What I Was Not Taught

Read. Laugh. Learn.

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Top Ten Reasons To Read

1) This book “breaks the mold” with regard to typical anesthesia instruction manuals or text books.

2) While focusing mainly on practical advice, it dispels myths regarding anesthesia practice and contradicts outdated techniques that seem to be universally taught to anesthesia students by well-meaning instructors.

3) It is riddled with useful information, humorous scenarios (mostly firsthand), and a large amount of opinion regarding anesthesia in an easy to follow format.

4) It is written from a humorist’s point of view which believes that it is much easier to be engaged and retain knowledge while reading a book when the student is laughing out loud throughout the whole process.

5) It empowers the student, especially those whose confidence may have already been shattered by overzealous instructors.

6) I wish that this book would have been listed among the “required” or “heavily suggested” reading materials when I was in school.

7) I don’t have any scientific evidence to support the claims inside it (Note: I consider this an advantage) and, unlike many research studies, no outside influences skew my judgment or water-down the conclusions that I reach.

8) Not one person is immune from the criticism inside it: not myself, other CRNA’s, nor MD’s; however, all of these same people [excluding myself] are also praised within many times.

9) You’ll need something interesting and relevant to read during long, boring cases.

10) My kids need to eat and my wife likes to shop.

What I Was Not (necessarily) Taught About Anesthesia

Still a “student” of anesthesia, but now actually getting compensated while I learn, I nevertheless remember the overwhelming sense of anxiety that I initially felt when [as a student] I was thrown into the operating room and expectedly instructed to function in an environment that was largely non-conducive to learning. As an anesthesia student, I’ve screamed at the top of my lungs into an MRI tunnel at an obese / sleep-apneic patient to “PLEASE BREATHE”, dodged flailing lines and cables that flung [who knows what?] nastiness in every general direction during ERCP’s, and [while drawing up atropine] nervously awaited an electrical confirmation of a heartbeat after approximately twelve seconds of asystole during insufflation of the abdomen of a healthy female undergoing a diagnostic laparoscopy – all in the course of my first couple of months in the operating room and while essentially by myself.

Although the program you are currently attending may be different with regard to the way that I was “taught”… Specifically, you may have a one-to-one or even one-to-two CRNA to student ratio; it is still very nerve-racking to learn how to do something that (1) you’ve never seen done before (2) there are apparently many alternative ways to do (3) you receive conflicting information [regarding] among different instructors (sometimes the same one) and (4) someone says to do it “their way” or to take the “highway”.

Even though you may have been a competent critical-care nurse on a high-acuity unit, chances are you too will be overwhelmed repeatedly during your first year or so of clinical exposure. Let me list some “facts” that I’ve come to appreciate over the years that may ease a little of your anxiety about all of this.

Fact # 1… More than likely, you have what it takes to do this. Remember that you impressed somebody during the whole application and interview process.

Fact #2… Average intelligence is all that you need. I am living proof of this. Your 4.0 undergraduate GPA will not help you in the operating room.

Fact #3… Anesthesia “instructors”, and nurses in general, can be brutal when teaching the next generation of providers. If you get your feelings hurt very easily, you might want to try another career.

Fact #4… Five years from now, many of you will look back [nostalgically] at your “instructors”, yes – the same ones who may have belittled you, yelled at you, or called you stupid (in my case, that would be “all of the above”), and chuckle at the incompetence that you once unwittingly and naively admired.

So… Toughen up your mentality and welcome the humility that you will probably endure over the next couple of years. Over time it will harden you to a point that you won’t care anymore. All the while you can soak up the principles of anesthesia practice even as you painstakingly encounter the trying situations which [in turn] yield a lifetime of lessons learned.

… Or you can just buy my book and expunge the whole process; or [at the very least] make things much easier for yourself.

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