Saturday, September 10, 2005

the inner monologue of a first-month anesthesia resident setting up her room in the morning

OK, my room. My room. This is my room right? Maybe I should check the OR schedule again. Am I even supposed to be here this morning? Where is everyone else?

So what am I supposed to do here? Set up my room. Setting up. OK, what to do, what to do. Machine check! Check the anesthesia machine! Yes, that sounds like something that someone in the know would do. Check the anesthesia machine with my EXPERT MACHINE CHECKING SKILLZ. Machine is...there. It's, uh...on. There are...noises emanating from it. Wait, how do I check the machine again?

OKOKOK, first thing's first. Check that the suction is working. Suction is...sucking. What next? Calibrate the O2 sensor to room air. Let me just unscrew the--GAH! The machine is broken! Someone broke my machine! This plastic part is off and there are wires poking out here! Cancel the first case! Anesthesia delay! There's a problem with...oh, wait, this part just snaps back in here. Oh. Heh. Resume.

OK, check the O2 tank failsafe. Let me just get in the back here and...ergh...unscrew this! Hissing! The hissing of gas! Gas is shooting out under pressure! THE ROOM'S GOING TO EXPLODE! Quick, is this supposed to happen, or should I screw the thing back on? Wait, keep unscrewing...ergh...oh, hissing stopped. Wait, let me get back to the front of the machine...oh, the failsafe is working. Good. Lemme just get back to the wall O2 and screw it back in. Argh! Tripped on a cord. Why are there all these cords and wires and shit back here? They're trying to kill me!

(10 minutes later, after laboriously and dubiously checking the other functions of the machine and the circuit)

Oh shit, it's almost 7:00 already. Gotta move. What next? OK, walk through it like you're bringing the patient in the room. What do you need? Patient gets up on the table, monitors on. Place the IV, start the fluids running...fluids. Need to set up my IV bag. Where's that IV bag stuff? Oh, back there. Here's a bag...oh wait, that's D5. Where's the LR? Need LR. Come to me, LR. Oh, here's another bag...wait, that's NS, and it's only 500ccs. Where are those big bags? WHERE ARE MY BIG BAGS OF LR? Cancel the first case, there's no LR in the room! Cancel the...oh wait, it's right here in front of me. Heh.

So lemme just get the first tubey thing and the second tubey thing and the three-way stopcock thing that hooks up in the middle...wait, how does this go again? Why don't they connect together? These don't hook up! Oh, I'm doing it backwards. It goes this way. And this goes this way...hey, I'm doing it! I'm hooking up my IV bag! I'm an IV bag goddess! Now let me just expertly flush this this up here...bubbles going out this way...ack! Water! The bag of LR is running out all over the floor! Wait, stop the thing...where is it...close this part here...OK, it stopped. But now my pants are all wet. It looks like I just peed myself, for chrissake. Which is actually not far off from the truth.

OK, then what next. Meds. Med cart. Med cart is...I can't open the med cart! It's stuck! It's...oh, right. Locked. Here's the key. Open that sucker up right there. So many medications. What to draw up? OK, emergency meds first. Let me just consult my cheat sheet here...phenylephrine, I'll do that one first, that's the one that needs to be diluted in that little bag. Lemme just get the bag...OK...and draw up the med...OK...and dilute it into the bag...GAH! I stuck the needle into the wrong port of the IV bag! Water! Shooting out everywhere! Leaking! Quick, throw the bag out! Destroy the evidence! Man, I need more blue towels back here. It's like waterworld.

(15 painful and comedy-of-errors minutes later, except not quite so comedic to me)

OK, my meds are set up. ET tubes are styletted. Let me get out my blades. Open up my box here...snap on the blade to the handle...OW! Caught my finger in the snapping part. Gotta stop doing that. How do people do this whole setup in half an hour? Am I mentally challenged because I'm so slow at this? Will I ever be able to do this right? Oh Christ, it's 7:15 already. Gotta go see the patient, I'm already late. Do I have everything I need? No time, no time! Just leave it, take care of the rest later! Go go go, or people are going to start yelling at you! With the yelling! And the loudness! Go now, go!

(Hustles out of room, trips over a cord, almost falling on face.)

Currently reading: All about MAC for my cases on Monday. This is someting the hardly ever used on the Peds Anesthesia service, so I've only ever done it once. Greeeaaat.


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