Medical education

I guess as students as will, inevitably, have to practice at some point. In the OR, while the patient is under anesthesia, it is remarkably easy to practice without causing undue pain to the patient. This is not to endorse senseless extraneous procedures on an anesthetized patient, but students must learn somehow. I guess I'm trying to rationalize my experience today in the OR. It all began innocently enough, with a very nice attending who went on to demonstrate and then permit me to practice insertion of a peripheral IV and then a laryngeal mask airway. These went rather well, although my initial attempts at mask ventilation was a bit difficult. Hopefully the patient didn't become hypoxic during my "practice session".

Then, we had a patient who required endotracheal intubation. An elderly, frail lady who also required large bore peripheral IVs. Mask ventilation went much easier with her, although there was some air leaking at some point. The trouble began when I attempted to insert the large bore IV. I had trouble, and then the anesthesiologist also had trouble. In the end we ended up poking quite a few times at the patient. While it's not entirely my fault, I feel that my presence is what started the whole thing. The anesthesiologist, trying to be nice and teach, also felt tremendous pressure to perform while the surgeon rushed ahead with the surgery. The delays incurred in trying to teach me as well as permit me to practice left the anesthesiologist behind the curve, so to speak. As a result of the pressure, the patient had to endure additional pokes - thankfully all under anesthesia, but I'm sure when she awakes and sees all the bruises my lesson will have cost quite a pretty penny (figuratively speaking, of course).