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Dam... that's deep
New CA1 having issues adjusting to anesthesia
- Thread starter Dasani water
- Start date
Dam... that's deep
Dasani water
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Haha I don’t know, maybe I’m totally off the mark. But I will say that my identity last year as being the patients doctor that was always around to answer questions and follow up on things was kinda nice. Aside from working out and occasionally hanging out with friends that didn’t happen to be on call, I didn’t do much. I feel like idk what I’m doing with myself now that I have time. Medicine is all I have really, being a young single person. It’s hard to try and live life when you haven’t really been doing it for the past few years. Everything they told me made sense so I buy what they said. I’m still gonna see a professional though. Can’t hurt.
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One word: Hobby.
Dasani water
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I know I need to work on it. It is incredibly sad but I just wish I had everything figured out. I know I’m not the only one struggling but it certainly feels that way.
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I think there's a difference between doctors who see medicine as a divine calling and love it and dedicate their life to their craft and their patients vs doctors who are in it for lifestyle/career but it isn't their life's passion.
The older physicians I've met who are workaholics and have always seemed phenomenal to me and are who I would want taking care of my family. I've known my fair share of co-residents who are more than happy to finish their shift, pass the buck, and don't seem all to concerned to follow up with things and while they're good, they just wouldn't be my first pick for who I would want to take care of a sick family member. I guess I think medicine shouldn't be just like any other job but maybe something more. But I am open to debate that idea.
Dr. Dasani, it's awesome you are a dedicated resident and I'm sure you'll make a great doctor. Just maybe get a hobby and find some balance so you don't end up miserable.
The older physicians I've met who are workaholics and have always seemed phenomenal to me and are who I would want taking care of my family. I've known my fair share of co-residents who are more than happy to finish their shift, pass the buck, and don't seem all to concerned to follow up with things and while they're good, they just wouldn't be my first pick for who I would want to take care of a sick family member. I guess I think medicine shouldn't be just like any other job but maybe something more. But I am open to debate that idea.
Dr. Dasani, it's awesome you are a dedicated resident and I'm sure you'll make a great doctor. Just maybe get a hobby and find some balance so you don't end up miserable.
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Yeah it’s worthwhile talking to a professional. It seems you’re having a bit of an identity crisis that likely would’ve occurred at some point regardless of which field you chose. The more you find peace and happiness away from work the less your works concerns will bother you. You appear to be an honorable, responsible physician. I’m happy to have you join the ranks and hope you’ll stick around.
Dasani water
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LOL at that last part. I'll work on it!! Thank you everyone for the support. It means a lot. I guess I never really realized my issues last year because I never had the time to think about them. I think my first step is to ask for help, and I'm sure I can get it. I know my PD has been supportive so I'll talk with them. Maybe they've experienced residents that feel like this and can offer advice too. I want to get better and be a safe and competent physician no matter what I do, so I will do whatever it takes to get there. On that journey, maybe I can better appreciate myself and what I do for a living once I work out all the kinks.
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Sometimes it takes a while to adjust. Every month wr are doing new things with a whole new set of people and sometimes even with a brand new computer system. Every time you think you have something down, you are on to the next thing.
Anesthesia sometimes seems easy but it's really only once you get down the basics. Looking back I wonder how I struggled so much to get a basic room setup down but really it took several weeks just to get comfortable without missing anything. It was the same for the wards, icu, etc. If you find yourself dreading getting to work everyday, maybe it's not right for you. But growing pains are natural.
Anesthesia sometimes seems easy but it's really only once you get down the basics. Looking back I wonder how I struggled so much to get a basic room setup down but really it took several weeks just to get comfortable without missing anything. It was the same for the wards, icu, etc. If you find yourself dreading getting to work everyday, maybe it's not right for you. But growing pains are natural.
Oh man. This cuts deep. But some patients will respect you as a doctor, and everything you do, and have some self-awareness for the effort you're going to go through/went through to keep them alive and well. Those ones will make you feel warm and nice inside. Most of them, you have to pat your own self on the back if that's the kind of thing you want. But some patients really do stand out and appreciate the things you do. Some surgeons too. Some PACU nurses and pre-op nurses too.
D
deleted171991
Where "some" is a synonym for "few". Sorry for the cynicism, but this is reality.
It's better in small places, but, in today's corporate healthcare world, those are fewer and fewer.
