thbarnes Posted August 23, 2006 Share Posted August 23, 2006 Ug! I was supposed to practice intubation in the OR this morning, but was brushed aside by med, anesthesiologist assistant, and certified nurse students. They made it clear I wasn't going to get an ET tube in edge-wise! What angers me is that it's going to be those same med students who are going to bitch me out on their ER residency when my patient in arrest isn't intubated. And when the anesthesiologist looks at me and says "Well, they need to learn" I want to ask him why he thinks I don't need to learn on my one day to practice (they have weeks) and if his student will be around when he has that big MI. Did anyone else in medic school have a similar experience? Any advice? Link to comment Share on other sites More sharing options...
bassnmedic Posted August 23, 2006 Share Posted August 23, 2006 Best advice I can give you is to talk with your instructor about this situation. Don't take matters into your own hands, also schedule another rotation after you speak with your instructor. Link to comment Share on other sites More sharing options...
stcommodore Posted August 23, 2006 Share Posted August 23, 2006 Different clinical sites can be just like that. My last programs home hospital was a university so we would have a better chance of getting a tube in the ER then the line for the tube in the OR. We got sent to another hospital that gave us a better chance so its just a matter of getting out there, giving it time, letting them get to know you and if you have to talking to your instructor to figure something else out. Link to comment Share on other sites More sharing options...
Nate Posted August 23, 2006 Share Posted August 23, 2006 I did not have any problems with getting my tubes in the OR. I was also at a teaching hospital, but we were scheduled on days opposite of those that the medical students would be there to sink their own tubes. Link to comment Share on other sites More sharing options...
cotjockey Posted August 23, 2006 Share Posted August 23, 2006 We had the same problem...for some reason paramedic students were at the end of the line after CRNA students and medical students...we just kept showing up until we got our tubes in. Your instructors should be able to help you out and find out what days there aren't going to be other students there or what days are going to be busy enough that there will be more tubes to sink. Also...even if there are other students, if you get in on the first case of the day, there are usually several procedures starting at once in different rooms...other students can't be in every room at the same time, so that is a good time to go. It also helps me to get in the good graces of one of the anesthesiologists or CRNA...if they like you, they'll help help you out. Link to comment Share on other sites More sharing options...
vs-eh? Posted August 23, 2006 Share Posted August 23, 2006 ...I want to ask him why he thinks I don't need to learn on my ONE DAY to practice (they have weeks) and if his student will be around when he has that big MI. That is actually what concerns me most... Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted August 23, 2006 Share Posted August 23, 2006 So how likely will it be that his student will take care of him during his big MI. That's a silly argument to make. Link to comment Share on other sites More sharing options...
nbsp Posted August 23, 2006 Share Posted August 23, 2006 So how likely will it be that his student will take care of him during his big MI. That's a silly argument to make. I think he meant that if he has an MI, paramedics will be more likely to be called than that anesthesiologist's students. Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted August 23, 2006 Share Posted August 23, 2006 ahh ok that makes more sense. I've always thought it a silly argument to make. I've heard medics and students alike say that since they didn't get to do something or the doctor denies the order they hoped the person didn't need an ambulance becuase they never knew if it would be that person on the truck. It's like, well I didn't get my intubations or iv sticks so I didn't learn them so I hope they don't need me to help them out. blah blah blah. and by the way, I'm in a terrible mood and really tired and I apologize if I am a little harsh. I think I'll go to bed now Link to comment Share on other sites More sharing options...
vs-eh? Posted August 23, 2006 Share Posted August 23, 2006 It's like, well I didn't get my intubations or iv sticks so I didn't learn them so I hope they don't need me to help them out. blah blah blah. Well, you SHOULD be doing a minimum number of IV's and intubations in hospital. If you don't meet these minimums you don't finish your hospital practicum and move on to field preceptorship until you do. Obviously you are going to be educated in advanced airway management and IV therapy, fluid/electrolyte/acid base/etc...prior to actually doing the procedure. I hope anyway... I have mentioned this before but...Most CMA accredited programs (and as a general rule of thumb for all programs) for ACP's require at least 20 IV starts and a minimum 70% success rate. Most people get 50+. Also for intubations, most require 6 days minimum (48 hours) in the OR with an anesthetist (you could potentially do an intubation in the ER too) and get a minimum of 20 intubations, with the last 3 in a row successful. You are given 2 attempts, following that it is unsuccessful. Again, I did around 30 tubes in the OR, with some getting as many as 50. You don't meet these minimums of clinical hospital practice? You go back and stay there until you do. Having one day to "practice" intubation on "real patients" is ridiculous. Most of the procedures that anesthetists do are elective/non-emergent surgeries. I wouldn't want some one day OR paramedic rolling into my hospital and accidentally chipping a tooth (a major concern) or lacerating vocal cords in their rushed desire to "practice". Link to comment Share on other sites More sharing options...
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