!!!

I got my mass general pocket guide, the hard to find Ezikiel pocket guide, i got my Ipad2 with lots of anesthesia apps, my nurse anesthesia pocket guide and i am ready to go.

I am so thankful that ive made it this far. Remember a while back, towards the beginning of my blog i spoke about my friend who failed out of the program. She got dismissed after the didactics portion. This is certainly not a reflections of her intelligence and i will say that this last semester was really hard and i can understand where she fell thru the cracks.

Now with clinicals its adjusting to another type of stress; waking up early, setting up the rooms before your preceptors come, answering questions on the spot, getting yelled at by your preceptors, doing actual procedures on my patients. No more mannequins. Well, maybe once in a while I'll sneak into the lab to play with the mannequins, we'll see.

I'm done!!!!

Ew!!!!
what a semester....and i am glad to say that i am done. All the hard work paid off, the grades are coming and i am loving it. Looking really good!!!!

And i am so nervous for clinicals but you know what they say "the antidote to anxiety is preparedness" and with that i am ready and preparing for my big day in the OR. I have orientation next week at the hospital. Ill be taking a tour, meeting the preceptors, getting my badge, locker and learning how to do the machine check.

I actually practiced the machine check this week. But you know that it is nothing compared to the newer machines that they have now. That hold thing from the simulation lab must be at least 15 years old (not kidding). That thing is so hold, some of the knobs and valves don't work; and the alarms on that hold thing goes off like all the time. Drives me crazy sometimes!!! Hard to practice when you are constantly trying to get that thing under control.

Any how.....trying to prepare for clinicals and I've been looking at the motorola zoom or the Ipad 2. Some of the Apps on those tablets are pretty cool and would be great accessories for clinicals. All my books would be at easy reach and quick access when i want to look something up for anesthesia.

The countdown is on to the first day y'all.....i basically have a little over a week to go.

Birthday!!!!

Had an amazing and surprising day a few days back. My classmates surprised me with a birthday party. I was shocked, cant believe they did that for me with their busy schedules and with finals upon us. I truly have amazing class mates. And not to forget the cake was great and so tasty.
Got a couple of birthday cards and lots of sweets.

Now i have 2 finals left to go and with that we come to the end of the didactic portion of our program. Everyone is so hyped and nervous about going into clinicals. I'm so nervous!!!!cant wait!!!!