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I've been a nurse anesthetist, now, for coming up on 20 years. I've put a lot of people to sleep.
To get into nurse anesthesia, it's a very structured regime. You have to have an RN and a bachelor's degree. You have to have experience working in a critical care area as a registered nurse, such as an emergency room, an intensive care unit, or a coronary care unit. You need experience working with patients before they will look at you as an applicant to get into a nurse anesthesia program. That program is very structured, very heavy into sciences: anatomy, physiology, chemistry, pharmacology, very science- oriented.
Before you do any job, you have to get set up, and that's especially true in anesthesia. We've got equipment and drugs that need to be ready before the patient even walks into the operating room. We need things to take care of the patient's breathing. We've got the drugs that we need, lots of syringes and needles. Always need needles in anesthesia. Again, miscellaneous supplies, things for breathing. You've got to have your favorite CD. A little IV fluid in case they're a little dry. Got to have my CD player. To be honest, this isn't for me, this is for patients.
Everybody's heard of sodium pentathol, the truth serum. People really don't tell the truth on it. We give them too much; they don't say anything. It's a great drug to go to sleep on. We give them a dose of this, and in about 30 seconds, they are asleep. They won't know anything until I wake them up at the end of the operation.
There's a newer drug than this, a new version of it. We like it. It happens to be a drug called Diprivan. Notice how white it is; looks like skim milk. We call it milk of amnesia. We give them this drug; they don't remember anything.
Another thing we need to do is paralyze these patients, paralyze every muscle so the surgeon can do their operation. I've got a half dozen drugs that will do that. This is one of them. I give you about that much, which is a little over a teaspoon of this drug. I put that into your vein, and 30 seconds later, you will not be able to move a single muscle in your body.
If I paralyze every muscle in your body, you might have a hard time breathing. I've got a cure for that too; we breathe for you. To do that, we stick this tube down your mouth into your lungs.
You hear all the stories about how lousy hospital food is... isn't true. We get pretty good food around here. This is not what patients eat. If you think we're going to eat what they eat, you're crazy.
Come on in. Come into the operating room. Welcome to surgery.
This is my partner, doing a general anesthetic for a patient undergoing an abdominal operation. His charge is to make this patient asleep, unconscious, insensitive to pain, and a relaxed situation for the surgeons to work in.
Among other things, we record and check their heart rate, their blood pressure, their respiration and the amount of carbon dioxide that they're breathing out. Every five minutes we have that documented. Things can change that fast in an operating room. Five minutes can be a long period of time. Things change sometimes as fast as every 30 seconds to a minute. You're always on your toes. The buzzword for anesthesia is constant vigilance.
Anesthesia is probably more of an art than it is a science. There's a science into what medicines do what, how the body functions and what we're going to be doing to those. Because everybody is different, over time and over experience, you also learn the art of anesthesia: what it's going to take to make this patient go through this anesthetic safely.
Surgery is really a team process. You couldn't do surgery without every member that's in here. We need to know what they need to do their operation. They need to know from our end how the patient is doing. If the patient is having problems, they alter what they do for the safety of the patient.
When the surgeons get obnoxious -- [horn honking] that's our cue to tell them to get this operation over with... not really. A sense of humor is very important in this profession because we also see a lot of things that are not very pretty. People with cancer, people who are dying. You need to be able to divorce yourself from those people. You take care of them. You care for them while they're on the operating table. You also have to leave that behind when you walk out the door.