Anesthesiology

Welcome to Obstetric Anesthesiology!

Obstetric Anesthesiology is a whole new world, with abundant opportunities to

• gain deep understanding of the unique features & complexities of human maternal physiology, normal & complicated pregnancy & parturition, and unique obstetric & anesthetic challenges:
• combine that knowledge with procedural skills & clinical decision-making in ways that permit interventions to promote or restore maternal & fetal safety, and relieve pain & suffering,
• reflect on the outcomes of our work, developing a transferable framework to consider & assess healthcare quality & value, and as a result, 
• promote individual learning & improvement, but also larger system improvements that may enhance healthcare quality & patient safety: 

• develop the communication, teamwork, collaboration, & leadership skills required of valued members of a large inter-professional practice;
• connect with patients & their families in meaningful & beneficial ways; and
• participate in, witness, & experience the awe of the human birth process.

Structure is Vital

Most residents & SRNAs find this to be a demanding, yet highly rewarding education experience. The rotation is purposefully structured, multi-faceted, organized, and competency-based. It is structured in way that leads trainees through progressive steps of graded responsibility, guided by layers of supervition.  You are expected to remain familiar with this site, and to use it throughout your month as the home of a working curriculum for the entirety of the rotation.

• The Daily Work Schedule is purposefully structured to achieve the dual priorities of education & excellent patient care in a highly complex & busy inter-professional practice unit. This schedule must be adhered to.
• Review the Education Program curriculum elements thoroughly & often, to clearly understand the terminal learning objectives, learning activities, performance expectations, & assessments.
• The Clinical / Procedural section provides a detailed and vital information regarding many procedures & policies that are unique to obstetric anesthetic care on this L&D unit.
• The Educational Resources section is an growing & evolving compendium of valuable information on a myriad of topics relevant to this subspecialty.

A Few Things to Keep in Mind Right from the Start

1. Take time to come to L&D to “learn the ropes” prior to your rotation!  Find the senior resident and get oriented before day one.
2. Study maternal physiology, neuraxial opioids, local anesthetics, & neuraxial technique before you begin the rotation. You will deliver obstetric anesthesia care from day one!
3. Know your patients well! The best way to know them is to interact & engage with  them.
4. Respect your patients. Birth is a among the most emotionally powerful & personally intimate life experiences. Childbirth pain can be severe. Patient values here are of central importance.
5. Your supervising attendings & fellows are always available to you. Ask questions, and call for help early!
6. L&D is a large inter-professional practice with multiple patients & providers, with the constant potential for very rapidly changing situations. Teamwork & proactive communication are essential to ensure safety & high quality healthcare outcomes. Get to know the entire team, and communicate liberally!
7. Read, read, read... as often as you can. The sub-specialty content is vast, and the curriculum rigorous, but you will have ample time & guidance.
8. Complete your paperwork properly & punctually, to ensure clear communication of vital medical information, appropriate reimbursement, & legal protection.
9. Know the fetal or infant status before you enter a room to interact with parturients. Most, but, not all fetuses & infants are healthy.  Avoid missing opportunities to convey compassion & empathy.
10. As the senior resident on call, it is your responsibility to ensure all tasks are addressed: evaluations, post-ops, room checks, etc. While portions can be delegated, you are responsible.