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!!!!