We are lucky enough as junior doctors to move through various areas of medicine and pick up how different folk operate. Here’s what my anaesthetic colleges have taught me.
Prepare for the worst
Shit goes wrong. We get blasé because we have done a task or a procedure a couple of hundred times. On the three hundred and first it may all go south. Have things to hand to be ready for this on the first three hundred.
Have a system
How to prepare for the worse? Well break down everything you should be doing into the same order every time. Fordian levels of factory efficiency can be achieved and assures that the one thing you need in an emergency is there.
Learning skills is a process
Competency isn’t binary. The anaesthetic way of increasingly distant supervision- moving from standing next to you, to being in the room less involved, to standing in the corner, then next door and then door the corridor is a nice way to learn skills. It ends up with never undertaking a skill for the first time.
Experience assistants are amazing.
ODP (Operating department practitioners) are life saving. Literally. Having someone standing next to you in tricky moments who knowns what they are doing, knows where everything is and hands you things before you know you need them. I don’t understand why more areas of medicine don’t have an equivalent position.
Seems strange that lot’s of drugs we give have standard dosing considering how much our patient’s vary. Eye balling the person in front of us and weighing up how much they need is something I will try and do more of, especially with analgesia.
Every health-care professional should be adept an undertaken risk/benefit analysis. Anaesthetists are somewhat lucky in that a large proportion of our work is elective, non-emergency. Therefore they are well placed to undertake the most important question; is this treatment actually worth it? Even more importantly discussing this with the patient beforehand.
Overall, a very educational agreeable bunch who have demystified what can be a slightly mystical branch of medicine.