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You need to stand up for yourself. I can't recall a single time when I've been disrespected by a junior resident without them getting put in their place.
Being disrespected by a midlevel? Hard to imagine that. I'm a doctor.
Yes mid levels... I just wanted to finish my fellowship without any problems. I wasn’t planning on staying anyway.
D
deleted171991
It depends a lot on the local culture. If they gang up against you, guess who your program is going to protect?
If only I had as many thousands of dollars as the number of trainees who have had their careers destroyed by some vengeful program. The only solution is to lay low, keep your mouth shut and your eyes on the prize.
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Our midlevels are there to support us in the icu. They will help us set up for procedures, not try to steal them.
D
deleted171991
Better than "and once again, he hits the nail with his head", because it certainly feels like that when one speaks up and management comes after one.
All one can do is make it about "patient safety" and other PC Newspeak.
Ha, at my fellowship not only did midlevels take our procedures but our attendings would actually teach them how to do the procedures while the fellow just watched. I’m not joking. I’m not trying to be pessimistic here but that’s how my fellowship was. I’m not saying all midlevels are bad, but the ones I worked with, I couldn’t stand.
D
deleted171991
I was reported by the chief midlevel because I refused to teach one of their students how to do a central line. I said she could watch, but it was not her job, so I wouldn't teach her. Thank gods my PD was a sweetheart; I would do anything for that man.
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If you like the one on one patient contact, and doing procedures, maybe consider pain?? Otherwise, perhaps give it a few more months, but consider getting out of anesthesia. DON’T throw another 2-3 years at it just because you have 3-6-12 months in it.
Do you enjoy surgeons/nurses/admin constantly criticizing you?? Do you enjoy having folks confuse you with a nurse? You like wondering every 3 years or less if your group is going to get a contract renewal from the hospital, and whatever doofus administrator(s) that are looking to save a buck?? Maybe you like working for corporations whose idea of “efficiency” is YOU working harder, while they and the hospital split the savings?? If so, then maybe anesthesia IS the right specialty for you.
I’ve been doing this for over 10 years, and I enjoy the work, but the AMC/EMR/bureaucracy gets worse every year. Yes, EM and hospitalists deal with the same issues, but they can limit themselves to a 12 hour shift. They’re not constantly held hostage by slow/disrespectful surgeons, understaffed corporations, or administrators who will accept cases anytime from anyone, even if it’s the local jerk surgeon who does his “money” cases at the ASC down the street, and dumps his low/no pay cases on the hospital at 6pm on Friday afternoon.
Find yourself something that pays $200-$300k, works 8-5 M-F, and folks appreciate you, and if you want to work harder for more money or more “thanks” from patients, it’s because YOU want to. There’s lots of things to see and do out there that don’t require you to be locked in a concrete box (OR/hospital) 60+ hours a week..
Do you enjoy surgeons/nurses/admin constantly criticizing you?? Do you enjoy having folks confuse you with a nurse? You like wondering every 3 years or less if your group is going to get a contract renewal from the hospital, and whatever doofus administrator(s) that are looking to save a buck?? Maybe you like working for corporations whose idea of “efficiency” is YOU working harder, while they and the hospital split the savings?? If so, then maybe anesthesia IS the right specialty for you.
I’ve been doing this for over 10 years, and I enjoy the work, but the AMC/EMR/bureaucracy gets worse every year. Yes, EM and hospitalists deal with the same issues, but they can limit themselves to a 12 hour shift. They’re not constantly held hostage by slow/disrespectful surgeons, understaffed corporations, or administrators who will accept cases anytime from anyone, even if it’s the local jerk surgeon who does his “money” cases at the ASC down the street, and dumps his low/no pay cases on the hospital at 6pm on Friday afternoon.
Find yourself something that pays $200-$300k, works 8-5 M-F, and folks appreciate you, and if you want to work harder for more money or more “thanks” from patients, it’s because YOU want to. There’s lots of things to see and do out there that don’t require you to be locked in a concrete box (OR/hospital) 60+ hours a week..
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I did my fellowship at an institution where the anesthesia department was powerful and well respected. Even so ...
I had one (pretty friendly and calm, actually) altercation with an OR nurse early in the year because I brought a patient to the room a couple minutes early. She gave me some **** and started making up nonsense about patient safety and my disregard for it, so I nicely called her on it, with a smile on my face. It led to a 1-on-1 with my program director with me explaining myself. Not worth it.
