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What Not to Say at Clinicals

What Not to Say at Clinicals

Clinicals are going to be the hardest, most exhausting, and intellectually challenging part of CRNA school. As you progress in your program and gain some confidence you will inevitably feel more comfortable at your clinical sites. You will let your guard down and become more relaxed and outgoing. It’s human nature. Remember, as I’ve mentioned before, that you are constantly being evaluated and scrutinized. Don’t get too comfortable and familiar with your preceptors that you end up saying something inappropriate and get yourself singled out. A great clinical experience can be ruined because of a seemingly innocent remark. Below are four examples of what not to say during clinical rotations, and reasons why not to say them.

1. "School is so Hard, I’m Exhausted"-

This is a terrible thing to say during clinicals. We know you are tired as an SRNA, but saying it means you are too tired to take care of our patients safely today. Also, do you think your patients want to know, or overhear, how tired you are? A big part of school is late night study sessions and early morning wake-ups for clinicals. You have to find a way to get enough rest so that you function properly. We are well aware that school is hard. Remember, your preceptors had to go through the program to get where they are too. We all made sacrifices, and stayed focused to pass our programs and boards. Keep in mind something I told myself and my classmates throughout school to help me stay motivated and bring me back to reality- “No one forced me to do this, I chose to get into this program and strive for a new direction in my career and life, no one owes you anything and this experience solely depends on what you make of it.” If becoming a CRNA was easy, I assure you everyone would do it.

2. "I Don't Know"-

If you are asked a question that stomps you, don't say "I don't know". To me, "I don't know" is synonymous with "I don't care". I don't care to look up the answer or think about it for a second. The truth is, many times you do know but just need guidance to get to the answer. Ask your preceptor to work the answer out with you. If you say "I don't know", the conversation is over. If you work out the answer then you show that you are engaged. Also, you are more likely to remember the information if you think about it and work it out, than if the answer is just given to you.

3. “In the ICU, I didn’t do it like that”-

That’s great. But this isn’t the ICU. We were all really good ICU nurses. However, anesthesia is a whole different ballgame. Yes, as I've mentioned, you should rely on your experiences as a bedside nurse and the instincts you developed. The trick is to also be open to learning a new form of nursing, and not to compare everything to your past career. You will inevitably be paired up with a CRNA who may have had much less years of experience than you at the bedside (maybe they only did two years of ICU nursing to your 6 years of experience). However, when it comes to anesthesia, that CRNA has much more experience than you do. You must continue to learn and adapt, be open minded and focused.

4. “Other CRNAs taught me to do this a different way”-

Anesthesia can be done many different ways, with varying techniques, and diverse rationales. CRNAs have the ability to make their own decisions on the spot as situations arise. We enjoy the autonomy of creating our own surgical “anesthesia recipes”. Be it how we tape the ETT, position the patient for induction, or even the medications we give for specific cases, everyone has their way of doing things. You will also soon learn that everyone thinks their way makes the most sense and is therefore the best. Use your clinical experience as an SRNA to learn as many different techniques as possible, ask to be with different CRNAs so that you can learn different ways of doing the same case. It will be up to you to adopt those habits you like, and more importantly, avoid those you don’t. But do yourself a huge favor, don’t tell your preceptor that they aren’t doing what all the other CRNAs you’ve been with are doing, that’s a sure way to get yourself sent on a long lunch break.

That’s all I’ve got for you this week. Some words of advice to keep you out of trouble in the OR. Be friendly, outgoing and eager to learn, but don’t let your mouth ruin a great learning opportunity. Some CRNAs are forgiving and some are not, it’s up to you to read the room and make your own decision. Most importantly, continue to get better with each clinical day. Have a great week at clinicals everybody!

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