Trainees come and go. OR nurses and techs are there to stay. Over and over again in my career I've seen the fragile feelings and egos of nurses and techs appeased at the expense of interns, residents, and fellows. Many permanent anesthesia faculty will just make a "time effort and headache calculus" assessment and play for peace and cooperation with the people who'll be there for years to come. It's weak, but it's understandable ... I guess. I wonder if they understand that the nurses and techs think less of THEM also when they cave in and fail to back up their resident.
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OP I'm having similar thoughts as an intern. I went into anesthesia wanting to do critical care but I'm again realizing how much I like the act of making a diagnosis in medicine and having ownership of patients. I don't like the dispo stuff or clinic but in anesthesia I'm wondering if I'll be satisfied with gen-a cases and being essentially behind the scenes. Is it even feasible to switch and get an anesthesia intern year to count towards IM? Is it even worth it if the end goal is Pulm/ccm versus anesthesia ccm +/- CT?
I'm probably just a "the grass is greener" person
Anesthesia + fertility, interesting combo
I'm probably just a "the grass is greener" person
Anesthesia + fertility, interesting combo
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Lots going on in this thread...... I've seen CA1's really struggle with the fast pace and steep learning curve in the OR. Some seem not to ever adjust all that well to the pace, but MOST do by the end of CA3 year. So, I suspect that some just take a frustratingly long time to get into the groove. But, again, when that critical learning curve is conquered, more or less, MOST adapt rather well.
Yes, anesthesia is a service specialty. To some this fact may not be as appealing. Personally, I look at it as an opportunity. That is not to say that I compromise patient care, but I do find it highly satisfying to work in a fast paced, challenging environment, navigating many personalities (including the surgeons), and quickly and safely move patients along the OR assembly line...... It is what it is. But, it doesn't need to be a negative. Again, I think that because some will struggle with these variables, it offers great opportunities.
Clearly this job/gig is not for everyone. It's important, though sometimes very difficult, to discern if this career just isn't for you, or if this is just a phase brought on by the realities of a CA1 adjusting to a new environment.
Please be mindful however that most of medicine (indeed most of the economy) is being commoditized. This does indeed apply to surgeons as well as the medical specialties. Of course there are degrees to it all. But the trends are towards steep production pressures for all. My only point is to try to accurately assess the realities of the "other side of things" also, before making a decision.
As for the the issue of depression/anxiety, this is important to get assessed I would say. It can be confusing for the individual, especially when there are very real stressors in your life. But, at some point, your response may not be a "normal" one. These things may be effecting you more than the norm, and to a greater degree than necessary if you have an underlying mood disorder. I would highly recommend you get this worked out with a psychiatrist. Medications can be highly effective.
Indeed, stress is a well known trigger of mood disorders for those who are genetically susceptible. Don't underestimate the importance of looking into this.
Yes, anesthesia is a service specialty. To some this fact may not be as appealing. Personally, I look at it as an opportunity. That is not to say that I compromise patient care, but I do find it highly satisfying to work in a fast paced, challenging environment, navigating many personalities (including the surgeons), and quickly and safely move patients along the OR assembly line...... It is what it is. But, it doesn't need to be a negative. Again, I think that because some will struggle with these variables, it offers great opportunities.
Clearly this job/gig is not for everyone. It's important, though sometimes very difficult, to discern if this career just isn't for you, or if this is just a phase brought on by the realities of a CA1 adjusting to a new environment.
Please be mindful however that most of medicine (indeed most of the economy) is being commoditized. This does indeed apply to surgeons as well as the medical specialties. Of course there are degrees to it all. But the trends are towards steep production pressures for all. My only point is to try to accurately assess the realities of the "other side of things" also, before making a decision.
As for the the issue of depression/anxiety, this is important to get assessed I would say. It can be confusing for the individual, especially when there are very real stressors in your life. But, at some point, your response may not be a "normal" one. These things may be effecting you more than the norm, and to a greater degree than necessary if you have an underlying mood disorder. I would highly recommend you get this worked out with a psychiatrist. Medications can be highly effective.
Indeed, stress is a well known trigger of mood disorders for those who are genetically susceptible. Don't underestimate the importance of looking into this.
